Post-COVID Mucormycosis-Conceptual Etiology and New Treatment Options

J Maxillofac Oral Surg. 2024 Dec;23(6):1516-1527. doi: 10.1007/s12663-024-02124-5. Epub 2024 May 16.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) has caused a massive pandemic in world. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is also a doorway for other opportunistic bacterial and fungal infections. Mucormycosis is strongly connected with patients suffering from COVID-19 disease. The major factors attributed are steroid induced immunosuppression; systemic disorders especially diabetes mellitus, hypoxia, and metabolic acidosis.

Aims and objectives: Unusual presentations of post-COVID mucormycosis in young patients without diabetes mellitus were observed. The new concept focuses on pathophysiology of the post-COVID mucormycosis which might involve other factors of coagulopathy and microembolism of vessels which provides a niche for fungal infection to invade in patients.

Results: The new concept of treating post Covid mucormycosis by combining the anti-fungal drugs along with fibrinolytic agents reduces the microcoagulopathy, increases the recovery rate and healing of the mucormycosis.

Conclusions: Based on the clinical and application of scientific knowledge, this concept paper focuses on new hypothesis and treatment plans of post-COVID mucormycosis and an attempt to explain the difference between conventional mucormycosis and post-COVID mucormycosis.

Keywords: COVID-19; Fibrinolytic agents; Mucormycosis; Thrombosis; Treatment options.