Neuro-mucormycosis: Lessons from COVID-19-associated cases

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Limited data exists on neurological presentations of COVID-19-associated mucormycosis (CAM) compared to COVID-19-unrelated rhino-orbito-cerebral mucormycosis (ROCM).
• Understanding these differences is crucial for diagnosis and management of mucormycosis, a serious fungal infection.

Purpose of the Study:

• To compare the neurological presentations and outcomes of CAM and COVID-19-unrelated ROCM.
• To identify factors associated with poor prognosis in CAM patients.

Main Methods:

• A case-control study comparing 78 CAM patients (Jan 2020-Dec 2021) with 72 COVID-19-unrelated ROCM patients (2016-2019).
• Data analyzed using non-parametric tests and generalized linear models (GLM) with SPSS software.
• Statistical significance set at P < 0.05.

Main Results:

• Neurological signs involving the second, third, and eighth cranial nerves were more frequent in the CAM group (P < 0.05).
• The mortality rate in the CAM group was 1.9 times higher than controls (P = 0.01), linked to increased corticosteroid use.
• Older age, gait ataxia, ptosis, and mydriasis predicted poor prognosis in CAM patients (P < 0.05).

Conclusions:

• Neurological manifestations of CAM are distinct from COVID-19-unrelated ROCM.
• Certain neurological signs in CAM correlate with a poorer prognosis.
• Further research is needed to validate these retrospective findings.