Invasive Aspergillosis of Nose and Paranasal Sinus in COVID-19 Convalescents: Mold Goes Viral?

Invasive Aspergillosis of the paranasal sinus is an aggressive illness, particularly affecting the immunocompromised and rarely, the immunocompetent. COVID-19 has been shown to cause a derangement of immune parameters both during active infection and the convalescent period. A retrospective study was done from June 10th 2021 to September 10th 2021 on patients who underwent endoscopic debridement of the involved sinuses for post COVID fungal rhinosinusitis. This study included the patients who had Aspergillus infection from the isolated nasal tissue samples. Patient's information, complaints, history of COVID infection, clinical findings, investigations and treatment details were obtained from the records. 13 patients with post-COVID Invasive Fungal Sinusitis were identified. Symptom onset usually occurred within 1 month of COVID 19 diagnosis in all the patients. Nasal obstruction (84%) and headache (61%) were the most common symptoms. Computerized tomography imaging showed maxillary sinus involvement in all patients followed by ethmoid sinus in 76% of patients. Microbiological diagnosis and histopathological confirmation of Aspergillus species was done. All 13 patients underwent endoscopic debridement of the involved sinuses followed by anti-fungal therapy with Posaconazole. All responded well to the treatment with no recurrence till date. Admist an infinite number of Mucormycosis cases in this era of COVID-19 pandemic, we experienced a surge of Aspergillus infection during this second wave. Presentation at a young age, with no known co-morbidities, with minimal symptoms and history of COVID-19 infection are some of the important aspects to be considered in this series. A better morbidity outcome is expected when early detection and treatment is made in patients with post Covid-19 viral illness with Aspergillosis of nose and paranasal sinus.

Establishment of a Rapid Response, 100-Bedded COVID-19 Hospital With General Wards and Intensive Care Unit Within 35 Days in North Karnataka, India: Report From the Field.

In the state of Karnataka, India, the first case of coronavirus disease (COVID-19) was diagnosed on March 9, 2020. As stated by the WHO, around 15% of COVID-19 patients require treatment in the Intensive Care Unit (ICU). Keeping this in mind, along with the increase in COVID-19 patients in Karnataka, it was predicted that the prevailing general wards and ICUs would be overburdened with the added non-COVID-19 diseases and infirmities. Hence, it was decided to set up a separate infrastructure to reduce the chances of transmission among the patients within the hospital. Thus, the board at SDM College of Medical Sciences & Hospital, Dharwad, Karnataka, took the responsibility to establish a fully equipped 100-bedded hospital in its premise as part of the national and state services to combat the outbreak. The aim of the study was to establish an isolated, fully functional hospital, equipped with all necessary diagnostic and critical care facilities to treat patients diagnosed with COVID-19 in North Karnataka, India.