Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India

Joshi, Samir; Telang, Rahul; Tambe, Muralidhar; Havaldar, Rajesh; Sane, Manasi; Shaikh, Afshan; Roy, Cherry; Yathati, Kireet; Sonawale, Sanjaykumar; Borkar, Rupalee; Magar, Rahul; Bhitkar, Harshal; Shitole, Satish; Nakate, Leena; Kudrimoti, Jyoti; Mave, Vidya

We provide an overview of the epidemiology and clinical course of mucormycosis in the coronavirus disease (COVID-19) pandemic era. We conducted a retrospective chart review of 178 patients with clinical or diagnostic, endoscopically or histopathologically confirmed rhino-sino-orbital or cerebral mucormycosis after COVID-19 treatment during the second wave of COVID-19 in Pune, India. Median time to symptom onset from COVID-19 detection was 28 days. Moderate or severe COVID-19 was seen in 73% of patients and diabetes in 74.2%. A total of 52.8% received steroids. Eschar over or inside the nose was seen in 75%, but baseline clinical and laboratory parameters were mostly unremarkable. Bone penetration was present in ≈90% of cases, 30% had soft-tissue swelling of the pterygopalatine fossa and 7% had cavernous sinus thrombosis, and 60% had multifocal mucormycosis. Of the 178 study cases, 151 (85%) underwent surgical debridement. Twenty-six (15%) died, and 16 (62%) of those had multifocal mucormycosis.