Operative Profile and Surgical Outcomes of COVID-19-Associated Mucormycosis: A Retrospective Observational Study

Background: Coronavirus disease-2019 (COVID-19)-associated mucormycosis (CAM) emerged as a serious opportunistic fungal infection during the COVID-19 pandemic, particularly in patients with diabetes mellitus and corticosteroid exposure. Surgical debridement combined with antifungal therapy is the mainstay of treatment; however, predictors of surgical outcomes and mortality require further evaluation. Aim and Objectives: To evaluate the operative profile, surgical outcomes, and predictors of mortality in patients with COVID-19-associated mucormycosis undergoing surgical management at a tertiary care center. Materials and Methods: This retrospective observational study included 60 patients with confirmed COVID-19associated mucormycosis who underwent surgical intervention between June 2021 and May 2022. Clinical, radiological, operative, and outcome data were retrieved from hospital medical records. Results: The mean age of patients was 52.4 ± 11.6 years, with male predominance (68.3%). Diabetes mellitus was present in 86.7% of patients, and 81.7% had received corticosteroids during COVID-19 treatment. Sinonasal involvement was observed in 46.7%, rhino-orbital in 33.3%, and rhino-orbito-cerebral involvement in 20.0% of patients. Endoscopic sinus debridement was performed in all patients, while 23.3% required maxillectomy and 10.0% required orbital exenteration. At 90-day follow-up, 68.3% of patients recovered, 16.7% had residual disease, and overall mortality was 31.7%. Mortality was significantly higher in patients with intracranial involvement (p = 0.0008) and in those undergoing extensive surgical procedures (p = 0.0003). Conclusion: COVID-19-associated mucormycosis is associated with high mortality, particularly in advanced disease. Early diagnosis, aggressive surgical debridement, and prompt antifungal therapy are essential for improving survival. Disease extent remains the most important predictor of outcome.