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Iranian Journal of Pathology، جلد ۲۰، شماره ۳، صفحات ۲۸۸-۲۹۶
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عنوان انگلیسی Clinical Challenges and Predictive Risk Factors for Outcomes in COVID-19–Associated Mucormycosis
چکیده انگلیسی مقاله Background & Objective: 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 (CNS) significantly increases morbidity and mortality. This study aimed to identify clinical risk factors and outcomes associated with disease severity and mortality in COVID-19–associated mucormycosis (CAM), with a focus on disease progression to orbital and CNS involvement.
Methods: A total of 180 confirmed CAM patients were enrolled and classified into three groups based on disease extent: sinus-only, sinus with orbital involvement, and sinus with both orbital and CNS involvement. Data were collected on demographics, clinical history, laboratory findings, imaging results, treatment modalities, and outcomes.
Results: Of the 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 those with extensive disease. Corticosteroid use was significantly associated with disease severity (p = 0.002). Invasive procedures, such as orbital exenteration, were significantly linked to CNS progression (p < 0.05). The overall mortality rate was 31% (55 of 180 patients).
Conclusion: Uncontrolled diabetes and corticosteroid therapy are major risk factors for severe CAM. Extension of mucormycosis beyond the sinuses, particularly to the orbit and CNS, is associated with poor clinical outcomes and often requires aggressive surgical management. Early diagnosis and prompt intervention are essential to improve survival in these patients.
کلیدواژه‌های انگلیسی مقاله COVID-19,Mucormycosis,Risk Factors,Mortality,Diabetes Mellitus,Central nervous system
نویسندگان مقاله Fardin Ahmadkhani |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Seyed Jamal Hashemi |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Roshanak Daei Ghazvini |
Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Mohammadreza Salehi |
Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Azin Tabari |
Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Laura Alcazar Fuoli |
Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain

Farzad Pakdel |
Department of Oculo-Facial Plastic Surgery, Department of Ophthalmology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran

Alireza Abdollahi |
Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Mohammadreza Firouzifar |
Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Masoud Moradi |
Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran

Sadegh Khodavaisy |
Tehran University of Medical Sciences

نشانی اینترنتی https://ijp.iranpath.org/article_726181_7f2118fa7835ad3d56be77af67055ad7.pdf
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