Spectrum of Opportunistic Fungal Infections in Covid-19 Affected Patients in a Tertiary Care Hospital

Abstract

Background and aim: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread around the world. COVID-19 patients particularly those with Diabetes, Critically ill and Immunocompromised patients have higher probability of suffering from opportunistic fungal infections. Treatment of COVID19 with immunosuppressive agents (e.g. corticosteroids and cytokine blockers) remains a complicated challenge, especially among patients with severe disease which may increase the risk of invasive fungal infections. We studied the association of risk factors in COVID-19 affected patients leading to opportunistic fungal infections. A cross-sectional observationa Materials and Methods: l study was conducted on a total number of 500 clinically suspected cases of fungal infection attending ENT outpatient department during May 2021 to August 2021. Samples were processed and identied by direct microscopy and culture. A total number of 500 clinically susp Results: ected cases were screened for microscopy and culture. Of which 324 cases (64.8%) identied with fungal growth. Among these 324 cases, 51.5% were Aspergillosis, 31.4% were Mucormycosis, 12.9% were Candidiasis, 2.4% were mixed infection with Mucormycosis and Aspergillosis and 1.5% were identied with other opportunistic fungi. Out of 324 cases, known diabetics were 50% and non-diabetic with increase blood glucose levels were 22.8% and on steroid therapy were 66.3%. Most of the cases were presented in the recovery phase of COVID-19 (74%) than during the active phase (26%) of the infection. COVID-19 is associated with secondary fungal infections due to im Conclusion: mune dysregulation and the wide spread use of immunomodulatory drugs along with certain risk factors like diabetes mellitus and immunocompromised conditions. Judicious use of steroids and stringent glycemic control can prevent the severity of the disease. Early recognition of this life threatening infection is the key to allow for optimal treatment and improved outcomes.