Antifungal Treatment of Mucormycosis Associated with COVID-19
Abstract
Mucormycosis is an angioinvasive fungal infection due to fungi of the order Mucorales. The prognosis from mucormycosis can be poor despite early diagnosis and aggressive therapy. The systematic review and meta-analysis by Muthu and colleagues [1] investigated the rate of mortality in patients with pulmonary mucormycosis. While there had been a significant decrease in the mortality rate over time, the recent (2010-2020) rate of mortality is still substantial, in which about one in two patients (49.8%; 95% confidence interval 43.2% to 56.3%) with pulmonary mucormycosis died from the disease. Yet, patients originated from the lower-middle-income countries had a higher mortality rate, in which about three in four patients (71.5%; 95% confidence interval 58.7% to 84.3%) with pulmonary mucormycosis died from the disease. Indeed, there has been a recent surge in the occurrence of mucormycosis in lower-middle-income countries, especially in India. As raised by Szarpak [2], the increased incidence with a fairly severe course of mycormycosis was reported in patients with a history of coronavirus disease 2019 (COVID-19) and received systemic corticosteroid therapy.