{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:06:01Z","timestamp":1774958761154,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A rise in secondary fungal infections during the COVID\u201019 pandemic necessitates a deeper understanding of the associated immunological perturbations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the clinical and immunological characteristics observed in patients with COVID\u201019 associated mucormycosis (CAM) infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/ Methods<\/jats:title><jats:p>Cases of mucormycosis with or post\u2010COVID\u201019 infection were compared with cases of acute COVID\u201019 and convalescent COVID\u201019. Lymphocyte subsets, cytokines and other laboratory markers were compared between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The frequency of proposed risk factors for CAM was diabetes mellitus (77%), recent history of steroid use (69%) and hypoxia during COVID\u201019 infection (52%). Iron metabolism was dysregulated in CAM patients with low TIBC and total iron. Further, CAM was accompanied with lymphopenia with drastic reduction in B cell counts; however, plasmablasts were not altered. Further, CAM patients had low immunoglobulin levels and antibodies specific to mucor peptide did not increase in CAM suggesting dysfunction in B\u2010cell response. There was increase in activated effector cytotoxic CD8 T cells and NK cells in CAM compared with COVID\u201019 infection and healthy controls. Among T helper cells, Tregs were reduced and Th\u20101 frequency was increased in CAM compared with COVID\u201019 infection. A distinct cytokine signature was evident in CAM with increase in IL\u20101\u03b2, IFN\u2010\u03b3, IL\u20106, IL\u201022, IL\u201017A, IL\u201010, IL\u20102, IL\u20108, IL\u20107, IL\u201021 and GM\u2010CSF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study on immunophenotyping in CAM suggesting the need for long\u2010term monitoring of B\u2010cell function after SARS\u2010CoV\u20102 in patients with dysregulated glycaemic control and the possible benefit of therapeutic supplementation with intravenous immunoglobulins in CAM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13546","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T07:24:10Z","timestamp":1668583450000},"page":"226-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Perturbations of immune landscape in COVID\u201019 associated mucormycosis"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-4076","authenticated-orcid":false,"given":"Nidhi","family":"Desai","sequence":"first","affiliation":[{"name":"Department of Pediatric Immunology and Leukocyte Biology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vandana","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Clinical &amp; Experimental Immunology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Durga","family":"Chougule","sequence":"additional","affiliation":[{"name":"Department of Clinical &amp; Experimental Immunology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Smrati","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Medicine, G.S. Medical College King Edward Memorial Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charuta","family":"Mandke","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology HBT Medical College and Dr R N Cooper Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reetika Malik","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology and Leukocyte Biology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amita","family":"Athvale","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, G.S. Medical College King Edward Memorial Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhi","family":"Kawle","sequence":"additional","affiliation":[{"name":"Department of Medicine, G.S. Medical College King Edward Memorial Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinayak","family":"Pai","sequence":"additional","affiliation":[{"name":"Department of Medicine, G.S. Medical College King Edward Memorial Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swapnal","family":"Pawaskar","sequence":"additional","affiliation":[{"name":"Department of Clinical &amp; Experimental Immunology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harshada","family":"Kharkar","sequence":"additional","affiliation":[{"name":"Department of Clinical &amp; Experimental Immunology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Snehal","family":"Bhosale","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology and Leukocyte Biology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankita","family":"Parab","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology and Leukocyte Biology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology HBT Medical College and Dr R N Cooper Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinnera Harish","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology HBT Medical College and Dr R N Cooper Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shashikant","family":"Mhashal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology HBT Medical College and Dr R N Cooper Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelam","family":"Redkar","sequence":"additional","affiliation":[{"name":"Department of Medicine HBT Medical College and Dr R N Cooper Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Madkaikar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology and Leukocyte Biology Indian Council of Medical Research\u2010 National Institute of Immunohaematology Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.18231\/j.ijirm.2021.014"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof4020046"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir865"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2012.01.002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2021.05.019"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13353"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa248"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2021.1898790"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41422-020-00455-9"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.02037"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abc8511"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202048838"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0944-y"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-020-00806-6"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10061550"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/vim.2020.0177"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.111980"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/JLB.4COVCRA0820-481RRR"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-021-00686-1"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14647"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI140491"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2588-y"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2012.01.003"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","unstructured":"Coronavirus disease 2019 (COVID\u201019) treatment guidelines [Internet].2021. Acccessed 12 July 2022.https:\/\/pubmed.ncbi.nlm.nih.gov\/34003615\/","DOI":"10.5415\/apallergy.2022.12.e22"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-016-0333-y"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00094-21"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof8040415"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2709.210934"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13338"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13391"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI82744"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01087-20"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/150.5.752"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.31.12.1109"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116419"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7080616"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-021-06862-4"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e3283165fd1"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2011.07.004"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1008536"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"issue":"6","key":"e_1_2_11_43_1","first-page":"576","article-title":"Pathological changes of the spleen in ten patients with coronavirus disease 2019(COVID\u201019) by postmortem needle autopsy","volume":"49","author":"Xu X","year":"2020","journal-title":"Chin J Pathol"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41422-021-00523-8"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep23002"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01744"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.abg5021"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2012.04.004"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-00837-0"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-01901-w"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.08.025"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060779"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aaw1327"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211043413"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-07-366526"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6030173"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2017.1342920"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13546","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T08:29:27Z","timestamp":1728376167000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,24]]},"references-count":56,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/myc.13546"],"URL":"https:\/\/doi.org\/10.1111\/myc.13546","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,24]]},"assertion":[{"value":"2022-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}