Clinical and laboratory profiles of invasive fungal infections in COVID-19 patients

Abstract

With the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many areas in the world witnessed an increase in fungal infections and the corresponding increase in mortality. In our study, we attempted to identify common fungal pathogens encountered in patients with COVID-19 and to find microbiological and histopathological parameters that may help diagnose these etiological agents. The clinical manifestations, demography, and disease outcomes in patients with fungal infections associated with COVID-19 were also studied. The observational cross-sectional study was performed at the Government Medical College and District Hospital, Palakkad, India. We used case records and laboratory records of patients admitted with COVID-19 and diagnosed with a fungal infection, as well as records of post-COVID-19 patients with fungal infection. The study period covered six months from March to August 2021. The study included 50 patients aged 40-74 years (median: 56 years). We found that mucormycosis and aspergillosis are important invasive fungal infections that prevail in COVID-19 patients. The most common risk factors associated with these fungal infections include diabetes mellitus and treatment with corticosteroids. KOH (potassium hydroxide) mount test and histopathological examination are very useful methods for etiological diagnostics. The overall mortality rate in the observed patients was 71.4% (85.7% for mucormycosis and 57.1% for aspergillosis). Thus, invasive fungal infections in COVID-19 patients with co-morbidities are associated with a high mortality rate.