Mucormycosis and COVID 19: Demography, associated co-morbidities and laboratory diagnosis in a Tertiary Care Hospital

Abstract

Purpose: The pathogenesis and treatment of severe COVID-19 infection in a patient makes him susceptible to many co-infections/super-infections, out of which the highest surge was of Post COVID mucormycosis. Prevention, early detection and management of Post COVID mucormycosis is essential due to its devastating and fatal outcome. The present study was performed to describe the clinico-demographic risk factors and role of various diagnostic modalities available for diagnosing mucormycosis in COVID-19 patients admitted in a super-speciality hospital. Method: A retrospective observational study was performed on 15 patients admitted with a clinical diagnosis of mucormycosis associated with COVID-19 infections, in a tertiary care centre between May 2021 to July 2021.Demographic details such as age, gender, Diabetes mellitus(DM), hypertension, glycosylated haemoglobin status ,existing immunocompromised conditions, other co-morbidities, time duration for reporting diseases after COVID-19 treatment, use of oxygen and/or ventilator support, steroid microbiological test results as well as pathological test results were collected from the patient records retrospectively. The data was compiled and analysed for association with development for mucormycosis. Results: The most common fungal species isolated in the study was Rhizopus species (53.33%). The most common clinical presentation was Nasal mucormycosis (53.33%) followed by Rhino –cerebral mucormycosis(13.3%) and Sino-nasal mucormycosis (13.3%).Diabetes mellitus was the most common associated co-morbidity(66.7%). Microscopy for fungal elements positivity was 66.67% while culture positivity was 85.7%.Culture and Histopathology findings correlated well clinically. Conclusion: Mucormycosis in COVID -19 was associated with deranged blood sugar levels either due to poorly controlled diabetes or steroid therapy. Fungal microscopy helped in early diagnosis while culture and histopathology could be employed together reliably for confirmatory diagnosis.