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Coronavirus Explained: What Is Mucormycosis Or Black Fungus And How It Affects COVID-19 Patients

Mucormycosis is a fungal infection that mainly affects people on medication for other health problems that reduces their ability to fight environmental pathogens is on a rise in COVID-19 patients

Coronavirus Explained What Is Mucormycosis Or Black Fungus And How It Affects COVID-19 Patients
Highlights
  • Mucormycosis also known as black fungus is a fungal infection
  • Mucormycosis affects people with compromised immunity
  • The fungal infection enters from the nose and can affect eyes and brain

New Delhi: Mucormycosis, a fungal infection, being found in COVID-19 patients with compromised immunity is resulting in disfiguration and in some cases, it is proving to be fatal. Mucormycosis is a fungal infection that mainly affects people on medication for other health problems that reduces their ability to fight environmental pathogens, according to the Indian Council of Medical Research (ICMR). But, according to Union Health Minister, Dr Harsh Vardhan awareness and early diagnosis can help curb the spread of the fungal infection. So, what are the symptoms of Mucormycosis or black fungus and what is the treatment? Experts answer all.

Also Read: As COVID Cases In India Sets World Record, Centre Recommends “Proning”. Here’s All You Need To Know

What Is Mucormycosis And Who Is At A Higher Risk?

Mucormycosis is a kind of a fungal infection. It is not a new fungus; it is there in the natural atmosphere and found in soil, manure, decaying fruits and vegetables. Since we are all healthy people whose immune system is able to fight this, we don’t get the illness. But people who have had COVID, some people who have got uncontrolled diabetes and people who are on certain medications like for cancer treatment, they are the ones who are at a high risk, explained Dr Girija Suresh, Senior Opthalmic Consultant, Fortis Hospital Mulund.

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As per ICMR, the five conditions that predispose an individual to mucormycosis are:

– Uncontrolled diabetes mellitus
– Immunosuppression by steroids
– Prolonged ICU stay
– Co-morbidities – post transplant/malignancy
– Voriconazole therapy

What Are The Symptoms Of Mucormycosis?

Pain and redness around eyes and/or nose, fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status are the signs and symptoms of mucormycosis, as per ICMR. Additionally, COVID-19 patients, diabetics or immunosuppressed individuals should look out for the following signs:

– Sinusitis – nasal blockade or congestion, nasal discharge (blackish/bloody), local pain on the cheekbone
– One-sided facial pain, numbness or swelling
– Blackish discoloration over bridge of nose/palate
– Toothache, loosening of teeth, jaw involvement
– Blurred or double vision with pain; fever, skin lesion; thrombosis (blockage of blood vessels) and necrosis (death of tissues due to lack of blood)
– Chest pain, pleural effusion (fluid fillling in the covering of lungs), haemoptysis (coughing out blood), worsening of respiratory symptoms

Also Read: Coronavirus Outbreak Explained: Do All COVID-19 Patients Need CT Scans?

Which Parts Of The Body Does It Attack?

Dr Satish Nair, ENT, Apollo Hospitals, Bannerghatta, explained that the fungal infection starts from the nose and later it affects the eyes and brain. It can also directly affect the brain which can be fatal, said Dr Nair. He added,

Nose and paranasal sinuses are in close relation to the eye and brain and any infection has the ability to invade these areas if not treated. The problem with the fungal infection begins when it invades into the blood vessel. Through blood vessels, the infection spreads faster and can also block a blood vessel resulting in complete loss of blood supply to an area.

Also Read: Coronavirus Explained: How COVID-19 Is Affecting Heart Even After The Recovery

Why Are COVID-19 Patients Contracting Mucormycosis Now?

Dr Nair reiterated that mucormycosis existed even before the COVID-19 pandemic. However, back then they would get two to three cases in a year that too in patients who are severely diabetic. But, now, in the last 10 days, Dr Nair has got 20 cases. Giving out the reason for the same, Dr Nair said,

One reason is that there is an increase in COVID-19 cases in general as a result of which more cases of black fungus are being reported. Secondly, moderate and severe COVID-19 patients are often treated with steroids. And if a diabetic patient is given steroids as part of COVID-19 treatment, it increases the blood sugar level which can result in complications. Hence, it is important to manage the use of steroids and control sugar. Thirdly, most of the patients are also on high-level anti-biotics. These anti-biotics take away any competing organism; they take away all the bacteria as a result of which fungus gets all the way to travel in the body.

Also Read: COVID-19 Explainer: All You Need To Know About Oxygen Concentrators

How To Prevent And Treat Mucormycosis?

