COVID-19 associated Mucormycosis, diabetes and steroid therapy: Experience in a Single Centre in Western Mexico.

Guzmán-Castro, Salvador; Chora-Hernandez, Luis David; Trujillo-Alonso, Gersain; Calvo-Villalobos, Ivan; Sanchez-Rangel, Antonio; Ferrer-Alpuin, Edgar; Ruiz-Jimenez, Miguel; Corzo-Leon, Dora E

BACKGROUND COVID19-associated mucormycosis (CAM) has emerged as a challenging complication as the current pandemic has increased the population requiring treatment with corticosteroids. CAM has caused a massive outbreak in India, reported to be causing cases in Iran, Egypt, and The Netherlands. OBJECTIVES To describe CAM cases occurring in a single centre in Western Mexico METHODS: Our group carried out a retrospective study from May 2020 to May 2021 to identify CAM cases in patients with previous COVID-19 diagnosis. RESULTS Six CAM cases occurred in a single centre in Western Mexico during the study period, most of them with diabetes (n= 5/6) and all received corticosteroid therapy even when only three had severe COVID-19. After analysing local COVID-19 burden, it was estimated that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for general population. CONCLUSION Similar to large reports in India and other countries, CAM cases reported in this study were diagnosed in individuals with diabetes, hyperglycaemic status and with history of previous use of corticosteroids. Identifying these individuals at risk can help the early identification of CAM. In addition, strict glycaemic control and avoidance of unnecessary corticosteroid in non-severe COVID-19 cases could help in preventing this complicated fungal infection.