Mucormycosis in patients with COVID-19 in Russia: the results of a prospective multi-center study

Abstract

We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation.The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011–2020.In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (≥100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially ≥10 days (OR=25,4). The main localization of mucormycosis in patients with COVID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of ≥2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%).90-days overall survival of patients with mucormycosis and COVID-19 – 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and ≥ 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046).

COVID-19, mucormycosis, and the cow: Damned lies!

“…The reported prevalence of COVID-19-associated pulmonary mucormycosis was similar in Chile and India [ 34 , 56 ]. The other countries that reported CAM include Pakistan, Iran, Egypt, Turkey, Egypt, Honduras, Mexico, Russia, Latin America, and several European countries (Romania, France, and others) [ 9 , 53 , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] ]. The occurrence of CAM in such high proportions (up to 1% of critically ill COVID-19 cases in France) in countries where cow dung is not used, points towards the need for a better explanation for CAM rather than India-specific factors [ 55 , 59 ].…”