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Mucormycosis co-infection in COVID-19 patients: An update

Alkhamiss, Abdullah S and Ahmed, Ahmed A and Rasheed, Zafar and Alghsham, Ruqaih and Shariq, Ali and Alsaeed, Thamir and Althwab, Sami A and Alsagaby, Suliman and Aljohani, Abdullah SM and Alhumaydhi, Fahad A and Alduraibi, Sharifa K and Alduraibi, Alaa K and Alhomaidan, Homaidan T and Allemailem, Khaled S and Alharbi, Raya A and Alamro, Samar A and Alqusayer, Arwa M and Alharbi, Sahim A and Alharby, Thekra A and Almujaydil, Mona S and Mousa, Ayman M and Alghaniam, Sultan A and Alghunaim, Abdulrhman A and Alghamdi, Rana and Fernández, Nelson and Al Abdulmonem, Waleed (2022) 'Mucormycosis co-infection in COVID-19 patients: An update.' Open Life Sciences, 17 (1). pp. 917-937. ISSN 2391-5412

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Mucormycosis (MCM) is a rare fungal disorder that has recently been increased in parallel with novel COVID-19 infection. MCM with COVID-19 is extremely lethal, particularly in immunocompromised individuals. The collection of available scientific information helps in the management of this co-infection, but still, the main question on COVID-19, whether it is occasional, participatory, concurrent, or coincidental needs to be addressed. Several case reports of these co-infections have been explained as causal associations, but the direct contribution in immunocompromised individuals remains to be explored completely. This review aims to provide an update that serves as a guide for the diagnosis and treatment of MCM patients’ co-infection with COVID-19. The initial report has suggested that COVID-19 patients might be susceptible to developing invasive fungal infections by different species, including MCM as a co-infection. In spite of this, co-infection has been explored only in severe cases with common triangles: diabetes, diabetes ketoacidosis, and corticosteroids. Pathogenic mechanisms in the aggressiveness of MCM infection involves the reduction of phagocytic activity, attainable quantities of ferritin attributed with transferrin in diabetic ketoacidosis, and fungal heme oxygenase, which enhances iron absorption for its metabolism. Therefore, severe COVID-19 cases are associated with increased risk factors of invasive fungal co-infections. In addition, COVID-19 infection leads to reduction in cluster of differentiation, especially CD4+ and CD8+ T cell counts, which may be highly implicated in fungal co-infections. Thus, the progress in MCM management is dependent on a different strategy, including reduction or stopping of implicit predisposing factors, early intake of active antifungal drugs at appropriate doses, and complete elimination via surgical debridement of infected tissues.

Item Type: Article
Uncontrolled Keywords: mucormycosis; immunocompromise; COVID-19; rhino-orbito-cerebral; pulmonary; diabetes: diabetes ketoacidosis; corticosteroids
Divisions: Faculty of Science and Health
Faculty of Science and Health > Life Sciences, School of
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 05 Sep 2022 16:04
Last Modified: 05 Sep 2022 16:04

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