Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India
During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospital...
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| Published in | Emerging infectious diseases Vol. 27; no. 9; pp. 2349 - 2359 |
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| Main Authors | , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
U.S. National Center for Infectious Diseases
01.09.2021
Centers for Disease Control and Prevention |
| Subjects | |
| Online Access | Get full text |
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| Abstract | During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use. |
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| AbstractList | During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use. During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use.During September-December 2020, we conducted a multicenter retrospective study across India to evaluate epidemiology and outcomes among cases of coronavirus disease (COVID-19)-associated mucormycosis (CAM). Among 287 mucormycosis patients, 187 (65.2%) had CAM; CAM prevalence was 0.27% among hospitalized COVID-19 patients. We noted a 2.1-fold rise in mucormycosis during the study period compared with September-December 2019. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients. COVID-19 was the only underlying disease in 32.6% of CAM patients. COVID-19-related hypoxemia and improper glucocorticoid use independently were associated with CAM. The mucormycosis case-fatality rate at 12 weeks was 45.7% but was similar for CAM and non-CAM patients. Age, rhino-orbital-cerebral involvement, and intensive care unit admission were associated with increased mortality rates; sequential antifungal drug treatment improved mucormycosis survival. The COVID-19 pandemic has led to increases in mucormycosis in India, partly from inappropriate glucocorticoid use. |
| Audience | Professional Academic |
| Author | Gupta, Neha Chakrabarti, Arunaloke Shastri, Prakash Singhal, Tanu Muthu, Valliappan Agarwal, Ritesh Marak, Rungmei Sethuraman, Nandini Rudramurthy, Shivaprakash M. Tadepalli, Karuna Savaj, Pratik Patel, Atul Savio, Jayanthi Xess, Immaculata Thangaraju, Deepak Shevkani, Manoj Sharma, Ratna Madan, Surabhi Sunavala, Ayesha |
| Author_xml | – sequence: 1 givenname: Atul surname: Patel fullname: Patel, Atul – sequence: 2 givenname: Ritesh surname: Agarwal fullname: Agarwal, Ritesh – sequence: 3 givenname: Shivaprakash M. surname: Rudramurthy fullname: Rudramurthy, Shivaprakash M. – sequence: 4 givenname: Manoj surname: Shevkani fullname: Shevkani, Manoj – sequence: 5 givenname: Immaculata surname: Xess fullname: Xess, Immaculata – sequence: 6 givenname: Ratna surname: Sharma fullname: Sharma, Ratna – sequence: 7 givenname: Jayanthi surname: Savio fullname: Savio, Jayanthi – sequence: 8 givenname: Nandini surname: Sethuraman fullname: Sethuraman, Nandini – sequence: 9 givenname: Surabhi surname: Madan fullname: Madan, Surabhi – sequence: 10 givenname: Prakash surname: Shastri fullname: Shastri, Prakash – sequence: 11 givenname: Deepak surname: Thangaraju fullname: Thangaraju, Deepak – sequence: 12 givenname: Rungmei surname: Marak fullname: Marak, Rungmei – sequence: 13 givenname: Karuna surname: Tadepalli fullname: Tadepalli, Karuna – sequence: 14 givenname: Pratik surname: Savaj fullname: Savaj, Pratik – sequence: 15 givenname: Ayesha surname: Sunavala fullname: Sunavala, Ayesha – sequence: 16 givenname: Neha surname: Gupta fullname: Gupta, Neha – sequence: 17 givenname: Tanu surname: Singhal fullname: Singhal, Tanu – sequence: 18 givenname: Valliappan surname: Muthu fullname: Muthu, Valliappan – sequence: 19 givenname: Arunaloke surname: Chakrabarti fullname: Chakrabarti, Arunaloke |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34087089$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.cmi.2018.07.011 10.3390/jof3030048 10.1016/j.ijantimicag.2019.01.002 10.1007/s10654-020-00698-1 10.3390/jof5010026 10.1111/myc.13256 10.1016/S1473-3099(19)30312-3 10.1038/s42255-021-00347-1 10.1111/myc.13225 10.1164/rccm.202004-1038LE 10.1016/j.cmi.2019.11.021 10.1016/j.autrev.2020.102564 10.1007/s11046-021-00528-2 10.1038/s41586-020-2355-0 10.1016/j.cmi.2020.10.021 10.1038/s42255-020-00339-7 10.1007/s15010-021-01602-z 10.1016/j.cmi.2020.12.035 10.1182/blood-2011-07-366526 10.1093/cid/cir867 10.1172/JCI140491 10.1016/j.jhin.2021.01.027 10.1093/mmy/myy060 10.1136/bmjopen-2020-044640 10.1093/mmy/myz031 10.1016/j.jinf.2020.09.024 |
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| SubjectTerms | Antifungal agents Antifungal Agents - therapeutic use Bacterial infections coronavirus disease Coronaviruses COVID-19 Diabetes Disease Disease transmission Drug dosages Epidemics Epidemiology Expedited Fungal infections Histopathology Humans Hypoxemia India India - epidemiology Intensive care Microscopy Mortality Mucormycosis Mucormycosis - diagnosis Mucormycosis - drug therapy Mucormycosis - epidemiology Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India Pandemics Patient outcomes Patients respiratory infections Retrospective Studies Risk factors SARS SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Statistics |
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| Title | Multicenter Epidemiologic Study of Coronavirus Disease–Associated Mucormycosis, India |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/34087089 https://www.proquest.com/docview/2580223364 https://www.proquest.com/docview/2537631043 https://pubmed.ncbi.nlm.nih.gov/PMC8386807 https://doaj.org/article/ab9113ba505c47cc8d57474ebea1caef |
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