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Epidemic in pandemic: Fungal sinusitis in COVID-19

Ripu Daman Arora1, Nitin M Nagarkar1, K S B S Krishna Sasanka1

  • 1Department of Otolaryngology and Head and Neck Surgery, AIIMS, Raipur, Chhattisgarh, India.

Journal of Family Medicine and Primary Care
|April 1, 2022
PubMed
Abstract

Insights

COVID-19 survivors are at high risk for invasive fungal infections like mucormycosis. Uncontrolled diabetes and steroid use significantly worsen these fungal infections, particularly in the paranasal sinuses.

Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic has seen a rise in invasive fungal infections, particularly mucormycosis and aspergillosis.
  • These infections often affect patients with a history of COVID-19, especially those with specific risk factors.

Observation:

  • A study evaluated 24 patients with invasive fungal lesions following COVID-19.
  • All patients had paranasal sinus involvement, with orbital, palatal, and cerebral extensions noted in a significant number.
  • Comorbidities like type 2 diabetes and the use of steroids were prevalent.

Findings:

  • Uncontrolled type 2 diabetes, excessive steroid use, elevated ferritin, and low hemoglobin were identified as key factors exacerbating mucormycosis.
  • Paranasal sinus involvement was universal, highlighting its critical role in the clinical presentation.

Implications:

  • Early recognition and management of invasive fungal infections in post-COVID-19 patients are crucial.
  • Aggressive management of diabetes and judicious use of steroids are essential to mitigate the risk and severity of these infections.
Keywords:
Amphotericin BCOVID-19invasive mucormycosisparanasal sinusessteroids

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