tetano
Editor, Senior Moderator
Med Mycol
. 2024 Jun 24:myae064.
doi: 10.1093/mmy/myae064. Online ahead of print. Factors Influencing Mortality in COVID-19-Associated Mucormycosis - The International ID-IRI Study
Meyha Sahin[SUP] 1 [/SUP], Mesut Yilmaz[SUP] 1 [/SUP], Ali Mert[SUP] 1 [/SUP], Behrouz Naghili[SUP] 2 [/SUP], Fatemeh Ravanbakhsh[SUP] 2 [/SUP], Mojtaba Varshochi[SUP] 2 [/SUP], Ilad Alavi Darazam[SUP] 3 4 [/SUP], Mohammad Javad Ebrahimi[SUP] 4 [/SUP], Maral Moafi[SUP] 4 [/SUP], Hamed Azhdari Tehrani[SUP] 5 [/SUP], Amjad Mahboob[SUP] 6 [/SUP], Naveed Rashid[SUP] 7 [/SUP], Ejaz Ahmed Khan[SUP] 7 [/SUP], Atousa Hakamifard[SUP] 4 8 [/SUP], Gülden Eser-Karlidag[SUP] 9 [/SUP], Abdolreza Babamahmoodi[SUP] 4 [/SUP], Amani El-Kholy[SUP] 10 [/SUP], Sayed Hussain Mosawi[SUP] 11 [/SUP], Ayşe Albayrak[SUP] 12 [/SUP], Jamal Wadi Al Ramahi[SUP] 13 [/SUP], Syam Kumar Addepalli[SUP] 14 [/SUP], Şafak Özer Balin[SUP] 15 [/SUP], Asfandiyar Khan[SUP] 16 [/SUP], Nirav Pandya[SUP] 17 [/SUP], Esra Gurbuz[SUP] 18 [/SUP], Gülden Sincan[SUP] 19 [/SUP], Hadia Azami[SUP] 11 [/SUP], Rıdvan Dumlu[SUP] 20 [/SUP], Reham Khedr[SUP] 21 [/SUP], Rezaul Karim Ripon[SUP] 22 [/SUP], Sevil Alkan[SUP] 23 [/SUP], Şükran Kose[SUP] 24 [/SUP], Bahadır Ceylan[SUP] 1 [/SUP], Hakan Erdem[SUP] 25 [/SUP]
Affiliations
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 three months post-COVID-19 diagnosis. Data collected through the IDI-IR 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 (ROCM). Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age [Hazard Ratio (HR)=1.06, (p<0.001)], rituximab use (HR=21.2, p=0.05), diabetic ketoacidosis (HR=3.58, p=0.009) 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<0.001). 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.
Keywords: COVID-19; COVID-19-associated mucormycosis; immunosuppression; mortality.
. 2024 Jun 24:myae064.
doi: 10.1093/mmy/myae064. Online ahead of print. Factors Influencing Mortality in COVID-19-Associated Mucormycosis - The International ID-IRI Study
Meyha Sahin[SUP] 1 [/SUP], Mesut Yilmaz[SUP] 1 [/SUP], Ali Mert[SUP] 1 [/SUP], Behrouz Naghili[SUP] 2 [/SUP], Fatemeh Ravanbakhsh[SUP] 2 [/SUP], Mojtaba Varshochi[SUP] 2 [/SUP], Ilad Alavi Darazam[SUP] 3 4 [/SUP], Mohammad Javad Ebrahimi[SUP] 4 [/SUP], Maral Moafi[SUP] 4 [/SUP], Hamed Azhdari Tehrani[SUP] 5 [/SUP], Amjad Mahboob[SUP] 6 [/SUP], Naveed Rashid[SUP] 7 [/SUP], Ejaz Ahmed Khan[SUP] 7 [/SUP], Atousa Hakamifard[SUP] 4 8 [/SUP], Gülden Eser-Karlidag[SUP] 9 [/SUP], Abdolreza Babamahmoodi[SUP] 4 [/SUP], Amani El-Kholy[SUP] 10 [/SUP], Sayed Hussain Mosawi[SUP] 11 [/SUP], Ayşe Albayrak[SUP] 12 [/SUP], Jamal Wadi Al Ramahi[SUP] 13 [/SUP], Syam Kumar Addepalli[SUP] 14 [/SUP], Şafak Özer Balin[SUP] 15 [/SUP], Asfandiyar Khan[SUP] 16 [/SUP], Nirav Pandya[SUP] 17 [/SUP], Esra Gurbuz[SUP] 18 [/SUP], Gülden Sincan[SUP] 19 [/SUP], Hadia Azami[SUP] 11 [/SUP], Rıdvan Dumlu[SUP] 20 [/SUP], Reham Khedr[SUP] 21 [/SUP], Rezaul Karim Ripon[SUP] 22 [/SUP], Sevil Alkan[SUP] 23 [/SUP], Şükran Kose[SUP] 24 [/SUP], Bahadır Ceylan[SUP] 1 [/SUP], Hakan Erdem[SUP] 25 [/SUP]
Affiliations
- PMID: 38914466
- DOI: 10.1093/mmy/myae064
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 three months post-COVID-19 diagnosis. Data collected through the IDI-IR 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 (ROCM). Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age [Hazard Ratio (HR)=1.06, (p<0.001)], rituximab use (HR=21.2, p=0.05), diabetic ketoacidosis (HR=3.58, p=0.009) 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<0.001). 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.
Keywords: COVID-19; COVID-19-associated mucormycosis; immunosuppression; mortality.