ABSTRACT
PURPOSE: To compare the clinical profile of COVID-related and non-COVID-related rhino-orbito-cerebral invasive fungal disease. METHODS: We have compared the comorbidities, clinical features, course of the disease and outcome between COVID-related and non-COVID-related acute invasive fungal rhinosinusitis (AIFRS) of the rhino-orbito-cerebral form. RESULTS: HbA1c and blood sugar at the time of admission were significantly higher in the non-COVID group (P < 0.05). Duration of stay, and use of steroids were significantly higher among the COVID group (P < 0.05). The period of hospital stay was significantly higher in the COVID group. The overall survival in the COVID group was 67.57%. In the non-COVID group the overall survival was 61.90%.This study found that odds of surgical treatment was significantly lower among non-survivors (P < 0.05). Similarly patients who developed stages 3 & 4 of the disease had a lower survival rate (P < 0.05). CONCLUSION: Diabetes mellitus is a key risk factor for the development of AIFRS. Pre-existing, grossly uncontrolled DM was the predisposing factor in the non-COVID group. Deranged glucose profile associated with COVID illness and its treatment and immunological disturbances in a vulnerable population, contributed to the surge in cases of AIFRS in the COVID-19-related group. Patients who underwent combined medical and surgical treatment had a significantly better outcome following AIFRS.
Subject(s)
COVID-19 , Rhinitis , Sinusitis , Acute Disease , Blood Glucose , Glycated Hemoglobin , Humans , Retrospective Studies , Rhinitis/epidemiology , Sinusitis/microbiologyABSTRACT
Acute invasive fungal sinusitis is an aggressive infection affecting immunocomprosmised patients and carries a high mortality. Patients with Covid-pneumonia are at an increased risk of developing invasive pulmonary fungal infections probably due to their reduced immunological competence. Here, we review three cases of Covid-associated invasive fungal sinusitis.
ABSTRACT
Tracheostomy in Covid-19 patients is an aerosol generating procedure putting health care workers at great risk. Retrospective study of tracheostomy in ten Covid-19 patients with ARDS using modifications of the surgical techniques revealed its efficacy in limiting the risks of spread to health care workers and improving surgical outcome.