In Mumbai many COVID-19 survivors have died due to mucormycosis, a fungal infection, during treatment in the state, so far 200 such patients are being treated out of which eight patients lost their lives. India has been reporting over 4 lakh COVID-19 infections daily for the past three days and the death toll has remained over 3000 for the past ten days.
Even as medical authorities wrestling with new emergent variants showing different symptoms in India, hospitals are perceiving a rise in deadly fungal infection in patients recovering from COVID. Hospitals in cities like Delhi, Pune and Ahmedabad have reported multiple cases of Mucormycosis, also known as black fungus which is visible in patients post COVID-19 recovery.
It is a rare problem developing in COVID patients, sometimes, during active COVID infection, but more commonly – weeks to months after recovery from COVID. It is a rare but hazardous fungal infection caused by a group of moulds known as mucormycetes, which are present naturally in the atmosphere.
It instigates in the sinuses/nose/teeth and has the potential to spread into the eye and even the brain. If not detected in time, this infection can be dangerous and life-threatening. Currently, there are no proven feasible measures for prevention and early detection is the best bet for now. Some of the things supported for preclusion are gargles and nasal douching with Betadine solution, strict control of diabetes, using steroids only on prescription by a physician.
Mucormycosis only causes serious complications when a patient has pre-existing health problems or has taken medication that conciliates the immunity system. People who have received steroids as a part of their Covid-19 treatment are at risk. Persons who have received immunomodulatory drugs e.g. Tocilizumab also faces risk.
Doctors say nothing is as risky as high and uncontrolled diabetes. Previously immunocompromised patients on cancer treatment or with autoimmune conditions are also vulnerable. Patients on steroids for other medical conditions can also be vulnerable. When the same COVID-19 patient is put on oxygen support, which has a humidifier containing water, the chances of him or her getting the fungal infection increase.
Fungal disease is already acknowledged but the cases are increasing because of COVID-19 related problems, wherein the use of steroids raises the sugar level in blood while some medicines result in suppression of immunity of patients. In such a scenario, the black fungus infects the patient easily and spreads.
If the fungus reaches the brain of the infected person, it can prove fatal. In one such case, one of the eyes of a patient had to be removed permanently to save his life. The hospital, which is managed by a trust, has been receiving several patients diagnosed with Mucormycosis who are being referred from various areas in Surat and other parts of Gujarat.
In Ahmedabad, at least five patients with mucormycosis are being operated upon every day at the civil hospital at Asarva. In Ahmedabad, doctors are receiving 5 to 10 such cases at the civil hospital, especially since the second wave of COVID-19 started. These patients are being examined on priority and operated on as early as possible.
Black Fungus generally affects COVID-19 recovered patients who have other comorbidities like diabetes, kidney or heart failure, cancer as well as patients who are on steroids or have had a transplant. However, it is most common in diabetic patients, said the Centers for Disease Control and Prevention (CDC) of the United States.
Prior to the COVID era, Black Fungus was extremely rare and found only in immunocompromised people. However, coronavirus itself reduces immunity levels, largely affects diabetic people and is treated with steroids if serious. As a result, COVID survivors are vulnerable to the infection, especially in the severe second wave.
Early detection will aid the patient’s medication for the fungal infection and clinical intervention to the affected area. Usually, MRI scans determine the extent of damage the fungus may have caused. Mucormycosis, if left undiagnosed or untreated, may result in blindness, removal of the nose, jaw-bone or even death. So, all those COVID 19 patients having symptoms like one-sided facial swelling, headache, nasal or sinus congestion, black lesions on nasal bridge or upper inside of the mouth, fever, partial loss of eyesight, Pain under the eyes should get diagnosed without any delay and secure their lives.
