Clinical, Morphological and Histopathological Staining Characteristics of Mucormycosis in COVID 19 Patients

Abstract

COVID 19, caused by severe acute respiratory syndrome – corona virus -2 (SARS – CoV 2), is a pandemic that affected millions of people worldwide. During the second wave of COVID -19 pandemic in India, an unprecedented surge in cases of mucormycosis was observed. This study was carried out to describe the clinical, morphological and histopathological staining characterstics of mucor mycosis in 16 covid patients in a tertiary care setting. Older patients with comorbidities like diabetes mellitus are commonly affected. The most common site of involvement was sinonasal tract (68.75%) followed by sinonasal tract and orbit (37.5%). Out of the 16 patients, 2 were partially vaccinated whereas others were not vaccinated. Histopathological examination of specimens revealed broad aseptate fungi in all cases. Tissue necrosis was present in all cases. Suppuration being the most common tissue reaction. 43.75% showed angioinvasion and 37.5% had bone invasion. All the cases were GMS positive with variable intestity. Treatment given in all cases were liposomal amphotericin B injection and surgical wound debridement. On follow up, 40 % of the patients died inspite of aggressive clinical management. Hence this fatal fungal infection should be kept in mind in covid 19 recovered patients especially those who are immunocompromised.