COVID-19-associated mucormycosis in Iran: A retrospective study on 52 patients

Abstract Background: COVID-19-associated mucormycosis (CAM) has become one of the most severe post-COVID-19 comorbidities. Objectives: To describe CAM cases, identify possible risk factors, and report outcomes of patients. Methods: This retrospective study was performed in Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran between February 2020 and September 2021. Patients with an active or previous diagnosis of COVID-19 have been included. Results: Of 94 patients with mucormycosis, 52 (33 men and 19 women; mean age:57.0±11.82 years) were identified with the confirmed diagnosis of COVID-19. Rhino-orbital, rhinomaxillary, rhino-orbital cerebral subtypes were detected in 6(11.5%), 18(34.6%), and 28(53.8%) patients. As a control, 130 (69 men and 61 women; mean age:57.0±11.82 years) random RT-PCR-confirmed COVID-19 patients without mucormycosis have been included. The mean interval between COVID-19 diagnosis and initial mucormycosis symptoms was 16.63 ±8.4 days (range 0-51). Those in the CAM group had a significantly more severe course of COVID-19 (P-value<0.01). Diabetes mellitus (DM), high-dose corticosteroid pulse therapy, smoking were found as risk factors (P-value<0.01 for all). New-onset post-COVID-19 hyperglycemia was lower in the CAM group (46.2% vs. 63.8%; P-value=0.028). After treatment of the CAM group, 41 (78.8%) of patients recovered from mucormycosis. The mean ages of the expired patients were significantly higher (66.18±9.56 vs. 54.56±11.22 years; P<0.01); and COVID-19 disease was more severe (P=0.046). Conclusion: smokers, COVID-19 patients with a history of DM, and those with severe disease are at a high risk of CAM, and the mortality rate is higher in older patients. More studies are required to clarify risk factors.