Risk Factors of COVID-19 associated mucormycosis in Iranian patients: a multicenter study.

Autor: Eshraghi B; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran., Khademi B; Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Mirmohammadkhani M; Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.; Department of Epidemiology and Biostatistics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran., Khataminia G; Infectious Ophthalmologic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.; Department of Ophthalmology, Faculty of Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Ghahvehchian H; Skull Base Research Center, Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Kiarudi MY; Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Nabie R; Nikookari Eye Center, Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran., Parandin M; Eye Research Center, Emam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran., Ghasemi Boroumand P; Department of Otolaryngology, Iran University of Medical Sciences, Tehran, Iran., Mohammadi R; Department of Medical Parasitology and Mycology, School of Medicine, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Zia Z; Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Karamirad S; Infectious Ophthalmologic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.; Department of Ophthalmology, Faculty of Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Jafarpour S; Skull Base Research Center, Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran., Fakoor M; Mashhad Eye Research Center, Department of Ophthalmology, Mashhad University of Medical Science, Mashhad, Iran., Varshochi M; Department of Infectious Diseases, Tabriz Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Shahraki K; Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran., Memarzadeh M; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran., Janipour M; Department of Otolaryngology, Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Mahdian Rad A; Infectious Ophthalmologic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.; Department of Ophthalmology, Faculty of Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahvaz, Iran., Kashkouli MB; Department of Ophthalmology and Visual Science, University of Louisville School of Medicine, Louisville, KY, USA., Shekarchian F; Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Manouchehri V; Nikookari Eye Center, Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran., Khosravi A; Eye Research Center, Emam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran., Abounoori M; Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.; Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran., Shahir A; Parsian Vision Research Institute, Isfahan, Iran., Sajjadi SMJ; Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran., Etezad Razavi M; Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Hosseini NS; Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Ebrahimi F; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran., Noorshargh P; Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Forouhari A; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran. ali_forouhari@yahoo.com., Pourazizi M; Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran. m.pourazizi@yahoo.com.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Aug 22; Vol. 24 (1), pp. 852. Date of Electronic Publication: 2024 Aug 22.
DOI: 10.1186/s12879-024-09755-6
Abstrakt: Background: To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients.
Methods: This prospective observational study was conducted in 8 tertiary referral ophthalmology centers in different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination and underwent standard accepted treatment strategy based on the disease stage.
Results: Two hundred seventy-four CAM patients (most were males (150, 54.7%)) with a mean age of 56.8 ± 12.44 years were enrolled. Patients with a history of cigarette smoking (Adjusted Odds Ratio (AOR) = 4.36), Intensive Care Unit admission (ICU) (AOR = 16.26), higher stage of CAM (AOR = 2.72), and receiving endoscopic debridement and transcutaneous retrobulbar amphotericin B (AOR = 3.30) had higher odds of mortality. History of taking systemic corticosteroids during COVID-19 was significantly associated with reduced odds of mortality (AOR = 0.16). Generalized Estimating Equations analysis showed that the visual acuity of deceased patients (LogMAR: 3.71, 95% CI: 3.04-4.38) was worse than that of patients who were discharged from the hospital (LogMAR: 2.42, 95% CI: 2.16-2.68) (P < 0.001).
Conclusions: This study highlights significant risk factors for mortality in patients with CAM, such as cigarette smoking, ICU admission, advanced CAM stages, receiving transcutaneous retrobulbar amphotericin B and worser visual acuity. Conversely, a history of systemic corticosteroid use during COVID-19 was linked to reduced mortality. These findings underscore the critical need for early identification and targeted interventions for high-risk CAM patients to improve clinical outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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