The underlying factors of occurrence of Mucormycosis in post-COVID-19 patients – A meta-analysis of case histories

Srishti Sen; Shubhangi Tiwari; Sinjini Banerjee; Mihir Ghosh; Boudhayan Bandyopadhyay

doi:10.18006/2024.12(3).457.497

Authors

Srishti Sen School of Bioscience, Engineering and Technology, VIT Bhopal University, Madhya Pradesh, India https://orcid.org/0009-0009-3919-3456
Shubhangi Tiwari School of Bioscience, Engineering and Technology, VIT Bhopal University, Madhya Pradesh, India https://orcid.org/0009-0001-0847-4572
Sinjini Banerjee Oberoi International School, JVLR, Mumbai, India https://orcid.org/0009-0005-5952-5375
Mihir Ghosh Department of Chemistry, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India https://orcid.org/0000-0003-3229-1562
Boudhayan Bandyopadhyay Department of Biotechnology, School of Life Science and Biotechnology, Adamas University, Kolkata, India https://orcid.org/0000-0002-3888-1988

DOI:

https://doi.org/10.18006/2024.12(3).457.497

Keywords:

Mucormycosis, COVID-19, Case Histories, Meta-Analysis

Abstract

Mucormycosis is a life-threatening fungal infection caused by fungi of the order Mucorales. It usually affects people with weakened immune systems, such as those with uncontrolled diabetes, acquired immunodeficiency syndrome, iatrogenic immunosuppression, and hematological malignancies, as well as individuals who have had organ transplants. The type of mucormycosis a person suffers from is often determined by their underlying conditions. The most common types are rhino-cerebral mucormycosis, pulmonary mucormycosis, cutaneous mucormycosis, cerebral mucormycosis, gastrointestinal mucormycosis, and disseminated mucormycosis. The incidence of mucormycosis has been increasing over the years, with an overall mortality rate of 54%. Recent cases have shown a correlation between COVID-19 and mucormycosis. Using anti-inflammatory drugs to combat the cytokine storm associated with COVID-19 can weaken the immune system, making individuals more susceptible to opportunistic fungal infections like mucormycosis. Underlying health conditions further exacerbate the condition. This study reviewing 198 cases of mucormycosis and conducting a meta-analysis found that post-COVID-19 patients most commonly developed rhino-orbital-cerebral mucormycosis, followed by pulmonary and gastrointestinal mucormycosis. The study also identified diabetes as the most common underlying factor contributing to the development of mucormycosis in post-COVID-19 patients, followed by hypertension and obesity. The study also examined the influence of age, affected organs, and the use of certain drugs on the development of mucormycosis. Age was found to be a significant factor in the infection. This meta-analysis is one of the first to compare post-COVID mucormycosis cases with those from the pre-COVID era. The hope is that this study and analysis will help identify the determinants of mucormycosis in post-COVID patients and aid the scientific community in finding a solution to this problem.

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