Covid: Black fungal infections can turn dangerous if left untreated

New Delhi: Mucormycosis, also known as black fungus, can turn dangerous if left untreated, doctors said on Friday amid reports of re-emergence of the rare deadly fungal infection among Covid-19 patients across hospitals in Delhi, Pune and Ahmedabad.

The fungal infection is caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems or take medicines that lower the body's ability to fight germs and sickness.

The common symptoms associated with the disease include headache, facial pain, nasal congestion, loss of vision or pain in eyes, swelling in cheeks and eyes and black crusts in the nose. The US Centre for Diseases Control and Prevention estimates Mucormycosis with an overall all-cause mortality rate of 54 per cent.

"Mucormycosis can be very dangerous if left untreated can cause mutilating damage to face, nose, eyes with disfigurement and loss of vision and also cause invasive brain infection," Dr. Mahesh Kumar, Consultant -Internal Medicine, Narayana Health City, Bengaluru.

While "Aspergillus and Candida are more common fungal infections, but this infection is dangerous because it involves the sinus and brain and happens to those who are in an immunocompromised state and/or to patients on steroids," added Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh.

According to health experts, Mucormycosis (previously called zygomycosis) has been a cause of disease and death in transplants, ICU and immunodeficient individuals since long. However, it is the rapid increase in numbers seen in unsuspected Covid patients which is a matter of grave concern. Patients who recover from the Covid infection are increasingly being pushed back into the ICUs. Last year, Mucormycisis had caused high mortality with many patients suffering from loss of eyesight, removal of nose and jawbone.

"Mucormycosis is affecting Covid patients more due to prolonged administration of steroids and subsequent immunocompromised state," Dr Suranjit Chatterjee, Senior Consultant, Department of Internal Medicine, Indraprastha Apollo hospital, New Delhi.

"In Covid, patients get steroids and immunity goes down and they may get this infection," Maurya said.

People with diabetes, those on steroids and humidified oxygen for a long time, and Covid patients with pre-existing comorbidities are the most at risk. Others include patients like those post chemotherapies, those on long-term immunosuppressive drugs.

The Drug Controller General of India, in March this year, gave approval to Mumbai-based bio-pharmaceutical firm Bharat Serums and Vaccines Limited to use anti-fungal medication -- Liposomal Amphotericin B or LAmB -- as a medical intervention in patients of Mucormycosis.

The risk of this fungus can be avoided by avoiding prolonged use of steroids. The treatment also involves anti-fungal and surgery (if required) to remove the affected area, Chatterjee said.

Judicious use of steroids and immunosuppressive drugs especially in elderly, immunocompromised, cancer and diabetic patients with Covid, are needed during the course of treatment, Kumar advised.