Mucormycosis during COVID-19 era: A retrospective assessment

Tuhin Mukherjee , Tanisha Das , Sourav Basak , Satyajit Mohanty , Krishnendu Adhikary , Prity Chatterjee , Rajkumar Maiti , Prithviraj Karak
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Abstract

In a retrospective view, this review examines the impact of mucormycosis on health workers and researchers during the COVID era. The diagnostic and treatment challenges arising from unestablished underlying pathology and limited case studies add strain to healthcare systems. Mucormycosis, caused by environmental molds, poses a significant threat to COVID-19 patients, particularly those with comorbidities and compromised immune systems. Due to a variety of infectious Mucorales causes and regionally related risk factors, the disease's incidence is rising globally. Data on mucormycosis remains scarce in many countries, highlighting the urgent need for more extensive research on its epidemiology and prevalence. This review explores the associations between COVID-19 disease and mucormycosis pathology, shedding light on potential future diagnostic techniques based on the fungal agent's biochemical components. Medications used in ICUs and for life support in ventilated patients have been reported, revealing the challenge of managing this dual onslaught. To develop more effective treatment strategies, it is crucial to identify novel pharmacological targets through “pragmatic” multicenter trials and registries. In the absence of positive mycology culture data, early clinical detection, prompt treatment, and tissue biopsy are essential to confirm the specific morphologic features of the fungal agent. This review delves into the history, pathogens, and pathogenesis of mucormycosis, its opportunistic nature in COVID or immunocompromised individuals, and the latest advancements in therapeutics. Additionally, it offers a forward-looking perspective on potential pharmacological targets for future drug development.

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COVID-19 时代的粘孢子菌病:回顾性评估
本综述以回顾性的视角,探讨了粘孢子虫病在 COVID 时代对卫生工作者和研究人员的影响。由于基础病理学尚未确定,病例研究有限,因此诊断和治疗面临挑战,这给医疗保健系统增加了压力。由环境霉菌引起的粘孢子菌病对 COVID-19 患者,尤其是合并症患者和免疫系统受损的患者构成重大威胁。由于各种传染性粘孢子菌病的病因和与地区相关的风险因素,该病的发病率在全球范围内呈上升趋势。在许多国家,有关粘孢子菌病的数据仍然很少,这突出表明迫切需要对其流行病学和发病率进行更广泛的研究。这篇综述探讨了 COVID-19 疾病与粘孢子菌病病理之间的关联,揭示了未来基于真菌病原体生化成分的潜在诊断技术。有报道称,重症监护室和呼吸机患者的生命支持药物揭示了管理这种双重冲击的挑战。为了制定更有效的治疗策略,必须通过 "务实 "的多中心试验和登记来确定新的药理靶点。在缺乏阳性真菌培养数据的情况下,早期临床检测、及时治疗和组织活检对于确认真菌病原体的具体形态特征至关重要。本综述深入探讨了粘孢子菌病的历史、病原体和发病机制,其在 COVID 或免疫力低下人群中的机会性,以及治疗方法的最新进展。此外,它还从前瞻性的角度探讨了未来药物开发的潜在药理靶点。
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