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The emergence of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), triggered a global pandemic. Concurrently, reports of mucormycosis cases surged, particularly during the second wave in India. This study aims to investigate mortality factors in COVID-19-associated mucormycosis (CAM) cases, exploring clinical, demographic, and therapeutic variables across mostly Asian and partly African countries. A retrospective, cross-sectional analysis of CAM patients from 22 medical centers across eight countries was conducted, focusing on the first 3 months post-COVID-19 diagnosis. Data collected through the ID-IRI included demographics, comorbidities, treatments, and outcomes. A total of 162 CAM patients were included. The mean age was 54.29 ± 13.04 years, with 54% male. Diabetes mellitus (85%) was prevalent, and 91% had rhino-orbital-cerebral mucormycosis. Surgical debridement was performed in 84% of the cases. Mortality was 39%, with advanced age (hazard ratio [HR] = 1.06, [P < .001]), rituximab use (HR = 21.2, P = .05), and diabetic ketoacidosis (HR = 3.58, P = .009) identified as risk factors. The mortality risk increases by approximately 5.6% for each additional year of age. Surgical debridement based on organ involvement correlated with higher survival (HR = 8.81, P < .001). The utilization of rituximab and diabetic ketoacidosis, along with advancing age, has been associated with an increased risk of mortality in CAM patients. A combination of antifungal treatment and surgical intervention has demonstrated a substantial improvement in survival outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

Background: In severe COVID-19 cases, a hypercoagulable state may occur. Antiphospholipid syndrome-related auto-antibodies (APSRAs) contribute to coagulopathy, but their role in COVID-19 remains unclear. We aimed to investigate the prevalence of positive APSRAs and their effect on clinical outcomes in confirmed COVID-19 patients. Materials and Methods: In this cross-sectional study, severe hospitalized COVID-19 cases were enrolled. Demographic and clinical data were obtained from the day of admission. APSRAs including IgG and/or IgM anticardiolipin (aCL) and anti-ß2-glycoprotein1 (anti-ß2GP1) as well as lupus anticoagulant (LAC) were measured. Results: In this study, 54 severe COVID-19 cases with positive RT-PCR and chest CT scans were recruited. Positive APSRAs were found in 7 (12.9%) patients. Positive LAC was a more prevalent marker as compared to other tests (11.1%). The prevalence of positive aCL (IgM or IgG) and anti-ß2 GPI (IgM or IgG) w as 1.8% (in an elderly woman). Lower oxygen saturation was found in the positive APSRAs group as opposed to the negative APSRAs group (70.3±9 vs. 84.8±9.7%). The mortality rate in the positive APSRAs group was significantly higher relative to the negative APSRAs group (83.3% vs. 27.1%; Pvalue: 0.01). Likewise, the mechanical ventilation requirement in the positive group was also higher (50% vs. 27.1%, P-value: 0.28). Conclusion: This study indicated that LAC might be associated with critical cases and high mortality of COVID-19. Nonetheless, the mortality was not related to macrothrombotic incidence. [ABSTRACT FROM AUTHOR]

Introduction: Neuropsychological manifestations are increasingly reported in patients with COVID-19, but the subject is poorly understood and our knowledge about cognitive impairment is limited. This study aimed to investigate neuropsychological involvement of COVID-19 and its relation to laboratory data. Material and methods: This study was conducted among patients admitted to a tertiary medical center in Iran, in the period March 2020 to March 2021. Neuropsychiatric assessments were carried out by the Addenbrooke’s Cognitive Examination (ACE) test in all patients and interpreted by a specialist. It was performed using the Persian version of ACE in six domains consisting of attention, orientation, memory, language, visual perception and visuospatial skills. Laboratory data were assessed among all patients. Statistical analyses were performed using SPSS. Results: Among 114 patients with COVID-19, the mean age was 48.46 ±13.61 years, and the male/female ratio was 1.32. The mean values of some abnormal laboratory data were: erythrocyte sedimentation rate (ESR) 57.2 ±29.8, C-reactive protein (CRP) 81.7 ±59.8 and D-dimer 459.3 ±395.4. Cognitive impairment was detected in 41 patients (63%). The mean score of ACE was 80.68 ±19.29. Statistical analysis showed correlations between total result of the ACE test and laboratory findings that were not statistically significant. Conclusions: In our study, no relation was found between laboratory test results and the overall cognitive examination score but statistical analysis showed a correlation between CRP and verbal fluency, between hemoglobin level and language and visuospatial domains, and also between total level of bilirubin and memory. These relations may suggest that we should follow the neurocognitive features in COVID-19 patients earlier. [ABSTRACT FROM AUTHOR]