Immune dysfunction in COVID-19 Associated Mucormycosis
The coronavirus pandemic (COVID-19) is associated with secondary bacterial and fungal infections globally. In India, inappropriate use of glucocorticoids, high prevalence of diabetes mellitus and a conducive environment for fungal growth are considered as the main factors for increased incidence of COVID-19 associated mucormycosis (CAM). Few cases of CAM without steroid abuse and normal blood glucose levels were also reported during the pandemic. This study was designed to explore whether altered immune responses due to severe COVID-19 infection predisposes towards development of mucormycosis. The global transcriptome profiling of monocytes and granulocytic cells derived from CAM, Mucormycosis, COVID-19 and healthy control groups were performed to identify the differentially expressed genes (DEGs) involved in dysregulated host immune response towards respective diseased and healthy conditions. Overall design: The current  study uses an RNA-Sequencing-based approach to obtain the host transcriptome from monocytes and granulocytes to identify the host immune response pathways activated or dysregulated in patients with CAM versus Mucormycosis, COVID-19 disease and healthy control groups. Total RNA was isolated from monocytes and neutrophils and used to prepare libraries for total RNA sequencing. The libraries for all the samples were prepared with paired-end chemistry and a length of 150 bp.  Once the cluster generation was completed, the clustered flow cell was loaded on the Illumina HiSeqX instrument to generate a minimum of 100M raw reads per sample.