Incidence and Screening for Rhino-cerebral Mucormycosis and other fungal infections in patients with COVID-19

AbstractBackground & Objectives: Mucormycosis is a fungal infection which mainly affects immunocompromisedpatients and the cases showed an upward trend coinciding with the second wave of COVID-19 pandemic inIndia. Considering the poor prognosis of established mucormycosis cases, it is worthwhile to identify them atearliest within COVID-19 patients. The objective of this study was to monitor COVID-19 patients prospectivelyfor mucor spp..and other fungal infections via detailed microbiological analysis of their nasal wash samples.Materials and Methods: COVID-19 patients were called upon at every week interval for one month after theirCOVID-19 infection and their nasal wash samples were subjected to KOH mount, Gram staining, Calcofluorwhite staining, SDA culture and LPCB mount. Results: A total of 297 samples were derived from 90 patients.16(5.3%) were positive for fungal elements in KOH and calcofluor staining. Culture of samples on SDA agarshowed that 13(4.3%) samples had Mucor spp. All 13 patients were hyperglycemic during their course ofCOVID-19. Conclusions:Around 4.3% nasal wash samples of COVID-19 immunocompromised patients takenwithin two weeks of COVID-19 infection demonstrated definite growth for mucor spp.. These patients could beclosely monitored for mucormycosis symptoms/complications and timely interventions could be providedtherein.