The coronavirus disease 2019 (COVID-19) pandemic has led to a concerning resurgence of mucormycosis. More than 47,000 cases of mucormycosis were reported in three months from India. We update our systematic review on COVID-19-associated mucormycosis (CAM) till June 21st, 2021, comparing cases reported from India and elsewhere. We included individual patient details of 275 cases of CAM, of which 233 were reported from India and 42 from the rest of the world. Diabetes mellitus was the most common underlying risk factor for CAM in India than in other countries. The fatality rate of cases reported from India (36.5%) was less than the globally reported cases (61.9%), probably due to the predominance of rhino-orbital mucormycosis. On a multivariate analysis, we found that pulmonary or disseminated mucormycosis cases and admission to the intensive care unit were associated with increased mortality, while combination medical therapy improved survival. The paucity of pulmonary and disseminated mucormycosis cases from India suggests that these cases were either not diagnosed or reported, further supported by a trend of search data from the Google search engine. In this review, we discuss the factors explaining the substantial rise in cases of CAM. We also propose a hypothetical model describing the epidemiologic triad of CAM.

2019 年冠状病毒病 (COVID-19) 大流行导致毛霉菌病卷土重来，令人担忧。印度三个月内报告了超过 47,000 例毛霉菌病病例。我们更新了截至 2021 年 6 月 21 日的 COVID-19 相关毛霉菌病 (CAM) 系统评价，比较了印度和其他地方报告的病例。我们纳入了 275 例 CAM 病例的个体患者详细信息，其中 233 例来自印度，42 例来自世界其他地区。在印度，与其他国家相比，糖尿病是 CAM 最常见的潜在危险因素。印度报告的病例死亡率（36.5%）低于全球报告的病例死亡率（61.9%），可能是由于鼻眼眶毛霉菌病占主导地位。在多变量分析中，我们发现肺部或播散性毛霉菌病病例和入住重症监护病房与死亡率增加相关，而联合药物治疗可提高生存率。印度的肺部和播散性毛霉菌病病例很少，表明这些病例要么没有被诊断，要么没有报告，谷歌搜索引擎的搜索数据趋势进一步支持了这一点。在这篇综述中，我们讨论了解释 CAM 病例大幅增加的因素。我们还提出了一个描述 CAM 流行病学三联征的假设模型。