Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 18 1 2026 02 15 147 156 EN Pariya Kouhi Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Seyed Alireza Mirhosseini Department of MD-MPH, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Ranjbar Department of MD-MPH, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mohammadreza Akbari Department of Internal Medicine, Shiraz Nephro-Urology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Zeinab Mehrabi Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Rojan Javaheri Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mahsa Moosavi Department of Education, Clinical Education Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Alishahi Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Kamran Rasekh Department of Infectious Disease, Ali Asghar Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Nazanin Fathi Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Yasaman Mansoori Department of Research, Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2024 09 24 2025 12 15 Background and Objectives: Numerous cases of mucormycosis appeared among COVID-19 patients, predominantly in Asian countries. This study aimed to investigate the clinical profile, in-hospital outcome, and one-year prognosis of COVID-19-associated mucormycosis (CAM). Materials and Methods: All patients who developed CAM in Shiraz, South Iran, between July and October 2021 were included in this study. We collected data on presentations, comorbidities, risk factors, and outcomes. Results: Sixty-two patients with CAM were analyzed; the mean age was 59.3 years, and 58.1% were male. Diabetes mellitus was present in 80.6% (11.2% uncontrolled), hypertension in 54.8%, and chronic kidney disease in 11.3%. All patients had sinonasal involvement; ophthalmic, cutaneous, cerebral, gastrointestinal, pulmonary, and renal involvement occurred in 41.9%, 8.1%, 6.4%, 6.4%, 1.6%, and 1.6%, respectively. In-hospital and one-year mortality were 40.3% and 48.3%. Concurrent CAM and COVID-19, hypertension, older age, and radiologically severe COVID-19 lung involvement were associated with higher mortality. In multivariable analysis, age ≥60 years predicted in-hospital (OR: 5.47; 95% CI: 1.53-19.56) and one-year mortality (OR: 7.65; 95% CI: 1.90-30.84). Long-term mortality was also associated with ≥3 risk factors (OR: 4.12; 95% CI: 1.09-15.52) and lung severity index >30 (OR: 9.35; 95% CI: 1.01-86.63). Conclusion: These findings emphasize the critical role of age in immune responses to opportunistic infections and highlight the impact of multiple comorbidities and severe lung damage on long-term prognosis in CAM. https://ijm.tums.ac.ir/index.php/ijm/article/view/5049 https://ijm.tums.ac.ir/index.php/ijm/article/download/5049/1872