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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

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

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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.

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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.

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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

22,70,55,138Cases
18,97,86,461Active
3,25,98,424Recovered
46,70,253Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 22,70,55,138 and 46,70,253 have died; 18,97,86,461 are active cases and 3,25,98,424 have recovered as on September 17, 2021 at 5:36 am.

India

3,33,81,728 34,403Cases
3,39,0563,867Active
3,25,98,424 37,950Recovered
4,44,248 320Deaths
In India, there are 3,33,81,728 confirmed cases including 4,44,248 deaths. The number of active cases is 3,39,056 and 3,25,98,424 have recovered as on September 17, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,11,525 3,595

52,893 310

63,20,310 3,240

1,38,322 45

Kerala

44,46,228 22,182

1,86,754 4,559

42,36,309 26,563

23,165 178

Karnataka

29,65,191 1,108

16,202 282

29,11,434 808

37,555 18

Tamil Nadu

26,40,361 1,693

16,756 120

25,88,334 1,548

35,271 25

Andhra Pradesh

20,34,786 1,367

14,708 105

20,06,034 1,248

14,044 14

Uttar Pradesh

17,09,628 23

193 11

16,86,549 11

22,886 1

West Bengal

15,59,567 707

8,025 25

15,32,922 725

18,620 7

Delhi

14,38,373 28

409 5

14,12,880 22

25,084 1

Odisha

10,18,298 580

5,335 105

10,04,845 681

8,118 4

Chhattisgarh

10,04,988 31

352 2

9,91,077 29

13,559

Rajasthan

9,54,230 4

103 1

9,45,173 5

8,954

Gujarat

8,25,677 22

149 0

8,15,446 22

10,082

Madhya Pradesh

7,92,374 7

119 5

7,81,738 12

10,517

Haryana

7,70,697 9

327 8

7,60,562 17

9,808

Bihar

7,25,864 12

72 6

7,16,134 6

9,658

Telangana

6,62,785 259

5,282 43

6,53,603 301

3,900 1

Punjab

6,01,180 30

314 11

5,84,399 38

16,467 3

Assam

5,97,074 468

5,381 15

5,85,914 479

5,779 4

Jharkhand

3,48,102 6

102 8

3,42,867 14

5,133

Uttarakhand

3,43,330 20

284 12

3,35,657 32

7,389

Jammu And Kashmir

3,27,466 170

1,421 72

3,21,630 98

4,415

Himachal Pradesh

2,16,430 127

1,568 82

2,11,215 206

3,647 3

Goa

1,75,183 95

699 1

1,71,195 96

3,289

Puducherry

1,25,170 107

963 63

1,22,380 42

1,827 2

Manipur

1,17,913 216

2,614 7

1,13,478 219

1,821 4

Tripura

83,787 31

427 26

82,553 56

807 1

Meghalaya

78,958 229

1,804 140

75,784 86

1,370 3

Mizoram

76,591 1,121

13,888 85

62,449 1,202

254 4

Chandigarh

65,168 4

31 2

64,319 2

818

Arunachal Pradesh

53,990 47

536 9

53,183 56

271

Sikkim

30,802 64

775 28

29,648 36

379

Nagaland

30,763 32

505 14

29,610 44

648 2

Ladakh

20,631 6

41 1

20,383 5

207

Dadra And Nagar Haveli

10,670

5 0

10,661

4

Lakshadweep

10,353

4 0

10,298

51

Andaman And Nicobar Islands

7,595 3

15 2

7,451 1

129

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