Identifying Independent Predictors of Mortality in COVID-19 Patients with Mucormycosis
Mohamed G Hamed1
, Abdelmonem Awad Hegazy2*, Ahmed Embaby1, Shimaa Abdelmoneem1, Amany Abd Al Badea3, Ali Awad3, Mohammad Walaa4, Mai Ahmed Gobran5, Omnia Awwad6, Doaa AbdElmonem7, Nahla A Zaitoun8, Mona Ahmed Abdelmaksoud9, Alhoussein Alsayed AbdelAal11Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt,
2Medical Lab Department, Faculty of Allied Medical Sciences, Zarqa University, Jordan,
3Otorhinolaryngology Department, Faculty of medicine, Zagazig University, Egypt,
4Chest Medicine Department. Faculty of Medicine Zagazig University, Egypt,
5Pathology Department, Faculty of Medicine, Zagazig University, Egypt,
6Family Medicine Fellowship in the Egyptian MOHP, Egypt,
7Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt,
8Family Medicine Department, Faculty of Medicine, Zagazig University, Egypt,
9Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
Corresponding Author E-mail: dr.abdelmonemhegazy@yahoo.com
Abstract: Background: Coronavirus disease 2019 (COVID-19) may lead to immunosuppression, leaving patients vulnerable to secondary invasive fungal infection like mucormycosis. The present study aimed to determine whether there are any risk factors associated with mortality in mucormycosis among COVID-19 patients. Patients and Methods: Patients with COVID-19 diagnosed with mucormycosis who received treatment at University Hospitals were included in the study. Complete blood count (CBC), glycated hemoglobin (HBA1c), C-reactive protein (CRP), serum albumin level, creatinine, ferritin levels, lactate dehydrogenase (LDH), D-dimer and histopathological observations were performed for all participants’ specimens. Results: The number (N) of patients included in the study was 46. About 85 % (39/46) of patients had post-COVID-19 syndrome and the other 7 cases were in the active phase of the disease. CRP, serum ferritin, D-dimer, CRP/albumin ratio and CRP/absolute lymphocyte counts were statistically significant (P<0.05) within non-survivors as compared to survivors. After analysis of multivariate analysis that patients had oxygen support, while elevated CRP/albumin ratios were independent predictors of mortality in COVID-19 patients associated with mucormycosis. Conclusions: Mucormycosis can be caused by immunosuppression conditions associated with COVID-19 infection. Oxygen levels and C-reactive protein/albumin are independent predictors of mortality and morbidity in post COVID-19 patients.
Keywords: Mucormycosis; Outcome predictors; Prognostic markers; SARS-CoV-2 Back to TOC