{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:08:19Z","timestamp":1762078099544,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T00:00:00Z","timestamp":1669507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Einstein-Montefiore Institute for Clinical &amp; Translational Research","award":["UL1TR002556-06"],"award-info":[{"award-number":["UL1TR002556-06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: COVID-19-associated mucormycosis (CAM) is associated with high morbidity and mortality. MUNCO is an international database used to collect clinical data on cases of CAM in real time. Preliminary data from the Mycotic Infections in COVID-19 (MUNCO) online registry yielded 728 cases from May to September 2021 in four South Asian countries and the United States. A majority of the cases (694; 97.6%) consisted of a mucormycosis infection. The dataset allowed for the analysis of the risk factors for adverse outcomes from CAM and this analysis is presented in this paper. Methods: The submission of cases was aided by a direct solicitation and social media online. The primary endpoints were full recovery or death measured on day 42 of the diagnosis. All patients had histopathologically confirmed CAM. The groups were compared to determine the contribution of each patient characteristic to the outcome. Multivariable logistic regression models were used to model the probability of death after a CAM diagnosis. Results: The registry captured 694 cases of CAM. Within this, 341 could be analyzed as the study excluded patients with an unknown CAM recovery status due to either an interruption or a lack of follow up. The 341 viable cases consisted of 258 patients who survived after the completion of treatment and 83 patients who died during the period of observation. In a multivariable logistic regression model, the factors associated with an increased risk of mortality include old age (OR = 1.04, 95% CI 1.02\u20131.07, p = 0.001), history of diabetes mellitus (OR 3.5, 95% CI 1.01\u201311.9, p = 0.02) and a lower BMI (OR 0.9, 95% CI 0.82\u20130.98, p = 0.03). Mucor localized to sinus disease was associated with 77% reduced odds of death (OR = 0.23, 95% CI 0.09\u20130.57, p = 0.001), while cerebral mucor was associated with an increased odds of death (OR = 10.96, 95% CI 4.93\u201324.36, p = \u22640.0001). Conclusion: In patients with CAM, older age, a history of diabetes and a lower body mass index is associated with increased mortality. Disease limited to the sinuses without a cerebral extension is associated with a lower risk of mortality. Interestingly, the use of zinc and azithromycin were not associated with increased mortality in our study.<\/jats:p>","DOI":"10.3390\/jcm11237015","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T06:04:36Z","timestamp":1669615476000},"page":"7015","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors Associated with Mortality in Coronavirus-Associated Mucormycosis: Results from Mycotic Infections in COVID-19 (MUNCO) Online Registry"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8927-6171","authenticated-orcid":false,"given":"Shitij","family":"Arora","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, NW651, 111 E 210th Street, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3440-0259","authenticated-orcid":false,"given":"Shivakumar","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Fazzari","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kranti","family":"Bhavana","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, Patna 801507, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhartendu","family":"Bharti","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, Patna 801507, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shweta","family":"Walia","sequence":"additional","affiliation":[{"name":"Maharaja Yeshwantrao Hospital, Indore 452010, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neetu","family":"Kori","sequence":"additional","affiliation":[{"name":"Maharaja Yeshwantrao Hospital, Indore 452010, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushila","family":"Kataria","sequence":"additional","affiliation":[{"name":"Medanta Institute of Education & Research, Gurugram 122018, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja","family":"Sharma","sequence":"additional","affiliation":[{"name":"Medanta Institute of Education & Research, Gurugram 122018, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavya","family":"Atluri","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics, University of California, Los Angeles, CA 90095, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charuta","family":"Mandke","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hinduhridaysamrat Balasaheb Thackarey Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai 400056, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod","family":"Gite","sequence":"additional","affiliation":[{"name":"Department of ENT, Hinduhridaysamrat Balasaheb Thackarey Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai 400056, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelam","family":"Redkar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hinduhridaysamrat Balasaheb Thackarey Medical College and Dr. Rustom Narsi Cooper Municipal General Hospital, Mumbai 400056, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayank","family":"Chansoria","sequence":"additional","affiliation":[{"name":"Department of Emergeny Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur 482003, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumit Kumar","family":"Rawat","sequence":"additional","affiliation":[{"name":"Bundelkhand Medical College Sagar, Sagar 470001, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajani S.","family":"Bhat","sequence":"additional","affiliation":[{"name":"Consultant Pulmonologist, Bangalore 560080, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameet","family":"Dravid","sequence":"additional","affiliation":[{"name":"Noble Hospital, Pune 411013, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yatin","family":"Sethi","sequence":"additional","affiliation":[{"name":"Venkateshwara Hospital, Dwarka, New Delhi 110075, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandan","family":"Barnawal","sequence":"additional","affiliation":[{"name":"Associate Consultant and Academic Co-Ordinator Nepal MediCiti, Karyabinayak 44600, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirmal Kanti","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Sarkari Kormochari Hospital, Dhaka 1212, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunit","family":"Jariwala","sequence":"additional","affiliation":[{"name":"Biodesign and Innovation Program, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Southern","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, NW651, 111 E 210th Street, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoram","family":"Puius","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, August 10). 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