The expanding cohort of aspergillosis and mixed fungal infections in covid 19 pandemic: our experience

Introduction-This study is aimed to present the clinical features, incidence, associated complications and management strategies in post Covid aspergillosis and mixed fungal infections at a tertiary health care setup. The development of Aspergillosis in Post Covid patients is a novel presentation of the fungus and with the advent of new data, our horizons regarding the association of Apsergillosis and Covid is ever expanding. Currently, the causation of invasive fungal sinusitis in the form of Mucormycosis has been well documented. However, with new data and going by the fungal culture reports, the incidence of mixed fungal infections and aspergillosis has not been well studied, and the clinical features and management strategies is an evolving spectrum on which we plan to shed some light. Materials and Methods- This is an observational prospective study conducted by us at a Tertiary Health Set up where patients presented with complains of nasal pain, facial pain, ptosis, proptosis , facial asymmetry and with scans suggestive of sinusitis with history of Covid, and clinical suspicion of invasive fungal sinusitis were evaluated. Subsequently, nasal crusts were sent for KOH and Fungal culture. After reviewing of the scans and evaluating the KOH report, these patients were posted for endoscopic sinus surgery with debridement. Conclusion-Thus, Aspergillosis should also be a cause for suspicion especially in post Covid patients, as a reason for invasive fungal sinusitis. Early treatment can help in early recovery and less morbidity, a direct association has been detected with Diabetes Mellitus and Aspergillosis, thus controlling blood sugar levels is of utmost importance in the management of these patients Incessant use of steroids should be avoided as it is a significant risk factor in the development of post Covid Aspergillosis could not be derived.