correlation of diagnostic yield with laboratory parameters and histopathological examination in clinically suspected cases of mucormycosis in post-covid-19 patients: a single-center study in ahmedabad, india

Background and objectives: mucormycosis is a complication in post-coronavirus disease 2019 (covid-19) patients in india. this study was done to evaluate the prognostic value of clinical, histopathologic findings, microbiological features, and biochemical parameters such as d-dimer, lactate dehydrogenase, and serum ferritin in post- covid-19-patients with rhino-orbital mucormycosis. methods: this retrospective observational study was carried out on biopsies taken from 50 post-covid-19 patients suspected of mucormycosis. the biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid– schiff, and wright-giemsa. in addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect mucor. the biochemical parameters were measured using architect ci8200 chemistry analyzer. results: overall, 30 cases (60%) were positive for fungal elements, and growth of mucor spp. was found in 28 cases (56%). in histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. there seemed to be a site-wise overlap between the nasal/maxillary sinus and rhinoorbital/rhino-cerebral variety. there was no difference between the patients in terms of gender. the most common risk factor was diabetes mellitus (observed in 80% of cases). in patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, c-reactive protein, and ddimer were greater than the normal range, whereas procalcitonin was within the reference range. conclusion: it can be concluded that raised metabolic markers, direct 10% koh examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate.