The following is a summary of “Imaging spectrum, associations and outcomes in acute invasive fungal rhino-ocular-cerebral sinusitis in patients with COVID-19 pneumonia,” published in the June 2023 issue of Family Medicine and Primary Care by Patel et al.

It has been hypothesized that Coronavirus Disease 2019 (COVID-19) may exacerbate mucormycosis infection due to its immunosuppressive pathogenesis. Early identification of conditions with a high mortality rate is essential for optimal treatment and improved outcomes. About 63 patients with clinical and microbiological evidence of rhino-ocular-cerebral mucormycosis and a history of COVID-19 infection participated in a retrospective study. The researchers retrieved and analyzed the clinical, demographic, and imaging data. 

Across audit cycles, descriptive statistics (mean [SD] and frequency [%]) were used to describe significant characteristics. All 63 patients had received injectable and oral corticosteroids. Of the 54 patients with associated comorbidities, diabetes mellitus was the most prevalent. Imaging revealed the involvement of the nasal and paranasal sinuses, the per sinus, the maxillary alveolar arch, and the hard palate in 62 (98.41%), 33 (52.38%), 5 (7.94%), and 5 (7.94%) patients, respectively. Orbital involvement was seen in 24 (38.10%) patients. 11 (17.46%) patients had involvement of the skull base, and 11 (17.46%) patients had intracranial extension of the disease. 

There were 16 patients on mechanical ventilation, of which 3 perished. The mean (SD) intensive care unit (ICU) stay was 13.2 days (6.8) for the five patients who died and 6.4 days (4.6) for the 30 patients who survived (P = 0.003). Cross-sectional imaging not only determines the extent of disease dissemination but also plays a crucial role in providing a surgical road map to treating surgeons and predicting the prognosis of patients with invasive fungal infections.

Source: journals.lww.com/jfmpc/Fulltext/2023/06000/Imaging_spectrum,_associations_and_outcomes_in.5.aspx