Mucormycosis, a very serious and life-threatening infection with a mortality rate of 40- 60%, is striking covid patients and pushing them back into operation theatres and ICUs. Mucormycosis starts spreading in days, if not recognized and intervened at the early stages of the disease.
Many Covid patients also suffer from comorbid conditions. Diabetes is of particular importance in India due to its high prevalence. Covid therapy with Steroids and immune-suppression predisposing conditions such as old age, cancer chemotherapy/radiotherapy, organ transplant recipients on immune-suppressors, or any disease requiring steroid treatment are well recognized co-morbid conditions.
The immunosuppressive state becomes very conducive for opportunistic fungal infections. Mucor is one of the difficult to treat dreaded infection in such a state. Mucormycosis is also called Black Fungus due to the black lesions it forms in the infected area. Mucor infects deeper tissues starting from the sinus and then extending to the eyeball involving the bone and the soft tissues and finally reaches brain tissues. Mucormycosis may progressively cause rapid deterioration of eyes, leading to permanent loss of vision. Once Mucor enters the brain, the patient deteriorates fast leading to paralysis, organ failure, other complications and death.
“Working at the tertiary care centre, in last one month we have seen more than 50 mucormycosis cases, out of which 16 patients are having good progress, 6 patients have succumbed to disease and remaining are fighting out with mucor in ICU s and wards. Treatment includes aggressive surgery/radical debridement exenteration of affected/blind eye, long term follow up along with anti-fungal medications. Apart from surgery, prolonged anti-fungal treatment plays a major role in curing the patient.” said Dr K Rambabu
Sr ENT Consultant, Apollo Hospitals, Hyderabad.
One of the major reasons for the exponential rise in cases in covid patients is the excessive usage of steroids. Steroids are leading to extremely uncontrolled sugar levels, which makes it a fertile field for the Black fungi to grow, multiply and invade at a rapid rate! Though on many occasions usage of steroids is invariably necessary, the dosage and duration need to be reconsidered, especially for diabetic patients, he added.
The toughest challenge with Mucor is the need for treatment at least within 48 hours. Therefore, it’s time for the sea of volunteers to address this undercurrent of Mucormycosis by building a credible network of medication through which all hospitals can reach out for immediate medication, pharma companies are informed about the need immediately and are supported by a coordinated distribution network for the logistics according to Dr K Rambabu
Symptoms to watch out for mucormycosis according to Dr K Rambabu include facial pain, headache, nasal congestion, redness of the eye and discolouration of skin colour on the face or in the mouth.
Dr K Rambabu
Sr ENT Consultant, Apollo Hospitals, Hyderabad;
Sai Siddharth, Ph D, IIM Ahmedabad;
Dr Madhav, ENT Surgeon Apollo Hospitals, Hyderabad.
