Mucor Mycosis and Other Fungal Infections in Covid-19 Patients During Second Wave of Pandemic at a Tertiary Care Hospital

Abstract

Objectives: In India, there has been a sudden Surge in Mucor mycosis cases during second wave of COVID-19, made the Government of India declare it as a notifiable disease. In this background, we did a study to know the fungal etiology of the suspected Mucor mycosis cases and to know the positivity rate of Mucor mycosis in COVID-19 patients during the second wave of the COVID-19 pandemic. Methods: In a retrospective study, we examined different samples from 112 Covid-19 positive, in-patients with suspected Mucor mycosis. A history of risk factors was taken. Potassium hydroxide (KOH) mount was done for all samples followed by culture on Sabouraud’s dextrose agar. Results: 81.25% of total cases were from 31 to 60 years of age group. Diabetes mellitus, steroid therapy, and Intensive care unit admissions were the risk factors observed. Fungal filaments were observed in 37 samples in KOH mount (33%) and culture was positive in 45 samples (40.17%). Mixed infection was seen in two cases (4.44%). The most common fungus isolated was Mucor in 23 samples (48.93%) followed by Aspergillus in 7 cases (14.89%; Aspergillus niger in four cases, Aspergillus fumigatus in 2 cases and Aspergillus flavus in 1 case) and Candida spp in 6 cases (12.76%). Among mixed infections, Mucor and A. niger in one case and Candida and A. niger in another case were isolated. Rhyzopus, Syncephalastrum, Penicillium, and Fusarium were the other fungi isolated. Conclusion: Mucorales were the most common species isolated (63.82%) followed by Aspergillus species. High suspicion and diagnosis of Mucor mycosis in Covid-19 patients is very important to initiate antifungal treatment, to reduce the mortality.