Histopathological spectrum of fungal infections in COVID 19 cases – A retrospective observational study

Abstract

A wide range of fungal and bacterial infections are associated with Corona virus disease (COVID19). There was a surge of mucormycosis during COVID19 pandemic in 2021. This study elaborates the histopathological findings observed in fungal infections of head and neck in COVID 19 patients. A retrospective observational study of histopathological findings of invasive fungal infection in COVID 19 case was conducted in our laboratory. All the tissue samples diagnosed as post COVID fungal infections during January 2021 to June 2021 were analyzed. Representative sections were taken and slides were stained with Hematoxylin & Eosin, Periodic Acidic Schiff (PAS) and Gomori Methenamine silver (GMS) stains. Histopathological features were studied. There were total 32 cases which had invasive fungal infections associated with COVID 19. The most affected age group was 31 to 50 years of age (50%), with male preponderance (87.5%). Diabetes was present in 62.5% cases, and steroid use during the treatment was present in 31.3% of the cases. The most common site was maxillary sinus (53.1%) followed by nasal cavity (34.4%). Isolated infection by mucor was seen in 68.8% cases, there were cases of secondary bacterial infection and candida with aspergillus infection. Angioinvasion was present in 56.3% cases and bone destruction in 15.6% cases.COVID 19 infection results in immune dysregulation and background of diabetes and over use of steroids increases risk of mucormycosis. An early histopathological diagnosis provides early diagnosis.