Universität zu Köln

Rudramurthy, Shivaprakash M., Hoenigl, Martin ORCID: 0000-0002-1653-2824, Meis, Jacques F., Cornely, Oliver A., Muthu, Valliappan ORCID: 0000-0003-0410-8468, Gangneux, Jean Pierre, Perfect, John and Chakrabarti, Arunaloke ORCID: 0000-0003-1555-3807 (2021). ECMM/ISHAM recommendations for clinical management of COVID-19 associated mucormycosis in low- and middle-income countries. Mycoses, 64 (9). S. 1028 - 1038. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Reports are increasing on the emergence of COVID-19-associated mucormycosis (CAM) globally, driven particularly by low- and middle-income countries. The recent unprecedented surge of CAM in India has drawn worldwide attention. More than 28,252 mucormycosis cases are counted and India is the first country where mucormycosis has been declared a notifiable disease. However, misconception of management, diagnosing and treating this infection continue to occur. Thus, European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology (ISHAM) felt the need to address clinical management of CAM in low- and middle-income countries. This article provides a comprehensive document to help clinicians in managing this infection. Uncontrolled diabetes mellitus and inappropriate (high dose or not indicated) corticosteroid use are the major predisposing factors for this surge. High counts of Mucorales spores in both the indoor and outdoor environments, and the immunosuppressive impact of COVID-19 patients as well as immunotherapy are possible additional factors. Furthermore, a hyperglycaemic state leads to an increased expression of glucose regulated protein (GRP- 78) in endothelial cells that may help the entry of Mucorales into tissues. Rhino-orbital mucormycosis is the most common presentation followed by pulmonary mucormycosis. Recommendations are focused on the early suspicion of the disease and confirmation of diagnosis. Regarding management, glycaemic control, elimination of corticosteroid therapy, extensive surgical debridement and antifungal therapy are the standards for proper care. Due to limited availability of amphotericin B formulations during the present epidemic, alternative antifungal therapies are also discussed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rudramurthy, Shivaprakash M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, Martin UNSPECIFIED orcid.org/0000-0002-1653-2824 UNSPECIFIED Meis, Jacques F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Muthu, Valliappan UNSPECIFIED orcid.org/0000-0003-0410-8468 UNSPECIFIED Gangneux, Jean Pierre UNSPECIFIED UNSPECIFIED UNSPECIFIED Perfect, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Chakrabarti, Arunaloke UNSPECIFIED orcid.org/0000-0003-1555-3807 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-600360
DOI:	10.1111/myc.13335
Journal or Publication Title:	Mycoses
Volume:	64
Number:	9
Page Range:	S. 1028 - 1038
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ASPERGILLOSIS; CORONAVIRUS; INFECTION; DIAGNOSIS; THERAPY Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60036