Risk Factors of Covid-19 Associated Mucormycosis in Iranian Patients: A Multicenter Study Publisher Pubmed

Summary: Study finds smoking, ICU stays, and advanced disease raise death risk in COVID-related fungal infections. Early action is key. #COVID19 #FungalInfection

Eshraghi B¹ ; Khademi B² ; Mirmohammadkhani M^{3, 4} ; Khataminia G^{5, 6} ; Ghahvehchian H⁷ ; Kiarudi MY⁸ ; Nabie R⁹ ; Parandin M¹⁰ ; Ghasemi Boroumand P¹¹ ; Mohammadi R¹² ; Zia Z² ; Karamirad S^{5, 6} ; Jafarpour S⁷ ; Fakoor M¹³ Show All Authors
Source: BMC Infectious Diseases Published:2024

Abstract

Background: To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients. Methods: This prospective observational study was conducted in 8 tertiary referral ophthalmology centers in different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination and underwent standard accepted treatment strategy based on the disease stage. Results: Two hundred seventy-four CAM patients (most were males (150, 54.7%)) with a mean age of 56.8 ± 12.44 years were enrolled. Patients with a history of cigarette smoking (Adjusted Odds Ratio (AOR) = 4.36), Intensive Care Unit admission (ICU) (AOR = 16.26), higher stage of CAM (AOR = 2.72), and receiving endoscopic debridement and transcutaneous retrobulbar amphotericin B (AOR = 3.30) had higher odds of mortality. History of taking systemic corticosteroids during COVID-19 was significantly associated with reduced odds of mortality (AOR = 0.16). Generalized Estimating Equations analysis showed that the visual acuity of deceased patients (LogMAR: 3.71, 95% CI: 3.04–4.38) was worse than that of patients who were discharged from the hospital (LogMAR: 2.42, 95% CI: 2.16–2.68) (P < 0.001). Conclusions: This study highlights significant risk factors for mortality in patients with CAM, such as cigarette smoking, ICU admission, advanced CAM stages, receiving transcutaneous retrobulbar amphotericin B and worser visual acuity. Conversely, a history of systemic corticosteroid use during COVID-19 was linked to reduced mortality. These findings underscore the critical need for early identification and targeted interventions for high-risk CAM patients to improve clinical outcomes. © The Author(s) 2024.