Epidemiological factors affecting post-COVID-19 acute invasive fungal rhinosinusitis incidence and prognosis

Background Acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease that presents usually in immune-compromised patients with impaired neutrophilic response. Aim To study and statistically analyze the epidemiological factors leading to the observed increased incidence of invasive fungal rhinosinusitis in coronavirus disease-19 (COVID-19) diseased patients and identify the prognostic factors that may affect the course and outcome of the disease. Methods This case-control study was carried out on 23 patients diagnosed with acute invasive fungal sinusitis patients, patients with positive coronavirus or recently recovered from coronavirus infection admitted to tertiary or secondary centers in El-Gharbia governorate, and 46 participants as a control. The study was focused on the epidemiological predisposing factors that may affect the incidence of the disease. Results COVID-19 reporting and data system (CORAD), level of O2 saturation, PH, steroid therapy dose and duration, duration of O2 therapy, and anterior septal deviation were insignificantly different between the two studied groups. Random blood sugar (RBS), neutropenia, and type O2 therapy were significantly different between the two studied groups. Steroid therapy dose and duration were significantly higher in the patients' group than control group (P < 0.05). In the total number of 23 patients, 16 (69.6%) patients had their middle turbinate as the first site to be affected by the pathology, 3 (13%) patients in the right maxilla, 1 (4.3%) patient in the left maxilla, 2 (8.7%) patients in the right sphenoid sinus, and 1 (4.3%) patient in the hard palate. Conclusions The prognostic factors favoring bad prognosis are uncontrolled co-morbidities, high CORAD grade, high grade of fungal invasion, serum neutropenia, the use of ventilators as an O2 delivery method, and medical treatment alone without surgical treatment.