Browsing by Author "Aggarwal, Sushil Kumar"

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    Case Report: Rhino-orbital Mucormycosis Related to COVID-19: A Case Series Exploring Risk Factors
    (American Society of Tropical Medicine and Hygiene, 2022) Aggarwal, Sushil Kumar; Kaur, Upinder; Talda, Dolly; Pandey, Akshat; Jaiswal, Sumit; Kanakan, Ahalya; Singh, Anshuman; Chakrabarti, Sankha Shubhra
    There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk. � 2022 American Society of Tropical Medicine and Hygiene. All rights reserved.
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    The Pathogenetic Dilemma of Post-COVID-19 Mucormycosis in India
    (International Society on Aging and Disease, 2022) Chakrabarti, Sankha Shubhra; Kaur, Upinder; Aggarwal, Sushil Kumar; Kanakan, Ahalya; Saini, Adesh; Agrawal, Bimal Kumar; Jin, Kunlin; Chakrabarti, Sasanka
    There has been a surge of mucormycosis cases in India in the wake of the second wave of COVID19 with more than 40000 cases reported. Mucormycosis in patients of COVID-19 in India is at variance to other countries where Aspergillus, Pneumocystis, and Candida have been reported to be the major secondary fungal pathogens. We discuss the probable causes of the mucormycosis epidemic in India. Whereas dysglycaemia and inappropriate steroid use have been widely suggested as tentative reasons, we explore other biological, iatrogenic, and environmental factors. The likelihood of a two-hit pathogenesis remains strong. We propose that COVID-19 itself provides the predisposition to invasive mucormycosis (first hit), through upregulation of GRP78 and downregulation of spleen tyrosine kinase involved in anti-fungal defense, as also through inhibition of CD8+ Tcell mediated immunity. The other iatrogenic and environmental factors may provide the second hit which may have resulted in the surge. Copyright: � 2021 Chakrabart SS. et al.