Table 1.
Basic characteristics and clinical presentations of 10 COVID-19 associated mucormycosis- aspergillosis patients
| Case no. | Age/ Gender | Clinical presentation | Interval between symptoms related to COVID-19 and to fungal infection (in days) | Comorbidities/ immuno-compromised state/ Other risk factors | Initial diagnosis |
|---|---|---|---|---|---|
| 1 | 45/ M | Headache, fever, altered sensorium, decrease vision | 15 | Uncontrolled diabetes mellitus x 3 years; Severe COVID pneumonia; Smoker 1 pack/day for 10 years, H/O Steroid, low dose, > 1 week | Probable Rhino orbital mucormycosis with COVID-19 Probable Aspergillosis |
| 2 | 46/M | Headache, right nasal obstruction, right periorbital swelling, right eye tear with black nasal discharge | Not tested before admission (COVID symptoms-25 days back) | Uncontrolled diabetes mellitus x 3 years; Severe COVID pneumonia. H/O Steroid intake for 5 -7 days; home-based oxygen therapy, smoker, H/O exposure to saw-dust (carpenter by occupation) | Proven rhino orbital mucormycosis with COVID-19 and proven aspergillosis |
| 3 | 49/M | Headache, facial swelling, Fever | 22 | Newly diagnosed uncontrolled diabetes mellitus; Severe COVID pneumonia; H/O Non-invasive ventilation (BiPAP) for 20 days with high dose parenteral steroid > 2 weeks | Proven rhino-orbital mucormycosis and probable aspergillosis |
| 4 | 62/F | Facial pain, nasal stuffiness, nasal discharge | 10 | Diabetes mellitus x 10 years; Moderate to severe COVID pneumonia. H/O Oxygen therapy and high steroid intake for 5-7 days | Probable Sinonasal mucormycosis and probable aspergillosis |
| 5 | 34/F | Headache, swelling, nasal discharge, right eye pain | Not tested before admission (H/O fever with COVID-19 symptoms 20 days back) | Newly diagnosed uncontrolled diabetes mellitus; Mild COVID, Incision and drain in hard palate 10 days before presentation, unsterile dressing, open wound | Proven rhino-orbital mucormycosis with COVID-19 and proven aspergillosis |
| 6 | 62/M | Eye pain, swelling, facial numbness | Not tested before admission (H/0 fever with cough, 10 days prior to admission) | Diabetes mellitus x 7 years; Moderate COVID, H/O low dose Steroid intake, chronic kidney disease; H/O dialysis; Smoker | Proven rhino-orbital mucormycosis with COVID-19 and proven aspergillosis |
| 7 | 45/M | Headache, periorbital swelling, vomiting | Not tested before admission (admitted to another center with symptoms suggestive of COVID-19, H/0 fever with cough, 11 days) | Uncontrolled Diabetes mellitus x 4 years, CKD ; Mild COVID, Smoker | Proven rhino-orbital mucormycosis and probable aspergillosis |
| 8 | 52/M | Headache, facial numbness, swelling, nasal discharge | 16 | Uncontrolled diabetes mellitus x 4 years; Moderate COVID, Previous hospitalization for COVID-19 for 1 week, H/O high dose steroid intake | Proven rhino-orbital mucormycosis with COVID-19, and proven aspergillosis |
| 9 | 42/F | Right eye swelling, pain, discharge | 5 | Diabetes mellitus x 1 years; Severe COVID pneumonia, No other significant history | Proven rhino-orbital mucormycosis with COVID-19 and proven aspergillosis |
| 10 | 55/F | Fever, cough, breathlessness, swelling of the nose | 23 | Newly diagnosed diabetes mellitus; Pancytopenia; Severe COVID pneumonia, H/O high dose steroid intake; H/O blood transfusion (5 whole units); Recovered COVID pneumonitis (2/5/21 – 19/5/21) | Probable nasal mucormycosis, probable aspergillosis |