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Invasive Fungal Sinusitis in Post COVID-19 Patients: A New Clinical Entity

Noha Ahmed El-Kholy1, Ahmed Musaad Abd El-Fattah1, Yasser W Khafagy1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

The Laryngoscope
|May 19, 2021
PubMed
Abstract

Insights

Early diagnosis and treatment of invasive fungal sinusitis in COVID-19 patients are crucial. This study highlights the importance of antifungal therapy and surgical debridement for improving survival rates in these critical cases.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Invasive fungal respiratory superinfections are increasingly reported in COVID-19 patients.
  • Acute invasive fungal sinusitis (AIFS) in this population remains under-described.
  • This study focuses on the clinical presentation and management of AIFS in COVID-19 survivors.

Purpose of the Study:

  • To describe the clinical entity of acute invasive fungal sinusitis in patients recovering from COVID-19.
  • To outline the management strategies and outcomes for this specific patient group.

Main Methods:

  • A prospective longitudinal study was conducted.
  • Included patients diagnosed with AIFS post-COVID-19.
  • Treatment involved antifungal agents (amphotericin B, voriconazole, posaconazole) and surgical debridement (restricted for COVID-19 PCR-positive cases).

Main Results:

  • 36 patients (mean age 52.92 years) were included; diabetes was a common comorbidity.
  • Mucor and Aspergillus species were the most frequent fungal pathogens.
  • High rates of sino-nasal, orbital, and cerebral involvement were observed, with facial pain and visual loss as common symptoms.

Conclusions:

  • Early clinical suspicion of AIFS in COVID-19 patients is vital.
  • Prompt management with antifungal therapy and surgical debridement improves outcomes.
  • Aggressive treatment is essential for increasing survival rates in this vulnerable population.
Keywords:
COVID-19Invasive fungal infectionSARS-CoV-2sinusitis

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