The impact of COVID-19 outbreak on the incidence of acute invasive fungal rhinosinusitis

• Published in: American journal of otolaryngology Vol. 42; no. 6; p. 103080
• Main Authors: Ismaiel, Wael F., Abdelazim, Mohamed H., Eldsoky, Ibrahim, Ibrahim, Ahmed A., Alsobky, Mahmoud E., Zafan, Ebtesam, Hasan, Abdulkarim
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2021; Elsevier Limited
• Subjects: Absidia; Acquired immune deficiency syndrome; Acute Disease; Aged; AIDS; Antibiotics; Aspergillus fumigatus; CD4 antigen; CD4-Positive T-Lymphocytes - immunology; CD8 antigen; CD8-Positive T-Lymphocytes - immunology; Chemotherapy; Coronavirus; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; Diabetes; Diabetes mellitus; Disease Outbreaks; Disease prevention; Female; Fungal; Fungal diseases; Fungi; Health risks; Hematology; Humans; Immune system; Immunity, Innate - immunology; Immunocompromised; Immunocompromised Host - immunology; Immunocompromised hosts; Immunology; Incidence; Infections; Innate immunity; Invasive Fungal Infections; Iron; Leukemia; Liver; Liver diseases; Lymphocytes; Lymphocytes T; Magnetic Resonance Imaging; Male; Medical prognosis; Middle Aged; Morbidity; Neutropenia; Otolaryngology; Pathogens; Patients; Renal function; Respiratory distress syndrome; Rhinitis; Rhinitis - diagnostic imaging; Rhinitis - epidemiology; Rhinitis - immunology; Rhinitis - microbiology; Rhinosinusitis; Rhizopus oryzae; Risk analysis; Risk Factors; Severe acute respiratory syndrome coronavirus 2; Sinusitis; Sinusitis - diagnostic imaging; Sinusitis - epidemiology; Sinusitis - immunology; Sinusitis - microbiology; Tomography, X-Ray Computed; Viral diseases; Young Adult; Coronavirus; Fungal; Rhinosinusitis; Immunocompromised
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2021.103080

Acute invasive fungal rhinosinusitis (AIFRS) is aggressive morbidity affecting immunocompromised patients. Coronavirus disease 2019 (COVID-19) may allow secondary fungal disease through a propensity to cause respiratory infection by affecting the immune system leading to dysregulation and reduced numbers of T lymphocytes, CD4+T, and CD8+T cells, altering the innate immunity. The aim of this study is to evaluate the incidence of acute invasive fungal rhinosinusitis (AIFRS) in COVID-19 patients.
Data for acute invasive rhinosinusitis was obtained from the Otorhinolaryngology departments at our tertiary hospital at the period from January 2017 to December 2020. Then the risk factors of comorbid diseases and fungal types between post-COVID-19 and non-COVID-19 groups regarding the incidence of AIFRS are compared.
Consequently, the incidence of AIFRS showed a more significant difference (P < 0.05) in post-COVID-19 patients than in non-COVID-19 especially in immunocompromised patients, diabetic, renal, and liver dysfunction patients as well as patients with risk factors of AIFRS. The most common organisms affecting patients with AIFRS are Rhizopus oryzae, Aspergillus fumigatus, and Absidia mucor.
The incidence of AIFRS is markedly prominent in post-COVID-19 patients than in those of non-COVID-19, especially in immunocompromised, diabetic, renal, and liver dysfunction patients and patients with risk factors for rhinosinusitis.