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Serum iron indices in COVID-19-associated mucormycosis: A case-control study.
Kumar H, Mohan; Sharma, Prashant; Rudramurthy, Shivaprakash M; Sehgal, Inderpaul Singh; Prasad, Kuruswamy Thurai; Pannu, Ashok Kumar; Das, Reena; Panda, Naresh K; Sharma, Navneet; Chakrabarti, Arunaloke; Agarwal, Ritesh; Muthu, Valliappan.
  • Kumar H M; Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Sharma P; Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Rudramurthy SM; Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Sehgal IS; Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Prasad KT; Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Pannu AK; Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Das R; Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Panda NK; Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Sharma N; Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Chakrabarti A; Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Agarwal R; Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Muthu V; Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Mycoses ; 65(1): 120-127, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1501485
ABSTRACT

BACKGROUND:

Whether dysregulated iron metabolism is associated with COVID-19-associated mucormycosis (CAM) remains unknown. Herein, we compare the serum iron indices in COVID-19 subjects with and without mucormycosis.

METHODS:

We conducted a case-control study enrolling COVID-19 participants with and without mucormycosis. We compared the baseline serum iron indices (iron, ferritin, total iron-binding capacity [TIBC], unsaturated iron-binding capacity and percentage transferrin saturation) between CAM cases and COVID-19 controls. Additionally, we performed a multivariate logistic regression analysis to assess whether any iron indices are associated with CAM.

RESULTS:

We enrolled 28 CAM cases (mean age 53.6 years old; 78.6% men) and 26 controls (mean age 57.2 years old; 73.1% men). Rhino-orbital (±cerebral) mucormycosis (85.7%) was the most clinical presentation. Diabetes mellitus was more frequent in the cases than controls (75% vs. 42.3%; p = .015). Hypoxaemia during COVID-19 illness was more common in controls than cases. The mean serum iron values (33 vs. 45 µg/dl, p = .03) and TIBC (166.6 vs. 201.6 µg/dl, p = .003) were significantly lower in CAM cases than controls. On multivariate analysis, we found a lower TIBC (odds ratio [OR] 0.97; 95% confidence interval [CI], 0.95-0.99) and diabetes mellitus (OR 5.23; 95% CI, 1.21-22.68) to be independently associated with CAM after adjusting for serum iron, ferritin and glucocorticoid therapy. The case fatality rate of CAM was 73.9%. The iron indices were not significantly different between CAM survivors and non-survivors.

CONCLUSIONS:

The CAM is associated with lower TIBC levels than COVID-19 subjects without mucormycosis, suggesting dysregulated iron metabolism in its pathogenesis. Further studies are required to confirm our preliminary observations.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ferritins / COVID-19 / Iron / Mucormycosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Middle aged Language: English Journal: Mycoses Journal subject: Microbiology Year: 2022 Document Type: Article Affiliation country: Myc.13391

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ferritins / COVID-19 / Iron / Mucormycosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male / Middle aged Language: English Journal: Mycoses Journal subject: Microbiology Year: 2022 Document Type: Article Affiliation country: Myc.13391