Clinical Spectrum and Outcome of COVID-19 Associated Rhino-Orbital-Cerebral Mucormycosis: A Cross-Sectional Study

Background. Rhino-orbital-cerebral mucormycosis, a severe and often fatal fungal infection, has seen a notable rise in incidence among COVID-19 patients, particularly in regions such as Iran. Methods. This cross-sectional study aimed to characterize the clinical spectrum, outcomes, and prognostic factors of ROCM in COVID-19 patients at a tertiary care hospital in southwestern Iran. Conducted from June 2021 to November 2022, the study included 48 consecutive patients with confirmed ROCM and COVID-19. Results. The mean age of participants was 54.79 ± 14.22 years, with the majority (85.4%) having diabetes mellitus. Common clinical presentations included periorbital/orbital edema (60.4%), ptosis (62.5%), and chemosis (45.8%), while headaches were uncommon. Treatment modalities primarily included sinus endoscopy (93.8%), antifungal therapy (95.8%), and jaw debridement (43.8%). The study revealed significant morbidity, with 35.4% of patients experiencing unilateral blindness, 31.3% jaw deformity, and a mortality rate of 22.9%. Statistical analysis identified diabetes and sinus endoscopy as inversely correlated with mortality, while facial palsy showed a direct correlation. Age was significantly associated with periorbital edema, and hospital stay duration was correlated with sinus endoscopy, facial palsy, and nasal congestion. Conclusion. These findings underscore the severe impact of Rhino-Orbital-Cerebral-Mucormycosis in COVID-19 patients, emphasizing the need for early diagnosis, aggressive management, and further research to improve outcomes in this high-risk population.