Revised workflow practices in the management of acute invasive fungal sinusitis during the COVID-19 pandemic

Regi Kurien*, Lalee Varghese, Lisa Mary Cherian, Rajan Sundaresan, Mary John, Manju Deena Mammen, Ranjeetha Racheal Inja, Abi Manesh, Hema Paul, Phaneendra Rao Gurijala, Joy Sarojini Michael, Meera Thomas, Kundavaram Paul Prabhakar Abhilash, Ajoy Mathew Varghese, Vedantam Rupa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To document changes in evaluation protocols for acute invasive fungal sinusitis (AIFS) during the COVID-19 pandemic and to analyse concordance between clinical and histopathological diagnosis based on new practice guidelines. Methods: Protocols for patient evaluation with suspected AIFS both prior and during the COVID-19 period are described. Retrospective analysis of patients with suspected AIFS from May 1st to June 30th 2021 and the concordance between clinical and final diagnosis was done. Results: Among 171 patients with high clinical suspicion, 160 (93.6%) correlated with the final histopathological diagnosis of invasive fungal sinusitis, providing a 100% sensitivity, positive predictive value of 93.6% and a negative predictive value of 100%. Conclusion: Our study highlights a valuable screening tool with good accuracy involving emphasis on red flag signs in high-risk populations. This could be valuable in situations demanding avoidance of aerosol generating procedures and in resource limited settings facilitating early referral to higher centres.

Original languageEnglish
JournalJournal of Laryngology and Otology
Publication statusAccepted/In press - 2022
Externally publishedYes


  • COVID-19
  • mucormycosis
  • paranasal sinuses
  • sinusitis

ASJC Scopus subject areas

  • Otorhinolaryngology

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