Diagnostic accuracy of nasal endoscopy and contrast magnetic resonance
imaging in COVID-19 associated mucormycosis (CAM)
Abstract
Key Points 1. COVID-19 associated mucormycosis (CAM) is a
life-threatening fungal disease that has become an epidemic and
notifiable disease after the second wave of COVID-19 in India 2. The
target group for CAM includes severely immunocompromised individuals
either by COVID-19, or corticosteroid therapy, or uncontrolled glycemic
index. 3. With an intention to find out the sensitivity and specificity
of diagnostic nasal endoscopy (DNE) and contrast-enhanced magnetic
resonance imaging (CEMRI), one hundred two consecutive patients of
target group with clinical features of CAM were enrolled in the study.
4. The sensitivity and specificity of DNE as compared to KOH mount were
73.4% and 94.7% respectively. The sensitivity and specificity of CEMRI
as compared to KOH mount were 87.5% and 50% respectively. 5. CEMRI
misses fewer cases than DNE. In cases of normal endoscopy in the target
group, imaging and biopsy should be advised to reduce false-negative
results. Nasal endoscopy, biopsy, and imaging can reliably detect the
majority of cases of CAM.