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Covid-19-Associated Mucormycosis: Histopathology of the Deadly Fungal Infection

Nidhi Anand1, Pallavi Srivastava1, Ashish Chandra Agrawal2

  • 1Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

International Archives of Otorhinolaryngology
|April 15, 2024
PubMed

Insights

COVID-19 significantly increased rhino-orbital-cerebral mucormycosis cases in India, particularly in diabetic patients. Early diagnosis and treatment are vital for managing this lethal fungal infection and improving patient outcomes.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Ophthalmology

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic saw a surge in rhino-orbital-cerebral mucormycosis, especially in India.
  • Diabetes mellitus is a known risk factor for both COVID-19 and mucormycosis.
  • Mucormycosis is a severe, invasive fungal infection with high mortality rates.

Purpose of the Study:

  • To detail the clinical presentation and histopathological characteristics of mucormycosis in COVID-19 patients.
  • To analyze the outcomes of mucormycosis in the context of COVID-19 infection.
  • To identify key risk factors and common clinical manifestations associated with this co-infection.

Main Methods:

  • A cross-sectional study analyzed biopsy samples and scrapings from 38 COVID-19 patients with suspected mucormycosis.
  • Histopathological evaluation included Hematoxylin & Eosin (H&E) staining, along with Grocott-Gomori methenamine-silver and Periodic acid-Schiff stains.
  • Clinical data, comorbidities, treatment history, and presenting symptoms were recorded and analyzed.

Main Results:

  • The study population (n=38) had a male predominance (2.5:1) and a mean age of 53 years.
  • Diabetes (68.4%), steroid intake (84.2%), and supplemental oxygen (55.3%) were common comorbidities/treatments.
  • Common symptoms included nasal blockage, discharge, eye pain, headache, and altered mentation. Histopathology revealed broad, irregular, nonseptate hyphae in 76.3% of cases.

Conclusions:

  • COVID-19 acted as a significant trigger for invasive mucormycosis, presenting as a lethal complication.
  • High prevalence of diabetes and steroid use underscores the importance of vigilant monitoring in at-risk COVID-19 patients.
  • Prompt diagnosis and aggressive management are critical for improving survival rates in COVID-19-associated mucormycosis.
Keywords:
COVID-19histopathologymucormycosisrhino-orbital-cerebral

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