Association of COVID-19 with Mucormycosis-An Appalling and Enervating Disease in North West India

ABSTRACT

Introduction: The pandemic Coronavirus Disease 2019 (COVID-19) continues to be a significant problem worldwide. The disease pattern ranges from mild to life threatening pneumonia. Association of COVID-19 with mucormycosis is rare but an increase in this association has been observed recently, particularly in a background of immunocompromised state with rhino-orbital-cerebral region being the most common site of involvement. Aim: To study the site and presentation of mucormycosis in COVID-19 patients with histopathological association. Materials and Methods: A descriptive study was conducted at American International Institute of Medical Sciences, Udaipur, Rajasthan, India, in which 1st 20 patients of COVID-19 with mucormycosis of rhino-orbital region were included in the study. The study was conducted for a period of two months (April-May 2021). Detailed clinical history and associated co-morbidities were noted for each patient. Histopathological examination of all the specimens resected for fungal infection was done along with special stain. Statistical analysis was done using Chi-square test. Results: COVID-19 association with mucormycosis was observed in all 20 cases. Maximum number of cases (11) was present in the age group of 20-40 years. Diabetes Mellitus (DM) had a strong association with mucormycosis. Maxillary sinus was most commonly associated site. Preoperative Potassium Hydroxide (KOH) was positive in all 20 cases, detailed histopathology study along with Periodic Acid Schiff (PAS) stain was performed in all cases. Additional microscopic findings like angioinvasion (03), granuloma (01) and giant cell reaction (13) were also recorded. Conclusion: COVID-19 has emerged as a global threat to mankind. In the present scenario the entire medical fraternity should have a prompt and team approach towards the management of this pandemic, in terms of, early detection of the infection, meticulous use of corticosteroids and screening of comorbidities to safeguard patients from such life threatening fungal infections.