Post coronavirus disease mucormycosis: a deadly addition to the pandemic spectrum

Abstract

Objective: To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease.

Methods: A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection.

Results: Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment.

Conclusion: New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.

Keywords: Coronavirus; Covid-19; Mucorales Infection; Mucormycosis; SARS-CoV-2 Infection.

Fig. 1.

(a–c) Coronal, non-contrast computed tomography scans of the paranasal sinuses, showing involvement of the sinuses with intracranial involvement.

Fig. 2.

(a–f) Axial, magnetic resonance imaging scans showing intra-orbital extension of mucormycosis.

Fig. 3.

(a–h) Coronal, magnetic resonance imaging scans showing intra-orbital extension of mucormycosis.