Clinical characteristics, management, and outcomes of post COVID-19 mucormycosis in a private ENT hospital in Surat: a retrospective analysis
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20242037Keywords:
Amphotericin, FESS, MucormycosisAbstract
Background: Objectives of the study were to assess the age group affected, common presentation, extent of disease of mucormycosis and treatment modalities in post covid patients.
Methods: All covid positive patients or recently recovered from covid with features of mucormycosis endoscopically and radiologically were included in this study. All patients that came in the outpatient department were screened using nasal endoscope and CT scans were performed. Patient’s clinical findings and endoscopic findings were correlated with the scans during the pandemic and decision to operate the cases was taken. It was a team approach by otorhinolaryngologist, ophthalmologist, endocrinologist, intensivist and nephrologist. Patients were followed up to 1 year.
Results: 65 patients that suggested of mucormycosis clinically, endoscopically, and radiologically were studied. It included 50 (76.9%) males and 15 (23.1%) females and histologically after operating, mucor was present in 44 cases (67.6) and 9 (13.8%) were aspergillosis.
Conclusions: Post-COVID mucormycosis was reported after the second COVID wave in India especially after steroid therapies in diabetic patients. Thus, a timely, aggressive, team approach using Modified Denkers or open maxillectomy along with proper intravenous antifungals is the key to survival in such patients.
References
Pillsbury HC, Fischer ND. Rhinocerebral Mucormycosis. Arch Otorhinolaryngol. 1977;103(10):600-4.
Binder U, Maurer E, Lass-Florl C. Mucormycosis from the pathogens to the disease. Clin Microbiol Infect. 2014;6:60-6.
Lewis RE, Kontoyiannis DP. Epidemiology and treatment of mucormycosis. Future Microbiol. 2013;8(9):1163-75.
Thornton CR. Detection of the 'Big Five' mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes. Adv Appl Microbiol. 2020;110:1-6.
Aranjani JM, Manuel A, Abdul Razack HI, Mathew ST. COVID-19 associated mucormycosis: evidence-based critical review of an emerging infection burden during the pandemic’s second wave in India. PLoS Negl Trop Dis. 2021;15(11):e0009921.
Satish D, Joy D, Ross A. Balasubramanya. Mucormycosis coinfection associated with global COVID-19: a case series from India. Int J Otorhi- nolaryngol Head Neck Surg. 2021;7(5):815–20.
Pathak L, Tripathi A, Nayyar SS, Kurkure R, Yadav A, Mishra J et al. The Egyptian Journal of Otolaryngology. 2023;39:19.
Mishra N, Mutya VSS, Thomas A, Rai G, Reddy B, Mohanan AA, et al. A case series of invasive mucormycosis in patients with COVID-19 infection. Int J Otorhinolaryngol Head Neck Surg. 2023;7(5):867-70.
Moorthy A, Gaikwad R, Krishna S, Hegde R, Tripathi KK, Kale PG. SARS-CoV-2, uncontrolled diabetes, and corticosteroids-an unholy trinity in invasive fungal infections of the maxillofacial region? A retrospective, multi-centric analysis. J Maxillofac Oral Surg. 2021;20(3):418-25.
Revannavar SM, PS S, Samaga L. COVID-19 triggering mucormyco- sis in a susceptible patient: a new phenomenon in the developing world. BMJ Case Rep. 2021;14(4):e241663.
Saldanha M, Reddy R, Vincent MJ. Paranasal mucormycosis in COVID-19 patient. Indian J Otolaryngol Head Neck Surg. 2021;22:1-4.
Trivedi KR, Shah C. A retrospective study of invasive fungal rhinosinusitis in adults for surgical outcomes at tertiary care hospital. Int J Otorhinolaryngol Head Neck Surg. 2023;9(11):856-9.