AI Article Synopsis
- There has been a significant increase in mucormycosis cases in India following the second wave of COVID-19, with over 40,000 cases reported.
- The rise in mucormycosis contrasts with other countries where different fungal pathogens like Aspergillus and Candida are more common in COVID-19 patients.
- The text discusses potential causes of this outbreak, suggesting that COVID-19 weakens the immune response while identifying other contributing factors, indicating a two-hit mechanism involving both viral infection and additional iatrogenic or environmental influences.
Article Abstract
There has been a surge of mucormycosis cases in India in the wake of the second wave of COVID-19 with more than 40000 cases reported. Mucormycosis in patients of COVID-19 in India is at variance to other countries where Aspergillus, Pneumocystis, and Candida have been reported to be the major secondary fungal pathogens. We discuss the probable causes of the mucormycosis epidemic in India. Whereas dysglycaemia and inappropriate steroid use have been widely suggested as tentative reasons, we explore other biological, iatrogenic, and environmental factors. The likelihood of a two-hit pathogenesis remains strong. We propose that COVID-19 itself provides the predisposition to invasive mucormycosis (first hit), through upregulation of GRP78 and downregulation of spleen tyrosine kinase involved in anti-fungal defense, as also through inhibition of CD8+ T-cell mediated immunity. The other iatrogenic and environmental factors may provide the second hit which may have resulted in the surge.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782544 | PMC |
| http://dx.doi.org/10.14336/AD.2021.0811 | DOI Listing |
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