Aspergillus rhinosinusitis among patients with COVID-19, northeastern Iran


SS Mojtahedi1*, H Zarrinfar2, MJ Najafzadeh3, M Bakhshaee4

Author address:

1Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

2Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Full conference title:

10th Advances Against Aspergillosis and Mucormycosis

Date: 2 February 2022



Invasive aspergillosis (IA) is one of the most common opportunistic fungal diseases in immunocompromised patients, especially those with hematopoietic stem cell transplantation (HSCT), patients with hematological malignancies. IArhinosinusitis can be a life-threatening opportunistic infection that occurs predominantly in immunocompromised individuals and is caused by various Aspergillus species. The concurrence IA with other infections such as COVID-19 can disrupt the treatment and control of the infection. In this study, Aspergillus rhinosinusitis was detected using sinus biopsy specimens among COVID-19 patients, northeastern Iran.



During an eight-month period, in two tertiary referral hospitals, 71 patients with rhinosinusitis (88 specimens) affected to COVID-19 with suspicion of fungal infections were evaluated. The sinus biopsy specimens were examined using mycological procedures and histopathology. The sinus specimens were examined by direct wet mounts with 20% potassium hydroxide (KOH) and cultured on Sabouraud dextrose agar. The cultures were then examined and evaluated to identify.



The specimens showed mycelium with septate (septate hyphae) in direct experiments of 12 (13.6%) cases, positive culture for Flavisection 10 (77%) and Nigrisection 3 (23%) in 13 (14.8%) cases, and positive histopathology results in 2 (2.27%) cases (10 specimens without histopathology examination). Of the 71 patients, 14 (19.7%) showed Aspergillus rhinosinusitis that 11 (15.5%) cases of them had diabetes mellitus, and 2 (10.5%) them died.



Aspergillus rhinosinusitis had a high incidence among COVID-19 patients, with a relatively high rate of diabetesmellitus. Mycological examination results showed a weak correlation with histopathology results. Most of these patients received amphotericin B liposomal and caspofungin, but no significant difference was observed between recovery and death. A multidisciplinary approach is essential to improve the conditions facilitating the emergence of COVID-19-associated IA.

Abstract Number: 36

Conference Year: 2022

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