Invasive fungal infection during COVID era at tertiary care hospital

Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Introduction: Invasive fungal infection is a leading cause of morbidity and mortality in COVID patients as a secondary infection. Invasive fungal infections are often rapidly life-threatening and require specialist consultation for prompt diagnosis and therapy. The reporting of these invasive fungal infections (Mucormycosis, Aspergillosis, and candidiasis) is less than its occurrence. Objective: This study was undertaken to diagnose invasive fungal infections in COVID patients during the first, second, and third COVID-19 pandemic waves by conventional methods. Materials and Methods: From March 2020 to December 2020 was considered the first wave pandemic, March 2021 to May 2021 was the second wave pandemic and December 2021 to February 2022 was considered the third wave pandemic era for this region. A total of 42, 168, and 87 samples were collected from patients clinically suspected to have invasive fungal infections during three pandemic waves from Covid indoor patients of RIMS, Ranchi. Among a total 24 were tissue samples, 13 BAL and 260 were nasal swabs/scrapes collected from suspected patients. KOH screening of all samples was done followed by culture on SDA media. Results A total of 83/297 (27.94%) cases were positive for KOH screening. In all, 91/297 (30.64%) samples showed culture positivity. A majority of growth was for Mucorales (48.2%), Aspergillus species (24.1%), Candida species (15%), and mixed growth (12.7%). Among Mucorales, Rhizopus was identified in 64% followed by Mucor (28%), Absidia (5%), and Rhizomucor (3%). Among Aspergillus species, majority were A. flavus (48%) followed by A. niger (37%), and A. fumigatus (15%). Maximum positivity for invasive fungal infections was observed during the second wave pandemic (62%) followed by the third wave (27%), and the first wave (11%) respectively. Discussion: Maximum cases were observed during and after the second wave COVID pandemic era due to excessive use of steroids during COVID treatment and cases were decreased during the third wave as compared with second wave timeframe due to the use of COVID vaccine, and many asymptomatic cases and home quarantine policy. Conclusion Early diagnosis and treatment of invasive fungal infections with antifungal therapy and surgical debridement are necessary to reduce mortality and end-organ damage.