CT Findings of COVID-19–associated Pulmonary Mucormycosis: A Case Series and Literature Review

Abstract

Dept. of Radiodiagnosis and ImagingPGIMER. Chandigarh. Sector-12 "In Press" papers have undergone full peer review and have been accepted for publication in Radiology. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.

Pulmonary mucormycosis in the aftermath of critical COVID-19 in an immunocompromised patient: Mind the diagnostic gap

“…Sen et al confirms findings of the previous review including high proportions of diabetic and corticoid treated patients amongst the ROCM cases. However, Sen et al report a lower mortality rate of 14%, which likely reflects that the CAM patients with highest mortality, such as pulmonary mucormycosis [7] , where not included in their report.…”

“…Bronchoscopy is not always possible due to severe respiratory distress or to the risk of transmission of SARS-CoV-2 associated with aerosol generating procedures. Culture of BAL-F has a low sensitivity (≈50%) and the radiographic changes of COVID-associated pulmonary fungal infection are often unspecific [ 7 , 14 ]. Our case was first diagnosed with probable invasive pulmonary aspergillosis on the basis of the ECMM/ISHAM consensus criteria for CAPA [14] , whereof the patient fulfilled 1) the host factor criteria due to need of intensive care, 2) the clinical criteria in terms of symptoms and chest CT findings and 3) the mycological criteria with evidence of aspergillosis with a GM index ≥0.5 in serum.…”

Serum iron indices in COVID‐19‐associated mucormycosis: A case–control study

“…5 Moreover, nearly two-thirds of the CAM subjects had rhino-orbito-cerebral (53%) and pulmonary (14%) involvement, sites known to have higher mortality. 17,31 Finally, our study is not without limitations. The major limitation is the small number of cases and controls from a single centre.…”

Residual Lung Lesions at 1-year CT after COVID-19

“…Finally, in patients with a CT DAD-pattern, a condition of prolonged ICU stay, early and inappropriate use of corticosteroids, virus-induced immune dysregulation, and concurrent use of immunomodulatory drugs, may have led to pulmonary fungal infections. These include COVID-19-associated pulmonary aspergillosis (9) and COVID-19-associated pulmonary mucormycosis (10). Such ongoing pulmonary fungal infections or healing status of these infections may have changed the features on CTs obtained at one-year follow-up.…”