Year : 2023  |  Volume : 17  |  Issue : 1  |  Page : 58-64

COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review

1 Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
2 Onco-Anaesthesiology and Palliative Medicine, DRBRAIRCH, AIIMS, India

Correspondence Address:
Nishkarsh Gupta
Onco-Anaesthesiology and Palliative Medicine, DRBRAIRCH, AIIMS, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_640_22

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Mucormycosis once considered a rare disease with an incidence of 0.005 to 1.7 per million, has become one of the greatest menaces during the coronavirus disease (COVID-19) pandemic. India alone has contributed to nearly 70% of the global caseload of COVID-associated mucormycosis (CAM) and it had even been declared as a notifiable disease. Second wave of COVID-19 pandemic saw a steep rise in the incidence of mucormycosis and these patients have been presenting to anesthesiologists for various surgical procedures due to its primary or secondary sequelae. Rhino-orbito-cerebral mucormycosis (ROCM) is the commonest manifestation and is caused by Rhizopus arrhizus. Injudicious use of corticosteroids in vulnerable patients could have been a major contributing factor to the sudden rise in ROCM during the pandemic. Concerns related to anesthetic management include COVID-19 infection and post COVID sequalae, common presence of uncontrolled diabetes mellitus, possibility of difficult mask-ventilation and/or intubation, various drug therapy-associated adverse effects, and interaction of these drugs with anesthetic agents. Thorough preoperative optimization, multidisciplinary involvement, perioperative care, and vigilance go a long way in improving overall outcomes in these patients.

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