Mahda Khezri - Department of Medical Laboratory Science, School of Paramedicine, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
Bahareh Nourian - Department of Medical Laboratory Science, School of Paramedicine, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
Ali Ghaemi - Department of Medical Laboratory Science, School of Paramedicine, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
Maryam Kaab Omeyr - Department of Medical Laboratory Science, School of Paramedicine, Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

Background and Objective: COVID-۱۹ has led the world to a crisis, with the course of disease ranging from mild respiratory illness to sever respiratory failure, making it a globalconcern. COVID-۱۹ patients are acquiring secondary infections such as mucormycosis also known as black fungus disease in the middle of the pandemic. Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection that mainly affects patients who are immunosuppressed. Most of these patients have diabetes and are treated with steroids for SARS-CoV-۲ infection. The combination of these two might have made them more likely to have fungal attack. In this study we investigate the role of mucormycosis and its challenges causing black fungus in patients with COVID-۱۹.Materials and Methods: PubMed, Scopus, Magiran, and google scholar were searched using keywords: “COVID-۱۹”, “Mucormycosis”, “Diabetes”, “Immunosuppression”, “Steroids”, “black fungus”.Results: : Mucormycosis has been associated with many underlying conditions that can cause an individual to have infections. Some of these factors include diabetes, steroidal use, neutropenia, organ or stem cell transplantation, hematological disorders, trauma and burns, metabolic acidosis, intravenous drug usage, renal insufficiency, broad-spectrum antibiotics and etc. apart from taking heavy dose of steroids, COVID-۱۹ patients use oxygen masks and ventilators to fight SARS-CoV-۲ infection, which can open a pass for the Mucorales fungus. Black fungus which appears in patients admitted in the Intensive Care Unit (ICU) can be fatal, causing loss of vision and even death. Early symptoms include blockage of the nasal cavity and greyish-black pigmentation in the nose or oral cavity. Ocular swelling is caused by spores of fungus near the eyes, and a few patients might get lesions over the cheeks. At the next stage, this fungus can infect the brain which makes the disease quite severe. As we know, the fatality rate goes up to ۵۰%.Conclusion: As we continue to investigate more outcomes about the clinical conditions of COVID-۱۹, we should be really careful and watch out for coinfections alongside the way. Mucormycosis, an opportunistic fungus, should be controlled by researchers and healthcare professionals. Understanding its influence and range of severity, especially in COVID-۱۹ patients due to their use of oxygen therapy is really vital. Also Healthcare workers should be educated to change flow meters frequently and to sterilize oxygen tubing. Treatments also include antifungal drugs like Amphotericin-B.

COVID-۱۹, Mucormycosis, Diabetes, Immunosuppression, Steroids, and black fungus