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Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review

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Abstract

Background

Mucormycosis and aspergillosis are angioinvasive infections mainly occurring in immunocompromised patients. However, mixed infection with mucormycosis and aspergillosis in post-COVID-19 patients is rare. In this report, we will report four cases and comprehensively review the published literature on COVID-19 associated mixed infection of aspergillosis and mucormycosis.

Method

Besides four of our cases, we searched for published articles using PubMed/MEDLINE, Scopus, and Web of Science databases from the beginning of 2020 until October 2023.

Result

During the COVID-19 pandemic, we analyzed 52 cases (4 from our research and 48 from other studies). The most common underlying disease (59.6%) was diabetes mellitus. However, 19.2% of COVID-19 patients had no underlying condition. Interestingly, rhino-orbital-cerebral mucormycosis featured prominently in India and Iran, while other countries primarily reported a higher prevalence of pulmonary cases.

Conclusion

In conclusion, this study highlights the presence of mixed aspergillosis and mucormycosis in COVID-19 patients who previously had common underlying diseases or even a healthy immune system. Therefore, managing COVID-19 patients should involve screening serum and respiratory samples using biomarkers to detect superinfections.

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Funding

This work was supported by the Hormozgan University of Medical Sciences, Bandar Abbas, Iran [Grant No: 4010150] and the ethic code [IR.HUMS.REC.1401.079].

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Authors and Affiliations

  1. Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

    Elahe Sasani

  2. Department of Oculo-Facial Plastic Surgery, Farabi Eye Hospital, Tehran, Iran

    Farzad Pakdel

  3. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Sadegh Khodavaisy

  4. Zoonoses Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Sadegh Khodavaisy

  5. Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Mohammadreza Salehi, Marjan Sohrabi & Arezoo Salami Khaneshan

  6. Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Amir Salami

  7. Pathology Department, Cancer Institute Hospital, IKHC, Tehran University of Medical Sciences, Tehran, Iran

    Pouyan Aminishakiba

  8. Resident of Internal Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

    Iman Amirafzali

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  1. Elahe Sasani
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Sasani, E., Pakdel, F., Khodavaisy, S. et al. Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review. Mycopathologia 189, 10 (2024). https://doi.org/10.1007/s11046-023-00808-z

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