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

Published online by Cambridge University Press:  08 April 2021

S Sharma
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
M Grover*
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
S Bhargava
Affiliation:
Department of Pathology, Sawai Man Singh Medical College and Hospital, Jaipur, India
S Samdani
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
T Kataria
Affiliation:
Department of Otorhinolaryngology and Head Neck Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, India
*
Author for correspondence: Dr Mohnish Grover, 8/250, Captain Amit Bharadwaj Marg, Malviya Nagar, Jaipur, Rajasthan, India E-mail: drmohnish.aiims@gmail.com

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.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr S Sharma takes responsibility for the integrity of the content of the paper

References

Wuhan City Health Committee. Wuhan Municipal Health and Health Commission's briefing on the current pneumonia epidemic situation in our city 2019. In: http://wjw.wuhan.gov.cn/front/web/showDetail/2019123108989 [14 January 2020]Google Scholar
Frazier, KM, Hooper, JE, Mostafa, HH, Stewart, CM. SARS-CoV-2 virus isolated from the mastoid and middle ear: implications for COVID-19 precautions during ear surgery. JAMA Otolaryngol Head Neck Surg 2020;146:964–6CrossRefGoogle ScholarPubMed
DeShazo, RD. Fungal sinusitis. Am J Med Sci 1998;316:3944Google ScholarPubMed
Ferguson, BJ. Definitions of fungal rhinosinusitis. Otolaryngol Clin North Am 2000;33:227–35CrossRefGoogle ScholarPubMed
Chakrabarti, A, Denning, DW, Ferguson, BJ, Ponikau, J, Buzina, W, Kita, H et al. Fungal rhinosinusitis: a categorization and definitional schema addressing current controversies. Laryngoscope 2009;119:1809–18CrossRefGoogle ScholarPubMed
Scheckenbach, K, Cornely, O, Hoffmann, TK, Engers, R, Bier, H, Chaker, A et al. Emerging therapeutic options in fulminant invasive rhinocerebral mucormycosis. Auris Nasus Larynx 2010;37:322–8CrossRefGoogle ScholarPubMed
Vairaktaris, E, Moschos, MM, Vassiliou, S, Baltatzis, S, Kalimeras, E, Avgoustidis, D et al. Orbital cellulitis, orbital subperiosteal and intraorbital abscess. Report of three cases and review of the literature. J Craniomaxillofac Surg 2009;37:132–6CrossRefGoogle ScholarPubMed
Mohindra, S, Mohindra, S, Gupta, R, Bakshi, J, Gupta, SK. Rhinocerebral mucormycosis: the disease spectrum in 27 patients. Mycoses 2007;50:290–6CrossRefGoogle ScholarPubMed
Munir, N, Jones, NS. Rhinocerebral mucormycosis with orbital and intracranial extension: a case report and review of optimum management. J Laryngol Otol 2007;121:192–5CrossRefGoogle ScholarPubMed
DeShazo, RD, Chapin, K, Swain, RE. Fungal sinusitis. N Engl J Med 1997;337:254–9CrossRefGoogle ScholarPubMed
Gillespie, MB, O'Malley, BW. An algorithmic approach to the diagnosis and management of invasive fungal rhinosinusitis in the immunocompromised patient. Otolaryngol Clin North Am 2000;33:323–34CrossRefGoogle ScholarPubMed
Ballester, DG, González-García, R, García, CM, Ruiz-Laza, L, Gil, FM. Mucormycosis of the head and neck: report of five cases with different presentations. J Craniomaxillofac Surg 2012;40:584–91CrossRefGoogle Scholar
Chen, N, Zhou, M, Dong, X, Qu, J, Gong, F, Han, Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–13CrossRefGoogle ScholarPubMed
Song, G, Liang, G, Liu, W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 2020;185:599606Google ScholarPubMed
Yang, X, Yu, Y, Xu, J, Shu, H, Liu, H, Wu, Y et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8:475–81CrossRefGoogle ScholarPubMed
Gangneux, JP, Bougnoux, ME, Dannaoui, E, Cornet, M, Ralph, ZJ. Invasive fungal diseases during COVID-19: we should be prepared. J Mycol Med 2020;30:100971CrossRefGoogle ScholarPubMed
Mehta, S, Pandey, A. Rhino-orbital mucormycosis associated with COVID-19. Cureus 2020;12:e10726Google ScholarPubMed
Paltauf, A. Mycosis mucorina. Virchows Arch Pathol Anat Physiol Klin Med 1885;102:543–64CrossRefGoogle Scholar
Arnáiz-García, ME, Alonso-Peña, D, González-Vela Mdel, C, García-Palomo, JD, Sanz-Giménez-Rico, JR, Arnáiz-García, AM. Cutaneous mucormycosis: report of five cases and review of the literature. J Plast Reconstr Aesthet Surg 2009;62:e434–41CrossRefGoogle ScholarPubMed
Werthman-Ehrenreich, A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med 2021;42:264.e5264.e8CrossRefGoogle Scholar
Wang, Y, Wang, Y, Chen, Y, Qin, Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 2020;92:568–76CrossRefGoogle ScholarPubMed
Yang, W, Cao, Q, Qin, L, Wang, X, Cheng, Z, Pan, A et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect 2020;80:388–93CrossRefGoogle ScholarPubMed
Zhang, Y, Li, WX, Huang, KW, Cao, ZX, Hao, JY. Hospital acquired pneumonia occurring after acute stage of the serious SARS and its treating strategies. Chin J Nosocomiol 2003;11:1081–7Google Scholar
Yin, CH, Wang, C, Tang, Z, Zhang, SW, Wang, BS. Clinical analysis of 146 patients with critical severe acute respiratory syndrome in Beijing areas. Clin J Emerg Med 2004;1:1214Google Scholar
Li, CS, Pan, SF. Analysis and causation discussion of 185 severe acute respiratory syndrome dead cases [in Chinese]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2003;15:582–4Google Scholar
Peeri, NC, Shrestha, N, Rahman, MS, Zaki, R, Tan, Z, Bibi, S et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol 2020;49:717–26CrossRefGoogle ScholarPubMed
White, L, Dhillon, R, Cordey, A, Hughes, H, Faggian, F, Soni, S et al. A national strategy to diagnose coronavirus disease 2019 – associated invasive fungal disease in the intensive care unit. Clin Infect Dis 2020;ciaa1298CrossRefGoogle Scholar
Rawson, TM, Moore, LS, Zhu, N, Ranganathan, N, Skolimowska, K, Gilchrist, M et al. Bacterial and fungal coinfection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis 2020;71:2459–68Google ScholarPubMed
RECOVERY Collaborative Group, Horby, P, Lim, WS, Emberson, JR, Mafham, M, Bell, JL et al. Dexamethasone in hospitalized patients with Covid-19--preliminary report. N Engl J Med 2021;384:693704Google Scholar
National Institutes of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines. In: https://www.covid19treatmentguidelines.nih.gov/ [15 July 2020]Google Scholar
Elinav, H, Zimhony, O, Cohen, MJ, Marcovich, AL, Benenson, S. Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature. Clin Microbiol Infect 2009;15:693–7CrossRefGoogle ScholarPubMed
Goldstein, EJ, Spellberg, B, Walsh, TJ, Kontoyiannis, DP, Edwards, J Jr, Ibrahim, AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 2009;48:1743–51Google Scholar
Jung, SH, Kim, SW, Park, CS, Song, CE, Cho, JH, Lee, JH et al. Rhinocerebral mucormycosis: consideration of prognostic factors and treatment modality. Auris Nasus Larynx 2009;36:274–9CrossRefGoogle ScholarPubMed