Factors influencing mortality in COVID-19-associated mucormycosis: The international ID-IRI study
Sahin, Meyha, Yilmaz, Mesut, Mert, Ali, Naghili, Behrouz, Ravanbakhsh, Fatemeh, Varshochi, Mojtaba, Darazam, Ilad Alavi, Ebrahimi, Mohammad Javad, Moafi, Maral, Tehrani, Hamed Azhdari, Mahboob, Amjad, Rashid, Naveed, Khan, Ejaz Ahmed, Hakamifard, Atousa, Eser-Karlidag, Gulden, Babamahmoodi, Abdolreza, El-Kholy, Amani, Mosawi, Sayed Hussain, Albayrak, Ayse, Al Ramahi, Jamal Wadi, Addepalli, Syam Kumar, Balin, Safak Ozer, Khan, Asfandiyar, Pandya, Nirav, Gurbuz, Esra, Sincan, Gulden, Azami, Hadia, Dumlu, Ridvan, Khedr, Reham, Ripon, Rezaul Karim, Alkan, Sevil, Kose, Sukran, Ceylan, Bahadir, Erdem, Hakan
The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 +/- 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.
- Dergi
- MEDICAL MYCOLOGY
- Yıl
- 2024
- Cilt
- 62
- Sayı
- 7
- ISSN
- 1369-3786
- eISSN
- 1460-2709
- DOI
- 10.1093/mmy/myae064
- WoS UID
- WOS:001272180500001