Die Mukormykose in Zeiten von COVID-19: Risiken und Herausforderungen

Durch einen sprunghaften Anstieg der Infektionszahlen im Rahmen der COVID-19 Pandemie hat die Mukormykose, eine sonst eher seltene Pilzinfektion, weltweit Bekanntheit erlangt. In diesem Artikel untersuchen wir die Risikofaktoren und Mechanismen, die zu dieser viral-fungalen Koinfektion führen. Wir betrachten die globalen Verteilungsmuster, die klinische Präsentation und die Herausforderungen bei der Diagnose und Behandlung der COVID-19-assoziierten Mukormykose.

Abstract

The first patients positive for SARS-CoV-2 were registered in December 2019. In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic, the beginning of a worldwide health crisis that revealed numerous medical challenges for healthcare systems and pandemic emergency strategies.

Among these challenges, mucormycosis, a typically rare fungal infection, gained global attention. With an average global incidence of about 2 per 1 million people, mucormycosis is considered a very rare disease, an opportunistic infection mostly affecting the lungs or skin and soft tissues in immunocompromised patients. Poorly controlled diabetes mellitus is one of the leading risk factors for rhino-orbital mucormycosis. Countries with a high prevalence of diabetes and limited healthcare resources have higher mucormycosis rates, with India and Pakistan being among the nations with particularly high incidences.

During the second wave of the COVID-19 pandemic in India, mucormycosis rates surged dramatically within a few weeks, with over 47,500 cases of COVID-19-associated mucormycosis (CAM) reported between May and August 2021. Mucormycosis is characterized by a high mortality rate of up to 90%, especially when the diagnosis is delayed, and treatment commences late. There were concerns about a potentially global threat.

In this article, we explore the risk factors and mechanisms leading to this viral-fungal coinfection. We present global distribution patterns, clinical presentation, and challenges in the diagnosis and treatment of COVID-19-associated mucormycosis.

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