Publication date: Jul 06, 2025

Since December 2019, a serious health crisis caused by severe acute respiratory syndrome-Coronavirus-2 affected all aspects of human lives. The available data about COVID-19-associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) survival issues are based on studies on small populations with limited follow-up durations. Therefore, this multicenter cohort of a large population with CA-ROCM is aiming to report the one-year survival rate and investigate the potential responsible risk factors affecting the mortality. This prospective, longitudinal, multicenter study included CA-ROCM patients from eight tertiary ophthalmology centers across Iran. Demographic, clinical, and therapeutic data were collected and patients were followed for a year. Survival analysis was performed using Cox proportional hazards models to identify mortality-associated risk factors. The research protocol is also available on ClinicalTrials. gov (NCT05097664). Among the 246 patients, 183 (74. 4%) survived within a year and 63 (25. 6%) died. Significant mortality risk factors included need for orbital exenteration (HR = 3. 01 vs. other treatments, p = 0. 019), advanced disease stage (HR = 2. 43 stage IV vs. II, p = 0. 02), age (HR = 1. 05, p 

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