Dr Girija Suresh says it’s important to follow all COVID precautions, especially wearing a mask, even after recovering from COVID-19 because low immunity can last for three months after recovery. During the recovery phase, one might inhale fungal spores from the air.

It is generally contracted by inhalation and touching objects and then touching nose, mouth and other body parts. Follow the same precautions you do for COVID-19, said Dr Suresh.

As per ICMR, the dos to prevent mucormycosis are preventing high sugar levels; monitoring blood glucose levels post COVID-19 discharge; judicious use of steroids, antibiotics and anti-fungals; using clean, sterile water for humidifiers during oxygen therapy.

ICMR suggests against considering all the cases with a blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunotherapy.

Adding to this, Dr Nair said, early diagnosis is the key. He believes, over the past few weeks, awareness among people has increased and now patients are coming at an earlier stage. He added,

If the infection is at the sinus level, the patient can be treated. Once it reaches the eyes, we have to see the damage it has caused; sometimes vision is involved and we may have to remove eye. The treatment has always been surgical debridement that is removing all the fungal material. Another option is anti-fungal medication.

Watch: Explained: What Is ‘Black Fungus’ In COVID-19 Patients

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World

26,43,68,460Cases
22,50,84,762Active
3,40,45,666Recovered
52,38,032Deaths
Coronavirus has spread to 196 countries. The total confirmed cases worldwide are 26,43,68,460 and 52,38,032 have died; 22,50,84,762 are active cases and 3,40,45,666 have recovered as on December 3, 2021 at 1:36 pm.

India

3,46,15,757 9,216Cases
99,976 213Active
3,40,45,666 8,612Recovered
4,70,115 391Deaths
In India, there are 3,46,15,757 confirmed cases including 4,70,115 deaths. The number of active cases is 99,976 and 3,40,45,666 have recovered as on December 3, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

66,37,221 796

10,882 180

64,85,290 952

1,41,049 24

Kerala

51,51,919 4,700

45,030 252

50,66,034 4,128

40,855 320

Karnataka

29,96,833 363

6,772 169

29,51,845 191

38,216 3

Tamil Nadu

27,28,350 715

8,155 45

26,83,691 748

36,504 12

Andhra Pradesh

20,73,252 159

2,138 11

20,56,670 169

14,444 1

Uttar Pradesh

17,10,417 12

93 1

16,87,413 11

22,911

West Bengal

16,17,408 657

7,690 22

15,90,208 667

19,510 12

Delhi

14,41,190 217

307 21

14,15,785 196

25,098

Odisha

10,49,597 252

2,211 26

10,38,971 276

8,415 2

Chhattisgarh

10,06,870 37

328 12

9,92,949 25

13,593

Rajasthan

9,54,827 21

213 10

9,45,659 11

8,955

Gujarat

8,27,570 50

318 25

8,17,158 24

10,094 1

Madhya Pradesh

7,93,199 12

128 4

7,82,543 8

10,528

Haryana

7,71,760 27

178 9

7,61,528 18

10,054

Bihar

7,26,230 5

32 0

7,16,534 4

9,664 1

Telangana

6,76,376 189

3,680 50

6,68,701 137

3,995 2

Assam

6,17,163 124

2,535 77

6,08,517 198

6,111 3

Punjab

6,03,352 32

344 13

5,86,402 18

16,606 1

Jharkhand

3,49,271 15

95 1

3,44,035 13

5,141 1

Uttarakhand

3,44,325 22

182 4

3,36,735 18

7,408

Jammu And Kashmir

3,37,263 177

1,697 10

3,31,089 167

4,477

Himachal Pradesh

2,27,354 85

835 29

2,22,669 113

3,850 1

Goa

1,79,046 56

367 40

1,75,295 16

3,384

Mizoram

1,35,765 315

3,717 55

1,31,545 368

503 2

Puducherry

1,28,998 33

299 10

1,26,826 23

1,873

Manipur

1,25,269 33

663 4

1,22,627 28

1,979 1

Tripura

84,835 15

94 6

83,916 8

825 1

Meghalaya

84,534 24

296 2

82,764 25

1,474 1

Chandigarh

65,475 4

65 1

64,590 5

820

Arunachal Pradesh

55,285 6

36 1

54,969 5

280

Sikkim

32,267 15

137 10

31,727 5

403

Nagaland

32,128 3

128 5

31,302 6

698 2

Ladakh

21,642 41

306 21

21,122 20

214

Dadra And Nagar Haveli

10,683

0 1

10,679 1

4

Lakshadweep

10,397 1

18 8

10,328 9

51

Andaman And Nicobar Islands

7,686 3

7 2

7,550 1

129

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