Wave of Invasive Fungal Disease on the Shores of COVID-19: A Case Series of COVID-19 Associated Rhino-Orbital Fungal Rhinosinusitis and Literature Review

Coronavirus disease 2019 (COVID-19) may be associated with a wide range of bacterial and fungal co-infections. Acute invasive fungal sinusitis is an aggressive infection affecting immunocompromised patients and high mortality rate. Here, in this case series, we have reviewed three cases of COVID-19 associated rhino-orbital invasive fungal disease. Patients with COVID-19 associated pneumonia with diabetes mellitus are at an increased risk of developing invasive pulmonary fungal infections probably due to their reduced immunological competence. Concurrent glucocorticoid therapy probably heightens the risk of mucormycosis. Physicians should be aware of and should have high index of suspicion of possible fungal infection in post COVID-19 patients. Aggressive management both medical and surgical, is required to improve outcomes of secondary invasive fungal infections in patients with COVID-19 infection.