Even as the nation is struggling to bring Corona second wave under control, many hospitals are reporting cases of deadly fungal infection which is forcing COVID recovered patients to get back into the Intensive Care Units. COVID triggered mucormycosis also colloquially addressed as the black fungus cases are being widely reported. Mucormycosis is almost fatal following COVID-19. Cases are being reported majorly from cities including Bangalore, New Delhi, Pune and Ahmedabad.
What is mucormycosis?
Mucormycosis is a rare but dangerous fungal infection that is caused by a group of moulds called mucormycosis. They are naturally found in the environment. It is known to cause serious complications in patients who have pre-existing health problems and in those who have taken medications that compromise the immune system. The infection affects the lungs and sinuses and can also enter the body through cuts and wounds.
People who have uncontrolled diabetes and have been administered heavy steroids to survive the complications of Corona infection are the ones who are worst affected. Last year we witnessed this deadly infection causing high mortality, loss of eyesight, removal of nose and jaw bone. In the second wave, the nation is recording a sudden surge in the cases and found that nearly 30 per cent of the patients lose their eyesight and could kill half of the ones with this condition apart from giving excruciating pain. Such is the sudden surge that the key drug- amphotericin B used to treat mucormycosis is under short supply.
- Nose obstruction
- Swelling of eyes and restricted movement of eyes
- Presence of black dry crusts in the nose
- Swelling of cheeks and facial skin discolouration
- Double vision and Loss of vision
- Onset of headache post Covid recovery
- Facial pain and numbness
- One-sided nose blockages
- Dental pain and loosening of teeth
What are the factors that contribute to mucormycosis in COVID recovered patients?
- A link is established between the usage of oxygen therapy and invasive ventilatory support and the development of mucormycosis. Usage of tap water instead of distilled water for humidification of oxygen is suspected to be a causative factor.
- Drugs like broad-spectrum antibiotics favour the development of fungal infections. When steroids are used in Corona positive patients, they make them immunocompromised. Their T cells are suppressed and they become more vulnerable to fungal infections. Steroid usage in the elderly who are either diabetic or in the pre-diabetic state leads to uncontrolled diabetes making them prone to infections.
Steps to be taken to prevent mucormycosis to bring down morbidity and mortality
- Keep your diabetes under control as the fungus feeds on sugar.
- Use only distilled water for humidification of oxygen.
- Avoid the usage of steroids and broad-spectrum antibiotics unless deemed lifesaving in Covid patients.
- Change the oxygen tubes and water as per the standard recommendations.
- Follow best antiseptic and hygienic precautions.
Watch for any of the symptoms listed above. If recognized early, it can pave way for diagnosis and appropriate antifungal treatment and aim for the best outcome thereby reducing morbidity and mortality. It is important to be in touch with your endocrinologist even after recovering from COVID to ensure good diabetes control and reduce risk of developing black fungus infection.