4.1 Article

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

Journal

JOURNAL OF LARYNGOLOGY AND OTOLOGY
Volume 135, Issue 5, Pages 442-447

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0022215121000992

Keywords

Coronavirus; Covid-19; SARS-CoV-2 Infection; Mucormycosis; Mucorales Infection

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A study found an association between coronavirus disease and fungal infection of the paranasal sinuses, with ethmoids being the most commonly affected sinuses. Intra-orbital extension occurred in 43.47% of cases, while intracranial extension was seen in only 8.69% of cases. Twenty-one out of 23 patients had diabetes mellitus, with 12 cases being uncontrolled, and all patients had a history of steroid use during their coronavirus treatment.
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.

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