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Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection

India saw an unprecedented and rapid rise of invasive coronavirus-associated mucormycosis (CAM) during the delta COVID-19 surge. There is little known about the pathophysiology and if there is a direct causation between the COVID-19 infection and invasive CAM. While the traditional risk factors such...

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Autores principales: Mandke, Charuta, Divekar, Rohit, Pradhan, Vandana, Arora, Shitij
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367188/
https://www.ncbi.nlm.nih.gov/pubmed/35944939
http://dx.doi.org/10.1136/bcr-2021-247893
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author Mandke, Charuta
Divekar, Rohit
Pradhan, Vandana
Arora, Shitij
author_facet Mandke, Charuta
Divekar, Rohit
Pradhan, Vandana
Arora, Shitij
author_sort Mandke, Charuta
collection PubMed
description India saw an unprecedented and rapid rise of invasive coronavirus-associated mucormycosis (CAM) during the delta COVID-19 surge. There is little known about the pathophysiology and if there is a direct causation between the COVID-19 infection and invasive CAM. While the traditional risk factors such as uncontrolled diabetes and other immunocompromising conditions are recognised, there could be several COVID-19-induced phenomena that may predispose the patients to develop CAM and are yet unrecognised. It has been proposed that prior severe COVID-19 is associated with invasive CAM. This could be due to the increased use of immunomodulators or the direct effects of the COVID-19 infection. We report four patients with CAM during the delta surge who did not have prior known COVID-19 infection but on subsequent testing had positive antibodies suggesting past asymptomatic infection. We report the quantitative abnormalities in lymphocyte subsets in all four patients and report CD19+ B cell lymphopenia and reduced percentage of CD27+ CD45RA+ naïve helper T cells. CAM may occur in patients after asymptomatic COVID-19 infection, in the absence of systemic corticosteroid and immunomodulator use, and may reflect underlying immune abnormalities possibly attributable to or unmasked by prior COVID-19 infection.
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spelling pubmed-93671882022-08-22 Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection Mandke, Charuta Divekar, Rohit Pradhan, Vandana Arora, Shitij BMJ Case Rep Case Reports: Findings that shed new light on the possible pathogenesis of a disease India saw an unprecedented and rapid rise of invasive coronavirus-associated mucormycosis (CAM) during the delta COVID-19 surge. There is little known about the pathophysiology and if there is a direct causation between the COVID-19 infection and invasive CAM. While the traditional risk factors such as uncontrolled diabetes and other immunocompromising conditions are recognised, there could be several COVID-19-induced phenomena that may predispose the patients to develop CAM and are yet unrecognised. It has been proposed that prior severe COVID-19 is associated with invasive CAM. This could be due to the increased use of immunomodulators or the direct effects of the COVID-19 infection. We report four patients with CAM during the delta surge who did not have prior known COVID-19 infection but on subsequent testing had positive antibodies suggesting past asymptomatic infection. We report the quantitative abnormalities in lymphocyte subsets in all four patients and report CD19+ B cell lymphopenia and reduced percentage of CD27+ CD45RA+ naïve helper T cells. CAM may occur in patients after asymptomatic COVID-19 infection, in the absence of systemic corticosteroid and immunomodulator use, and may reflect underlying immune abnormalities possibly attributable to or unmasked by prior COVID-19 infection. BMJ Publishing Group 2022-08-09 /pmc/articles/PMC9367188/ /pubmed/35944939 http://dx.doi.org/10.1136/bcr-2021-247893 Text en © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
spellingShingle Case Reports: Findings that shed new light on the possible pathogenesis of a disease
Mandke, Charuta
Divekar, Rohit
Pradhan, Vandana
Arora, Shitij
Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title_full Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title_fullStr Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title_full_unstemmed Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title_short Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection
title_sort quantitative b and t cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic covid-19 infection
topic Case Reports: Findings that shed new light on the possible pathogenesis of a disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367188/
https://www.ncbi.nlm.nih.gov/pubmed/35944939
http://dx.doi.org/10.1136/bcr-2021-247893
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