Diagnostic Accuracy of Frozen Section in Post COVID Fungal Infections

The emergence of fatal fungal infections during the second wave of COVID-19 in 2021 devastated human health worldwide. India had a sudden surge in the incidence of Mucormycosis from April to July 2021 which necessitated rapid diagnosis for a prompt surgical intervention to decrease morbidity and mortality. Intraoperative frozen section diagnosis with permanent histopathology confirmation is one of the standard diagnostic tools for the diagnosis of Acute invasive fungal infections. A single institutional prospective study was conducted on the suspected cases of Mucormycosis in COVID patients who had intraoperative frozen section consultation at HCG Cancer Centre, Bengaluru from April 8th to July 27th 2021.61 fresh tissue samples from 55 patients were received for frozen section evaluation. Of the 61 samples evaluated in the frozen section, 47 were positive and 14 were negative for mucor mycosis. On the evaluation of permanent H and E sections of the 14 negative cases, 3 were positive for mucormycosis, which showed fungal elements on special stains. In our study, the frozen section showed a 94% concordance rate with permanent histopathology sections with 94 % sensitivity and 100% specificity and hence proves to be a diagnostic tool for acute fulminant fungal infections.