{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:17:19Z","timestamp":1789521439307,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T00:00:00Z","timestamp":1645660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>This study aimed to determine the patient demographics, risk factors, which include comorbidities, medications used to treat COVID-19, and presenting symptoms and signs, and the management outcome of COVID-19-associated invasive fungal sinusitis. A retrospective, propensity score-matched, comparative study was conducted at a tertiary care center, involving 124 patients with invasive fungal sinusitis admitted between April 2021 and September 2021, suffering from or having a history of COVID-19 infection. Among the 124 patients, 87 were male, and 37 were female. A total of 72.6% of patients received steroids, while 73.4% received antibiotics, and 55.6% received oxygen during COVID-19 management. The most common comorbidities were diabetes mellitus (83.9%) and hypertension (30.6%). A total of 92.2% had mucor, 16.9% had aspergillus, 12.9% had both, and one patient had hyalohyphomycosis on fungal smear and culture. The comparative study showed the significant role of serum ferritin, glycemic control, steroid use, and duration in COVID-19-associated invasive fungal disease (p &lt; 0.001). Headache and facial pain (68, 54.8%) were the most common symptoms. The most involved sinonasal site was the maxillary sinus (90, 72.6%). The overall survival rate at the three-month follow-up was 79.9%. COVID-19-related aggressive inflammatory response, uncontrolled glycemic level, and rampant use of steroids are the most important predisposing factors in developing COVID-19-associated invasive fungal sinusitis.<\/jats:p>","DOI":"10.3390\/jof8030223","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T07:22:35Z","timestamp":1645687355000},"page":"223","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Spectrum of Invasive Fungal Sinusitis in COVID-19 Patients: Experience from a Tertiary Care Referral Center in Northern India"],"prefix":"10.3390","volume":"8","author":[{"given":"Surendra Singh","family":"Baghel","sequence":"first","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Kumar","family":"Keshri","sequence":"additional","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhakar","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungmei","family":"Marak","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-8187","authenticated-orcid":false,"given":"Ravi Sankar","family":"Manogaran","sequence":"additional","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan Kumar","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arulalan","family":"Mathialagan","sequence":"additional","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govind","family":"Bhuskute","sequence":"additional","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Kumar","family":"Dubey","sequence":"additional","affiliation":[{"name":"Neurootology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha Krishan","family":"Dhiman","sequence":"additional","affiliation":[{"name":"Head Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"ref_1","unstructured":"Wuhan City Health Committee (2020, January 14). Wuhan Municipal Health and Health Commission\u2019s Briefing on the Current Pneumonia Epidemic Situation in Our City, Available online: http:\/\/wjw.wuhan.gov.cn\/front\/web\/showDetail\/2019123108989."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"ofab201","DOI":"10.1093\/ofid\/ofab201","article-title":"Characterization of Bacterial and Fungal Infections in Hospitalized Patients With Coronavirus Disease 2019 and Factors Associated With Health Care-Associated Infections","volume":"8","author":"Kubin","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_3","first-page":"39","article-title":"Fungal sinusitis","volume":"316","author":"DeShazo","year":"1998","journal-title":"Am. J. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/j.1439-0507.2005.01167.x","article-title":"Cerebral zygomycosis","volume":"48","author":"Sundaram","year":"2005","journal-title":"Mycoses"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/j.1439-0507.2007.01364.x","article-title":"Rhinocerebral mucormycosis: The disease spectrum in 27 patients","volume":"50","author":"Mohindra","year":"2007","journal-title":"Mycoses"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.anl.2009.09.001","article-title":"Emerging therapeutic options in fulminant invasive rhinocerebral mucormycosis","volume":"37","author":"Scheckenbach","year":"2010","journal-title":"Auris Nasus Larynx"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jcms.2008.10.007","article-title":"Orbital cellulitis, orbital subperiosteal and intraorbital abscess: Report of three cases and review of the literature","volume":"37","author":"Vairaktaris","year":"2009","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1097\/00005537-199707000-00004","article-title":"Rhinocerebral mucormycosis: Evolution of the disease and treatment options","volume":"107","author":"Peterson","year":"1997","journal-title":"Laryngoscope"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102146","DOI":"10.1016\/j.dsx.2021.05.019","article-title":"Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India","volume":"15","author":"Singh","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s11046-020-00462-9","article-title":"Fungal Co-infections Associated with Global COVID-19 Pandemic: A Clinical and Diagnostic Perspective from China","volume":"185","author":"Song","year":"2020","journal-title":"Mycopathologia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/BF01932420","article-title":"Mycosis mucorina","volume":"102","author":"Paltauf","year":"1885","journal-title":"Virchows Arch. Pathol. Anat. Physiol. Klin. