The New Normal Anesthesiologist and the Challenging Post-COVID-19 Mucormycosis Patients − Our Experience

Abstract

Rhino-orbital-cerebral mucormycosis (ROCM) is an aggressive, lethal, angioinvasive fungal infection that has presented as an opportunistic infection in the backdrop of a highly infectious and severe second coronavirus disease 2019 (COVID-19) wave in India. The dominant delta strain during the second wave led to an unprecedented rise in hospital admissions with moderate to severe COVID-19 illness. A working staging system is helpful in triaging these patients to prioritize surgical debridement and liposomal amphotericin B induction therapy. The evaluation and optimization of post-COVID-19 sequelae becomes a cornerstone in achieving a favorable perioperative outcome. As anesthesiologists, we share our experience in managing this novel subset of patients. Post-COVID-19 sequelae with a prothrombotic state and multisystem involvement, challenging and shared airway, and amphotericin B-related complications are being the key concerns.

Keywords

• airway
• amphotericin b
• anesthesia
• post-covid sequelae
• prothrombotic
• mucormycosis