Invasive Fungal Sinusitis in Post-COVID-19 Patients with Diabetes Mellitus

Invasive fungal sinusitis for example mucormycosis, aspergillosis, etc. is manifested particularly in immunocompromised patients and specifically those with diabetes mellitus. Mucormycosis is highly invasive and relentlessly progressive, resulting in higher rates of morbidity and mortality than many other infections.

So the present study aimed to determine the factors that lead to the development, the natural history of progression and the therapeutic interventions done for this grave complication in COVID patients.

Study included patients admitted in general medicine ward in King Edward Memorial (KEM) Hospital, Mumbai. Advised Investigations- imaging studies like CT scan, MRI done were noted down. Operative procedures like functional endoscopic sinus surgery (FESS), abscess drainage, dental extraction, were performed at the hospital and details were taken. Fungal cultures, sugar monitoring, liver function test, renal function test, complete blood counts, ECGs, chest X-rays, and amphotericin charting were also done.

On retrospective analysis of the presenting patient's records, they found that all patients had received steroids for COVID-19 treatment and had co-morbidities, especially diabetes mellitus. Prolonged hospitalization further exposes the patient to various multi-resistant bacteria making them prone to various secondary infections.

So this study brings out the fact that physicians need to know the associated risk factors, that may lead to invasive fungal co-infection in COVID-19 patients, and to regularly examine the patient for any developing signs so appropriate diagnosis and treatment can be initiated as early as possible.

It is an unrelenting disease process that requires the utmost care.

Reference:

Ingle C, Goyal A, Hange S. Invasive Fungal Sinusitis in Post-COVID-19 Patients with Diabetes Mellitus. J Assoc Physicians India 2022;70(11):75–78.