Top 5 Takeaways

1. Unexpected Increase in Cases: An unexpected number of mucormycosis cases were reported among COVID-19 patients in Honduras between May and September 2021.
2. Investigation Collaboration: The investigation was a collaborative effort involving the Honduras Field Epidemiology Training Program, SE-COMISCA, PAHO, and CDC.
3. COVID-19 Association: Out of 17 mucormycosis cases, 11 were associated with COVID-19, with most patients being unvaccinated and receiving treatments like corticosteroids and tocilizumab.
4. High Mortality Rate: Ten out of the 17 patients died during hospitalization, including eight of the 11 with COVID-19–associated mucormycosis.
5. Need for Vigilance: The report emphasizes the need for clinicians to remain vigilant for mucormycosis during the COVID-19 pandemic, even in immunocompetent patients.

Original Article Author and Citation

Corresponding Author

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

Suggested Citation

Mejía-Santos H, Montoya S, Chacón-Fuentes R, et al. Notes from the Field: Mucormycosis Cases During the COVID–19 Pandemic — Honduras, May–September 2021. MMWR Morb Mortal Wkly Rep 2021;70:1747–1749. DOI: http://dx.doi.org/10.15585/mmwr.mm7050a2

Summary

On July 15, 2021, the Secretary of Health of Honduras reported an unexpected number of mucormycosis cases among COVID-19 patients. An investigation was conducted in collaboration with multiple health organizations to study these cases in four hospitals. Mucormycosis, a severe fungal infection, was found in 17 patients, 11 of whom had COVID-19. The study highlighted a high mortality rate and emphasized the need for vigilance in diagnosing and treating mucormycosis during the COVID-19 pandemic.

Methods

The investigation defined a mucormycosis case based on laboratory identification of Mucorales in patients with a clinical diagnosis of mucormycosis. Cases were considered COVID-19–associated if the patient had a positive SARS-CoV-2 test or COVID-19 diagnosis within 60 days before to 14 days after the mucormycosis diagnosis. Data were collected from four hospitals using a standardized case report form.

Discussion

The study found that most mucormycosis patients were male, with a median age of 54 years. Diabetes was the most common underlying condition. The high mortality rate and severe outcomes, such as facial disfiguration and limb loss, underscore the seriousness of mucormycosis. The apparent increase in cases may be linked to the COVID-19 surge and associated treatments, or heightened awareness and testing prompted by educational efforts.

Conclusion

Clinicians should be vigilant for mucormycosis during the COVID-19 pandemic. Early diagnosis and prompt treatment are crucial. Preventive measures include COVID-19 vaccination, glycemic control in diabetic patients, and judicious use of steroids. Ongoing clinician education is essential to improve the prevention, diagnosis, and treatment of mucormycosis.

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