AbstractBackground: CAM (COVID-19 associated invasive Mucormycosis) has been increasingly documented in patients with coronavirus disease 2019 (COVID-19). Predisposing factors include diabetes, steroid use, neutropenia, malignancies, and immunocompromised individuals. The etiology and the exact route of entry for CAM in COVID patients are poorly understood. In India, the incidence of CAM in COVID patients is on the rise. Repeated use of steam inhalation with herbal medicines might cause nasal mucosal trauma which leads to CAM Patients and Methods: Analytical cross-sectional study was conducted to determine the cause for CAM. COVID positive patients with and without Mucormycosis admitted to our hospital were included in the study. A detailed history about the practice of steam inhalation, comorbid illnesses like Diabetes Mellitus (DM), and the use of steroids were assessed and analyzed. Results: 63 CAM patients and 154 Non-Mucormycosis COVID positive patients were taken for the study and analyzed. Injudicious use of steam inhalation (84.1% vs 40.9%) multiple times per day (> 3 times) are strongly associated with CAM among COVID-positive patients (P value 0.0001). Uncontrolled DM (P-value 0.011) and prolonged duration of steroids > 8 days (P-value <0.001) were significantly associated with CAM when compared to control groups. Early diagnosis and treatment improved the outcome of CAM patients. Conclusion: Injudicious use of steam inhalation can cause nasal mucosal trauma which can result in Invasive Mucormycosis in already immune depleted COVID positive patients Keywords: CAM COVID-19 associated invasivemucormycosis); Coronavirus disease 2019 (COVID-19); Steam inhalation.