Mucormycosis in Post Novel Corona Virus Patients: An Institutional Experience

Abstract

Mucormycosis is an emerging angioinvasive fungal infection caused by ubiquitous saprophytic filamentous fungus that belongs to the class Zygomycosis. Mucormycosis or black fungus infections in patients with recent COVID-19 infections has given rise to a new epidemic during the second wave of this current COVID-19 pandemic in India. Steroid misuse, poor glycemic control, use of industrial grade oxygen, improper humidification and specific variants strains have resulted in profound immunosuppression and are attributed for the high incidence of COVID associated Mucormycosis (CAM) in India. The aims of the present study were to assess the age and gender specific incidence of CAM, the utility of special stains (PAS and GMS) for diagnosing mucormycosis (false negatives and sensitivity). In the present study emphasis was laid on identifying if there exists a correlation between host response, angioinvasion and bone invasion with mortality. The Present study is a retrospective, cross sectional analytical study taken up in the Department of Pathology, Guntur Medical College for a period of 2 months between 1st of May 2021 to 30th of June 2021. Results were tabulated in Microsoft excel 2016 and SPSS software version 14 was used for calculation of odds ratio and for performing multivariate analysis. All samples were routinely fixed using 10% buffered formalin, processed and sectioned. All the sections were stained with Haematoxylin and Eosin and also special stains for fungus like periodic acid Schiff (PAS) and Gomori Methenamine silver (GMS) were used wherever required. CAM is a serious complication after recovery from COVID-19 infection due to its high morbidity and mortality (13.7% in this series). CAM epidemiology and presentation is mostly similar to non-COVID mucormycosis seen in pre-COVID era.

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

“…In a study by Ganesan et al 5 and Sahu et al 1 diabetes was present in 88% of the cases; in the present study it was 62.5%. Corticosteroid administration was present in 31.5% of patients in the current study however it was 63% in a study by Chaganti et al 14 In a review by Hoenigl et al the systemic corticosteroids were given in 79% of the cases and among these cases 81% patients received systemic corticosteroids before the confirmation of diagnosis of mucormycosis. 15 As per Singh et al diabetes was present in 80% case and steroid use was present in 76.3% cases.…”