Clinical profile and outcome of COVID-19 associated mucormycosis in Shiraz, South Iran: a longitudinal study.
Numerous cases of mucormycosis appeared among COVID-19 patients, predominantly in Asian countries. This study aimed to investigate the clinical profile, in-hospital outcome, and one-year prognosis of COVID-19-associated mucormycosis (CAM).
All patients who developed CAM in Shiraz, South Iran, between July and October 2021 were included in this study. We collected data on presentations, comorbidities, risk factors, and outcomes.
Sixty-two patients with CAM were analyzed; the mean age was 59.3 years, and 58.1% were male. Diabetes mellitus was present in 80.6% (11.2% uncontrolled), hypertension in 54.8%, and chronic kidney disease in 11.3%. All patients had sinonasal involvement; ophthalmic, cutaneous, cerebral, gastrointestinal, pulmonary, and renal involvement occurred in 41.9%, 8.1%, 6.4%, 6.4%, 1.6%, and 1.6%, respectively. In-hospital and one-year mortality were 40.3% and 48.3%. Concurrent CAM and COVID-19, hypertension, older age, and radiologically severe COVID-19 lung involvement were associated with higher mortality. In multivariable analysis, age ≥60 years predicted in-hospital (OR: 5.47; 95% CI: 1.53-19.56) and one-year mortality (OR: 7.65; 95% CI: 1.90-30.84). Long-term mortality was also associated with ≥3 risk factors (OR: 4.12; 95% CI: 1.09-15.52) and lung severity index >30 (OR: 9.35; 95% CI: 1.01-86.63).
These findings emphasize the critical role of age in immune responses to opportunistic infections and highlight the impact of multiple comorbidities and severe lung damage on long-term prognosis in CAM.
All patients who developed CAM in Shiraz, South Iran, between July and October 2021 were included in this study. We collected data on presentations, comorbidities, risk factors, and outcomes.
Sixty-two patients with CAM were analyzed; the mean age was 59.3 years, and 58.1% were male. Diabetes mellitus was present in 80.6% (11.2% uncontrolled), hypertension in 54.8%, and chronic kidney disease in 11.3%. All patients had sinonasal involvement; ophthalmic, cutaneous, cerebral, gastrointestinal, pulmonary, and renal involvement occurred in 41.9%, 8.1%, 6.4%, 6.4%, 1.6%, and 1.6%, respectively. In-hospital and one-year mortality were 40.3% and 48.3%. Concurrent CAM and COVID-19, hypertension, older age, and radiologically severe COVID-19 lung involvement were associated with higher mortality. In multivariable analysis, age ≥60 years predicted in-hospital (OR: 5.47; 95% CI: 1.53-19.56) and one-year mortality (OR: 7.65; 95% CI: 1.90-30.84). Long-term mortality was also associated with ≥3 risk factors (OR: 4.12; 95% CI: 1.09-15.52) and lung severity index >30 (OR: 9.35; 95% CI: 1.01-86.63).
These findings emphasize the critical role of age in immune responses to opportunistic infections and highlight the impact of multiple comorbidities and severe lung damage on long-term prognosis in CAM.
Authors
Kouhi Kouhi, Mirhosseini Mirhosseini, Ranjbar Ranjbar, Akbari Akbari, Mehrabi Mehrabi, Javaheri Javaheri, Moosavi Moosavi, Alishahi Alishahi, Rasekh Rasekh, Fathi Fathi, Mansoori Mansoori
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