RESUMEN
OBJECTIVES: This study aims at reporting the surgical outcomes of COVID associated pulmonary mucormycosis with special emphasis on surgical mortality. METHODS: This prospective observational study was conducted in a dedicated thoracic surgical unit in Gurugram, India over 18 months. An analysis of demography, peri-operative variables were carried out. Various parameters were analysed to assess the factors affecting mortality. RESULTS: Total of 44 patients with diagnosis of CAPM were managed during the study period. All were started on anti-fungal therapy. However, 33 patients (75%) were operated whereas rest 11 (25%) were not considered suitable for surgery. In the surgical cohort (n = 33), there were 20 males (60.6%) and 13 females (39.4%), with a mean age of 54.8 years (range, 33-72 years). The mean duration of the symptoms was 1.1 weeks. Non-anatomical wedge resection of lobe(s) was performed in 5 patients (15.1%), lobectomy/bi-lobectomy was required in 26 patients (78.9%) and left pneumonectomy in 2 patients (6%). There were 5 peri-operative deaths (15.1%), all due to fungal sepsis. ECOG scale > 2 (P ≤ 0.001), higher Charlson Comorbidity Index score > 2 (P = 0.04) and pneumonectomy (P = 0.02) were the predictors of mortality. On comparison with NCPM, there was no difference in the incidence of post-operative complications (P = 0.50) and the post-operative mortality (P = 0.69). CONCLUSION: Aggressive surgical resection with clear margins should be offered in CAPM, whenever feasible. Surgery for CAPM was not associated with higher post-operative complications including mortality compared to Non-COVID Pulmonary Mucormycosis.