Post coronavirus disease mucormycosis: a deadly addition to the pandemic spectrum

TLDR

The study aims to investigate the association between mucormycosis and COVID‑19. A prospective observational study at a tertiary centre over four months included all paranasal sinus mucormycosis patients with current or prior COVID‑19. Among 23 patients, all had COVID‑19, most involved ethmoid sinuses, 43 % had intra‑orbital spread, 9 % intracranial, diabetes was present in 91 % (uncontrolled in 52 %), and all had steroid exposure, underscoring the strong link between COVID‑19, steroid use, and uncontrolled diabetes in mucormycosis.

Abstract

Abstract Objective To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease. Methods A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection. Results Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment. Conclusion New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.