Abstract：
The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 ± 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes.
Over a third of patients who developed mucormycosis after COVID-19 died. Older people, those on specific immunosuppressive treatments, and those with diabetic ketoacidosis had a higher risk of death. However, undergoing surgery as part of treatment significantly improved survival.
Over a third of patients who developed mucormycosis after COVID-19 died. Older people, those on specific immunosuppressive treatments, and those with diabetic ketoacidosis had a higher risk of death. However, undergoing surgery as part of treatment significantly improved survival.
摘要：
由严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）引起的COVID-19的出现，引发了全球大流行。同时,毛霉菌病病例报告激增,尤其是在印度的第二波浪潮中。本研究旨在调查COVID-19相关毛霉菌病（CAM）病例的死亡因素，探索临床，人口统计学,以及大部分亚洲国家和部分非洲国家的治疗变量。回顾，对来自8个国家22个医疗中心的CAM患者进行了横断面分析，重点关注COVID-19诊断后的前三个月。通过IDI-IR收集的数据包括人口统计，合并症,治疗,和结果。共纳入162名CAM患者。平均年龄54.29±13.04岁,54%的男性。糖尿病（85%）很普遍，91%患有犀牛-眶-脑毛霉菌病(ROCM)。84％的病例进行了手术清创。死亡率为39%,高龄[危险比（HR）=1.06，（p<0.001）]，利妥昔单抗的使用（HR=21.2，p=0.05），糖尿病酮症酸中毒（HR=3.58，p=0.009）被确定为危险因素。每增加一岁，死亡风险增加约5.6%。基于器官受累的手术清创与更高的生存率相关(HR=8.81,p<0.001)。利妥昔单抗和糖尿病酮症酸中毒的使用随着年龄的增长，与CAM患者死亡风险增加相关。抗真菌治疗和手术干预的结合已证明了生存结果的显着改善。
超过三分之一的患者在COVID-19死亡后出现毛霉菌病。老年人,接受特定免疫抑制治疗的患者和糖尿病酮症酸中毒患者的死亡风险较高.然而,接受手术作为治疗的一部分显着提高生存率。
超过三分之一的患者在COVID-19死亡后出现毛霉菌病。老年人,接受特定免疫抑制治疗的患者和糖尿病酮症酸中毒患者的死亡风险较高.然而,接受手术作为治疗的一部分显着提高生存率。
