Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study

Introduction: In India, especially in Southern part of the country during the second wave of the pandemic there has been a sudden surge of rhino-orbital invasion by various fungi like Fusarium, Mucor, Aspergillus etc., in post Coronavirus Disease-2019 (COVID-19) patients. Several risk factors have b...

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Main Authors: BM Shanker Venkatesh, P Ganga Bhavani, K Manjusha, Sania Sultana
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-02-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/16003/52209_CE[Ra1]_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf
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author BM Shanker Venkatesh
P Ganga Bhavani
K Manjusha
Sania Sultana
author_facet BM Shanker Venkatesh
P Ganga Bhavani
K Manjusha
Sania Sultana
author_sort BM Shanker Venkatesh
collection DOAJ
description Introduction: In India, especially in Southern part of the country during the second wave of the pandemic there has been a sudden surge of rhino-orbital invasion by various fungi like Fusarium, Mucor, Aspergillus etc., in post Coronavirus Disease-2019 (COVID-19) patients. Several risk factors have been attributed like lowering of cell-mediated immunity by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), lymphopenia and associated reduction in CD4+ (Cluster of Differentiation) and CD8+ cell population, Steroid-induced hyperglycaemia, immunosuppression, and uncontrolled diabetes. Aim: To detect rhino-orbital fungal conquering post COVID-19 cases. Materials and Methods: This was a cross-sectional study done at a tertiary eye care centre in Hyderabad, between May to June 2021 and the study subjects were post COVID-19 patients with fungal invasion reporting to Government SD Eye Hospital and Government ENT Hospital Hyderabad, India. The patients were evaluated for associated co-morbidities, location of fungal infection, use of steroids, oxygen therapy usage and microbiologically identified the causative fungi. Descriptive analysis was done and data was presented as numbers and percentages were calculated. Results: Overall, 470 cases of post COVID-19 suspected fungal invasion cases were referred from the Ophthalmology and Ear, Nose, and Throat (ENT) Departments, of which 287 (61.06%) cases were culture positive for various fungal elements. Fusarium spp. was predominantly seen in 165 (57.49%) cases followed by Aspergillus spp. in 71 (24.74%) cases, Mucor was isolated in 42 (14.64%) cases and other fungi like Candida spp. were isolated in 5 (1.74%) cases and Bipolaris spp. was seen in 4 (1.39%) cases. Pre-existing Diabetes Mellitus (DM) was present in 233 (81.18%) cases, cases, corticosteroid intake for the treatment of COVID-19 was recorded in 203 (70.73%) cases and oxygen therapy was administered in 160 (55.74%) cases. Conclusion: As per the evaluation especially in post COVID-19 patients there seems to be a nexus between diabetes, imprudent use of steroids, decreased immune status, inappropriate use of oxygen therapy and invasion of fungi, therefore cautious and prudent use of the steroids and oxygen among the COVID-19 treatment protocol is advised.
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spelling doaj.art-c9690b85cd9e478aaf95115cdd710ead2023-02-04T05:07:16ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-02-01162DC15DC1910.7860/JCDR/2022/52209.16003Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional StudyBM Shanker Venkatesh0P Ganga Bhavani1K Manjusha2Sania Sultana3Professor, Department of Microbiology, Sarojini Devi Eye Hospital/Osmania Medical College, Hyderabad, Telangana, India.Assistant Professor, Department of Microbiology, Sarojini Devi Eye Hospital/Osmania Medical College, Hyderabad, Telangana, India.Postgraduate Trainee, Department of Microbiology, Sarojini Devi Eye Hospital/Osmania Medical College, Hyderabad, Telangana, India.Postgraduate Trainee, Department of Microbiology, Sarojini Devi Eye Hospital/Osmania Medical College, Hyderabad, Telangana, India.Introduction: In India, especially in Southern part of the country during the second wave of the pandemic there has been a sudden surge of rhino-orbital invasion by various fungi like Fusarium, Mucor, Aspergillus etc., in post Coronavirus Disease-2019 (COVID-19) patients. Several risk factors have been attributed like lowering of cell-mediated immunity by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), lymphopenia and associated reduction in CD4+ (Cluster of Differentiation) and CD8+ cell population, Steroid-induced hyperglycaemia, immunosuppression, and uncontrolled diabetes. Aim: To detect rhino-orbital fungal conquering post COVID-19 cases. Materials and Methods: This was a cross-sectional study done at a tertiary eye care centre in Hyderabad, between May to June 2021 and the study subjects were post COVID-19 patients with fungal invasion reporting to Government SD Eye Hospital and Government ENT Hospital Hyderabad, India. The patients were evaluated for associated co-morbidities, location of fungal infection, use of steroids, oxygen therapy usage and microbiologically identified the causative fungi. Descriptive analysis was done and data was presented as numbers and percentages were calculated. Results: Overall, 470 cases of post COVID-19 suspected fungal invasion cases were referred from the Ophthalmology and Ear, Nose, and Throat (ENT) Departments, of which 287 (61.06%) cases were culture positive for various fungal elements. Fusarium spp. was predominantly seen in 165 (57.49%) cases followed by Aspergillus spp. in 71 (24.74%) cases, Mucor was isolated in 42 (14.64%) cases and other fungi like Candida spp. were isolated in 5 (1.74%) cases and Bipolaris spp. was seen in 4 (1.39%) cases. Pre-existing Diabetes Mellitus (DM) was present in 233 (81.18%) cases, cases, corticosteroid intake for the treatment of COVID-19 was recorded in 203 (70.73%) cases and oxygen therapy was administered in 160 (55.74%) cases. Conclusion: As per the evaluation especially in post COVID-19 patients there seems to be a nexus between diabetes, imprudent use of steroids, decreased immune status, inappropriate use of oxygen therapy and invasion of fungi, therefore cautious and prudent use of the steroids and oxygen among the COVID-19 treatment protocol is advised.https://www.jcdr.net/articles/PDF/16003/52209_CE[Ra1]_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdfaspergilluscoronavirus disease-2019diabetes mellitusfusariummucorsteroid therapy
spellingShingle BM Shanker Venkatesh
P Ganga Bhavani
K Manjusha
Sania Sultana
Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
Journal of Clinical and Diagnostic Research
aspergillus
coronavirus disease-2019
diabetes mellitus
fusarium
mucor
steroid therapy
title Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
title_full Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
title_fullStr Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
title_full_unstemmed Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
title_short Rhino-orbital Fungal Invasion in Post COVID-19 Cases at a Tertiary Eye Care Centre in Hyderabad- A Cross-sectional Study
title_sort rhino orbital fungal invasion in post covid 19 cases at a tertiary eye care centre in hyderabad a cross sectional study
topic aspergillus
coronavirus disease-2019
diabetes mellitus
fusarium
mucor
steroid therapy
url https://www.jcdr.net/articles/PDF/16003/52209_CE[Ra1]_F(KR)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf
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