Post-COVID pulmonary fungal infections: An unanticipated predicament or a ticking time bomb? Clinico-microbiological profile of cases encountered during the second wave of COVID-19 pandemic at a teaching hospital in the Himalayas with a brief literature review.

INTRODUCTION

This study attempts to generate preliminary data regarding post-COVID pulmonary fungal infections, namely, COVID-19-associated pulmonary aspergillosis (CAPA), COVID-19-associated pulmonary mucormycosis (CAPM), and mixed infections from the Himalayas and compares the micro-radio-clinical profile and outcomes of the affected patients.

MATERIALS AND METHODS

A retrospective data analysis was conducted, where clinical profiles, microbiological and radiological reports, and outcomes of = 16 patients of post-COVID pulmonary infections were compared.

RESULTS

Of = 16 patients, = 7 had CAPA ( = 5 s, = 1 1 ), = 5 CAPM (Rhizopus arrhizus) and = 4 with mixed infections ( 3 infected with and spp. and = 1 with and ). Thick-walled cavitary lesions, air-fluid levels, and multiple centrilobular nodules were some of the common radiological findings reported among these patients.

CONCLUSION

The immuno-compromised state following COVID-19 infection and treatment might be responsible for the progression of regular exposure to the dense Himalayan vegetation into an invasive pulmonary fungal infection. Suspecting post-COVID pulmonary fungal infection is necessary for primary care physicians to ensure timely referral to higher centers. Mixed pulmonary fungal infections (coinfection with spp. and spp.) are also emerging as important sequelae of COVID-19.