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Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran: A Prospective Cohort Study

Advances in Infectious Diseases 2023年第3期13卷 407-423页

作者： Somayeh Dolatabadi Mehdi Bakhshaee masoumeh hosseinpoor Ali Alizadeh Noghani Mohammadreza Afzalzadeh Imaneh Roshanzamir Bashir Rasoulian Zahra Eslami Mohammadie Alireza Ghodsi Nazanin Forghani Parisa Arjmand Zahra Valipour Nima Ameli Department of Biology Hakim Sabzevari University Sabzevar Iran Sinus and Surgical Endoscopic Research Center Mashhad University of Medical Sciences Mashhad Iran Student Research Committee Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran Student Research Committee Faculty of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran Department of Otolaryngology Mashhad University of Medical Sciences Mashhad Iran

Background: The key contribution of this paper is from investigating the mortality and morbidity rates and related factors associated with COVID-19-associated-mucormycosis among Iranian patients. The existing literature is scarce on this topic, particularly in the context of Iran. The present study investigates mortality and morbidity among 62 confirmed COVID-19-associated-mucormycosis Iranian patients in relation to their demographic characteristics, laboratory test results, predisposing factors, and COVID-related factors. Material and Methods: In this prospective cohort study, the patients were identified in the fifth wave of the disease, between 1st August and 15th October 2021, with data collected at baseline with a three-week follow-up. This was a multicenter investigation with patients admitted to two clinics in Iran. 62 participants were admitted, with the key criteria of them being COVID-19-associated-mucormycosis patients. 53 out of 60 patients underwent corticosteroid therapy and debridement surgery. Intravenous remdesivir (200 mg/ kg/day at day 1, 100 mg/kg/day in following days for up to 5 days) and corticosteroids were administered for 53 out 54 patients. Oxygen therapy was only needed for 30% (n = 19) of the patients. Results: A 40% mortality rate was observed within the three-week follow-up, with deaths concentrated among those with controlled diabetes mellitus (61%) and long-term diabetes mellitus patients (an average of eight versus four years). Higher mortality was also observed in patients with higher leucocytes and those with rhino-orbital-cerebral (59%), followed by nasal (55.6%) mucormycosis. Among survivors, 32% were reinfected, and 56% suffered from loss of vision. Conclusion: The study concludes that mucormycosis is associated with a higher mortality rate among COVID-19 patients with diabetes mellitus, particularly corticosteroid recipients. Thus, urgent attention to this coinfection is warranted in Iran.

关键词： Mucorales COVID-19 Mucormycosis Coinfection Dexamethasone Diabetes Mellitus

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Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran:A Prospective Cohort Study

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Advances in Infectious Diseases（传染病进展） 2023年第3期

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