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

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.

Retrospective, observational study.

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

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.

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.

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.