Şahin, MeyhaYılmaz, MesutMert, AliNaghili, BehrouzRavanbakhsh, FatemehVarshochi, MojtabaAlavi Darazam, IladEbrahimi, Mohammad JavadMoafi, MaralTehrani, Hamed AzhdariMahboob, AmjadRashid, NaveedKhan, Ejaz AhmedHakamifard, AtousaEser Karlıdağ, GüldenBabamahmoodi, AbdolrezaEl-Kholy, AmaniMosawi, Sayed HussainAlbayrak, AyşeWadi Al Ramahi, JamalAddepalli, Syam KumarBalin, Şafak ÖzerKhan, AsfandiyarPandya, NiravGürbüz, EsraSincan, GüldenAzami, HadiaDumlu, RıdvanKhedr, RehamRipon, Rezaul KarimAlkan, SevilKöse, ŞükranCeylan, BahadırErdem, Hakan2024-07-032024-07-032024Şahin, M., Yılmaz, M., Mert, A., Naghili, B., Ravanbakhsh, F., Varshochi, M. ... Erdem, H. (2024). Factors influencing mortality in covid-19-associated mucormycosis - the international ID-IRI study. Medical Mycology, 62(7). http://dx.doi.org/10.1093/mmy/myae0641369-37861460-2709http://dx.doi.org/10.1093/mmy/myae064https://hdl.handle.net/20.500.12511/12692The 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 three months post-COVID-19 diagnosis. Data collected through the IDI-IR 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 (ROCM). Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age [Hazard Ratio (HR)=1.06, (p<0.001)], rituximab use (HR=21.2, p=0.05), diabetic ketoacidosis (HR=3.58, p=0.009) 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<0.001). 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.eninfo:eu-repo/semantics/closedAccessCOVID-19COVID-19-Associated MucormycosisImmunosuppressionMortalityArticle62710.1093/mmy/myae064Q10012721805000012-s2.0-8519922368638914466Q1