Covid-associated pulmonary mucormycosis more deadly

Tribune News Service

Chandigarh, September 3

Covid-associated pulmonary mucormycosis (CAPM) is more deadly than Covid-associated mucormycosis (CAM), as per a PGI study.

A team of doctors from the PGI, Chandigarh, systematically studied the involvement of lungs in mucormycosis and discussed how the CAPM differed from mucormycosis involving other parts of the body.

Also read: High viral load doesn’t relate to disease severity, says PGI, Chandigarh

Mucormycosis, which is commonly known as black fungus, generally involves nose, sinuses and eyes.

As per the lead author of the study, Dr Mandeep Garg, the CAPM infection is “more dangerous” than the non-pulmonary CAM.

“We found that the CAPM infection is more dangerous and has higher mortality when compared to the non-pulmonary CAM,” said Dr Garg – a renowned chest radiologist and a professor in the Department of Radiodiagnosis at the PGI, Chandigarh.

Dr Garg attributed the high mortality in the CAPM to the difficulty in diagnosing the “superimposed fungal infection in lungs, which are already infected with Covid”.

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“Both these infections can have similar clinical and radiological features. These patients are often very sick and difficulty in obtaining respiratory symptoms leads to further delay in the diagnosis. Moreover, many CAPM patients remain unproven and die even before reaching the hospital,” he said.

Another important observation made in the study, which has been published in the radiology journal, was that 47 per cent of the CAPM patients had no associated risk factor. Diabetes was seen only in 29.4 per cent of these patients.

“This is in contrast to other cases of non-pulmonary CAM where more than 80 per cent patients are reported to have underlying diabetes. Also 71 per cent of the CAPM patients were found on mechanical ventilation in contrast to only 40 per cent of the non-pulmonary CAM,” Dr Garg elaborated.

The study has been co-authored by Dr Nidhi and Dr Shameema from the Department of Radiodiagnosis; Dr Harsimran from the Department of Microbiology; Dr Vikas Suri from Internal Medicine; and Dr Valliappan and Prof Ritesh Agarwal from Pulmonary Medicine.

The study also highlighted that CT scan could play a crucial role in the diagnosis of the CAPM.

“The presence of cavitation, consolidation, pleural effusion and nodules seen on CT chest are ‘red-flag’ signs for superimposed fungal infection,” said Dr Garg.

“Without any delay, such patients should be further worked up for fungal infections so that anti-fungal treatment can be started at the earliest and the life of these patients can be saved,” he said.

Expertspeak

“We found that the Covid-associated pulmonary mucormycosis infection is more dangerous and has higher mortality when compared to the non-pulmonary Covid-associated mucormycosis,” said Dr Garg – a renowned chest radiologist and a professor in the Department of Radiodiagnosis at the PGI, Chandigarh.

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