Dental Perspective on Mucormycosis in COVID-19: a Literature Review.

Purpose of review: The purpose of this paper is to gain an understanding of existing knowledge and attain familiarity on mucormycosis for early diagnosis and treatment. It highlights the systematic factors, signs and symptoms, diagnostic tests and treatment procedure for mucormycosis from dentistry point of view. PubMed/ Medline, Scopus, Web of Science were the search engine used. Study selection encompassed systematic reviews, critical reviews and case reports related to mucormycosis in COVID-19 patients and only mucormycosis. 19 articles were selected between Years 2001 to 2021. Analysis was done based on patient's comorbidity, site of mucormycosis infection, use of steroids and its effect on people with COVID -19 infection.

Recent findings: Rhino-orbito-cerebral mucormycosis is the most common of all systemic manifestations of mucormycosis. Diabetes mellitus and long-term corticosteroid therapy are the leading risk factors with pre-existing diabetes mellitus accounting for almost 80% cases.  Elements that facilitate the growth of mucor in COVID-19 patients are the presence of low oxygen levels, high blood glucose levels, acidic media, high levels of iron, immunosuppression, and episodes of prolonged hospitalization. Mucormycosis is heterogenic in nature. Its management requires an individualized plan that considers the immunity status of the host, stage of the infection, systemic disease, early diagnosis and susceptibility to anti-fungal agents. Supervised use of corticosteroids and betadine gargle prevent the occurance of mucormycosis.

Summary: The paper sheds some light on the warning signs and diagnostic tests that can help in early identification of infection by a dentist. This enables the timely implementation of therapy resulting in good prognosis of the treatment.