“STUDY OF INVASIVE MUCORMYCOSIS REPORTED ON HISTOPATHOLOGY IN POST COVID-19 CASES AT A TERTIARY CARE HOSPITAL OF CENTRAL INDIA: A CASE SERIES”

Abstract

Background: Coronavirus disease 2019 (Covid-19) is an infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In recent studies observed that, in Covid-19 infected patient who treated with widespread use of broad-spectrum antibiotic or steroid and recovered developed secondary bacterial or fungal infection in 8%. Mucormycosis infection of the sinuses is a form of life-threatening invasive fungal sinusitis that typically affects immunocompromised individuals with an impaired neutrophilic response. Aims: 1) To study the histopathological features in cases labelled as invasive fungal sinusitis. 2) To study the association of age, gender, positive history of Covid-19 infection, co-morbidities, use of corticosteroids and clinical presentation of cases of mucormycosis. 3) To compare our observations with the study of other authors. Materials And Methods: A cross – sectional observational study was undertaken at Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh in Department of Pathology, over a period of 6 months from May to October 2021. Biopsies received were then processed as per the standard operating procedure and stained with H & E staining and observed under microscope. Results: On histopathological examination, we observed that the lesional tissue in the nasal biopsy/ maxillary sinus biopsy was lined by respiratory epithelium and showed numerous broad, non – sepatate hyphae, at places showing branching. Few of the cases showed focal spore formation. Conclusions: This study was useful in understanding histopathological features of this not–so–common fungal infection. This study also subtly pointed towards the demerits of inadvertent use of corticosteroids in treatment of Covid-19 patients, especially in those with co-morbidities like diabetes mellitus and elderly patients. The need of the hour, therefore, is to have “customized” treatment for every patient