COVID-19 and mucormycosis

Lipnitsky A.V., Polovets N.V., Surkova R.S., Murugova A.A., Toporkov A.V., Victorov D.V.

Federal Government Health Institution «Volgograd Plague control Researsh Institute» of Federal Service for Surveillance in the Sphere of Consumers Rights Protection and Human Welfare, Volgograd, Russia

Mucormycosis is an angioinvasive disease caused by fungi of the order Mucorales. Coronavirus disease (COVID-19), associated mucormycosis (CAM) is a global emerging threat. More than 40 000 CAM cases have been reported in India. Emergense of CAM has been attributed to host, environmental and agents-related factors. Mucorales spore burden has been reported globally, however their presence is higher in tropical countries, such as India. Before the COVID-19 pandemic, patients with diabetes mellitus, hematological malignancies, solid organ transplants, corticosteroid therapy and neutropenia were more prone to mucormycosis. In COVID-19 patients, virus-induced endothelial dysfunction, hyperglycemia, and immune dysfunction following corticosteroid use. COVID-19 infection may directly induce hyperglycaemia by damaging beta cells of the pancreas or by corticosteroid therapy. In addition, corticosteroid treatment reduces the innate immune function of phagocytic cells. Free iron acquisition from the host is an important virulence factor of Mucorales.