Coronavirus disease 2019 (COVID‐19) associated mucormycosis (CAM) was reported predominantly from India during the second wave of COVID‐19 and has a high mortality rate. The present study aims to understand the fungal community composition of the nasopharyngeal region of CAM‐infected individuals and compare it with severe COVID‐19 patients and healthy controls. The fungal community composition was decoded by analyzing the sequence homology of the internal transcribed spacer‐2–(ITS‐2) region of metagenomic DNA extracted from the upper respiratory samples. The alpha‐diversity indices were found to be significantly altered in CAM patients (p < 0.05). Interestingly, a higher abundance of Candida africana, Candida haemuloni, Starmerella floris, and Starmerella lactiscondensi was observed exclusively in CAM patients. The interindividual changes in mycobiome composition were well supported by beta‐diversity analysis (p < 0.05). The current study provides insights into the dysbiosis of the nasal mycobiome during CAM infection. In conclusion, our study shows that severe COVID‐19 and CAM are associated with alteration in mycobiome as compared to healthy controls. However, the sequential alteration in the fungal flora which ultimately leads to the development of CAM needs to be addressed by future studies.

中文翻译：

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印度 COVID-19 相关毛霉菌病患者鼻咽区真菌群落组成的宏基因组学见解

在第二波 COVID-19 期间，印度主要报告了 2019 年冠状病毒病 (COVID-19) 相关毛霉菌病 (CAM)，死亡率很高。本研究旨在了解 CAM 感染者鼻咽区域的真菌群落组成，并将其与重症 COVID-19 患者和健康对照进行比较。通过分析从上呼吸道样本中提取的宏基因组DNA的内部转录间隔区-2-(ITS-2)区域的序列同源性，解码了真菌群落的组成。发现 CAM 患者的 α 多样性指数显着改变（p< 0.05）。有趣的是，丰度更高非洲假丝酵母,血念珠菌,花星花， 和乳星菌仅在 CAM 患者中观察到。 β-多样性分析充分支持了菌群组成的个体间变化（p< 0.05）。目前的研究提供了对 CAM 感染期间鼻部真菌群失调的见解。总之，我们的研究表明，与健康对照相比，严重的 COVID-19 和 CAM 与真菌组的改变有关。然而，最终导致 CAM 发展的真菌菌群的连续变化需要通过未来的研究来解决。