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India’s COVID-19 patients at risk of potentially fatal fungal infections

With coronavirus deaths in India surpassing 4,000 again on Sunday, doctors are increasingly concerned about the rising number of fungal infections.

India sees record Covid-19 deaths, new cases in 24 hours
India's daily number of Covid-19 cases eased to as low as 357,000 before creeping up again - Copyright AFP Money SHARMA
India's daily number of Covid-19 cases eased to as low as 357,000 before creeping up again - Copyright AFP Money SHARMA

With coronavirus deaths in India surpassing 4,000 again on Sunday, doctors are increasingly concerned about the rising number of potentially fatal fungal infections affecting either people who have Covid-19 or those who have recently recovered from the disease.

Also called the “black fungus” – the disease is becoming a threat to recovering and recovered Covid-19 patients. Called mucormycosis, this often fatal infection is caused by exposure to mucor mold which is commonly found in soil, plants, manure, and decaying fruits and vegetables, according to the BBC.

Dr. Akshay Nair, a Mumbai-based eye surgeon, spoke with the BBC. He said the mold “is ubiquitous and found in soil and air and even in the nose and mucus of healthy people.” It affects the sinuses, the brain, and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS, he added.

Dr. Nair, along with many of his colleagues, believes mucormycosis, which has an overall mortality rate of 50 percent, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.

Steroids are extremely useful in reducing inflammation in the lungs of COVID patients, but there are side effects that have to be monitored closely. Steroids also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients.

It is thought this drop in immunity could be triggering these cases of mucormycosis. “Diabetes lowers the body’s immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel being added to the fire,” says Dr Nair.

A 47-year-old man with mucormycosis and electron micrograph of his skin showing sporangia of Mucorales fungi. Image courtesy of Ran Yuping et al. (Creative Commons SA 3.0)https://en.wikipedia.org/wiki/Mucormycosis#/media/File:Mucormycosis.jpg

The New York Times is reporting that in the western state of Maharashtra, which includes the commercial hub of Mumbai, local news media reports that around 200 patients who had recovered from Covid were being treated for mucormycosis and that eight had died.

In Gujarat, a western state north of Maharashtra, separate hospital wards are being set aside to treat patients with mucormycosis, and state officials have placed orders for 5,000 doses of amphotericin b, a medicine used to treat it.

The anti-fungal medication is an intravenous injection which costs 3,500 rupees ($48) a dose and has to be administered every day up to eight weeks.

The Hindustan Times is reporting that Niti Aayog (health) member VK Paul on Friday said that the occurrence of mucormycosis is natural and the correlation between the disease and Covid-19 is not exclusive. The infection affects only those who have a high blood sugar level, notwithstanding the presence of Covid-19 infection, he said.

“It is a fungus that breeds on wet surfaces. It is very uncommon to happen among patients who do not have diabetes. There are reports of this fungal infection among Covid-19 patients. But I want to reassure you that there is no major outbreak and we are monitoring the cases at our level,” Paul said.

Written By

Karen Graham is Digital Journal's Editor-at-Large for environmental news. Karen's view of what is happening in our world is colored by her love of history and how the past influences events taking place today. Her belief in man's part in the care of the planet and our environment has led her to focus on the need for action in dealing with climate change. It was said by Geoffrey C. Ward, "Journalism is merely history's first draft." Everyone who writes about what is happening today is indeed, writing a small part of our history.

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