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Given the potential increase in cases of COVID-19 associated mucormycosis (CAM) in the Region of the Americas, the Pan American Health Organization / World Health Organization (PAHO/WHO) recommends that Member States prepare health services in order to minimize morbidity and mortality due to CAM.

Introduction

In recent months, an increase in reports of cases of COVID-19 associated Mucormycosis (CAM) has been observed mainly in people with underlying diseases, such as diabetes mellitus (DM), diabetic ketoacidosis, or on steroids. In these patients, the most frequent clinical manifestation is rhino-orbital mucormycosis, followed by rhino-orbital-cerebral mucormycosis, which present as secondary infections and occur after SARS CoV-2 infection.

Globally, the highest number of cases has been reported in India, where it is estimated that there are more than 4,000 people with CAM.

In a retrospective multicenter study conducted in India between September to December 2020, it was found that among 287 patients with mucormycosis, 187 (65.2%) had CAM; with a prevalence of 0.27% among hospitalized patients with COVID-19. When comparing the period under study with the same period in 2019, a 2.1-fold increase in mucormycosis was observed.

Regarding the characteristics of the 187 patients with CAM, 80.2% were male, 32.6% had COVID-19 as the only underlying disease, 78.7% were treated with gluco-corticosteroids for COVID-19, 60.4% had diabetes mellitus, 62.6% had rhino-orbital mucormycosis, and 23.5% had rhino-orbital-cerebral mucormycosis.

Additionally, cases have been described in Brazil, Chile, Honduras, Mexico, Paraguay, the United States of America, Uruguay, Italy and United Kingdom.