Microbiological Profile of Post-COVID-19 Mucormycosis in Various Samples

Document Type : Original Article


Department of Microbiology, Kurnool Medical College, Kurnool, India


Background and aim: Increase in fungal superinfections among post-COVID-19 patients created a panic during pandemic times in India. Rhino-orbital mucormycosis cases have seen a rise in India among COVID-19 patients. This study aims and objectives to know the Incidence of Mucormycosis among COVID-19 infected patients and the age and sex distribution of Post COVID-19 Mucormycosis patients.
Material and methods: All clinical specimens were received at the Microbiology department from respective hospital units in sterile normal saline leak-proof containers. Fungal cultures were followed until growth occurred or till 28 days. Macroscopic and microscopic characteristics identified positive culture fungal growth.
Results: Out of 97 post covid fungal infection patients in this study, 33 (34.02%) were female, and 64 (65.9%) were male. Predominant populations were in the age group of 41 - 60; it was 60 out of 97 (61.8%), followed by 61-71 years (24.7%). Out of 97 fungal pathogens, Mucor, Aspergillus, and Mucor fungi were isolated predominantly; it was 32 (32.9%), 29 (29.8%), 16 (16.4%), and 11 (11.3%), respectively.
Conclusions: Early Diagnosis and treatment will help manage SARS-CoV-2-associated fungal infections. The formulation of stringent infection control protocols, antimicrobial usage policy, and updated COVID-19 management guidelines by government authorities helps reduce infections.


Main Subjects

[1] American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America. American thoracic society/centers for disease control and prevention/infectious diseases society of america: controlling tuberculosis in the United States. American journal of respiratory and critical care medicine. 2005;172(9):1169-227. https://doi.org/ 10.1164/rccm.2508001.
[2] Cohen J. Wuhan seafood market may not be source of novel virus spreading globally. Science. 2020;10(10.1126).
[3] Chen J. COVID-19 Scientific Advisory Group Rapid Response Report. Alberta Health Services. 2020.
[4] WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. World Health Organization (WHO). 2020.
[5] Ferguson BJ. Mucormycosis of the nose and paranasal sinuses. Otolaryngologic Clinics of North America. 2000;33(2):349-65. https://doi.org/10.1016/S0030-6665(00)80010-9.
[6] Bengoechea JA, Bamford CG. SAR-CoV-2, bacterial co‐infections, and AMR: the deadly trio in COVID-19?. EMBO molecular medicine. 2020;12(7):e12560. https://doi.org/10.15252/emmm.202012560.
[7]  Kumari A, Rao NP, Patnaik U, Malik V, Tevatia MS, Thakur S, et al. Management outcomes of mucormycosis in COVID-19 patients: A preliminary report from a tertiary care hospital. medical journal armed forces india. 2021;77(2):S289-95. https://doi.org/10.1016/j.mjafi.2021.06.009.
[8] Ferguson BJ. Mucormycosis of the nose and paranasal sinuses. Otolaryngologic Clinics of North America. 2000;33(2):349-65. https://doi.org/10.1016/S0030-6665(00)80010-9.
[9] Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. The American journal of emergency medicine. 2021;42:264-e5. https://doi.org/10.1016/j.ajem.2020.09.032.
[10] Honavar SG. Code mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian journal of ophthalmology. 2021;69(6):1361-65. https://doi.org/10.4103/ijo.IJO_1165_21.
[11]  Ravani SA, Agrawal GA, Leuva PA, Modi PH, Amin KD. Rise of the phoenix: Mucormycosis in COVID-19 times. Indian journal of ophthalmology. 2021;69(6):1563-68. https://doi.org/10.4103/ijo.IJO_310_21.
[12] Zhang Y, Li WX, Huang KW, Cao ZX, Hao JY. Hospital acquired pneumonia occurring after acute stage of the serious SARS and its treating strategies. Chin J Nosocomiol. 2003;11(13):1081-7.
[13] Yin CH, Wang C, Tang Z. Clinical analysis of 197 patients with critical severe acute respiratory syndrome in Beijing areas. CHINESE JOURNAL OF CRITICAL CARE MEDICINE. 2004;24(4):248-9.
[14] Li CS, Pan SF. Analysis and causation discussion of 185 severe acute respiratory syndrome dead cases. Zhongguo wei zhong bing ji jiu yi xue= Chinese critical care medicine= Zhongguo weizhongbing jijiuyixue. 2003;15(10):582-4.
[15] Dilek A, Ozaras R, Ozkaya S, Sunbul M, Sen EI, Leblebicioglu H. COVID-19-associated mucormycosis: case report and systematic review. Travel medicine and infectious disease. 2021;44:102148. https://doi.org/10.1016/j.tmaid.2021.102148.
[16] Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clinical microbiology and infection. 2020;26(7):944-e9. https://doi.org/10.1016/j.cmi.2019.11.021.
[17] Chakrabarti A, Singh R. Mucormycosis in India: unique features. Mycoses. 2014;57:85-90.
[18] Karimi‐Galougahi M, Arastou S, Haseli S. Fulminant mucormycosis complicating coronavirus disease 2019 (COVID‐19). InInternational forum of allergy & rhinology 2021;11(6):1029-30. https://doi.org/10.1002/alr.22785.
[19] Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A, et al. Coronavirus disease (Covid-19) associated mucormycosis (CAM): case report and systematic review of literature. Mycopathologia. 2021;186(2):289-98. https://doi.org/10.1007/s11046-021-00528-2.
[20] Moorthy A, Gaikwad R, Krishna S, Hegde R, Tripathi KK, Kale PG, et al. SARS-CoV-2, uncontrolled diabetes and corticosteroids—an unholy trinity in invasive fungal infections of the maxillofacial region? A retrospective, multi-centric analysis. Journal of maxillofacial and oral surgery. 2021;20(3):418-25. https://doi.org/10.1007/s12663-021-01532-1.
[21] Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020;8(5):475-81. https://doi.org/10.1016/S2213-2600(20)30079-5.
[22] Koehler P, Cornely OA, Böttiger BW, Dusse F, Eichenauer DA, Fuchs F, et al. COVID‐19 associated pulmonary aspergillosis. Mycoses. 2020;63(6):528-34. https://doi.org/10.1111/myc.13096.
[23] Chao CM, Lai CC, Yu WL. COVID-19 associated mucormycosis–An emerging threat. Journal of Microbiology, Immunology and Infection. 2022;55(2):183-90. https://doi.org/10.1016/j.jmii.2021.12.007.
 [24] Dogra S, Aggarwal A, Passi G, Sharma A, Singh G, Barnwal RP. Mucormycosis amid COVID-19 crisis: pathogenesis, diagnosis and novel treatment strategies to combat the spread. Frontiers in microbiology. 2022;12:1-27. https://doi.org/10.3389/fmicb.2021.794176.