REVIEW ARTICLE |
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Year : 2023 | Volume
: 17
| Issue : 1 | Page : 58-64 |
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COVID-19 associated Mucormycosis (CAM): Implications for perioperative physicians – A narrative review
Anju Gupta1, Bhavana Kayarat1, Nishkarsh Gupta2
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 India
 Source of Support: None, Conflict of Interest: None  | Check |
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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