COVID-19 & other Diseases

"Among the more recent therapeutic developments in mucormycosis treatment are: the lipid formulations of amphotericin B, which are now the drugs of choice; the new triazole posaconazole, with promising efficacy as salvage treatment; the iron chelators deferasirox and deferiprone; the echinocandins in combination with amphotericin B (AmB) and recombinant growth factors such as granulocyte colony-stimulating factor (G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF)."

Background Severe coronavirus disease 2019 (COVID-19) is frequently associated with hyperinflammation and hyperferritinemia. The latter is related to increased mortality in COVID-19. Still, it is not clear if iron dysmetabolism is mechanistically linked to COVID-19 pathobiology" "Alterations of iron homeostasis can persist for at least two months after the onset of COVID-19 and are closely associated with non-resolving lung pathologies and impaired physical performance. Determination of serum iron parameters may thus be a easy to access measure to monitor the resolution of COVID-19."

***!!!*** "Mucormycosis is a life-threatening respiratory fungal infection that typically occurs in patients with abnormalities in iron metabolism. Here the authors show that iron...

****!!!!**** "Among the known iron chelators, deferoxamine supports the growth of Zygomycetes because it acts as xenosiderophore, delivering iron to iron-uptaking molecules of these species. Conversely, the newer iron chelators deferiprone and deferasirox do not exhibit similar activity, apparently because they share higher affinity constants for iron and, as a result, deprive the fungi of iron, inhibiting their growth. This activity has been documented in various culture systems and in many animal models of zygomycosis, and therefore suggests that these drugs might be used as adjuvant treatment for systemic zygomycosis. There are few case reports in which the newer iron chelators have been used as antifungals,"

****!!!!*** "Considering the low efficacy of monotherapy, combination-therapy strategies have been described. It is known that fungi are susceptible to zinc deprivation ..."

"The relationship between filamentous fungi and broiler chicks has long been recognized."

As many as 32 patients have died of mucormycosis in the last 20 days at a government-run hospital in Madhya Pradesh's Indore city, an official said on Wednesday.

****!!!!**** "The treatment of mucormycosis and other fungal infection is provided free of cost in all Central Government hospitals and autonomous institutions under the ministry, he said in a separate reply. Ayushman Bharat PM-JAY provides free health cover up to Rs. 5 lakh per year per family. The scheme was launched with 10.74 crore beneficiary families. However, 33 states/UTs have increased the beneficiary base to 13.44 families. Beneficiaries of Ayushman Bharat PM-JAY can avail free treatment of post-Covid related complications including Mucormycosis, Black Fungus etc. under the scheme. States are also being supported in terms of allocation and supply of Amphotericin B. Amphotericin B is being provided at an affordable price under the Pradhan Mantri Bhartiya Janaushadhi Pariyojna (PMBJP)."

Over three hundred people, who had fully recovered from Covid-19 infection, have succumbed to mucormycosis in Karnataka.

Mucormycosis, wrongly reported as black fungus, has created some level of panic and fear among people. Also, the colour of the fungus is immaterial and not linked to the severity of the disease.

****!!!!**** "When working with mycotoxicosis, choosing the correct binder can present a challenge."

{This article related to molds that do NOT cause mucormycosis} "Toxigenic molds (can) produce mycotoxins, which are toxic substances that increase inflammatory processes such as asthma, gastro-intestinal issues, mental health problems such as depression, and a number of other diseases. Two of the primary types of toxigenic molds are: Stachybotrys chartarum, Aspergillus"

"The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 2-Day OAT + TOX Workshop, speakers extolled the virtues of comprehensive metabolic tests like the Organic Acids Test (OA"

This review focuses on aspects of antimycotic therapy specific to veterinary medicine. In the first part, drug availability, limited mostly by economic consideration but also by clinical applicability and specific adverse effects, is described for polyenes, ...

Mucormycosis is an angioinvasive disease caused by saprophytic fungi of the order Mucorales. The exact incidence of mucormycosis in India is unknown due to the lack of population-based studies. The estimated prevalence of mucormycosis is around 70 times ...

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Mucormycosis is a fungal infection caused by organisms belonging to the order Mucorales. Although considered uncommon, mucormycosis has been steadily increasing in incidents for the last two decades. Mortality of the disease is unacceptably high despite ...

