Preprint / Version 1

Focusing COVID-19-associated mucormycosis: a major threat to immunocompromised COVID-19

Authors

  • Neelam Sharma Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana 133207 India
  • Lotfi Aleya Chrono-Environment Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
  • Ahmed Al-Harrasi Natural & Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
  • Saurabh Bhatia Natural & Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
  • Aayush Sehgal GHG Khalsa College of Pharmacy, Gurusar Sadhar, Ludhiana, Punjab India
  • Ishrat Zahoor Chitkara College of Pharmacy, Chitkara University, Punjab, India
  • Sukhbir Singh Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana 133207 India
  • Tapan Behl School of Health Sciences and Technology, University of Petroleum and Energy Studies, Dehradun, Uttarakhand India
  • Shahid Wani Chitkara College of Pharmacy, Chitkara University, Punjab, India
  • Simona Bungau Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania

Keywords:

Antifungal therapy, Black fungus, COVID-19-associated mucormycosis, Pulmonary mucormycosis, Rhino-orbital-cerebral mucormycosis

Abstract

COVID-19 disease has been identified to cause remarkable increase of mucormycosis infection cases in India, with the majority of cases being observed in individuals recovering from COVID-19. Mucormycosis has emanated as an outcome of the recent COVID-19 pandemic outbreak as rapidly developing fatal illness which was acquired by Mucorales fungus which is a subcategory of molds known as mucormycetes. Mucormycosis is one of the serious, sporadic mycotic illnesses which is a great threat to immunocompromised COVID-19 patients and affects people of all ages, including children with COVID-19 infections. This is associated with tissue damaging property and, therefore, causes serious clinical complications and elevated death rate. The COVID-19-associated mucormycosis or “black fungus” are the terms used interchangeably. The rapid growth of tissue necrosis presenting as “rhino-orbital-cerebral, pulmonary, cutaneous, gastrointestinal, and disseminated disease” are various clinical forms of mucormycosis. The patient’s prognosis and survival can be improved with proper surgeries using an endoscopic approach for local tissue protection in conjunction with course of appropriate conventional antifungal drug like Amphotericin-B and novel drugs like Rezafungin, encochleated Amphotericin B, Orolofim, and SCY-078 which have been explored in last few years. This review provides an overview of mucormycosis including its epidemiology, pathophysiology, risk factors, its clinical forms, and therapeutic approaches for disease management like antifungal therapy, surgical debridement, and iron chelators. The published patents and ongoing clinical trials related to mucormycosis have also been mentioned in this review. Graphical abstract Keywords: Antifungal therapy, Black fungus, COVID-19-associated mucormycosis, Pulmonary mucormycosis, Rhino-orbital-cerebral mucormycosis

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