Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran: A Prospective Cohort Study

Background: The key contribution of this paper is from investigating the mortality and morbidity rates and related factors associated with COVID-19-associated-mucormycosis among Iranian patients. The existing literature is scarce on this topic, particularly in the context of Iran. The present study investigates mortality and morbidity among 62 confirmed COVID-19-associated-mucormycosis Iranian patients in relation to their demographic characteristics, laboratory test results, predisposing factors, and COVID-related factors. Material and Methods: In this prospective cohort study, the patients were identified in the fifth wave of the disease, between 1st August and 15th October 2021, with data collected at baseline with a three-week follow-up. This was a multicenter investigation with patients admitted to two clinics in Iran. 62 participants were admitted, with the key criteria of them being COVID-19-associated-mucormycosis patients. 53 out of 60 patients underwent corticosteroid therapy and debridement surgery. Intravenous remdesivir (200 mg/ kg/day at day 1, 100 mg/kg/day in following days for up to 5 days) and corticosteroids were administered for 53 out 54 patients. Oxygen therapy was only needed for 30% (n = 19) of the patients. Results: A 40% mortality rate was observed within the three-week follow-up, with deaths concentrated among those with controlled diabetes mellitus (61%) and long-term diabetes mellitus patients (an average of eight versus four years). Higher mortality was also observed in patients with higher leucocytes and those with rhino-orbital-cerebral (59%), followed by nasal (55.6%) mucormycosis. Among survivors, 32% were reinfected, and 56% suffered from loss of vision. Conclusion: The study concludes that mucormycosis is associated with a higher mortality rate among COVID-19 patients with diabetes mellitus, particularly corticosteroid recipients. Thus, urgent attention to this coinfection is warranted in Iran.

Chest computed tomography findings of COVID-19 in children younger than 1 year: a systematic review

Background The aim of this systematic review is to evaluate the chest computed tomography(CT)findings in infants with confirmed COVID-19 infection by providing a comprehensive review of the existing literature.Data sources A systematic search was conducted on PubMed and Embase from the onset of the COVID-19 outbreak to October 20,2020,for studies that discussed the chest CT findings in infants younger than 1 year with COVID-19 infection.Results A total of 35 studies comprising 70 COVID-19(58.5% boys)confirmed infants were included.The mean age of the included patients was 4.1 months with a range of 1 day to 12 months.Chest CT scans showed bilateral abnormalities in 34 patients,and unilateral lung involvement in 25 patients.Ground-glass opacities(GGO)(71.43%)were found to be the most prevalent chest CT manifestation,followed by peribronchial thickening(60%),linear or band-shaped opacities(32.8%),consolidation(28.57%),nodule(18.57%),effusion(7.14%)and focal lucency(7.14%).Conclusions GGO and peribronchial thickening were the most prevalent findings in the infants’chest CT scans.Linear or band-shaped opacities,consolidation,and pulmonary nodules are more common in infants than in adults.These findings suggest that the disease is more likely to be presented as an atypical pneumonia(peribronchial thickening and linear or bandshaped opacities)in this age group.Other chest CT scan manifestations can be classified as typical COVID-19 infection(peripheral GGO),lobar pneumonia(consolidation)and opportunistic infections(pulmonary nodules).