COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey
| Author | Ayşin Kılınç Toker | en |
| Author | Ayse Turunc Ozdemir | en |
| Author | Azade Kanat | en |
| Author | Esma Eryilmaz Eren | en |
| Author | Hafize Sav | en |
| Author | Ibrahim Ozcan | en |
| Author | İlhami Çelik | en |
| Orcid | Ayşin Kılınç Toker [0000-0002-6775-1234] | en |
| Orcid | Ayse Turunc Ozdemir [0000-0002-0748-8593] | en |
| Orcid | Azade Kanat [0000-0003-2499-0101] | en |
| Orcid | Esma Eryilmaz Eren [0000-0002-2712-9694] | en |
| Orcid | Hafize Sav [0000-0001-8435-396X] | en |
| Orcid | Ibrahim Ozcan [0000-0002-4359-2988] | en |
| Orcid | İlhami Çelik [0000-0002-2604-3776] | en |
| Issued Date | 2024-04-30 | en |
| Abstract | Background: Mucormycosis, a fatal fungal infection, has increased during the COVID-19 pandemic and posed significant challenges for clinicians. Objectives: Our research focused on identifying the clinical traits of patients with COVID-19-associated mucormycosis (CAM), comparing them with a control group, and identifying risk factors for the development of CAM. Methods: Our study was conducted on 39 CAM patients and 78 control patients from September 2020 to October 2022 at a tertiary education center and regional hospital. The control group was selected blindly in a 1:2 ratio among patients who did not develop mucormycosis, were hospitalized due to COVID-19, and were either discharged or deceased. The control group was matched to the case group regarding age and hospitalization date. To test potential risk factors for CAM, we performed a binary logistic regression analysis. The variables included in the multivariate binary logistic regression model were gender, diabetes, cumulative steroid dose (dexamethasone equivalent), duration of steroid treatment, and tocilizumab/anakinra treatment. Results: In our study, 39 patients were diagnosed with CAM. The average age of the patients was 66 ± 11.5 years. Of the patients, 54.7% (n = 64) were male, with a statistically significantly higher proportion of men in the CAM group (74.4% vs. 44.9%, P = 0.003). The diabetes rate was 51.3% (n = 60) among all patients, and it was higher in the CAM group (69.2% vs. 42.3%, P = 0.006). Regarding in-hospital mortality, the rate was higher in the CAM group (56.4% vs. 14.1%, P < 0.001). The median length of stay in the hospital was 37 days for the CAM group and 10 days for the control group (P < 0.001). The cumulative steroid dose was elevated in the CAM group compared to the control group (191 ± 61.4 mg vs. 117 ± 69.8 mg, P < 0.001). The duration of steroid treatment was 16.5 ± 6.2 days in the CAM group, compared to 9.8 ± 4.7 days in the control group (P < 0.001). Among CAM cases, paranasal involvement was the most common (56.4%), followed by rhino-orbital involvement (33.3%). Conclusions: Male gender, diabetes mellitus, and steroid use for more than ten days were identified as positive risk factors, while tocilizumab/anakinra use was identified as a negative risk factor for the development of CAM. | en |
| DOI | https://doi.org/10.5812/jjm-146817 | en |
| Keyword | Mucormycosis | en |
| Keyword | COVID-19 | en |
| Keyword | Risk Factors | en |
| Publisher | Brieflands | en |
| Title | COVID-19 Associated Mucormycosis and Risk Factors: A Case-Control Study from Turkey | en |
| Type | Research Article | en |