A prospective study on emergence of mucormycosis in recently recovered COVID-19 patients

Suvarna Landge; Sarala Menon; Chhaya Chande; Monita Kulkarni; Kavita Bhilkar; Jyoti Bade; Ameeta Joshi

doi:10.18203/2320-6012.ijrms20232089

Authors

Suvarna Landge Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Sarala Menon Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Chhaya Chande Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Monita Kulkarni Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Kavita Bhilkar Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Jyoti Bade Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Ameeta Joshi Department of Microbiology, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232089

Keywords:

Aspergillosis, COVID-19, Diabetes mellitus, Post-covid-mucormycosis, Steroid

Abstract

Background: Mucormycosis is an angio-invasive fungal infection with high morbidity and mortality. This infection seems to be increasing during the second wave of COVID-19. Objectives of this study were to identify and characterise the fungal species causing post-covid-mycosis, to analyze the cases for underlying co-morbidities if any and to correlate the associated risk factors with the progression of disease.

Methods: Prospective observational study which constituted conventional fungal culture of 188 tissue specimens collected from clinically suspected mucormycosis patients who had history of COVID.

Results: This study noted the occurrence of disease with predominance of males (72.03%). Most common symptoms were facial/periorbital swelling, followed by facial pain and headache. Among co-morbid conditions, diabetes mellitus was the most common (71.17%). Use of steroids (65.25%), antivirals therapy (22.86%), oxygen support (11.86%) used in management of COVID patients were found to be risk factors in post-covid-mucormycosis. radiological diagnosis showed involvement of paranasal sinuses (77.11%), followed by orbit (16.94%) and brain (5.90%). Mucor spp. was isolated in 21 cases. Although commonest fungus isolated was Aspergillus, analysis of the data for last 5 years showed a significant rise of Mucormycosis cases. Mortality was seen in 17.79% cases.

Conclusions: Fungal aetiology should be kept in mind in patients with above clinical presentations with history of recent COVID-19 infection especially who received steroids.

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