Post COVID-19 mucormycosis- histopathology and associated factors

Introduction: SARS-COV-2 infection (COVID-19) may be associated with wide range of bacterial and fungal infections. Mucormycosis is a common and potentially life threatening opportunistic fungal infection responsible for morbidity and mortality. Many factors like diabetes mellitus, hypertension and corticosteroid therapy might have been a role in the immunocompromised state of the patients. The aim of present study was to know the predisposing factors and role of histopathology in diagnosis and assessing the prognosis of post COVID-19 mucormycosis cases. Material and methods: It is a prospective observational study conducted in tertiary care hospital over a period of 6 months from April 2021 to September 2021. Functional endoscopic sinus surgery (FESS) and maxillectomy samples from 157 post COVID-19 mucormycosis suspected cases were studied and details regarding history of diabetes mellitus, hypertension and corticosteroid therapy were retrieved. All tissue samples were examined under H&E stain and special fungal stain (PAS). Results: On histopathological examination, out of total 157 cases, 94 cases were found to be positive for mucormycosis. Of these 94 cases, 63 were males and 31 were females. Age range was from 23 to 75 years. 5 cases showed mixed mucormycosis and aspergillosis infection. Also out of 94 post COVID mucormycosis cases, 72 were diabetic, 21 were hypertensive and 68 had a history of corticosteroid intake for treatment of COVID-19 infection. Conclusion: Histopathology plays a pivotal role in accurate diagnosis and assessing the severity and invasiveness of mucormycosis. Diabetes mellitus and corticosteroid use are the important associated factors. Keywords: post COVID -19; mucormycosis; daibetes; steroid therapy