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Skiada, A., Pavleas, I., and Drogari-Apiranthitou, M. (2020). Epidemiology and Diagnosis of Mucormycosis: An Update. J. Fungi, 6.","DOI":"10.3390\/jof6040265"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chander, J., Kaur, M., Singla, N., Punia, R.P.S., Singhal, S.K., Attri, A.K., Alastruey-Izquierdo, A., Stchigel, A.M., Cano-Lira, J.F., and Guarro, J. (2018). Mucormycosis: Battle with the Deadly Enemy over a Five-Year Period in India. J. Fungi, 4.","DOI":"10.3390\/jof4020046"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Prakash, H., and Chakrabarti, A. (2019). Global Epidemiology of Mucormycosis. J. Fungi, 5.","DOI":"10.3390\/jof5010026"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e434","DOI":"10.1016\/j.bjps.2008.04.040","article-title":"Cutaneous mucormycosis: Report of five cases and review of the literature","volume":"62","year":"2009","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mishra, P., Singh, R.K., Nath, A., Pande, S., Agarwal, A., Sanjeev, O.P., Gupta, D., Singh, P., Ghatak, T., and Hashim, Z. (2021). A novel epidemiological scoring system for the prediction of mortality in COVID-19 patients. Trans. R Soc. Trop. Med. Hyg.","DOI":"10.1093\/trstmh\/trab108"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.4103\/ijo.IJO_1565_21","article-title":"Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India\u2014Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1","volume":"69","author":"Honavar","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.dsx.2021.02.034","article-title":"Newly diagnosed diabetes in patients with mild to moderate COVID-19","volume":"15","author":"Sathish","year":"2021","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"John, T., Jacob, C., and Kontoyiannis, D. (2021). When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis. J. Fungi, 7.","DOI":"10.3390\/jof7040298"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00592-009-0109-4","article-title":"Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes","volume":"47","author":"Yang","year":"2010","journal-title":"Acta Diabetol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E139","DOI":"10.1152\/ajpendo.00480.2020","article-title":"COVID-19 endocrinopathy with hindsight from SARS","volume":"320","author":"Kothandaraman","year":"2021","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/myc.12278","article-title":"Evaluation of 28 cases of mucormycosis","volume":"58","author":"Kursun","year":"2015","journal-title":"Mycoses"},{"key":"ref_24","first-page":"243","article-title":"Case series of rhinocerebral mucormycosis occurring in diabetic patients","volume":"6","author":"Mohammadi","year":"2015","journal-title":"Caspian J. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.anorl.2015.08.027","article-title":"ENT mucormycosis. Report of 4 cases","volume":"133","author":"Kermani","year":"2016","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"944.e9","DOI":"10.1016\/j.cmi.2019.11.021","article-title":"A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India","volume":"26","author":"Patel","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1093\/mmy\/myu086","article-title":"A prospective study of mucormycosis in north India: Experience from a tertiary care hospital","volume":"53","author":"Bala","year":"2015","journal-title":"Med. Mycol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103080","DOI":"10.1016\/j.amjoto.2021.103080","article-title":"The impact of COVID-19 outbreak on the incidence of acute invasive fungal rhinosinusitis","volume":"42","author":"Ismaiel","year":"2021","journal-title":"Am. J. Otolaryngol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., Mafham, M., Bell, J.L., Linsell, L., Staplin, N., Brightling, C., and Ustianowski, A. (2021). Dexamethasone in Hospitalized Patients with COVID-19. N. Engl. J. Med., 384, 693\u20137044.","DOI":"10.1056\/NEJMoa2021436"},{"key":"ref_30","unstructured":"(2021, May 27). Available online: https:\/\/covid.aiims.edu\/clinical-guidance-formanagement-of-adult-covid-19-patients\/."},{"key":"ref_31","unstructured":"Centers for Disease Control and Prevention (2022, February 10). Fungal Diseases, Available online: https:\/\/www.cdc.gov\/fungal\/diseases\/mucormycosis\/definition.html."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.anl.2008.07.003","article-title":"Rhinocerebral Mucormycosis: Consideration of prognostic factors and treatment modality","volume":"36","author":"Jung","year":"2009","journal-title":"Auris Nasus Larynx"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2652","DOI":"10.1002\/lary.29632","article-title":"Invasive Fungal Sinusitis in Post COVID-19 Patients: A New Clinical Entity","volume":"131","author":"Khafagy","year":"2021","journal-title":"Laryngoscope"}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/3\/223\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:26:18Z","timestamp":1760135178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/8\/3\/223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,24]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jof8030223"],"URL":"https:\/\/doi.org\/10.3390\/jof8030223","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,24]]}}}