Radiological findings of mucormycosis rhinosinusitis among Indian COVID-19 patients during the pandemic second wave

Abstract

Background Sinonasal mucormycosis is a quickly progressing and lethal fungal disease which showed an increased incidence in COVID-19 patients in the Indian population during the second wave of the pandemic. The objective of this study was to study the various sinus areas affected and the imaging findings of the disease. Methods The imaging records of patients with sinonasal mucormycosis during the second wave of the COVID-19 pandemic were reviewed and analysed for whom computed tomography (CT) and/or magnetic resonance imaging (MRI) images had been performed. Results Of the 65 patients, 6.1% had single sinus involvement, and 93.9% had multiple sinus involvement, and out of latter, 91.8% had bilateral sinuses affected by the disease process. A total of 49.2% patients with sinus involvement had erosions of the sinus walls. A total of 35.4% patients had only sinonasal mucormycosis, 38.5% patients had rhino-orbital mucormycosis, 4.6% patients had rhino-cerebral mucormycosis and 16.9% patients had rhino-orbitocerebral mucormycosis. The pterygopalatine fossa was affected in 26.2% patients. A total of 9.2% patients had cavernous sinus thrombosis. A total of 12% of the cases had infarction in the cerebral hemispheres. Conclusion In a setting of sinonasal mucormycosis, especially in the immuno-compromised and with those infected with COVID-19, cross-sectional imaging can assess the presence and extent of the disease and helps plan its medical and surgical management.