Impacts of adipokines in the development and consequence of COVID-19-associated mucormycosis

Adipokines play fundamental roles in regulating inflammatory responses. Patients with COVID-19 and mucormycosis suffer from inflammatory responses leading to immune dysregulation. This study therefore focused on clarifying whether visfatin and vaspin, known adipokines with immunoregulatory effects, participate in the development and outcome of COVID-19-associated mucormycosis (CAM). Serum samples were obtained from 75 patients suffering from COVID-19 and mucormycosis and 20 non-comorbid healthy individuals. The serum levels of visfatin and vaspin were assessed by enzyme-linked immunosorbent assay. The frequencies of some immune cells were measured using a cell counter. The serum level of vaspin was significantly decreased in patients with different forms of COVID-19 and mucormycosis compared to healthy subjects (P < 0.001-0.05). There was no significant difference in vaspin among subjects with varying forms of COVID-19 and CAM. Visfatin level was significantly higher in patients with moderate and severe COVID-19 than in healthy controls (P < 0.001-0.05). Visfatin was significantly increased in patients with COVID-19 compared to CAM (P < 0.01). However, there was no significant difference in visfatin levels between patients with severe and moderate COVID-19. The same trend was observed between healthy individuals and CAM. Vaspin level was significantly correlated to neutrophil to lymphocyte ratio (NLR) in subjects with severe COVID-19 (P < 0.05). Changes in vaspin and visfatin levels may participate in the pathogenesis of CAM, perhaps due to the influence of anti-and pro-inflammatory mediators.