Indian Journal of Pathology and Oncology 2022;9(3):227–231 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Pathology and Oncology Journal homepage: www.ijpo.co.in Original Research Article Changing faces and habitat of mucormycosis epidemic in sequential COVID waves Aarti Tyagi 1, *, Shweta Grover 1 , Rani Bansal 1 1 Dept. of Pathology, Subharti Medical College, Merrut, Uttar Pradesh, India ARTICLE INFO Article history: Received 05-05-2022 Accepted 23-05-2022 Available online 26-08-2022 Keywords: COVID Mucormycosis Diabetes Sporangia ABSTRACT Background: The Corona virus poses a greater challenge in the form of the deadly fungal infection, mucormycosis. Aims: To study the histopathological features giving emphasis on the varying presentation of mucormycosis in sequential covid waves. Materials and Methods: A prospective study comprising 31 patients histopathologically diagnosed with mucormycosis were included in the study. Demographic features, predisposing conditions, and clinical features were obtained from medical records. Tissue sections were reviewed with hematoxylin and eosin (H and E), and special stains like Gomori’s methenamine silver (GMS), and periodic acid Schiff (PAS) potassium hydroxide (KOH) examination and fungal culture. Results: The study included 21 males and 10 females with age ranging from 35-75 years. On histopathological examination, inflammation, granulomas, foreign body giant cells along with necrosis was seen. Invasion into soft tissues, muscles, and adipose tissues along with Angioinvasion, perineural spread was identified. Fungal balls, round to ovoid mature sporangia with column-shaped columella, presence of proliferating hyphae in tissues like skeletal muscle, cartilage etc which are supposed to be relatively resistant for inflammatory pathology got noted as one of our astounded histopathological findings insinuating how a human body acts as a culture media exhibiting diversity of a human makeup. The trend of presentation and severity kept changing with successive covid wave. Conclusions: Diagnosis of mucormycosis is gruesome and more difficult as compared to other infectious organism. In addition, like any malignant pathology, perivascular and neural infiltration is one of the important histological features of invasive mucormycosis as it indicates the severity and prognosis. There is drastically different trend of presentation in covid and its different mutant waves. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction As India continues to battle the COVID 19 pandemic, many new serious complications of the infection have surfaced. The Corona virus poses a greater challenge in the form of the deadly fungal infection mucormycosis. Mucormycosis is a fungus belonging to Phylum Zygomycota, class Zygomycetes, Order Mucorales, family mucoraceae and mucor species. * Corresponding author. E-mail address: aartityagi.1212@gmail.com (A. Tyagi). In early December 2019, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) infection were identified in Wuhan and subsequently causing a worldwide pandemic. It is associated with a wide range of disease patterns, ranging from mild to life- threatening pneumonia. A wide range of co-infections exists and may be associated with preexisting morbidities or may develop as a hospital-acquired infection such as ventilator- associated pneumonia. 1 In the absence of any proven antiviral therapies or vaccines, the glucocorticoids have been shown to https://doi.org/10.18231/j.ijpo.2022.054 2394-6784/© 2022 Innovative Publication, All rights reserved. 227