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COVID-19-Associated Mucormycosis: Identifying Mortality Predictors in a Retrospective Cohort Study.
Zahra Ghavami1, Mahboubeh Haddad1, Fereshte Sheybani1
1Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Open Forum Infectious Diseases
|November 24, 2025
Summary
COVID-19-associated mucormycosis (CAM) is a serious complication. Elevated CRP levels predict mortality, while prolonged antifungal treatment and posaconazole use improve survival in CAM patients.
Area of Science:
- Infectious Diseases
- Mycology
- Critical Care Medicine
Background:
- COVID-19-associated mucormycosis (CAM) is a severe complication of COVID-19.
- Immunosuppressive treatments exacerbate CAM risk.
- Understanding CAM's clinical outcomes and mortality predictors is crucial.
Purpose of the Study:
- To assess clinical outcomes in adult patients with CAM.
- To identify predictors of mortality in CAM.
- To inform treatment strategies for improved patient survival.
Main Methods:
- Retrospective cohort study conducted at a major referral center in Iran.
- Data collected from the start of the COVID-19 pandemic through its fifth wave.
- Analysis of clinical characteristics, comorbidities, treatments, and survival rates.
Main Results:
- Diabetes mellitus (76.5%) and corticosteroid use (90.1%) were common. One-year survival was 50.6%.
- Elevated CRP levels (P=.001) predicted increased mortality.
- Palatal necrosis (HR: 2.12) was a risk factor, while longer antifungal treatment and posaconazole use (HR: 0.16) reduced mortality.
Conclusions:
- Early diagnosis and prompt, prolonged treatment are vital for CAM patients.
- Elevated CRP identifies patients at higher risk of mortality.
- Further research is needed to refine risk stratification and optimize therapeutic protocols for CAM.
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