Clinical hallmarks of mucormycosis infections include the unique susceptibility of patients with increased available serum iron, the propensity of the organism to invade blood vessels, and defective phagocytic function."

****!!!!*** "Previously, we demonstrated that Rhizopus, the most common cause of mucormycosis, invades endothelial cells by binding of its CotH proteins to the host receptor GRP78. ..."

"Patients with cystic fibrosis are often infected by pseudomonas aeruginosa, a bacterium that infects the lungs and prevents breathing, often causing death. P. aeruginosa itself can also be infected by viruses, which can affect the clinical outcomes of cystic fibrosis patients. Researchers have now used P. aeruginosa as a kind of 'model system' for understanding how bacteria's interactions with viruses may affect human health." "Cystic fibrosis patients will often use phage therapy, which uses viruses to kill bacteria, to target P. aeruginosa, which has some strains that are resistant to antibiotics. Knowing the immune profiles of the bacteria's population may help improve this kind of therapy."

"They found that the electron transport chain so critical to the conversion of electrons to energy can and is operating deep down in the oxygen-deprived biofilm and that in these environments, the bacterium depends on a specific part of the chain's terminal oxidase -- a protein called CcoN4 -- to access oxygen and grow normally. Cells lacking this protein do not survive as well as cells with it and the researchers believe therefore that CcoN4 contributes to the bacterium's virulence. They also found that CcoN4 plays a role in using phenazines optimally within biofilms."

"Probiotics typically aim to rebalance bacteria populations in the gut, but new research suggests they may also help break apart stubborn biofilms." :They found Candida yeast species are more likely to team up with the bacteria in biofilms than other yeast species. Additional results show both Candida albicans and Candida tropicalis form thick biofilms when grown alongside E. coli and S. marcescens bacteria. Other non-Candida yeast species could only form thin biofilms -- not any thicker than a single species grown alone. :s.

The COVID-19 pandemic has highlighted controversies and unknowns about how respiratory pathogens spread between hosts. Traditionally, it was thought that respiratory pathogens spread between people through large droplets produced in coughs and through contact with contaminated surfaces (fomites). However, several respiratory pathogens are known to spread through small respiratory aerosols, which can float and travel in air flows, infecting people who inhale them at short and long distances from the infected person. Wang et al. review recent advances in understanding airborne transmission gained from studying the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and other respiratory pathogens. The authors suggest that airborne transmission may be the dominant form of transmission for several respiratory pathogens, including SARS-CoV-2, and that further understanding of the mechanisms underlying infection from the airborne route will better inform mitigation measures. Science , abd9149, this issue p. [eabd9149][1] ### BACKGROUND Exposure to droplets produced in the coughs and sneezes of infected individuals or contact with droplet-contaminated surfaces (fomites) have been widely perceived as the dominant transmission modes for respiratory pathogens. Airborne transmission is traditionally defined as involving the inhalation of infectious aerosols or “droplet nuclei” smaller than 5 μm and mainly at a distance of >1 to 2 m away from the infected individual, and such transmission has been thought to be relevant only for “unusual” diseases. However, there is robust evidence supporting the airborne transmission of many respiratory viruses, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS)–CoV, influenza virus, human rhinovirus, and respiratory syncytial virus (RSV). The limitations of traditional views of droplet, fomite, and airborne transmission were illuminated during the COVID-19 pandemic. Droplet and fomite transmission of SARS-CoV-2 alone cannot account for the numerous superspreading events and differences in transmission between indoor and outdoor environments observed during the COVID-19 pandemic. Controversy surrounding how COVID-19 is transmitted and what interventions are needed to control the pandemic has revealed a critical need to better understand the airborne transmission pathway of respiratory viruses, which will allow for better-informed strategies to mitigate the transmission of respiratory infections. ### ADVANCES Respiratory droplets and aerosols can be generated by various expiratory activities. Advances in aerosol measurement techniques, such as aerodynamic and scanning mobility particle sizing, have shown that the majority of exhaled aerosols are smaller than 5 μm, and a large fraction are

Besides infections such as oropharyngeal candidiasis, pneumonia, etc., doctors have also reported several cases of a serious fungal infection called mucormycosis in COVID-infected patients.

Here, we address some of the myths associated with so-called black fungus and its links with COVID-19. We also outline the facts about mucormycosis.