Top 5 Takeaways

1. Emergence of COVID-19-Associated Mucormycosis: Multiple cases of mucormycosis were reported in Arkansas following COVID-19 diagnosis, highlighting a new public health concern.
2. Patient Demographics: The median age of affected patients was 57 years, and all were non-Hispanic White persons. Most patients had underlying conditions such as diabetes.
3. Clinical Presentation: Mucormycosis manifested in various forms including rhino-orbital, pulmonary, disseminated, and gastrointestinal symptoms.
4. High Mortality Rate: Six out of ten patients died during hospitalization or shortly after discharge, indicating the severe nature of the infection.
5. Public Health Response: The Arkansas Department of Health issued alerts and is conducting ongoing surveillance to improve prevention, diagnosis, and treatment of mucormycosis.

Original Article Author and Citation

Corresponding Author

Jeremy A.W. Gold, jgold@cdc.gov

Suggested Citation

Dulski TM, DeLong M, Garner K, et al. Notes from the Field: COVID-19–Associated Mucormycosis — Arkansas, July–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1750–1751. DOI: http://dx.doi.org/10.15585/mmwr.mm7050a3

Summary

In Arkansas, between July and September 2021, ten cases of COVID-19–associated mucormycosis were reported. This fungal infection, typically affecting immunocompromised individuals, emerged among COVID-19 patients, likely due to immune dysregulation and treatments such as corticosteroids. The median age of patients was 57 years, with a significant number having diabetes. The infection presented in various forms and had a high mortality rate, with six patients dying during hospitalization or shortly after discharge. The Arkansas Department of Health has initiated efforts to improve the prevention, diagnosis, and treatment of mucormycosis.

Methods

Cases were identified through laboratory confirmation of Mucorales in patients diagnosed with COVID-19 within the preceding 60 days. Data were collected using standardized forms and stored in a secure database. Patient demographics, clinical course, and outcomes were analyzed to understand the impact and spread of the infection.

Discussion

The study highlights the emergence of mucormycosis in COVID-19 patients, a condition previously rare in the United States. The findings suggest that COVID-19 and its treatments may increase susceptibility to this severe fungal infection. The high mortality rate underscores the need for heightened clinical awareness and prompt treatment. The Arkansas Department of Health’s response includes issuing health alerts and conducting ongoing surveillance to mitigate the impact of this infection.

Conclusion

COVID-19–associated mucormycosis represents a significant public health challenge, particularly in patients with underlying conditions like diabetes. Prompt antifungal therapy, surgical intervention, and maintaining glycemic control are critical for improving patient outcomes. Continued surveillance and adherence to treatment guidelines are essential to manage and prevent this severe infection.

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