Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran: A Prospective Cohort Study  

作　　者：Somayeh Dolatabadi Mehdi Bakhshaee Masoumeh Hosseinpoor Ali Alizadeh Noghani Mohammadreza Afzalzadeh Imaneh Roshanzamir Bashir Rasoulian Zahra Eslami Mohammadie Alireza Ghodsi Nazanin Forghani Parisa Arjmand Zahra Valipour Nima Ameli Somayeh Dolatabadi;Mehdi Bakhshaee;Masoumeh Hosseinpoor;Ali Alizadeh Noghani;Mohammadreza Afzalzadeh;Imaneh Roshanzamir;Bashir Rasoulian;Zahra Eslami Mohammadie;Alireza Ghodsi;Nazanin Forghani;Parisa Arjmand;Zahra Valipour;Nima Ameli(Department of Biology, Hakim Sabzevari University, Sabzevar, Iran;Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran;Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran)

机构地区：[1]Department of Biology, Hakim Sabzevari University, Sabzevar, Iran [2]Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran [3]Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran [4]Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran [5]Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran

出　　处：《Advances in Infectious Diseases》2023年第3期407-423,共17页传染病进展（英文）

摘　　要：Background: The key contribution of this paper is from investigating the mortality and morbidity rates and related factors associated with COVID-19-associated-mucormycosis among Iranian patients. The existing literature is scarce on this topic, particularly in the context of Iran. The present study investigates mortality and morbidity among 62 confirmed COVID-19-associated-mucormycosis Iranian patients in relation to their demographic characteristics, laboratory test results, predisposing factors, and COVID-related factors. Material and Methods: In this prospective cohort study, the patients were identified in the fifth wave of the disease, between 1^st August and 15^th October 2021, with data collected at baseline with a three-week follow-up. This was a multicenter investigation with patients admitted to two clinics in Iran. 62 participants were admitted, with the key criteria of them being COVID-19-associated-mucormycosis patients. 53 out of 60 patients underwent corticosteroid therapy and debridement surgery. Intravenous remdesivir (200 mg/ kg/day at day 1, 100 mg/kg/day in following days for up to 5 days) and corticosteroids were administered for 53 out 54 patients. Oxygen therapy was only needed for 30% (n = 19) of the patients. Results: A 40% mortality rate was observed within the three-week follow-up, with deaths concentrated among those with controlled diabetes mellitus (61%) and long-term diabetes mellitus patients (an average of eight versus four years). Higher mortality was also observed in patients with higher leucocytes and those with rhino-orbital-cerebral (59%), followed by nasal (55.6%) mucormycosis. Among survivors, 32% were reinfected, and 56% suffered from loss of vision. Conclusion: The study concludes that mucormycosis is associated with a higher mortality rate among COVID-19 patients with diabetes mellitus, particularly corticosteroid recipients. Thus, urgent attention to this coinfection is warranted in Iran.Background: The key contribution of this paper is from investigating the mortality and morbidity rates and related factors associated with COVID-19-associated-mucormycosis among Iranian patients. The existing literature is scarce on this topic, particularly in the context of Iran. The present study investigates mortality and morbidity among 62 confirmed COVID-19-associated-mucormycosis Iranian patients in relation to their demographic characteristics, laboratory test results, predisposing factors, and COVID-related factors. Material and Methods: In this prospective cohort study, the patients were identified in the fifth wave of the disease, between 1^st August and 15^th October 2021, with data collected at baseline with a three-week follow-up. This was a multicenter investigation with patients admitted to two clinics in Iran. 62 participants were admitted, with the key criteria of them being COVID-19-associated-mucormycosis patients. 53 out of 60 patients underwent corticosteroid therapy and debridement surgery. Intravenous remdesivir (200 mg/ kg/day at day 1, 100 mg/kg/day in following days for up to 5 days) and corticosteroids were administered for 53 out 54 patients. Oxygen therapy was only needed for 30% (n = 19) of the patients. Results: A 40% mortality rate was observed within the three-week follow-up, with deaths concentrated among those with controlled diabetes mellitus (61%) and long-term diabetes mellitus patients (an average of eight versus four years). Higher mortality was also observed in patients with higher leucocytes and those with rhino-orbital-cerebral (59%), followed by nasal (55.6%) mucormycosis. Among survivors, 32% were reinfected, and 56% suffered from loss of vision. Conclusion: The study concludes that mucormycosis is associated with a higher mortality rate among COVID-19 patients with diabetes mellitus, particularly corticosteroid recipients. Thus, urgent attention to this coinfection is warranted in Iran.

关 键 词：MUCORALES COVID-19 MUCORMYCOSIS COINFECTION DEXAMETHASONE Diabetes Mellitus 

分 类 号：R58[医药卫生—内分泌]