A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India
Background and Purpose: Morbidity and mortality of opportunistic fungal infections in COVID-19 patients are less studied and defined. The patients receiving immunosuppressive therapy, broad-spectrum antibiotics, corticosteroids, and invasive and non-invasive ventilation are the high-risk groups.Mate...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Mazandaran University of Medical Sciences
2023-03-01
|
| Series: | Current Medical Mycology |
| Subjects: | |
| Online Access: | http://cmm.mazums.ac.ir/article_150667_6a904aac872d3ada1f732d22b9d65892.pdf |
| _version_ | 1827805914732691456 |
|---|---|
| author | Sujata Raychaudhuri Juhi Taneja Jaseetha Sasidharan Mukta Pujani Kanika Singh Tathagata Chatterjee Manjula Jain Rajkumar Chandoke Anil Rai Zafar Abbas Asim Das |
| author_facet | Sujata Raychaudhuri Juhi Taneja Jaseetha Sasidharan Mukta Pujani Kanika Singh Tathagata Chatterjee Manjula Jain Rajkumar Chandoke Anil Rai Zafar Abbas Asim Das |
| author_sort | Sujata Raychaudhuri |
| collection | DOAJ |
| description | Background and Purpose: Morbidity and mortality of opportunistic fungal infections in COVID-19 patients are less studied and defined. The patients receiving immunosuppressive therapy, broad-spectrum antibiotics, corticosteroids, and invasive and non-invasive ventilation are the high-risk groups.Materials and Methods: The demographic profile as well as clinical and radiological findings of all the patients with COVID-19 suspected of Mucormycosis (MM) were recorded. The tissue samples from all the patients were sent for microbiological (KOH mount and culture) and histopathological analysis for confirmation of MM.Results: In total, 45 COVID-19 patients suspected of MM were included in the study an MM was confirmed in 42 patients. The mean age of the patients was 50.30±14.17 years with a female: male ratio of 1.1:1. The most common symptom was headache (52.38%) followed by purulent nasal discharge (38.09%) and facial pain in 33.33% of the cases. The ocular symptoms included a diminution of vision (33.33%) and redness of the eye (2.38%).The most common site of involvement was rhino-orbital (42.85%) followed by sinonasal (23.80%) and rhino cerebral (19.04%). Majority (38.09%) of the patients were diagnosed with stage II of Rhino-orbital-cerebral Mucormycosis (ROCM) based on radiology. A history of diabetes mellitus and steroids was present in 97.61% and 85.71% of the cases, respectively. Moreover, KOH was positive for MM in 97.61% of the cases while the culture was positive in only 35.71% of the cases. In addition, on histopathology, MM was confirmed in 64.28 % of the cases. Mixed growth with Aspergillus species and Rhizopus species was observed in 14.28% of the cases in culture and 11.90% of the cases in histopathology test. Furthermore, angioinvasion was found in 23.80% of the cases according to the histopathology test.Conclusion: Based on the results, the most common conditions associated with MM in COVID-19 patients were diabetes mellitus and steroid therapy. A high level of clinical suspicion aided with diagnostic tests, including KOH mount, culture, histopathology, and radiology which helped the early detection of opportunistic fungal infection in COVID-19 patients to ensure timely treatment. |
| first_indexed | 2024-03-11T21:34:00Z |
| format | Article |
| id | doaj.art-95924029527d48ecba06d97ad1ef1f2b |
| institution | Directory Open Access Journal |
| issn | 2423-3439 2423-3420 |
| language | English |
| last_indexed | 2024-03-11T21:34:00Z |
| publishDate | 2023-03-01 |
| publisher | Mazandaran University of Medical Sciences |
| record_format | Article |
| series | Current Medical Mycology |
| spelling | doaj.art-95924029527d48ecba06d97ad1ef1f2b2023-09-27T05:39:49ZengMazandaran University of Medical SciencesCurrent Medical Mycology2423-34392423-34202023-03-01911710.22034/cmm.2023.150667150667A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in IndiaSujata Raychaudhuri0Juhi Taneja1Jaseetha Sasidharan2Mukta Pujani3Kanika Singh4Tathagata Chatterjee5Manjula Jain6Rajkumar Chandoke7Anil Rai8Zafar Abbas9Asim Das10Department of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Microbiology, ESIC Medical College and Hospital, Faridabad, IndiaDepartment of Ear, Nose, and Throat, ESIC Medical College and Hospital, Faridabad, IndiaDepartment of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Pathology, ESIC Medical College and Hospital Faridabad, IndiaDepartment of Ear, Nose, and Throat, ESIC Medical College and Hospital, Faridabad, IndiaDepartment of Radio Diagnosis, ESIC Medical College and Hospital, Faridabad, IndiaDepartment of Physiology, ESIC Medical college and Hospital, Faridabad, IndiaBackground and Purpose: Morbidity and mortality of opportunistic fungal infections in COVID-19 