Background: Acute invasive fungal rhinosinusitis (AIFR) is a potentially fatal infection that usually complicates immunosuppressive status like uncontrolled or newly discovered diabetes mellitus, during the coronavirus disease (COVID19) pandemic, worsening of underlying diabetes and newly discovered cases have been observed.Aim: To highlight the impact of COVID-19 on emerging cases of AIFRS comparing this with AIFR before COVID-19 pandemic. Methods: This is a retrospective comparative study between AIFR patients presenting to Tanta University Hospital, Egypt between July and December 2020 with a recent proven COVID-19 infection and AIFR patients presenting to the same institution prior to the covid-19 pandemic between January 2017 and December 2019.Results: There was a dramatic increase in the rate of incidence of AIFR in patients with recent covid-19 infection in comparison with pre COVID-19 pandemic numbers. On the other hand, there was no statistical difference in the severity, extent of lesion or survival rate between the two groups.Conclusion: A bidirectional relationship between Covid-19 and diabetes mellitus was observed together with immune dysregulation playing a possible role in subsequent increase in the rate of incidence of AIFR making it more emerging and more challenging.