Expert Consensus on the Prevention of Secondary Mucormycosis Following Respiratory Viral Infections

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), Min Quan^{¹^,^#}, Fu Qiao^{³^,^#}, Hazrat Bilal^{⁴^,^#}, Wenjie Fang^⁵, Bin Xu^⁴, Yijian Chen^⁶, Jing Liu^⁷, Hong Peng^⁸, Jue Pan^⁹, Li Gu^¹⁰, Zhihui Zhou^¹¹, Wenjie Yang^¹², Ying Ge^¹³, Jingping Zhang^¹⁴, Jiabin Li^¹⁵, Xiaopan Wang^⁵, Anhua Wu^¹⁶, Nek Wali Shah Momin^¹⁷, Mohammad Daud Habib^¹⁸, Ajmal Khan Manduzai^¹⁹, Ahmed Nasir Hanifi^²⁰, Atifa Popal^²¹, Chin Samnang^²², Abdella Gemechu^²³, Surajit De Mandal^²⁴, Pratibha Gaur^²⁵, Pratibha Kale^²⁶, Tejas Gohel^²⁷, Vinaykumar Hallur^²⁸, Bahareh Abbasi^²⁹, Susan Farshi^³⁰, Shahla Mohammad Ganji^³¹, Eisa Nasiri^³², Hamid Reza Jamaati^³³, Leslie Thian Lung Than^³⁴, Afreenish Amir^³⁵, Rahat Ullah Khan^³⁶, Waheed Iqbal^³⁷, Irum Mehmood^³⁸, Nizamuddin^³⁹, Matiur Rahman^⁴⁰, Sijad Ur Rehman^⁴¹, Rani Faryal^⁴², Syeda Marriam Bakhtiar^⁴³, Muhammad Nadeem Khan^⁴², Wei Liu^⁴⁴, Zhiyong Zong^{¹^,²}(

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1Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China

2Laboratory of Pathogen Research, West China Hospital, Sichuan University, Chengdu, Sichuan, China

3Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan, China

4Jiangxi Key Laboratory of Oncology, JXHC Key Laboratory of Tumor Metastasis, Jiangxi Cancer Hospital & Institute, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China

5Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology; The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China

6Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China

7Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China

8Department of Infectious Diseases, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, China

9Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

10Department of Infectious Diseases, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

11Department of Infectious Disease, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

12Department of Infectious Diseases, Tianjin First Central Hospital, Tianjin, China

13Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

14Department of Infectious Diseases, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China

15Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

16Center for Infection Control, Xiangya Hospital, Central South University, Changsha, Hunan, China

17French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan

18Amiri Medical Complex, Kabul, Afghanistan

19Mili Institute of Higher Education, Kabul, Afghanistan

20Central Public Health Laboratory (CPHL), Directorate of Diagnostic Services (DDS), Ministry of Public Health (MoPH), Kabul, Afghanistan

21Mellat Medical Complex, Kabul, Afghanistan

22Advisors to the Royal Government of Cambodia, Phnom Penh, Cambodia

23Haramaya University, College of Health and Medical Sciences, School of Medical Laboratory Sciences, Harar, Ethiopia

24Department of Microbiology, Shri Davara University, Chhattisgarh, India

25Department of Biotechnology & Microbiology, SRM University Delhi NCR, Sonepat, Haryana, India

26Department of Microbiology, Institute of Liver and Biliary Sciences, New Delhi, India

27Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India

28Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India

29Genetic Lab, National Institute for Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran

30Tehran University of Medical Sciences, Tehran, Iran

31Department of Molecular Medicine, Medical Biotechnology Institute, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran

32Shahid Beheshti University of Medical Sciences, Tehran, Iran

33Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

34Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia

35National Fungal Disease Surveillance, National Institutes of Health, Islamabad Capital Territory, Pakistan

36Institute of Pathology and Diagnostic Medicine (IPDM), Department of Medical Microbiology, Khyber Medical University, Peshawar, Pakistan

37Department of Pharmacology, Khyber Medical College, Peshawar, Pakistan

38Hayatabad Medical Complex, Peshawar, Pakistan

39Department of Medicine, Khyber Teaching Hospital/Khyber Medical College, Peshawar, Pakistan

40Health Services Academy, Islamabad, Pakistan

41Gajju Khan Medical Complex, Swabi, Pakistan

42Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan

43Department of Bioinformatics and Biosciences, Capital University of Science and Technology, Islamabad, Pakistan

44Department of Dermatology and Venerology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China

^# These authors contribute equally to this work: Junyan Qu, Xinyao Liu, Min Quan, Fu Qiao, Hazrat Bilal

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Abstract

The epidemiological patterns of respiratory viruses are complex and highly diverse. Infections caused particularly by SARS-CoV-2 and influenza viruses are frequently followed by secondary mucormycosis, posing significant challenges to clinical management and public health. To address the challenges posed by secondary mucormycosis following respiratory viral infections, the Fungal Prevention and Control Team of the Center for Infectious Diseases at West China Hospital, Sichuan University, convened experts from relevant disciplines across the world to develop the "Expert Consensus on the Prevention of Secondary Mucormycosis Following Respiratory Viral Infections". This consensus aims to provide systematic guidance and optimize prevention strategies. It identifies high-risk populations for mucormycosis after respiratory viral infections and offers 12 preventive recommendations focusing on four areas: education and training, personal protection, early diagnosis and treatment, and infection control. The document also highlights key measures that remain controversial or insufficiently supported by evidence and outlines directions for future research to promote greater awareness and research of mucormycosis.