Mucor Mycosis Associated with COVID-19: A Case Series at a Tertiary Care Center in India

Background: COVID-19 patients across the globe have been reporting several post-COVID health conditions such as respiratory, vascular, cardiac and renal complications and opportunistic infections; the most common of which has been fungal infections. Objective: The objective of our study was to identify socio-demographic characteristics, risk factors, clinical parameters, site of involvement and outcome of patients with COVID-19 associated Mucor Mycosis (CAM) at a tertiary care centre in Rewa (Madhya Pradesh, India), Materials and Methods: This was a prospective observational study, conducted between 1st May to 30th June 2021; including 40 patients who had Mucor Mycosis with recent or active COVID-19. The data was collected using a structured data collection form by trained interviewers who were already working in Mucor Mycosis Ward. Results: The overall mean and median age of the patients was 50.8 years and 52.5 years respectively, with majority of the males (72.5%). Of total, 47.5% patients had active COVID-19, whereas 50% had recent COVID-19 infection. Twenty-two patients (55%) had co-morbidities, among whom the majority had underlying diabetes mellitus (50%). History of Oxygen supplementation and use of steroids was found in 75% and 45% of the patients respectively. History of self-consumption of decoction (Kadha) and self-administration of inhalation drugs was found among 22 (80%) and 8 (20%) patients respectively. Twnty-one patients (52.5%) had gone through operative procedure/ intervention and 11 (27.5%) patients received conservative treatment. In terms of outcome, 20 patients (50%) had been successfully discharged, followed by 14 deaths (35%), 3 referrals (7.5%) to the higher centres and 3 readmissions (7.5%). Conclusion: Addictions and Indian traditional therapies might have played crucial role in occurrence of CAM. In addition, although Oxygen supplementation and steroid consumption have been life-saving against COVID-19, yet might be responsible for acute surge in CAM cases.