Thursday, September 19, 2024

Mucormycosis: ‘Black Fungus’ Rising in COVID-19 Patients in India

Doctors in India are concerned about the rising numbers of potentially fatal fungal infections, Mucormycosis. This Black Fungal infection is affecting either Covid-19 patients or the ones recently recovered from the disease. The mucormycosis has a high mortality rate and reports of the New York Times say it was present in India before the pandemic.

Last Saturday, Dr. Akshay Nair, an eye surgeon in Mumbai, was waiting to operate on a 25-year-old woman. She had recovered from a Covid infection three weeks ago. Inside the surgery room an ear, nose, and throat specialist was already working on this woman also suffering from diabetes. The specialist was removing mucormycosis infected tissues from her nose via inserting a tube in her nose.

After this removal of infected tissues, Dr. Nair would carry out the three-hour operation to remove the patient’s eye. Dr. Nair told the BBC;

“I will be removing her eye to save her life. That’s how this disease works.”

This condition is so rare but doctors and medical officers say it seems to be infecting some Covid-19 patients. Because they have weakened immune systems and other conditions, specifically diabetes, leave them vulnerable to this fungal infection.

What is mucormycosis?

Mucormycosis infection is caused by exposure to mucor mold. This mold is commonly found in soil, plants, manure, decaying fruits, and vegetables. Dr. Nair says, “It is ubiquitous and found in soil and air and even in the nose and mucus of healthy people.”
It affects the brain, the sinuses, and the lungs. It can be life-threatening in diabetic and in highly immunocompromised individuals, e.g. cancer patients or people with HIV/AIDS.

Why Mucormycosis Is Affecting COVID-19 Patients?

Reports from Medical Experts say that this fungal infection (mortality rate of 50%) is likely to occur due to the use of Steroid medicines. Steroid-based medicines are like life-saving treatments for severely infected COVID-10 patients. Steroids reduce the inflammation in the lungs for Covid-19. And to some extent stop some of the damage that can happen when our immune system gets overstrain in fighting off coronavirus. But, according to reports, steroids reduce the body’s immunity. Furthermore, these steroid medicines also push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients.

steroid medicine, reason of Mucormycosis infection

Most likely, this decrease in immunity is giving the chance for this mucor mold to grow and potentially erode the facial structures and harm the brain. Dr. Nair also says that;

“Diabetes lowers the body’s immune defenses, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire.” 

Number of Mucormycosis Infection Cases in India

As the rising COVID-19 Infections were not enough damaging for India that now this Mucormycosis fungus has found its way to the country. Dr. Nair works in three hospitals in Mumbai and has seen a total of 40 cases suffering from the fungal infection in April. Most of these patients were diabetic and recovered from COVID-19 infection at home. Out of these 40, Eleven patients undergo eye removal surgery.

According to Dr. Renuka Bradoo, head of the ear, nose, and throat wing at Mumbai’s Sion Hospital, 24 cases of fungal infection appeared in the past two months. That is more than normal six cases a year. Dr. Raghuraj Hegde, an eye surgeon, in the Southern City of Bengaluru, has seen 19 cases of mucormycosis in the past two weeks. He says,

“Some were so sick that we couldn’t even operate on them.”

Some of Dr. Naik’s colleagues in Mumbai, Bangalore, Hyderabad, Delhi, and Pune- reported 58 cases of the infection, from December to February. Most of the cases appeared 12 to 15 days after recovery from Covid-19.

Doctors and Medical experts are surprised by this rising number of fungal infected patients amid this second wave of COVID-19. There were normally 1 to 2 patients per year affecting by Mucormycosis. But now these rising numbers are really alarming. Medical and Health experts are keeping close tabs on this condition. Dr. VK Paul who leads India’s Covid task force said,

“We have heard that in some areas, people who are Covid-infected or recovered suffer from mucormycosis. But there is not a big outbreak of it.” 

He added,

“We are watching and monitoring. It is a fungus that has a strong relation to diabetes. If the person is not diabetic, it is very uncommon that the person would have mucormycosis.”

India’s western state of Maharashtra has been badly crushed by the pandemic. Local news media reported that around 200 patients previously recovered from Covid were being treated for mucormycosis. Also, according to reports eight people have died due to the severity of infection.

Symptoms of Mucromycosis Infection

Patients appeared at hospitals with a stuffy and bleeding nose, swelling of eyes, pain in the eye area, drooping of eyelids, and blurred & loss of vision. There were also black patches of skin around the nose in some patients. Doctors say that most of the patients were already losing vision when arrived at the hospital. In rare cases, the doctors have to remove the jaw bone of patients to stop the spreading of the fungus.

How Doctors Are Treating The Disease Beside The Surgerical Treatment?

-amphotericin-b-injection for Mucormycosis infection
An amphotericine B injection administered to people suffering with Mucormycosis infection

Dr. Rahul Baxi, a Mumbai-based diabetologist says, The best way to halt the possibility of this infection was to make sure that Covid-19 patients – both in treatment and after recovery -get the right dose and duration of steroid administrations.

As of medication, a worth 3,500 rupees ($48) anti-fungal intravenous injection has to be administered every day for up to eight weeks. And this is the only effective drug against the disease.

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