Immune profile in patients with COVID-19 associated rhino-orbital-cerebral mucormycosis

Abstract

Purpose : Rhino-orbital-cerebral mucormycosis (ROCM) is a prevalent manifestation of mucormycosis affecting COVID19 patients with significant morbidity and mortality. Despite sharing a similar set of risk factors, only a subset of patients is affected by ROCM . Hence, we have performed immune-profiling in patients with active COVID19-associated ROCM (Ca-ROCM) to determine their anti-fungal immunity status

Methods : Study includes subjects (i) with COVID19 and ROCM (C⁺R⁺, n=13), (ii) with COVID19 and no ROCM (C⁺R^-, n=9) and (iii) without COVID19 history and no ROCM (C^-R^-, n=7). Proportions of ~50 immune cells subsets (immunophenotyping) and 60 secreted factors (multiplex ELISA) were determined in the peripheral blood of the study subjects using flow cytometry. The COVID subjects included in the study were of non-severe form in C⁺R⁺ and C⁺R^- group

Results : A significant reduction in the natural killer (NK cells), dendritic cells and lymphocytes along with a significant increase in neutrophils was observed in C⁺R⁺ group compared to the other groups. A significant increase in sIL-1Rs, sTNFRs, sICAM1, IL-6, IL-8, MMP, MPO, NGAL, PDGF-AA/BB, HGF and VEGF, along with significant reduction in angiogenin and IFNα was also observed in C⁺R⁺ group. Area under the curve and logistic regression analysis demonstrated that proportion of NK cells, Angiogenin and sIL-1R levels were unique in patients with ROCM

Conclusions : The distinct immune profile in patients with Ca-ROCM can be explored as an additional factor in stratifying COVID-19 patients with increased risk of ROCM thereby reducing the morbidity and mortality burden of Ca-ROCM.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.