Clinico-epidemiological Profile of COVID-19Associated Invasive Fungal Rhinosinusitis Reported in the Teaching Hospital of Diwaniya,Qadisiya Province, Iraq: A Case Series

Abstract

Introduction: With the current COVID-19 pandemic, the increasing use of glucocorticoids has resulted in more adverse effects and secondary bacterial or fungal infections. Objective: To find out the clinic-epidemiological profile of patients having COVID-19 associated invasive fungal rhinosinusitis in Diwaniya teaching hospital- Qadisiya province - Iraq.Method: Retrospective case series study of 24 patients with COVID-19 who were admitted to Alshafa centre in Al-Diwaniyah Province from 1st of May 2020 to end of August 2021. Patients were moderate to severe COVID-19 received treatment according to local guidelines. Patients who developed signs and symptoms of nose and paranasal sinuses disorder were seen by otolaryngologists and treated by a multidisciplinary team if invasive mucormycosis and its comorbidities were detected.Results: Out of 24 patients, 8 were female and two patients were excluded because their histopathological examination hasn’t confirmed acute invasive fungal rhinosinusitis. The average age was 54 years old, they all had diabetes, 2 patients had chronic kidney diseases, and 2 patients had malignancy (leukaemia). Furthermore, 19 patients were with severe SARS-COV-2 while 5 patients had moderate symptoms. All patients were confirmed COVID-19 positive by PCR test.Conclusion: Invasive fungal infections of the nose and paranasal sinuses are highly lethal conditions with significant morbidity. Early recognition and high index of suspicion are needed in the case of COVID-19 patients who complain features of sinusitis with careful prescription of drugs that affect immune response in COVID-19 patients.