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Article ; Online: Are Unique Regional Factors the Missing Link in India's COVID-19-Associated Mucormycosis Crisis?

Skaria, Jessy / John, Teny M / Varkey, Shibu / Kontoyiannis, Dimitrios P

mBio

2022  Volume 13, Issue 2, Page(s) e0047322

Abstract: The exact cause of the disproportionate increase in COVID-19-associated mucormycosis (CAM) cases in India remains unknown. Most researchers consider the major cause of India's CAM epidemic to be the conjunction of the COVID-19 pandemic and associated ... ...

Abstract The exact cause of the disproportionate increase in COVID-19-associated mucormycosis (CAM) cases in India remains unknown. Most researchers consider the major cause of India's CAM epidemic to be the conjunction of the COVID-19 pandemic and associated corticosteroid treatment with the enormous number of Indians with diabetes mellitus (DM). However, excess CAM cases were not seen to the same extent in the Western world, where diabetes is prevalent and corticosteroids are also used extensively for COVID-19 treatment. Herein, we hypothesize that previously overlooked environmental factors specific to India were important contributors to the country's CAM epidemic. Specifically, we propose that the spread of fungal spores, mainly through fumes generated from the burning of Mucorales-rich biomass, like cow dung and crop stubble, caused extensive environmental exposure in the context of a large population of highly vulnerable patients with DM and COVID-19. Testing this hypothesis with epidemiologic studies, phylogenetic analyses, and strategic environmental sampling may have implications for preventing future epidemics.
MeSH term(s) Adrenal Cortex Hormones ; COVID-19/drug therapy ; COVID-19/epidemiology ; Humans ; Mucormycosis/epidemiology ; Pandemics ; Phylogeny
Chemical Substances Adrenal Cortex Hormones
Language English
Publishing date 2022-03-31
Publishing country United States
Document type Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID 2557172-2
ISSN 2150-7511 ; 2161-2129
ISSN (online) 2150-7511
ISSN 2161-2129
DOI 10.1128/mbio.00473-22
Database MEDical Literature Analysis and Retrieval System OnLINE

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