{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:03:55Z","timestamp":1771023835582,"version":"3.50.1"},"reference-count":9,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,7,21]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>India saw an unprecedented and rapid rise of invasive coronavirus-associated mucormycosis (CAM) during the delta COVID-19 surge. There is little known about the pathophysiology and if there is a direct causation between the COVID-19 infection and invasive CAM. While the traditional risk factors such as uncontrolled diabetes and other immunocompromising conditions are recognised, there could be several COVID-19-induced phenomena that may predispose the patients to develop CAM and are yet unrecognised. It has been proposed that prior severe COVID-19 is associated with invasive CAM. This could be due to the increased use of immunomodulators or the direct effects of the COVID-19 infection. We report four patients with CAM during the delta surge who did not have prior known COVID-19 infection but on subsequent testing had positive antibodies suggesting past asymptomatic infection. We report the quantitative abnormalities in lymphocyte subsets in all four patients and report CD19+ B cell lymphopenia and reduced percentage of CD27+ CD45RA+ na\u00efve helper T cells. CAM may occur in patients after asymptomatic COVID-19 infection, in the absence of systemic corticosteroid and immunomodulator use, and may reflect underlying immune abnormalities possibly attributable to or unmasked by prior COVID-19 infection.<\/jats:p>","DOI":"10.1136\/bcr-2021-247893","type":"journal-article","created":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T11:20:25Z","timestamp":1660044025000},"page":"e247893","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Quantitative B and T cell abnormalities in four patients presenting with mucormycosis and prior asymptomatic COVID-19 infection"],"prefix":"10.1136","volume":"15","author":[{"given":"Charuta","family":"Mandke","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr Rustom Narsi Cooper Municipal General Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Divekar","sequence":"additional","affiliation":[{"name":"Division of Allergic Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vandana","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Immunology, Indian Council of Medical Research, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8927-6171","authenticated-orcid":false,"given":"Shitij","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine, Montefiore Hospital and Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"2025082801282984000_15.8.e247893.1","unstructured":"BMJ . Available: https:\/\/blogs.bmj.com\/bmj\/2021\/07\/02\/coronavirus-disease-associated-mucormycosis-warrants-timely-collaborative-registers\/ [Accessed 08 Aug 2021]."},{"key":"2025082801282984000_15.8.e247893.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2021.05.019"},{"key":"2025082801282984000_15.8.e247893.3","doi-asserted-by":"crossref","unstructured":"Patel A , Agarwal R , Rudramurthy SM , et al . MucoCovi network. multicenter epidemiologic study of coronavirus disease\u2013associated mucormycosis, India. 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