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Clinical Challenges and Predictive Risk Factors for Outcomes in COVID-19–Associated Mucormycosis

Summary

During the COVID-19 pandemic, a dangerous fungal infection called mucormycosis has become a serious complication, especially for patients with uncontrolled diabetes or those taking certain medications. Researchers studied 180 patients with this condition and found that the infection can spread from the sinuses to the eyes and brain, leading to severe outcomes. The most important factors in surviving this infection are early detection, keeping blood sugar controlled, careful use of steroids, and aggressive treatment with antifungal medications and sometimes surgery.

Background

Mucormycosis has emerged as a severe complication in COVID-19 patients, particularly among those with uncontrolled diabetes and those receiving corticosteroid therapy. The infection’s tendency to spread from the sinuses to the orbit and central nervous system significantly increases morbidity and mortality.

Objective

This study aimed to identify clinical risk factors and outcomes associated with disease severity and mortality in COVID-19–associated mucormycosis, with a focus on disease progression to orbital and CNS involvement.

Results

Of 180 patients, 63.3% had sinus-only involvement, 23.9% had sinus and orbital involvement, and 12.8% had sinus, orbital, and CNS involvement. Uncontrolled diabetes was observed in 38% of patients and was more prevalent in extensive disease. Corticosteroid use was significantly associated with disease severity (p=0.002). The overall mortality rate was 31% with lowest survival in CNS-involved patients at 52%.

Conclusion

Uncontrolled diabetes mellitus and corticosteroid therapy are major risk factors for severe CAM. Extension of mucormycosis beyond the sinuses to the orbit and CNS is associated with poor outcomes and requires aggressive surgical management. Early diagnosis, tight glycemic control, and multidisciplinary treatment approach are essential to improve patient survival.
  • Published in:Iran Journal of Pathology,
  • Study Type:Observational Study,
  • Source: PMID: 40746929, DOI: 10.30699/ijp.2025.2044252.3371
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