Clinicopathological Features of Fungal Infections in COVID-19 Patients: A Retrospective Study in Yazd, Iran

Maryam  Vajihinejad; Faezesadat  Heidari; Zahra  Eslami; Ali  Sartipzadeh

doi:10.18502/aptj.v5i2.19456

Maryam Vajihinejad Department of Pathology, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Faezesadat Heidari Department of Infectious Disease, School of Medicine, Infectious Disease Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Zahra Eslami General pharmacist, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Ali Sartipzadeh Medical Doctor, Shahid Sadoughi University of Medical Sciences, Yazd,Iran.

DOI: https://doi.org/10.18502/aptj.v5i2.19456

Keywords: COVID-19, Fungal Infection, Mucormycosis, Epidemic

Abstract

Patients with COVID-19 due to unspecified medical treatment, hospitalization in the intensive care unit, need for invasive or non-invasive ventilation, prescription of broad-spectrum antibiotics, use of corticosteroids, and suffering from other underlying diseases, especially diabetes, are opportunistic to fungal infection. This study investigated the clinicopathology of fungal infections in patients with COVID-19 in samples sent to the pathology department of Shahid Sadoughi Hospital in Yazd, Iran, from 2020 to 2022.

Methods: This is an analytical cross-sectional study. The information related to patients with COVID-19 and fungal infections who were referred to the pathology department of Shahid Sadoughi Hospital in Yazd, Iran, from March 2020 to March 2022 was analyzed. Age, gender, clinical manifestations, type of fungal infection, site of involvement, mortality, duration of hospitalization and hospitalization department, need for mechanical ventilation, and clinical symptoms were extracted from patients’ files and recorded in a researcher-made questionnaire. The data were statistically analyzed using SPSS version 26.

Results: In this study, fungal infections were confirmed in 53 patients with COVID-19 based on pathological diagnosis. Among them, 30 (56.6%) were men and 23 (43.4%) were women. The average age of the patients was 54.26 ± 18.07 years. In the pathological examination of fungal samples, 50 (94.3%) cases of mucormycosis, 2 (3.8%) cases of Aspergillus, and 1 (1.9%) case of simultaneous mucormycosis and Aspergillus were reported. Fungal infections involved the nasal cavity in 31 (58.5%) cases and paranasal sinuses in 18 (34%) cases. After the treatment period, the patients were discharged, and 14 (26.4%) patients died.

Conclusion: We concluded that fungal infections following COVID-19 infection are associated with serious complications and a high mortality rate; therefore, it is recommended that patients who are liable to suffer from fungal infections avoid overtreatment and treat them more carefully for COVID-19 to prevent possible fungal infection