Interleukin-37: A Link Between COVID-19, Diabetes, and the Black Fungus

Area of Science:

• Immunology
• Infectious Diseases
• Endocrinology

Background:

• The COVID-19 pandemic presented significant challenges, with diabetes identified as a key comorbidity.
• Systemic corticosteroids were used to manage severe COVID-19, reducing mortality but potentially increasing risks.
• A notable increase in invasive fungal infections, specifically maxillofacial mucormycosis (black fungus), was observed.

Purpose of the Study:

• To explore the common link between black fungus, diabetes, corticosteroids, and COVID-19.
• To investigate the role of interleukin 37 (IL-37) in the dysregulated immune response observed in these conditions.
• To emphasize the need for careful consideration of treatment protocols to mitigate secondary infections.

Main Methods:

• Review of clinical observations and existing literature on COVID-19, diabetes, mucormycosis, and corticosteroid use.
• Analysis of the immunological mechanisms, including the role of cytokine IL-37.
• Correlation of treatment strategies with the incidence of secondary infections.

Main Results:

• A dysregulated immune response is a common factor in patients with COVID-19, diabetes, and mucormycosis, particularly those treated with corticosteroids.
• Interleukin 37 (IL-37), a cytokine that broadly reduces inflammation, may play a role in this immune dysregulation.
• The combination of diabetes, COVID-19, and corticosteroid therapy creates a high-risk scenario for secondary infections like mucormycosis.

Conclusions:

• Careful management of corticosteroid use in diabetic COVID-19 patients is crucial.
• Factors such as hospital crowding and medical oxygen shortages may exacerbate the risk of secondary infections.
• Understanding the immune response, including the role of IL-37, is vital for preventing and treating COVID-associated fungal infections.