Author(s)

Somayeh Dolatabadi¹, Mehdi Bakhshaee², Masoumeh Hosseinpoor², Ali Alizadeh Noghani³, Mohammadreza Afzalzadeh², Imaneh Roshanzamir², Bashir Rasoulian², Zahra Eslami Mohammadie⁴, Alireza Ghodsi³, Nazanin Forghani⁵, Parisa Arjmand², Zahra Valipour², Nima Ameli^2*

¹Department of Biology, Hakim Sabzevari University, Sabzevar, Iran.
²Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
³Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
⁴Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
⁵Department 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 1^st August and 15^th 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.

Mucorales, COVID-19, Mucormycosis, Coinfection, Dexamethasone, Diabetes Mellitus

Dolatabadi, S. , Bakhshaee, M. , Hosseinpoor, M. , Noghani, A. , Afzalzadeh, M. , Roshanzamir, I. , Rasoulian, B. , Mohammadie, Z. , Ghodsi, A. , Forghani, N. , Arjmand, P. , Valipour, Z. and Ameli, N. (2023) Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran: A Prospective Cohort Study. Advances in Infectious Diseases, 13, 407-423. doi: 10.4236/aid.2023.133034.