A rare but serious fungal infection, known as mucormycosis and colloquially as “black fungus”, is being detected relatively frequently among Covid-19 patients in India. The disease often manifests in the skin and also affects the lungs and the brain.
Multiple cases were reported in the Indian states of Delhi, Maharashtra and Gujarat. Doctors in some states have noted a rise in cases of mucormycosis among people hospitalized or recovering from Covid 19, with some requiring urgent surgery.
The infection is serious and causes a group of moulds known as mucormycetes present naturally in the environment. It mainly affects people who are on medication for health problems that reduces their ability to fight environmental pathogens.
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.
Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.
Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body’s immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients.
It’s thought that this drop in immunity could be triggering these cases of mucormycosis.
Patients suffering from the fungal infection typically have symptoms of stuffy and bleeding nose; swelling of and pain in the eye; drooping of eyelids; and blurred and finally, loss of vision. There could be black patches of skin around the nose.
Doctors say most of their patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain.
In some cases, doctors in India say, patients have lost their vision in both eyes. And in rare cases, doctors have to surgically remove the jaw bone in order to stop the disease from spreading.
An anti-fungal intravenous injection which costs $48 a dose and has to be administered every day up to eight weeks is the only drug effective against the disease.