Emergence of mucormycosis in post-COVID infections in tertiary care hospital Warangal

Abstract

ABSTRACT Introduction: Mucormycosis is an emerging fungal infection associated with high mortality, especially in post-COVID state. Mucormycosis, though fungal spores ubiquitous in the environment, is a clinical disease that occurs in immunocompromised conditions. However, the incidence of mucormycosis is enormously increased in post-COVID-19 infections and in those who are immunocompromised. It presents as rhino-orbital-cerebral mucormycosis. The diagnosis is done by KOH mount and culture on Sabouraud dextrose agar (SDA). The identification of post-COVID risk factors, clinical features, and KOH mount helps in early diagnosis. Early treatment helps in preventing progressive tissue invasion, surgical debridement and thus improves the outcome. Aims and Objectives: To establish etiological agents of mucormycosis.To establish the relation of diabetes mellitus, steroid usage, oxygen inhalation, and other risk factors in postCOVID patients suspected with mucormycosis.To study and establish associated high-risk factors for the sudden explosion of mucormycosis cases in post-COVID state. Material and Methods: The study was done on a total of 81 patients of suspected mucormycosis admitted at MGM Hospital and 20 controls of post-COVID patients over a period of 3 months. Demographic features, predisposing conditions, clinical features, culture characters, and radiological features were all obtained and analyzed. Results: The history of diabetes mellitus, steroid usage, and oxygen inhalation were analyzed. Among 81 debrided tissue samples received, 52 were KOH mount positive and out of them only 32 showed growths on SDA. Among them, 9 were Rhizopus, 13 were Mucor, and 10 were other species. Conclusion: Mucormycosis is a rare and uncommon disease in the past; However, in the COVID-19 pandemic, its association with post-COVID state is established. The common presentation of rhino-orbital-cerebral mucormycosis is dreadful; however, early diagnosis and prompt treatment in time will decrease mortality and morbidity remarkably.