Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

Bhadania, Simple; Bhalodiya, Neena; Sethi, Yashendra; Kaka, Nirja; Mishra, Sonali; Patel, Nayna; Wasim, Asad Ullah; Joshi, Saumya S; Shah, Kenisha

doi:10.7759/cureus.20569

Cited by 14 publications

(14 citation statements)

References 28 publications

(49 reference statements)

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“… 93 A prospective study by Anand et al in 2022 that compared serum ferritin values among COVID-19 and non-COVID patients demonstrated a higher serum ferritin level among COVID-patients, and mucormycosis patients had higher serum ferritin levels, especially among the non-survivors and critically ill patients. 94 Similar findings were observed by Rao et al and Bhadania et al 95 , 96 …”

Section: Risk Factorssupporting

confidence: 84%

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

Alrasheedi

Alotaibi

Alshalan

et al. 2023

JAA

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Sinusitis is a common condition with various forms and different etiologies. In the era of COVID-19, a large number of studies covered the association between sinusitis and COVID-19, while others reported the impact of COVID-19 on the development of acute invasive fungal rhinosinusitis (AIFR), together with the most commonly associated predisposing factors. Fungal sinusitis, particularly AIFR, can be life-threatening. It is important to dissect this association and improve current evidence and management. Therefore, we conducted this literature review to highlight the association between COVID-19 and sinusitis based on evidence from the available studies in the literature. Evidence shows that chronic sinusitis might have a negative impact on COVID-19 outcomes. However, current results are conflicting, and further studies are needed. On the other hand, COVID-19 can also cause olfactory dysfunction, which is usually temporary. In addition, we found several studies that indicated the association between COVID-19 and AIFR. The condition is usually associated with severe morbidities, as affected patients are usually immunocompromised, including those with uncontrolled diabetes, malignancy, immunosuppression, AIDS, the administration of chemotherapy and other immunosuppressive drugs, and COVID-19.

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Section: Risk Factorssupporting

confidence: 84%

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

Alrasheedi

Alotaibi

Alshalan

et al. 2023

JAA

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“…Serum ferritin of more than 1000 ng/mL was associated with increased morbidity in terms of hospital stay and recovery time as shown by Bhanuprasad K et al, and serum ferritin was significantly greater in mucormycosis patients and was also significantly connected to mortality [ 31 ]. Another study conducted by Bhadania S et al recorded a significant difference in serum ferritin levels between mild (193.6 ng/mL) and severe invasive mucormycosis (342.1 ng/mL) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Estimation of Serum Ferritin in Mucormycosis Patients and Prognostication Based on the Ferritin Value

C¹,

Senthilkumar²,

Nivedha³

et al. 2022

Cureus

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Introduction: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been implicated in a variety of vulnerable bacterial and fungal diseases. Mucormycosis is a life-threatening infection caused by fungi belonging to the class Zygomycetes and the order Mucorales. The aim of the present study is to evaluate the level of serum ferritin level in mucormycosis patients and to prognosticate them based on those values. Materials and methods: This prospective observational study was conducted in the Department of General Medicine, Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli, in 50 diagnosed mucormycosis patients. Results: During the study period, 44 had prior COVID-19 illness (post-COVID). Six patients had mucormycosis with no prior COVID-19 illness. Rhino-orbital involvement was found in 44 of the 50 cases, with three of them having cerebral extension. Forty-one cases recovered and were discharged, six cases remained sick and were hospitalized, and three died. The post-COVID patients (554.13 ± 371.60) have greater serum ferritin levels than non-COVID patients (259.95 ± 110.15), which are statistically significant. Conclusion: Mucormycosis patients tend to have higher serum ferritin values, especially among non-survivors and sick patients than survivors. For a better chance of recovery and survival, early identification, surgical debridement, and antifungal medications are essential.

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“…In addition, studies including patients with invasive fungal infections in general, and not mucormycosis specifically, and studies including mucormycosis cases not associated with COVID-19 and not separately with CAM cases were excluded. Sixteen studies were excluded due to unavailable–insufficient information [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Four studies were excluded as they included patients with non-microbiologically confirmed SARS-CoV-2 infection [ 25 , 26 , 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

et al. 2022

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A mucormycosis surge was reported during the COVID-19 pandemic in India. A literature search until 14 July 2022, with the aim of updating COVID-19-associated mucormycosis (CAM), identified 663 studies and 88 met inclusion criteria (8727 patients). India reported 8388 patients, Egypt 208 and Europe 40. Rhino-orbito-cerebral mucormycosis (ROCM) was identified among 8082 (98.3%) patients, followed by 98 (1.2%) with pulmonary. In India, 82.6% of patients had diabetes mellitus, with 82% receiving corticosteroids. In Europe, 75% presented pulmonary CAM, 32.5% had diabetes and 40% were immunocompromised. CAM was identified at a median of 17.4 days (IQR 7.5 days) post COVID-19 diagnosis, and PCR was performed in five studies. Rhino-orbital invasion is clinically obvious, while cerebral involvement presents with cavernous sinus thrombosis, meningitis and cerebrovascular disease. Symptoms of pulmonary CAM usually overlap with severe COVID-19 pneumonia. High-dose liposomal Amphotericin B (and early surgical debridement in ROCM) are the mainstay of therapy. The median mortality rate was estimated to be 21.4% (IQR 31.9%), increased by the presence of pulmonary (80% (IQR 50%) or cerebral involvement (50% (IQR 63.9%). In summary, different CAM clinical phenotypes need to be distinguished, influenced by geographical presentation. Opportunities exist for diagnosis and therapy optimization, based on earlier high-dose antifungal therapy, early source control, strict glycemic control and restriction of steroids to COVID-19 patients with oxygen requirements.

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Hyperferritinemia and the Extent of Mucormycosis in COVID-19 Patients

Cited by 14 publications

References 28 publications

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

Epidemiological Characteristics, Pathogenesis and Clinical Implications of Sinusitis in the Era of COVID-19: A Narrative Review

Estimation of Serum Ferritin in Mucormycosis Patients and Prognostication Based on the Ferritin Value

Clinical Phenotypes of COVID-19 Associated Mucormycosis (CAM): A Comprehensive Review

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