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COVID-19 associated mucormycosis: the urgent need to reconsider the indiscriminate use of immunosuppressive drugs

Alfonso J Rodriguez-Morales,R. Sah,José Millán-Oñate,Ángel González,J. Montenegro-Idrogo,S. Scherger,Carlos Franco-Paredes,A. Henao-Martínez

Published 2021 in Therapeutic Advances in Infectious Disease

ABSTRACT

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Invasive mycoses represent opportunistic infections occurring predominantly among highly immunosuppressed individuals, including those with advanced human immunodeficiency virusassociated immunosuppression, uncontrolled diabetes mellitus, drug-induced immunosuppression during transplantation, autoimmune disorders, or hematological malignancies. The overuse of high-dose glucocorticoids and the administration of highly immunosuppressive drugs such as inhibitors of the Janus kinase inhibitors or IL-6 receptor inhibitors to treat patients with the coronavirus disease 2019 (COVID-19) are responsible in part for the increasing number of life-threatening opportunistic infections identified in this patient population.1,2 In addition to the iatrogenic immunosuppression induced by these medications, there has been clear evidence from the onset of the COVID-19 pandemic that lymphopenia is a common laboratory finding, indicating some degree of immunological dysfunction in individuals with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.3,4

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