Mucormycosis in the COVID-19 Environment: A Multifaceted Complication
Authors
Rohit Sharma
Department of Rasa shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
Praveen Kumar
Department of Medicinal Chemistry, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India
Abdur Rauf
Department of Chemistry, University of Swabi, Swabi, Pakistan
Ashun Chaudhary
Department of Plant Science (Botany), Central University of Himachal Pradesh, Dharamshala, India
Pradeep Prajapati
Department of Rasashastra and Bhaishajya Kalpana, All India Institute of Ayurveda, New Delhi, India
Talha Emran
Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
Clara Lima
Department of Food Science, Federal University of Lavras, Lavras, MG, Brazil
Carlos Conte-Junior
Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, Brazil
The second wave of coronavirus disease 2019 (COVID-19) caused severe infections with high mortality. An increase in the cases of COVID-19-associated mucormycosis (CAM) was reported predominantly in India. Commonly present in immunocompromised individuals, mucormycosis is often a life-threatening condition. Confounding factors and molecular mechanisms associated with CAM are still not well understood, and there is a need for careful research in this direction. In this review, a brief account of the diagnosis, management, and advancement in drug discovery for mucormycosis has been provided. Here, we summarize major factors that dictate the occurrence of mucormycosis in COVID-19 patients through the analysis of published literature and case reports. Major predisposing factors to mucormycosis appear to be uncontrolled diabetes, steroid therapy, and certain cancers. At the molecular level, increased levels of iron in COVID-19 might contribute to mucormycosis. We have also discussed the potential role and regulation of iron metabolism in COVID-19 patients in establishing fungal growth. Other factors including diabetes prevalence and fungal spore burden in India as contributing factors have also been discussed.
Keywords: mucormycosis, SARS-CoV-2, diabetes, steroids, amphotericin-B, COVID-19, GRP78, hepcidin
Author Biography
Talha Emran, Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
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