COVID-19-associated-mucormycosis: possible role of free iron uptake and immunosuppression

Mol Biol Rep. 2022 Jan;49(1):747-754. doi: 10.1007/s11033-021-06862-4. Epub 2021 Oct 28.


COVID-19-associated-mucormycosis, commonly referred to as the "Black Fungus," is a rare secondary fungal infection in COVID-19 patients prompted by a group of mucor molds. Association of this rare fungal infection with SARS-CoV-2 infection has been declared as an endemic in India, with minor cases in several other countries around the globe. Although the fungal infection is not contagious like the viral infection, the causative fungal agent is omnipresent. Infection displays an overall mortality rate of around 50%, with many other secondary side effects posing a potential threat in exacerbating COVID-19 mortality rates. In this review, we have accessed the role of free iron availability in COVID-19 patients that might correlate to the pathogenesis of the causative fungal agent. Besides, we have analyzed the negative consequences of using immunosuppressive drugs in encouraging this opportunistic fungal infection.

Keywords: COVID-19; Free iron; Hyperferritinemia; Mucormycosis; Pathogenesis; Rhizopus oryzae.

Publication types

  • Review

MeSH terms

  • COVID-19 / complications*
  • Fungi / isolation & purification
  • Fungi / pathogenicity
  • Humans
  • Hyperferritinemia* / complications
  • Hyperferritinemia* / microbiology
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppressive Agents / adverse effects
  • India / epidemiology
  • Iron / metabolism
  • Mortality
  • Mucormycosis* / epidemiology
  • Mucormycosis* / etiology
  • Mucormycosis* / microbiology
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / microbiology
  • Rhizopus oryzae / isolation & purification
  • Rhizopus oryzae / pathogenicity


  • Immunosuppressive Agents
  • Iron