Increased acute invasive fungal rhinosinusitis in COVID-19 patients

Abstract

Aim: Acute invasive fungal rhinosinusitis (AIFRS) is a rare infection of the nose and paranasal sinuses that can be fatal. Infection may lead to tissue infarction, necrosis, and thrombosis and rapidly spread intracranially. The aim of this study is to highlight the increasing cases of AIFRS after covid-19 and to investigate the parameters affecting mortality.
 Material and Method: Total 11 patients diagnosed with AIFRS after COVID-19 were included in this study. Patient age, gender, comorbid diseases, initial symptoms, time between COVID-19 diagnosis and AIFRS diagnosis, intensive care hospitalization history, medical treatments, surgical findings, antifungal treatment, fungal species grown in culture, mortality, and the relationships of these parameters with mortality were also evaluated.
 Results: A total of 11 patients diagnosed with AIFRS after COVID-19 were included in the study. Among these patients, 81.8% were male, 18. 2% were female, and ages ranged from 57 years to 89 years. The mean time between COVID-19 infection and development of IFRS in patients was 26.09±18.04 days. The initial symptoms in 45.45% of the patients were unilateral periorbital edema, vision loss, and total ophthalmoplegia. The surgical approach was purely endoscopic in all patients. In our study, the mortality rate was 72.7% in COVID-19 related AIFRS patients.
 Conclusion: As a result, in our study, we found an increase in AIFRS incidence and mortality due to the systemic effects of COVID 19 and the treatments used for it. AIFRS should be suspected when a patient presents acute sinusitis symptoms after COVID-19 infection.