Evidence map›Paper›PMID 36921716›Full record

SynthesisClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2023

COVID-19-associated mucormycosis: a systematic review and meta-analysis of 958 cases.

Laşin Özbek, Umur Topçu, Mehtap Manay, Buğra Han Esen, Sevval Nur Bektas, Serhat Aydın, Barış Özdemir, Sofya N Khostelidi, Nikolai Klimko, Oliver Cornely and 5 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed
21.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 112 citations in OpenAlex.

  1. Trial
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  4. Active Surveillance for Invasive Mold Disease - Four Hospitals, Atlanta, Georgia, 2020-2024.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2026
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  9. Lineage-specific endosymbiosis in Mucorales: restriction ofCurrent research in microbial sciences · 2026
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  14. Fatal Pharyngeal Cellulitis Caused byInfection and drug resistance · 2026
    Article
  15. Inflammatory indices as early predictors of mortality in mucormycosis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 5 countries.

Laşin ÖzbekSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Umur TopçuSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Mehtap ManaySchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Buğra Han EsenSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Sevval Nur BektasSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Serhat AydınSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Barış ÖzdemirSchool of Medicine, Koç University, School of Medicine, Istanbul, Turkey.
Sofya N KhostelidiDepartment of Clinical Mycology, Allergy, and Immunology, I. I. Mechnikov North-Western State Medical University, St Petersburg, Russia.
Nikolai KlimkoDepartment of Clinical Mycology, Allergy, and Immunology, I. I. Mechnikov North-Western State Medical University, St Petersburg, Russia.
Oliver CornelyDivision of Infectious Diseases (ECMM Diamond Excellence Center), Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Johnny ZakhourDivision of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
Souha S KanjDivision of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
Danila SeidelDivision of Infectious Diseases (ECMM Diamond Excellence Center), Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Martin HoeniglDivision of Infectious Diseases (ECMM Diamond Excellence Center), Medical University of Graz, Graz, Austria.
Önder ErgönülDepartment of Infectious Diseases and Clinical Microbiology, Koç University, School of Medicine, Istanbul, Turkey; Koç University İşbank Center for Infectious Diseases, Koç University, Istanbul, Turkey. Electronic address: oergonul@ku.edu.tr.
Koç University · TRAmerican University of Beirut Medical Center · LBNorth-Western State Medical University named after I.I. Mechnikov · RUUniversity Hospital Cologne · DEMedical University of Graz · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMucormycosis, a rare fungal infection, has shown an increase in the number of reported cases during the COVID-19 pandemic.

objectivesTo provide a comprehensive insight into the characteristics of COVID-19-associated mucormycosis, through a systematic review and meta-analysis. METHODS OF DATA SYNTHESIS: Demographic information and clinical features were documented for each patient. Logistic regression analysis was used to predict the risk of mortality. DATA SOURCES: PubMed, Scopus, Web of Science, Cochrane, CINAHL, Ovid MEDLINE, and FungiSCOPE. STUDY ELIGIBILITY CRITERIA: Studies reporting individual-level information in patients with adult COVID-19-associated mucormycosis (CAM) between 1 January 2020 and 28 December 2022.

participantsAdults who developed mucormycosis during or after COVID-19.

interventionsPatients with and without individual clinical variables were compared. ASSESSMENT OF RISK OF BIAS: Quality assessment was performed based on the National Institutes of Health quality assessment tool for case series studies.

resultsNine hundred fifty-eight individual cases reported from 45 countries were eligible. 88.1% (844/958) were reported from low- or middle-income countries. Corticosteroid use for COVID-19 (78.5%, 619/789) and diabetes (77.9%, 738/948) were common. Diabetic ketoacidosis (p < 0.001), history of malignancy (p < 0.001), underlying pulmonary (p 0.017), or renal disease (p < 0.001), obesity (p < 0.001), hypertension (p 0.040), age (>65 years) (p 0.001), Aspergillus coinfection (p 0.037), and tocilizumab use during COVID-19 (p 0.018) increased the mortality. CAM occurred on an average of 22 days after COVID-19 and 8 days after hospitalization. Diagnosis of mucormycosis in patients with Aspergillus coinfection and pulmonary mucormycosis was made on average 15.4 days (range, 0-35 days) and 14.0 days (range, 0-53 days) after hospitalization, respectively. Cutaneous mucormycosis accounted for <1% of the cases. The overall mortality rate was 38.9% (303/780).

conclusionMortality of CAM was high, and most reports were from low- or middle-income countries. We detected novel risk factors for CAM, such as older age, specific comorbidities, Aspergillus coinfection, and tocilizumab use, in addition to the previously identified factors.

Indexed as

CoinfectionCOVID-19MucormycosisAdultAgedHospitalizationHumansPandemicsCorticosteroidsCOVID-19Fungal infectionsMucormycosisOpportunistic infections

Identifiers

PMID36921716
PMCPMC10008766
OpenAlexW4324067482

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.