A Comparative Analysis of COVID-19-Associated and Non-COVID-19-Associated Mucormycosis

Background: COVID-19-associated Mucormycosis (CAM) has emerged as a significant complication during the COVID-19 pandemic. However, there is a lack of comprehensive comparative studies with non-COVID-associated mucormycosis (NCM). Objective: This study aims to compare the clinical characteristics, risk factors, and outcomes of CAM and NCM to enhance the understanding and management of these infections, particularly during the COVID-19 pandemic. Method: A retrospective multicenter study was conducted at Cukurova University, Malatya İnönü University, and Gaziantep University. We analyzed and compared cases of CAM and NCM diagnosed between January 2018 and February 2022. Data were collected from the infectious diseases and clinical microbiology departments, including demographic details, underlying conditions, treatment regimens, and outcomes. Results: A total of 38 cases were analyzed, with 21 cases of COVID-19-associated mucormycosis (CAM) and 17 cases of non-COVID-19-associated mucormycosis (NCM). The key findings of the study were as follows: CAM was strongly associated with corticosteroid use (p<0.001) and diabetes (p=0.001), while NCM cases were more frequently linked to malignancy and neutropenia (p<0.05). Clinically, CAM cases had a higher incidence of cavernous sinus involvement and bone destruction (p=0.003) compared to NCM cases. However, there was no significant difference in overall survival between the CAM and NCM groups (p=0.201). Conclusion: The study highlights the critical role of corticosteroid use and diabetes as prominent risk factors for CAM. Timely diagnosis and intervention are essential to prevent severe complications, such as cavernous sinus involvement and bone destruction. These findings emphasize the need for tailored management strategies for CAM in the context of COVID-19, with particular attention to these risk factors.