Coincidence of uncontrolled diabetes mellitus and COVID-19 Is a serious threat to Mucormycosis: a systematic review
- Author Parthiba Pramanik
- Co-Author Purushottam Pramanik
- DOI 10.17605/O
- Country : India
- Subject : Education
Keywords : COVID-19, Diabetes mellitus, Steroid therapy. Mucormycosis
Abstract
Mucormycosis is an angioinvasive life-threatening fungal infection caused by mold of fungi having Class Zygomycetes and the order Mucorales. It is characterized by vascular invasion by the fungal hyphae which leads to thrombosis and necrosis. Mucormycosis cases increases gradually in people with active COVID-19 as well as those recovered from COVID-19 particularly in India. Indian Government now declared mucormycosis as notifiable disease. Diabetes mellitus (DM) augments severity of COVID-19 and risk factor for mucormycosis. The aim of this systemic review of literature is to find out correlation between COVID-19 along with comorbid DM and mucormycosis. We searched PubMed and Google Scholar up to 20th May, 2021 using key words. Subsequently we analyzed collected data and characterized event of mucormycosis in people with COVID-19 along with or without comorbid DM. Mucormycosis was predominant among male patients with active COVID-19 or recovered from COVID-19. COVID-19 patients with comorbid DM are maximally affected. Rhinocerebral mucormycosis or craniofacial mucormycosis is most prominent type of mucormycosis in India. Uncontrolled blood sugar in DM and vamped use of corticosteroids in a back ground of COVID-19 increase risk of mucormycosis. Germination of Mucorales spores is enhanced in hyperglycemic-COVID patients due to hypoxia, increase serum iron load, metabolic acidosis, decrease phagocytic activity of leukocytes and immunosuppression. Steroid therapy in severe COVID-19 cases creates ideal environment like immunosuppression and hyperglycemia to increase chance of mucormycosis. Maintenance of optimal blood sugar level and judicious use of corticosteroids in COVID-19 patients may be suggested to prevent infection from mucormycosis.
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