Comparative Mortality and Risk Analysis in Mucormycosis Cases: Pre-Pandemic Versus COVID-19 Association.

Abstract

Objectives: This study aims to compare the clinical profiles, outcomes, and mortality-related risk factors of COVID-19-associated mucormycosis (CAM) with cases identified before the pandemic. Additionally, it seeks to evaluate the impact of the COVID-19 pandemic on the epidemiology and severity of mucormycosis infections.

Study design: Retrospective, observational study.

Setting: The study was conducted across multiple medical centers in Shiraz, Iran.

Methods: We reviewed clinical data of patients diagnosed with mucormycosis before and during the COVID-19 pandemic. The study included a detailed analysis of demographic profiles, clinical characteristics, risk factors, treatment outcomes, and mortality. Mortality-related risk factors were specifically analyzed through logistic regression models to identify predictors of poor outcomes in CAM patients.

Results: The study included 122 cases of mucormycosis, with 85 cases associated with COVID-19. Patients with CAM showed higher prevalences of diabetes mellitus and hypertension compared to pre-pandemic cases, while malignancies were higher in peri-pandemic cases than in CAM cases (p < 0.05). CAM cases also demonstrated significantly higher in-hospital mortality (23.1%) compared to pre-pandemic cases (7.7%). Elevated platelet counts and the presence of periorbital edema were more commonly observed in CAM patients. Mortality-based analysis indicated that malignancies and high platelet counts were significant predictors of mortality in CAM patients.

Conclusion: COVID-19 has markedly affected the severity and mortality of mucormycosis, with CAM cases showing worse outcomes than pre-pandemic incidences. Our study emphasizes the need for aggressive management and increased awareness of risk factors to enhance survival rates in CAM patients during the pandemic.