(27) Prevalence and Predictors of COVID-19 Associated Mucormycosis: A Systematic Review and Meta-Analysis

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1072

Presenting Author(s)

Asha K. Rajan, PharmD
– Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education , CHENNAI, Tamil Nadu, India

Co-Author(s)

Muhammed Rashid, MPharm, BPharm
– Research Scholar, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Manipal, Udupi, Karnataka, India
Dhruv Patel
– Post-graduate student, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Karnataka, India
Viji Chandran
– Research scholar, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
Sreedharan Nair, MPharm, PhD, PhD
– Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India
Vishal Shanbhag
– Department of Critical Care, Kasturba Hospital, Manipal, Karnataka, India
Girish Thunga
– Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Manipal, Karnataka, India

Background: COVID-19-associated mucormycosis (CAM; black fungus infection) is a major threat across the globe. However, there is a lack of evidence regarding risk factors for CAM.

Objectives: We aimed to assess the prevalence of comorbidities and risk factors associated with CAM through a systematic review and meta-analysis.

Methods: Our study was registered in PROSPERO, International prospective register of systematic reviews [CRD42021256784]. MEDLINE/PubMed, Scopus, Embase, and the Cochrane Library were searched from 2019 to October 2021. A bibliographic search of selected articles and random searches of Google Scholar and Research Gate were also performed. Quantitative (observational) and qualitative (descriptive) studies that presented the incidence, risk, and consequences of mucormycosis in pediatric and adult COVID-19 patients were eligible for inclusion. The Joanna Briggs Institute critical appraisal checklist for prevalence, cross-sectional, and cohort studies was used to assess the risk of bias of included studies. Joanna Briggs's appraisal does not prefer to present the quality in scores; instead, it clearly mentions appropriate factors against each question. Descriptive studies were assessed using the tool developed by Murad et al.

Results: A total of 115 studies (5269 CAM patients) out of 1484 non-duplicate records were included in the systematic review, with 45 studies included in the meta-analysis. The majority (n=70;61%) of the studies were from India. The prevalence of diabetes and steroid use among CAM patients was 78% and 71% respectively. Meanwhile, both DM (OR:0.94;95%CI:0.39to2.23) and steroid use (OR:0.81; 95%CI:0.32to2.05) were not significantly associated with a higher risk of CAM. Additionally, COVID-19 disease (OR:1.51;95%CI:0.88to2.61) was also not a significant (p=0.14) factor for CAM. The quality of descriptive studies ranged from 0 to 6. All the studies reported good quality by scoring 6 (n=60;77%) and 5 (n=18;23%). Joanna Briggs's appraisal (9 items) for observational studies pointed out the bias factors in each study.

Conclusions: Our study concluded that even though there was a higher prevalence of diabetes and steroid use among CAM patients; both the factors were not associated with a higher risk of CAM.