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- Title
Serum iron indices in COVID‐19‐associated mucormycosis: A case–control study.
- Authors
Kumar H, Mohan; Sharma, Prashant; Rudramurthy, Shivaprakash M.; Sehgal, Inderpaul Singh; Prasad, Kuruswamy Thurai; Pannu, Ashok Kumar; Das, Reena; Panda, Naresh K.; Sharma, Navneet; Chakrabarti, Arunaloke; Agarwal, Ritesh; Muthu, Valliappan
- Abstract
Background: Whether dysregulated iron metabolism is associated with COVID‐19‐associated mucormycosis (CAM) remains unknown. Herein, we compare the serum iron indices in COVID‐19 subjects with and without mucormycosis. Methods: We conducted a case–control study enrolling COVID‐19 participants with and without mucormycosis. We compared the baseline serum iron indices (iron, ferritin, total iron‐binding capacity [TIBC], unsaturated iron‐binding capacity and percentage transferrin saturation) between CAM cases and COVID‐19 controls. Additionally, we performed a multivariate logistic regression analysis to assess whether any iron indices are associated with CAM. Results: We enrolled 28 CAM cases (mean age 53.6 years old; 78.6% men) and 26 controls (mean age 57.2 years old; 73.1% men). Rhino‐orbital (±cerebral) mucormycosis (85.7%) was the most clinical presentation. Diabetes mellitus was more frequent in the cases than controls (75% vs. 42.3%; p =.015). Hypoxaemia during COVID‐19 illness was more common in controls than cases. The mean serum iron values (33 vs. 45 μg/dl, p =.03) and TIBC (166.6 vs. 201.6 μg/dl, p =.003) were significantly lower in CAM cases than controls. On multivariate analysis, we found a lower TIBC (odds ratio [OR] 0.97; 95% confidence interval [CI], 0.95–0.99) and diabetes mellitus (OR 5.23; 95% CI, 1.21–22.68) to be independently associated with CAM after adjusting for serum iron, ferritin and glucocorticoid therapy. The case fatality rate of CAM was 73.9%. The iron indices were not significantly different between CAM survivors and non‐survivors. Conclusions: The CAM is associated with lower TIBC levels than COVID‐19 subjects without mucormycosis, suggesting dysregulated iron metabolism in its pathogenesis. Further studies are required to confirm our preliminary observations.
- Subjects
TRANSFERRIN; MUCORMYCOSIS; IRON; LOGISTIC regression analysis; CASE-control method; IRON metabolism
- Publication
Mycoses, 2022, Vol 65, Issue 1, p120
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.13391