Post Covid-19 Sino-Orbital Mucormycosis: A Therapeutic Challange

Muhammad Adnan; Muhammad Shahid; Muhammad Awais; Syed Abid Hassan Naqvi; Muhammad Usman Ghani; Umer Ijaz

doi:10.51253/pafmj.v72i1.7454

Authors

Muhammad Adnan Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Shahid Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Awais Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Syed Abid Hassan Naqvi Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Usman Ghani Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Umer Ijaz Armed Forces Institute of Opthamology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i1.7454

Keywords:

Coronavirus disease, Invasive fungal sinusitis, Sino-orbital mucormycosis

Abstract

Objective: To determine the frequency of sino-orbital mucormycosis outcomes in diagnosed patients of COVID-19 and its association with the duration of the disease.

Study Design: Case series.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Pak Emirates Military Hospital, Rawalpindi, from Feb to Jul 2021.

Methodology: A sample size of 20 was calculated using WHO calculator. Diagnosed patients of COVID-19 who fulfilled the inclusion criteria were selected through consecutive sampling technique. The mode of presentation, in-depth imaging findings, associated co-morbidities and management/follow up details were collected.

Results: Total 20 patients were included in study. There were 12 (60%) male and 8 (40%) female. Mean age of patients was 60.4 ± 9.8 years. Outcomes of study were treatment, still of follow up, mortality and mortality with sepsis, survival and exenteration (15%, 15%, 25%, 5%, 25% 15% respectively). Among all the patients, 2(10%) patients showed intraconal and extraconal orbital involvement, 9 (45%) showed left, 8 (40%) showed right and 1(5%) showed both orbits involvement. Outcomes of sino-orbital mucormycosis showed significant association with COVID-19 duration (p=0.03).

Conclusion: Sino-Orbital mucormycosis is a common and potentially life-threatening complication of COVID-19. Early initiation of anti-fungal treatment as well as surgical intervention are key to decrease both the mortality and morbidity associated with the disease.