Table 2.
Mortality associated with invasive fungal disease due to Mucorales.
| Author | Year | Study design | Study design | Study period | Country | Level of care | Population description (%) | Number of patients | Mortality type (n/N (%)) |
|---|---|---|---|---|---|---|---|---|---|
| Bonifaz et al.23 | 2014 | Retrospective cohort study | Multi-center | January 1985–December 2012 | Mexico | Tertiary | Children with mucormycosis ROC (77.27%), primary cutaneous, pulmonary |
22 | Death: 16/22 (72.7%) |
| Bonifaz et al.32 | 2021 | Retrospective cohort study | Single-center | January 1985–December 2019 | Mexico | Tertiary | Pediatric patients with mucormycosis ROC (75.9%), primary cutaneous (8.41%), pulmonary (7.47%) |
214 | Overall: 46/111 (41.4%) |
| Bonifaz et al.35 | 2021 | Retrospective cohort study | Single-center | January 1985–December 2019 | Mexico | Tertiary | Adults and children Primary cutaneous* (n = 18), secondary# cutaneous (n = 97) |
115 | Mortality: Primary cutaneous: 9/18 (50%) Secondary: 42/97 (43.3%) |
| Chakrabarti et al.24 | 2019 | Prospective cohort study | Multi-center | April 2016–September 2017 | India | Tertiary | Adult patients in ICU ROC (n = 29), pulmonary (n = 17) | 398 | Overall 42-day: 64.8% Overall 84-day: 65.8% |
| Chowdhary et al.29 | 2014 | Antifungal susceptibility study | Multi-center | 2004–2013 | India | Tertiary | Pulmonary (n = 39), ROC (n = 15), cutaneous/subcutaneous (n = 13), disseminated (n = 4) | 71 | 28/54 (51.8%) |
| Dolatabadi et al.33 | 2018 | Retrospective cohort study | Multi-center | 2008–2014 | Iran | Provincial | Adults and children sinuses (86%) | 208 | Mortality: 11/41 (26.8%) |
| Kontoyiannis et al.14 | 2016 | Retrospective cohort study | Multi-center | Janary 2005–June 2014 | USA | Teaching and non-teaching hospital | Patients with mucormycosis-related hospitalization. USA hospital-based database covering more than 560 participating hospitals and 104 million patients |
555 | Discharge death rate: 130/555 (23%) |
| Lee et al.22 | 2020 | Retrospective cohort study | Single-center | January 2011–August 2018 | South Korea | Tertiary | Adult patients with hematological diseases | 27 | 6-week mortality: 6/26 (23.1%) 12-week mortality: 7/26 (26.9%) |
| Legrand et al.20 | 2016 | Retrospective/period A: October 2013–January 2015 Prospective/period B: January 2015–February 2016 |
Multi-center | October 2013– February 2016 | France | Tertiary | Adult burns patients with invasive wound mucormycosis: >20% total body surface area | 77 | Period A: 4/5 (80%) Period B: 1/3 (33.3%) |
| Manesh et al.21 | 2019 | Retrospective cohort study | Single-center | September 2005–September 2015 | India | Tertiary | Patients with culture proven mucormycosis Paranasal sinuses (73.9%), MSK (15.2%) |
184 | Overall mortality: 57/184 (30.97%) Mortality in patients with hematological conditions:16/28 (57.14%) |
| Marty et al.36 | 2016 | Single-arm open-label trial with matched case-control analysis | Multi-center | April 2008–June 2013 | USA, Germany, France, Russia, Belgium, India, Israel, Czech Republic, Brazil, Thailand, Lebanon, and Switzerland | Tertiary | Adult patients with mucormycosis Pulmonary only (27%), pulmonary and other organs (32%), non-pulmonary disease (41%) |
37 in the single-arm open-label trial33 amphotericin B-treated matched controls | Isavuconazole Day-42 crude all-cause mortality primary treatment: 7/21 (33%) Day-42 crude all-cause mortality refractory group: 5/11 (45%) Day-42 crude all-cause mortality intolerant to other antifungal agents: 2/5 (40%) Day-84 crude all-cause mortality primary treatment: 9/21 (43%) Day-84 crude all-cause mortality refractory group: 5/11 (45%) Day-84 crude all-cause mortality intolerant to other antifungal agents: 2/5 (40%) Weighted all-cause mortality: 33% (13.2–53.5%) Amphotericin B Day-42 crude all-cause mortality primary treatment: 13/33 (39%) Weighted all-cause mortality: 41% (20.2%–62.3%) |
| Millon et al.34 | 2016 | Retrospective cohort study | Multi-center | January 2012–December 2014 | France | Tertiary | Adult patients Pulmonary (n = 17), disseminated (n = 14), ROC (n = 8), cutaneous (n = 4), GIT (n = 1) |
44 | Mortality Day 28: 27/44 (61%) Mortality Day 84: 32/44 (72%) |
| Pana et al.31 | 2016 | Retrospective review of prospectively collected cases | Multi-center | 2005–2014 | 15 countries (54 in European and 9 in non-European countries) | Not stated | Pediatric patients Disseminated (38.1%), pulmonary (19%), skin and soft tissue (19%), paranasal sinuses/sino-orbital (15.8%), ROC (7.5%) |
63 | Crude mortality, overall: 21 (33.3%) |
| Patel et al.26 | 2020 | Prospective cohort study | Multi-center | January 1, 2016–September 30, 2017 | India | Tertiary | Adults with proven mucormycosis ROC (67.7%), pulmonary (13.3%), cutaneous (1.0.5%), other (8.5%) |
485 | 90-day mortality: 242/465 (52.0%) |
| Prakash et al.6 | 2019 | Prospective cohort study | Multi-center | January 2013–December 2015 | India | Tertiary | Children and adults with mucormycosis ROC (63.9%), pulmonary (12.9%), cutaneous (9.5%), GIT (6.4%), renal (5.4%), other (1.8%) |
388 | Overall: 129/276 (46.7%) |
| Salmanton-Garcia et al.25 | 2020 | Retrospective review of prospectively collected cases | Multi-center | 1997–2019 | Multiple: mostly from India (n = 30, 16.1%), the United States (n = 24, 12.9%), Spain (n = 21, 11.3%), and Germany (n = 19, 10.2%) | Not stated | Adults and children with mucormycosis Disseminated (18.2%), eye (9.1%) |
22 | Day 42: 7/22 (31.8%) Overall: 11/22 (50%) Attributable: 8/11 (72.7%) |
| Van den Nest et al.15 | 2021 | Retrospective cohort study | Single-center | January 2009–August 2017 | Austria | Tertiary | Children and adults with invasive or localized filamentous fungi Pulmonary (n = 11), disseminated (n = 4), heart (n = 2), CNS (n = 1) |
18 | 30-day mortality: 9/11 (81.8%; 95% CI 55.8%–97.2%) 90-day mortality: 10/11 (90.9%; 95% CI 66.7%–99.5%) |
n/N, number that died/number included in study; ROC, rhino-orbital-cerebral; ICU, intensive care unit; USA, United States of America; MSK, musculoskeletal system; GIT, gastrointestinal tract; CI, confidence interval; CNS, central nervous system.
^Infection sites tabulated if identified for mucormycosis in the study
*Primary cutaneous: face (44.4%), leg (33.3%); forearm (11.1%), simultaneous thorax and leg (5.5%), and ear and neck (5.5%).
#
Secondary cutaneous: face (65.9%), nose and palate (20.6%), gum and palate (11.4%), ear and neck (1.03%), disseminated (1.03%), and organs affected as part of disseminated disease: soft tissue and wounds (n = 4), stomach (n = 1).