COVID19 associated mucormycosis: Is GRP78 a possible link?

Gumashta, Jyotsna; Gumashta, Raghvendra

doi:10.1016/j.jiph.2021.09.004

Cited by 24 publications

(25 citation statements)

References 39 publications

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“…The estimated prevalence of otherwise rare mucormycosis in India has been 80 times higher than the global prevalence [4]. There is sufficient existing literature about mucormycosis surge during that time contributing to mortality and morbidity in COVID-19 patients owing to the immune dysregulation in the background of pre-existing comorbidities [2,5].…”

Section: Introductionmentioning

confidence: 99%

“…It has been well documented that immune dysfunction, preferred hypoxic environment, dysglycemia, acidic medium such as diabetic ketoacidosis (DKA)/metabolic acidosis, steroid-induced immunosuppression, and raised free iron level are all favorable factors for the development of mucormycosis in COVID-19 patients [2,6,11,12]. The current literature strongly establishes the higher risk and mortality of mucormycosis in COVID-19 patients with concomitant poorly controlled diabetes mellitus (DM) especially if associated with corticosteroid use [5,13].…”

Section: Introductionmentioning

confidence: 99%

“…Mucormycosis has not been a menace in these cases. Hence, a complex interplay of several factors contributes to the development as well as more severe extents of the infection in previous or concurrent COVID-19 infected patients [5]. Thus, although DM and steroid-associated hyperglycemia are cynosures of our current understanding of the risk factors of mucormycosis, a deeper understanding beyond this is integral in view of the above facts.…”

Section: Introductionmentioning

confidence: 99%

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Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

Bhadania¹,

Bhalodiya²,

Sethi³

et al. 2021

Cureus

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IntroductionCoronavirus disease 2019 (COVID-19) disease attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown associations with various fungal opportunistic infections such as mucormycosis, invasive candidiasis, and aspergillosis, which have contributed to the mortality of the disease. In India, the incidence of mucormycosis had risen rapidly during the second wave. There is ample literature demonstrating the role of iron in the pathogenesis of mucormycosis. The hyperferritinemia associated with COVID-19 may have played a significant role in promoting the invasion and extent of the fungus.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

Bhadania¹,

Bhalodiya²,

Sethi³

et al. 2021

Cureus

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“…The sudden significant increase in Mucorales detection in our hospital in August 2021 led us to propose various hypotheses. First, an effect related to the SARS-CoV-2 variant cannot be formally excluded [ 16 ]. As in India, the detection of Mucorales in our centre coincided with the spread of the Delta variant among ICU patients in France.…”

Section: Discussionmentioning

confidence: 99%

“…As in India, the detection of Mucorales in our centre coincided with the spread of the Delta variant among ICU patients in France. Second, the widespread use of dexamethasone/tocilizumab therapy during this fourth wave, a combination that was not used or was less frequently used during the previous waves, could constitute a plausible explanation for this emergence [ 16 ]. However, since mid-September, the incidence of Mucorales detection in COVID-19 patients drastically decreased in our centre, while the Delta variant was still predominant in France and dexamethasone/tocilizumab combination therapy was still being used to treat severe COVID-19.…”

Section: Discussionmentioning

confidence: 99%

A Clustered Case Series of Mucorales Detection in Respiratory Samples from COVID-19 Patients in Intensive Care, France, August to September 2021

Guemas

Cassaing

Malavaud

et al. 2022

JoF

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While COVID-19-associated pulmonary aspergillosis is now well described in developed countries, COVID-19-associated mucormycosis (CAM) has seemed to remain quite rare in Europe. A retrospective study was performed between March 2020 to September 2021 among COVID-19 adult patients in the intensive care unit (ICU) at Toulouse Hospital (Southern France). PCR screening on respiratory samples, which target Aspergillus or Mucorales DNA, were performed, and the number of fungal detections was evaluated monthly during the study period. During the 19 months of the study, 44 (20.3%) COVID-19 ICU patients had a positive PCR for Aspergillus, an overall rate in keeping with the incidence of ICU COVID-19 patients. Ten patients (7.1%) had a positive Mucorales PCR over the same period. Surprisingly, 9/10 had a positive Mucor/Rhizopus PCR in August-September 2021, during the fourth Delta SARS-CoV-2 variant wave. Epidemic investigations have identified a probable environmental cause linked to construction works in the vicinity of the ICU (high levels of airborne spores due to the mistaken interruption of preventive humidification and summer temperature). Even if CAM are apparently rare in Europe, a cluster can also develop in industrialised countries when environmental conditions (especially during construction work) are associated with a high number of COVID-19 patients in the ICU.

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Mucormycosis in pre‐COVID‐19 and COVID‐19 era: A study of prevalence, risk factors and clinical features

Arjmand

Bahrami

Mohammadie

et al. 2022

Laryngoscope Investig Oto

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Objective Mucormycosis is a rare yet devastating fungal disease with a frequently fatal outcome. The purpose of this study was to compare the prevalence of mucormycosis, evaluate its risk factors, and assess the patients' outcomes in pre‐COVID‐19 and COVID‐19 era. Methods In this retrospective observational study, clinical data of 158 patients with confirmed histopathological diagnosis of mucormycosis were collected from the medical records departments of Imam Reza and Ghaem hospitals, Mashhad, Iran during 2018–2021. The collected data were risk factors associated with mucormycosis including age, gender, underlying diseases, details of corticosteroid administration, and complications such as blindness and mortality. Results Of 158 studied patients, 48 patients were diagnosed in the pre‐pandemic period whereas 110 cases were admitted during the pandemic era. COVID‐19 associated mucormycosis (CAM) was observed in 58.1% of the pandemic cases. In the pre‐pandemic period, cancer (89.5% vs. 39%, p < .001) was significantly more prevalent while during the pandemic era, the prevalence of diabetes mellitus (16.7% vs. 51%, p < .001) was remarkably higher. Moreover, the mortality rate of mucormycosis was considerably reduced after the pandemic (64.6%–45.4%), especially in CAM patients (35.9%). Conclusion The COVID‐19 pandemic has led to an increased prevalence of mucormycosis, due to the convergence of interlinked risk factors such as diabetes mellitus, corticosteroid therapy, and COVID‐19. Therefore, clinicians must be aware of the probable occurrence of mucormycosis in the first or second week of COVID‐19 infection in vulnerable patients and use the steroids cautiously. Level of evidence 4 Laryngoscope Investigative Otolaryngology, 2022.

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COVID19 associated mucormycosis: Is GRP78 a possible link?

Cited by 24 publications

References 39 publications

Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

A Clustered Case Series of Mucorales Detection in Respiratory Samples from COVID-19 Patients in Intensive Care, France, August to September 2021

Mucormycosis in pre‐COVID‐19 and COVID‐19 era: A study of prevalence, risk factors and clinical features

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