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T-cell dysfunction as a potential contributing factor in post-COVID-19 mucormycosis

Himanshu Dandu1, Manish Kumar2, Hardeep Singh Malhotra3

  • 1Department of Internal Medicine, King George's Medical University, Lucknow, India.

Mycoses
|October 28, 2022
PubMed
Abstract

Insights

T-cell exhaustion is more severe in non-COVID mucormycosis than in post-COVID cases, leading to poorer outcomes. This study highlights differences in T-cell immune dysfunction between these patient groups.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Oncology

Background:

  • The second wave of COVID-19 in India saw a rise in mucormycosis cases, often linked to immunosuppressive drugs and underlying conditions.
  • While mucormycosis cases increased post-COVID-19, their mortality rates were lower than in non-COVID mucormycosis cases.

Purpose of the Study:

  • To investigate detailed T-cell characteristics in post-COVID and non-COVID mucormycosis patients.
  • To identify underlying differences in T-cell immune dysfunction between these groups.

Main Methods:

  • Histopathologically confirmed mucormycosis cases (13 post-COVID, 13 non-COVID) and 15 healthy individuals were studied.
  • Flow cytometry was used to evaluate T-cell activation markers (CD44, HLADR, CD69, CD38) and exhaustion markers (CTLA, PD-1, LAG-3, TIM-3).

Main Results:

  • All mucormycosis patients exhibited significant T-cell depletion compared to healthy individuals.
  • Both post-COVID and non-COVID groups showed increased T-cell activation and exhaustion.
  • Non-COVID mucormycosis patients displayed significantly higher CD4+ T-cell activation (HLADR, CD38) and marked T-cell exhaustion (LAG-3 expression on CD4+ and CD8+ T cells) compared to post-COVID patients.

Conclusions:

  • Non-COVID mucormycosis cases exhibit more pronounced T-cell exhaustion than post-COVID cases.
  • T-cell immune dysfunction appears more severe in non-COVID mucormycosis, characterized by continuous activation followed by extreme exhaustion.
  • These findings suggest a link between the severity of T-cell immune dysfunction and patient outcomes in mucormycosis.
Keywords:
T cellsactivationexhaustionmucormycosisnon-COVIDpost-COVID

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