Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;74(Suppl 2):3498-3504.
doi: 10.1007/s12070-021-02970-6. Epub 2021 Nov 13.

Role of COVID 19 Inflammatory Markers in Rhino-Orbito-Cerebral Mucormycosis: A Case Study in Predisposed Patients at a Designated Nodal Centre

Nitya Goddanti  1 , Y Mounika Reddy  1 , M Kiran Kumar  1 , M Rajesh  1 , L Sudarshan Reddy  1
Affiliations

Role of COVID 19 Inflammatory Markers in Rhino-Orbito-Cerebral Mucormycosis: A Case Study in Predisposed Patients at a Designated Nodal Centre

Nitya Goddanti et al. Indian J Otolaryngol Head Neck Surg. 2022 Oct.

Abstract

Mucormycosis is a very morbid and potentially life threatening fungal infection. Sudden emergence and rapidly increasing numbers, of an otherwise rare infection in active Corona virus disease 2019 (COVID-19) or recently recovered patients has made us question the cause for this epidemic in India. This retrospective cohort study was done at Government Ear, Nose and Throat (ENT) hospital, Hyderabad, a designated nodal centre for mucormycosis for the state of Telangana, between April 2021 and June 2021. This study included patients with mucormycosis who had a recent history of COVID-19 infection. Potential predisposing factors (diabetes mellitus, history of oxygen and corticosteroids usage) and inflammatory marker values, predominantly deranged in COVID-19 infection (D-dimer and Serum Ferritin) were evaluated. A correlation between the marker values and susceptibility factors was also studied. Majority of these subjects showed elevated serum markers and had one or more of the predisposing factors for COVID-19 associated mucormycosis (CAM). A significant association was found between elevated marker values and susceptibility factors (diabetes, use of oxygen). Contrary to the popular belief, that the inadvertent use of steroids, use of industrial oxygen or elevated blood sugars caused this epidemic, our study concludes that their role is limited to affecting the extent of morbidity/mortality. B.1.1.7 and B.6.117 variants of severe acute respiratory syndrome coronavirus 2 (SARSCoV2), predominant during the second wave in India, facilitated the fungal invasion and spread by altering the gene expression and inducing inflammatory and immunomodulatory changes.

Keywords: COVID-19; COVID-19 associated mucormycosis; D-dimer; Mucormycosis; Serum ferritin.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Showing the age-sex distribution of the patients
Fig. 2
Fig. 2
Showing the number of patients with elevated D-dimer and serum ferritin levels
Fig. 3
Fig. 3
Showing the distribution of patients with elevated market levels according to susceptibility factors
See this image and copyright information in PMC

References

    1. Campbell CM, Kahwash R. Will complement inhibition be the new target in treating COVID-19-related systemic thrombosis? Circulation. 2020;141:1739–1741. doi: 10.1161/CIRCULATIONAHA.120.047419. - DOI - PubMed
    1. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012;54(SUPPL. 1):S23–S34. doi: 10.1093/cid/cir866. - DOI - PubMed
    1. Chander J, Kaur M, Bhalla M, Punia RS, Singla N, Bhola K, Alastruey-Izquierdo A, Stchigel AM, Guarro J. Changing epidemiology of mucoralean fungi: chronic cutaneous infection caused by mucor irregularis. Mycopathologia. 2015;180:181–186. doi: 10.1007/s11046-015-9908-z. - DOI - PubMed
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 621 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London, England) 2020;395(10223):507–13. doi: 10.1016/S0140-6736(20)30211-7. - DOI - PMC - PubMed
    1. Akshay R, Huy NT. Rising incidence of mucormycosis in patients with COVID-19: another challenge for India admits the second wave. Lancet Respiratory Med. 2021 doi: 10.1016/S2213-2600(21)00265-4. - DOI - PMC - PubMed

LinkOut - more resources