From the past few days, a fungal infection named Mucormycosis is being reported in a few COVID-19 patients during or post recovery. Mucormycosis is caused by a set of micro-organisms known as mucormycetes, which are present naturally in the environment. Mucormycetes are seen mostly in soil and in decaying organic matter like leaves, compost and piles.
Mucormycosis is targeting COVID positive or recovered patients because COVID affects the immune system and weak immunity is one of the major things black fungus need to grow.
Mucormycosis: Black Fungus
Black fungus is said to be a fungal infection that mainly affects people who are on medication for other health issues. It reduces the body’s ability to fight germs and sickness. It affects sinuses or lungs of individuals if fungal spores are inhaled from the environment. It can attack the skin after a cut, burn, or other type of skin injury. Mucormycosis if uncared for can lead to serious disease.
What leads to Mucormycosis?
Uncontrolled diabetes mellitus- It is a situation when blood sugar levels are too high over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased appetite.
Prolonged ICU stay- Few patients who are stabilized in ICU during acute illness patients develop metabolic, immunological, and neuromuscular disturbances. Their body gets dependent on it, which in the long term weakens the immune system.
Comorbidities- Comorbidities like malignancy may lead to the black fungus. ‘Malignancy’ defines the presence of cancerous cells that have the ability to spread to other sites in the body and destroy tissues.
Voriconazole therapy- A recent increase in the incidence of mucormycosis at many transplant centres has been linked to the introduction and widespread use of voriconazole prophylaxis in these high-risk populations. However, it is not known if this association reflects a true link.
Immunosuppression by Steroids- Immunosuppression is the state in which the immune system does not function well as it should. Long-term use of high-dose steroids can also cause Immunosuppression.
Member (Health), NITI Aayog, Dr. V.K. Paul says, “Steroids should never be administered at an early stage of COVID-19. It should be taken only after the sixth day of infection. Patients should stick to appropriate doses of the drugs and take the drug for a specific number of days as advised by the doctors. Rational use of medicines should be ensured to avoid adverse side effects of the drug.”
He further added, “Other than steroids, use of COVID-19 drugs such as Tocilizumob, Itolizumab also suppresses the immune system. And when these drugs are not used appropriately, it increases the risk, as our immune system fails to fight the fungal infection.”
How is it related to COVID-19?
COVID treatment requires intake of drugs like dexamethasone, which decreases the immune system response. Patients who undergo oxygen therapy in ICU, where humidifiers are used, are also prone to fungal infection due to exposure to moisture. Not all COVID patients get infected by Mucormycosis. It is uncommon in those who do not have diabetes.
Mucormycosis: Warning signs
The warning signs are- pain or redness around eyes or nose, fever, headache, coughing, shortness of breath, bloody vomits and altered mental status .COVID positive patients, diabetics or immunosuppressed individuals can suspect it if there is one sided facial pain, numbness or swelling. It can be suspected if there is nasal blockade or congestion or blackish or bloody discharge. It may cause local pain on the cheek bone
Blurred or double vision, toothache, loosening of teeth and haemoptysis are some of the other symptoms. One must seek medical help for detecting fungal infection.