ABSTRACT
Mucormycosis is a lethal human disease caused by fungi of the order Mucorales. Mucormycosis is caused by fungi mainly belonging to the genera Mucor, Rhizopus, and Lichtheimia, all of which belong to the order Mucorales. The number of individuals with mucormycosis-causing disorders has increased in recent years, hence, leading to the spread of mucormycosis. Throughout the coronavirus disease 2019 (COVID-19) pandemic, numerous cases of mucormycosis in COVID-19-infected patients have been reported worldwide, and the illness is now recognized as COVID-19-associated mucormycosis, with most of the cases being reported from India. Immunocompromised patients such as those with bone marrow sickness and uncontrolled diabetes are at a greater risk of developing mucormycosis. Genes, pathways, and other mechanisms have been studied in Mucorales, demonstrating a direct link between virulence and prospective therapeutic and diagnostic targets. This review discusses several proteins such as high-affinity iron permease (FTR1), calcineurin, spore coat protein (CotH), and ADP-ribosylation factors involved in the pathogenesis of mucormycosis that might prove to be viable target(s) for the development of novel diagnostic and therapeutic methods. Copyright © 2022 The Chinese Medical Association, Published by Wolters Kluwer Health, Inc.
ABSTRACT
Background: Long COVID, or post-COVID-19 sequelae, is being seen in a growing number of patients reporting a constellation of symptoms, both pulmonary and extrapulmonary. Studies on COVID-19 recovered patients are scarce. Thus, there is a need to add granularity to our existing knowledge about the course and long-term effects of the infection. Aim: To describe the clinical details and risk factors of post-COVID sequelae in the North Indian population. Method: This prospective observational study was conducted at a tertiary healthcare centre in Northern India between October 2020 to February 2021. Patients aged >18 years with a confirmed COVID-19 disease were recruited after at least two weeks of diagnosis and interviewed for any post-COVID-19 symptoms. Results: Of 1234 patients recruited, who were followed up for a median duration of 91 days (IQR: 45-181 days), 495 (40.11%) patients had symptoms. In 223 (18.1%) patients, the symptoms resolved within four weeks, 150 (12.1%) patients had symptoms till twelve weeks, and 122 (9.9%) patients had symptoms beyond twelve weeks of diagnosis of COVID-19. Most common long COVID-19 symptoms included myalgia (10.9%), fatigue (5.5%), shortness of breath (6.1%), cough (2.1%), disturbed sleep (1.4%), mood disturbances (0.48%) and anxiety (0.6%). The major determinants of developing post-COVID-19 symptoms in the patients were hypothyroidism and the severity of the disease. Conclusion: Most often, patients complain of myalgias, fatigue, dyspnoea, cough and disturbed sleep. Patients who are hypothyroid or have recovered from moderate to severe COVID-19 are at higher risk of developing post-COVID sequelae. Therefore, a multidisciplinary approach is required to diagnose and manage COVID-19 recovered patients.