Clinicoradiological Findings of COVID-19-Associated Mucormycosis in a Referral Tertiary Care
Somayeh Haji Ahmadi, Ali Zokaei, Seyyed-Ali Alaei, Kiana Shirani, Rasoul Mohammadi, Mohammad Amin NajafiAbstract
Background:
Mucormycosis, an opportunistic fungal infection, has surged during the COVID-19 pandemic, especially with the delta variant, due to factors like steroid use and diabetes. This study examines radiological features through computed tomography (CT) and magnetic resonance imaging (MRI) findings in COVID-19-associated mucormycosis (CAM) patients.
Materials and Methods:
This single-center cross-sectional study conducted between March 2021 and March 2022 at a tertiary care center involved COVID-19 patients over 18 diagnosed with mucormycosis through pathological and endoscopic findings. Paranasal CT scans and brain, sinus, and orbit MRIs were performed to assess various involvements, including sinus, retroantral fat, intraorbital, and bone status, as well as cavernous sinus, internal carotid artery, superior ophthalmic vein, superior ophthalmic fissure, and intraparenchymal brain involvement. Demographic and clinical data, including medical history and laboratory findings, were collected. Statistical analysis using independent t-tests, Chi-squared tests, Fisher’s exact test, and logistic regression was conducted with a significance threshold of
Results:
This study of 54 CAM patients in Isfahan, Iran, found a high prevalence of diabetes (68.5%) and a 24.1% mortality rate. Imaging revealed significant sinonasal (87%), brain (35.2%), and intraorbital (60%) involvement. Chest CT scans showed predominant ground glass opacity (96.3%) and lower-zone lung involvement.
Conclusion:
This cross-sectional study underscores the critical role of imaging in diagnosing and managing CAM. Paranasal CT and MRI scans revealed extensive sinonasal, brain, and intraorbital involvement, essential for guiding surgical interventions.