{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T01:29:02Z","timestamp":1774747742668,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Most COVID\u201019\u2010associated mucormycosis (CAM) cases are reported from India and neighbouring countries. Anecdotally cases from Europe have been presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the disease burden and describe the clinical presentation of CAM in Germany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified cases through German mycology networks and scientific societies, and collected anonymised clinical information via FungiScope\u00ae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 13 CAM cases from six tertiary referral hospitals diagnosed between March 2020 and June 2021. Twelve patients had severe or critical COVID\u201019, eleven were mechanically ventilated for a median of 8\u00a0days (range 1\u201027\u00a0days) before diagnosis of CAM. Eleven patients received systemic corticosteroids. Additional underlying medical conditions were reported for all but one patient, five were immunocompromised because of malignancy or organ transplantation, three were diabetic. Eleven patients developed pneumonia. Mortality was 53.8% with a median time from diagnosis of mucormycosis to death of 9\u00a0days (range 0\u2013214\u00a0days) despite treatment with liposomal amphotericin B and\/or isavuconazole in 10 of 13 cases. CAM prevalence amongst hospitalised COVID\u201019 patients overall (0.67% and 0.58% in two centres) and those admitted to the intensive care unit (ICU) (1.47%, 1.78% and 0.15% in three centres) was significantly higher compared to non\u2010COVID\u201019 patients (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for respective comparisons).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>COVID\u201019\u2010associated mucormycosis is rare in Germany, mostly reported in patients with comorbidities and impaired immune system and severe COVID\u201019 treated in the ICU with high mortality compared to mainly rhino\u2010orbito\u2010cerebral CAM in patients with mild COVID\u201019 in India. Risk for CAM is higher in hospitalised COVID\u201019 patients than in other patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13379","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T18:59:12Z","timestamp":1634756352000},"page":"103-109","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Results from a national survey on COVID\u201019\u2010associated mucormycosis in Germany: 13 patients from six tertiary hospitals"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4388-3117","authenticated-orcid":false,"given":"Danila","family":"Seidel","sequence":"first","affiliation":[{"name":"Department I of Internal Medicine Excellence Center for Medical Mycology (ECMM) Medical Faculty and University Hospital Cologne University of Cologne Cologne Germany"},{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"},{"name":"German Centre for Infection Research (DZIF) Partner Site Bonn\u2010Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8166-7178","authenticated-orcid":false,"given":"Michaela","family":"Simon","sequence":"additional","affiliation":[{"name":"Institute of Clinical Microbiology and Hygiene Regensburg University Hospital Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2457-6437","authenticated-orcid":false,"given":"Rosanne","family":"Sprute","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine Excellence Center for Medical Mycology (ECMM) Medical Faculty and University Hospital Cologne University of Cologne Cologne Germany"},{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"},{"name":"German Centre for Infection Research (DZIF) Partner Site Bonn\u2010Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4402-1810","authenticated-orcid":false,"given":"Matthias","family":"Lubnow","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care University Hospital Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-5563","authenticated-orcid":false,"given":"Katja","family":"Evert","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudius","family":"Speer","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Heidelberg Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0957-7386","authenticated-orcid":false,"given":"Jessica","family":"See\u00dfle","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Infectious Diseases Heidelberg University Hospital Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9253-1340","authenticated-orcid":false,"given":"Elham","family":"Khatamzas","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases Heidelberg University Hospital Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-3350","authenticated-orcid":false,"given":"Uta","family":"Merle","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Infectious Diseases Heidelberg University Hospital Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Behrens","sequence":"additional","affiliation":[{"name":"Department Medizinische Mikrobiologie und Technische Hygiene Medizet St\u00e4dtisches Klinikum M\u00fcnchen GmbH Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor Wolfgang","family":"Blau","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Cancer Immunology Charit\u00e9 University Medicine Berlin Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Enghard","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care Charit\u00e9 University Medicine Berlin Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian S.","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Nephrology and Intensive Care Medicine University of Marburg Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3181-3667","authenticated-orcid":false,"given":"Joerg","family":"Steinmann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Hygiene, Medical Microbiology and Infectiology Klinikum N\u00fcrnberg Paracelsus Medical University Nuremberg Germany"},{"name":"Institute of Medical Microbiology University Hospital Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-2646","authenticated-orcid":false,"given":"Oliver","family":"Kurzai","sequence":"additional","affiliation":[{"name":"National Reference Center for Invasive Fungal Infections Leibniz Institute for Natural Product Research and Infection Biology\u2010Hans Knoell Institute Jena Germany"},{"name":"Institute for Hygiene and Microbiology University of W\u00fcrzburg W\u00fcrzburg 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Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7070556"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2704.204895"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13096"},{"key":"e_1_2_8_5_1","article-title":"The emergence of COVID\u201019 associated mucormycosis: Analysis of cases from 18 countries","author":"Hoenigl M","year":"2021","journal-title":"The Lancet"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13641"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13335"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2709.210934"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof5010026"},{"key":"e_1_2_8_10_1","first-page":"1","article-title":"COVID\u201019\u2010associated 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