One-Year Patient Survival After COVID-19-Associated Rhino-Orbital-Cerebral Mucormycosis: A Multicenter Study.

IF 3.6 3区生物学 Q2 MYCOLOGY

Mycopathologia Pub Date : 2025-07-06 DOI:10.1007/s11046-025-00966-2

Bahram Eshraghi, Behzad Khademi, Mohsen Bahmani Kashkouli, Gholamreza Khataminia, Mohammad Yaser Kiarudi, Reza Nabie, Mahdi Abounoori, Samira Chaibakhsh, Hossein Ghahvehchian, Fereshte Rastegarnasab, Mohammadmehdi Parandin, Zahra Zia, Soroush Karamirad, Soheyla Jafarpour, Mostafa Fakoor, Mojtaba Varshochi, Majid Mirmohammadkhani, Alireza Ramezani-Majd, Masoud Janipour, Atefe Mahdian Rad, Farid Shekarchian, Vahideh Manouchehri, S Mohammad Javad Sajjadi, Mohammad Etezad Razavi, Hajar Khosropour, Ali Forouhari, Fatemeh Ebrahimi, Mohsen Pourazizi

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引用次数: 0

Abstract

Introduction: Since December 2019, a serious health crisis caused by severe acute respiratory syndrome-Coronavirus-2 affected all aspects of human lives. The available data about COVID-19-associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) survival issues are based on studies on small populations with limited follow-up durations. Therefore, this multicenter cohort of a large population with CA-ROCM is aiming to report the one-year survival rate and investigate the potential responsible risk factors affecting the mortality.

Materials and methods: This prospective, longitudinal, multicenter study included CA-ROCM patients from eight tertiary ophthalmology centers across Iran. Demographic, clinical, and therapeutic data were collected and patients were followed for a year. Survival analysis was performed using Cox proportional hazards models to identify mortality-associated risk factors. The research protocol is also available on ClinicalTrials.gov (NCT05097664).

Results: Among the 246 patients, 183 (74.4%) survived within a year and 63 (25.6%) died. Significant mortality risk factors included need for orbital exenteration (HR = 3.01 vs. other treatments, p = 0.019), advanced disease stage (HR = 2.43 stage IV vs. II, p = 0.02), age (HR = 1.05, p < 0.001), and diabetes duration (HR = 1.05, p = 0.002). Paradoxically, steroid administration for COVID management was associated with improved survival (HR = 2.72 for no steroids, p = 0.018).

Discussion: COVID-19-associated Rhino-Orbital-Cerebral Mucormycosis carries a substantial one-year survival rate of 74.4% in Iran. Age, diabetes, advanced disease stage, and need for orbital exenteration are the probable fatal risk factors. Interestingly, administration of steroids for COVID management was associated with a better survival.

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一项多中心研究：covid -19相关鼻-眶-脑毛霉菌病后患者一年的生存率

自2019年12月以来，由严重急性呼吸系统综合征-冠状病毒-2引起的严重健康危机影响到人类生活的方方面面。关于covid -19相关的鼻-眶-脑毛霉菌病（CA-ROCM）生存问题的现有数据是基于对小群体的研究，随访时间有限。因此，本多中心队列研究的目的是报告CA-ROCM患者的一年生存率，并调查影响死亡率的潜在危险因素。材料和方法：这项前瞻性、纵向、多中心研究纳入了来自伊朗8个三级眼科中心的CA-ROCM患者。收集了人口统计学、临床和治疗数据，并对患者进行了一年的随访。采用Cox比例风险模型进行生存分析，以确定与死亡相关的危险因素。该研究方案也可在ClinicalTrials.gov （NCT05097664）上获得。结果：246例患者中，1年内存活183例（74.4%），死亡63例（25.6%）。重要的死亡危险因素包括眼眶摘除（HR = 3.01, p = 0.019）、疾病晚期（HR = 2.43， IV期vs II期，p = 0.02）、年龄（HR = 1.05, p）。讨论：在伊朗，与covid -19相关的鼻-眶-脑毛霉菌病的一年生存率高达74.4%。年龄、糖尿病、疾病晚期和需要眼眶清除术是可能的致命危险因素。有趣的是，在COVID管理中使用类固醇与更好的生存率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mycopathologia 生物-真菌学

CiteScore

6.80

自引率

3.60%

发文量

审稿时长

3 months

期刊介绍： Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.