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Epidemiology of mucormycosis in COVID-19 patients in northwest Iran: Rhizopus arrhizus as the predominant species

Summary

This study found that COVID-19 patients in northwestern Iran who received high-dose steroid treatment developed serious fungal infections called mucormycosis. The infection was caused primarily by a fungus called Rhizopus arrhizus and affected mainly the sinuses and brain. The steroids used to treat COVID-19 weakened patients’ immune systems and triggered diabetes, both of which made them vulnerable to this dangerous fungal infection.

Background

COVID-19 patients face increased risk of secondary opportunistic fungal infections due to high-dose corticosteroid therapy and immune suppression. Mucormycosis has emerged as a serious co-infection in COVID-19 patients with high mortality rates. Geographic variation in Mucorales species distribution necessitates local epidemiological investigation.

Objective

This study aimed to assess demographic features, clinical characteristics, species diversity, and contributing factors among COVID-19 patients with concurrent mucormycosis in northwestern Iran.

Results

Of 70 suspected patients, 63 had laboratory-confirmed COVID-19 and mucormycosis (mean age 56.65±14.49 years, 63.5% male). Most common involvement sites were sinus (63.5%), cerebral (16%), and orbital (11%). Rhizopus arrhizus was identified as the main causative agent in 21 (33%) positive cultures, with 84% of patients having received dexamethasone and 25.4% having diabetes mellitus.

Conclusion

Corticosteroid therapy for COVID-19 management suppresses immunity and can induce hyperglycemia and diabetes, promoting opportunistic fungal infections like mucormycosis. Increased physician awareness of this risk and vigilant monitoring are essential for early detection and improved patient outcomes.
  • Published in:Current Medical Mycology,
  • Study Type:Cross-sectional descriptive study,
  • Source: PMID: 41122126
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