Rhino-orbital mucormycosis during COVID-19 pandemic: our clinical experience

Background: The ongoing COVID-19 pandemic declared by the WHO was compounded by the sudden and unexpected increase of Rhino-orbital mucormycosis infections during the year 2021. Mucormycosis a life-threatening infection, with added COVID-19 infection further increases the morbidity and mortality of the disease. Our aim is to shed some light on possible risk factors, treatment options and outcomes when these diseases occur together. Methods: 22 cases diagnosed with rhino-orbital mucormycosis with history of COVID-19 infection were selected. Cases underwent surgical and medical management. Patients were followed up for 3 months and were continued on medical treatment and regular post-operative DNE, CECT PNS and brain and relapses were treated accordingly. Results: Of these 22 patients, 15 were males and 7 were females ranging between 31-60 years. 15 (68.18%) had history of DM, 16 (72.72%) gave history of oxygen therapy and 18 (81.82%) had history of high dose steroid therapy. 15 (68.18%), 4 (18.18%) and 3 (13.64%) respectively underwent Endoscopic debridement, Total maxillectomy and Medial maxillectomy. There were 3 cases of relapse which were managed with additional full course treatment with Intravenous Liposomal Amphotericin B. Conclusion: COIVD-19 and uncontrolled DM to both be probable pre-disposing factors for developing Mucormycosis. Oxygen therapy & high dose of steroids used in the treatment of COIVD-19 may increase incidences of mucormycosis. Early treatment with surgery is necessary to reduce the need for more radical procedures and improving the recovery.