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Epidemiology of mucormycosis in COVID-19 patients in northwest Iran: Rhizopus arrhizus as the predominant species

Summary

During the COVID-19 pandemic, some patients developed a severe fungal infection called mucormycosis alongside their coronavirus infection. This study found that 63 COVID-19 patients in Iran developed mucormycosis, which primarily affected the sinuses and brain. The researchers identified that a fungus called Rhizopus arrhizus caused most infections, and patients who received corticosteroids (used to treat severe COVID-19) had a higher risk, especially those who developed diabetes from the steroids.

Background

COVID-19 patients face increased risk of secondary opportunistic infections, particularly invasive fungal infections. High-dose corticosteroid therapy used for COVID-19 management causes immunosuppression and hyperglycemia, predisposing patients to mucormycosis. COVID-19-associated mucormycosis (CAM) is a deadly fungal infection with high mortality rates.

Objective

To assess demographic features, clinical characteristics, species diversity, and contributing factors among COVID-19 patients with mucormycosis in northwestern Iran. The study aimed to provide local epidemiological data on CAM incidence and identify the causative Mucorales species.

Results

Among 63 COVID-19 patients with mucormycosis (mean age 56.65±14.49 years, 63.5% male), the most common involvement site was sinus (63.5%). Eighty-four percent received intravenous dexamethasone and 25.4% had diabetes mellitus. Of 21 positive cultures identified, Rhizopus arrhizus was the predominant species.

Conclusion

Corticosteroid therapy for COVID-19 not only causes immune dysfunction but may also lead to mucormycosis development through corticosteroid-induced diabetes in vulnerable patients. Physician awareness and vigilant glucose monitoring are crucial for early detection and management of this neglected mycosis.
  • Published in:Current Medical Mycology,
  • Study Type:Cross-sectional Descriptive Study,
  • Source: PMID: 41122126
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