patients are less studied and defined. The patients receiving immunosuppressive therapy, broad-spectrum antibiotics, corticosteroids, and invasive and non-invasive ventilation are the high-risk groups.Materials and Methods: The demographic profile as well as clinical and radiological findings of all the patients with COVID-19 suspected of Mucormycosis (MM) were recorded. The tissue samples from all the patients were sent for microbiological (KOH mount and culture) and histopathological analysis for confirmation of MM.Results: In total, 45 COVID-19 patients suspected of MM were included in the study an MM was confirmed in 42 patients. The mean age of the patients was 50.30±14.17 years with a female: male ratio of 1.1:1. The most common symptom was headache (52.38%) followed by purulent nasal discharge (38.09%) and facial pain in 33.33% of the cases. The ocular symptoms included a diminution of vision (33.33%) and redness of the eye (2.38%).The most common site of involvement was rhino-orbital (42.85%) followed by sinonasal (23.80%) and rhino cerebral (19.04%). Majority (38.09%) of the patients were diagnosed with stage II of Rhino-orbital-cerebral Mucormycosis (ROCM) based on radiology. A history of diabetes mellitus and steroids was present in 97.61% and 85.71% of the cases, respectively. Moreover, KOH was positive for MM in 97.61% of the cases while the culture was positive in only 35.71% of the cases. In addition, on histopathology, MM was confirmed in 64.28 % of the cases. Mixed growth with Aspergillus species and Rhizopus species was observed in 14.28% of the cases in culture and 11.90% of the cases in histopathology test. Furthermore, angioinvasion was found in 23.80% of the cases according to the histopathology test.Conclusion: Based on the results, the most common conditions associated with MM in COVID-19 patients were diabetes mellitus and steroid therapy. A high level of clinical suspicion aided with diagnostic tests, including KOH mount, culture, histopathology, and radiology which helped the early detection of opportunistic fungal infection in COVID-19 patients to ensure timely treatment.http://cmm.mazums.ac.ir/article_150667_6a904aac872d3ada1f732d22b9d65892.pdfaspergillosiscovid-19indiamucormycosis |
| spellingShingle | Sujata Raychaudhuri Juhi Taneja Jaseetha Sasidharan Mukta Pujani Kanika Singh Tathagata Chatterjee Manjula Jain Rajkumar Chandoke Anil Rai Zafar Abbas Asim Das A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India Current Medical Mycology aspergillosis covid-19 india mucormycosis |
| title | A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India |
| title_full | A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India |
| title_fullStr | A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India |
| title_full_unstemmed | A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India |
| title_short | A critical appraisal of mucormycosis in COVID- 19 patients in a tertiary care centre in India |
| title_sort | critical appraisal of mucormycosis in covid 19 patients in a tertiary care centre in india |
| topic | aspergillosis covid-19 india mucormycosis |
| url | http://cmm.mazums.ac.ir/article_150667_6a904aac872d3ada1f732d22b9d65892.pdf |
| work_keys_str_mv | AT sujataraychaudhuri acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT juhitaneja acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT jaseethasasidharan acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT muktapujani acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT kanikasingh acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT tathagatachatterjee acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT manjulajain acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT rajkumarchandoke acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT anilrai acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT zafarabbas acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT asimdas acriticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT sujataraychaudhuri criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT juhitaneja criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT jaseethasasidharan criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT muktapujani criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT kanikasingh criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT tathagatachatterjee criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT manjulajain criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT rajkumarchandoke criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT anilrai criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT zafarabbas criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia AT asimdas criticalappraisalofmucormycosisincovid19patientsinatertiarycarecentreinindia |