Determinants of Mortality in COVID-19–Associated Opportunistic Fungal Infections

Abstract

COVID-19–associated mucormycosis (CAM) affected over 50,000 people during the second wave of the pandemic in India. Epidemiological aspects of CAM were reported, but there is a lack of published literature on mortality and its determinants in CAM and other fungal infections. The present study investigated patterns and determinants of mortality in these patients. The retrospective study reviewed case records of 390 patients, with at least 1 year of follow-up, for information related to demographics, epidemiology, clinical features, laboratory investigations, and treatment. The association between categorical variables was studied using the chi-square test of independence and logistic regression between 2 groups of those who survived and those who died during hospitalization or after discharge. A total of 157 (40%) patients did not survive; of these, 112 (29%) died during hospitalization and 45 (11%) had postdischarge mortality. The risk of mortality was associated with higher age, use of corticosteroids (odds ratio, 1.38; 95% confidence interval, 0.87–2.16), visual acuity <3/60 at presentation, palate involvement, and abnormal levels of white blood cells and red blood cells. The demographic, clinical, laboratory, and microbiological parameters may be predictors of mortality in patients of rhino-orbital-cerebral mucormycosis.