Resurgence of opportunistic fungal infections in the era of COVID-19: A cross-sectional analytical study

Background: There was a sudden upsurge of fungal infections in people affected by coronavirus disease 2019 (COVID-19), especially in India. The main reason is impaired innate defense mechanisms. These rapidly progressive and destructive diseases necessitate early identification for improved outcomes. The challenges faced during early diagnosis dictate an urgent need to study the characteristics of these secondary infections. Therefore, we conducted a cross-sectional analytical study of cases reported in our institute. Objective: This study aimed to evaluate frequency, possible contributing factors, and clinical-radiologic features in patients with fungal infections during the COVID-19 pandemic. Methods: Clinical details of all patients were collected from hospital records and analyzed. Results: Seventy patients of fungal infections with (94.2%) and without (5.7%) COVID-19 have been reported to our institute. Our study showed male (61.4%) predilection. Corticosteroids were part of COVID-19 treatment regimen in a total of 80% of patients. Diabetes was the most common co-morbidity (75.8%). The right maxillary sinus (64.3%) and maxilla (61.4%) were the most common sites involved. Medicinal treatment with amphotericin (52.9%) and posaconazole (32.9%) was given to 85.8% of patients. Maxillectomy was performed for 45.4% of patients. Conclusion: A triad of diabetes, decompensation of underlying co-morbidities, and unbridled use of corticosteroids during COVID-19 appear to surge of opportunistic fungal infections.