The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Amitabh Dube

Amitabh Dube

Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India

Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were
evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20-30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre-existing diabetes mellitus.
Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).

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Gain of Function Research: the Clairvoyant Lens on Pandemics

Pandemic influenza viruses have emerged three times in this century. It is important to examine the potential risk of novel microorganisms/viruses through the add-on research mechanism of Gain of Function Research (GoFR). This mechanism consists of the practice of serial passaging of microorganisms to increase their transmissibility, virulence, immunogenicity, and host tropism through the inclusive feature of selective pressure of culture medium. Although, the GoFR can be a double-edged sword that has the potential to give an insight and better appreciation of current and future pandemics with antecedent apprehension of initiating a pandemic, itself. Moreover, with its inherent potential to give a head start on a virus, GoFR has the potential to develop vaccines or therapeutics, before the virus emerges in its true virulent form. Likewise, the GoFR studies can be vital in research on antivirals and antimicrobial agents and can help inform the development of combination therapies. Passive immunotherapy, which often includes a combination of products, is particularly dependent on GoFR experiments for evaluating efficacy. GoFR if made use of meticulously and with caution could help Medical Sciences and Humankind tremendously.

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