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The black fungus is the latest focus of medical attention, thanks to the uproar it has been causing amidst the ongoing pandemic. Mucormycosis, commonly known as the black fungal disease, is one of the most lethal fungal infections. It is rare but life-threatening, and complicates the course of severe COVID-19.
Lately, people who are suffering from COVID-19 as well as those who have recovered a short while ago are observed to be affected. In almost 80% of the reported cases, pre-existing diabetes mellitus was present. This is specific to diabetic patients as there are a few cases of mucormycosis with just 5-10 days of steroid therapy, hence diabetes mellitus coupled with steroids extends the chance of getting infected. Excessive usage of corticosteroids in COVID-19 treatment seems to increase the occurence of mucormycosis.
Mucormycosis is not a newly discovered illness- it has been known to humankind for a long time, and was especially noted to affect diabetic patients and immunodeficient individuals. Mucormycetes- the group of fungi causing this disease- live as spores in soil or grow on stale organic matter. The most common way of getting infected is inhaling these spores. A person may also get infected if these spores come in contact with an open wound or scar on the body. Once they enter the body, they replicate quickly because of favourable conditions like low oxygen, elevated iron levels, reduced phagocytic activity of WBCs (especially in immunocompromised people) and high glucose levels (in diabetic patients).
COVID-19 patients are usually administered with corticosteroids that essentially mimic hormones like cortisol and suppress the immune system, which starts an inflammatory response when infected with diseases like COVID-19. This is done to protect the tissues and keep tissue damage at a minimum. This helps patients in many ways, but at the same time may make them susceptible to mucormycosis due to immunosuppression.
There are many types of mucormycosis based on how and where it infects people. Some symptoms of affected individuals include:
Rhino cerebral (affects the sinus and brain): One-sided facial swelling, headaches, nasal congestion, fever and black lesions on the nasal bridge
Pulmonary (affects the lungs): Fever, cough, chest pains and shortness of breath
Cutaneous (affects the skin): Blisters and ulcers along with pain and redness of the affected area
Gastrointestinal (affects the GI tract): Abdominal pain, nausea and gastrointestinal bleeding
Of these, rhino cerebral and pulmonary mucormycosis are the most reported types.
The best precautionary method to avoid the black fungal infection is to maintain good oral hygiene, especially for recently recovered COVID-19 patients. Taking care of the mouth by brushing twice/thrice a day and oral clean-ups can help immensely. It is also advised to disinfect the toothbrush and tongue cleaner at regular intervals, and they should be kept separately if people have just recovered from COVID-19. Other than this, the cleaning and replacement of humidifiers should be done at regular intervals. Daily masks should be disinfected/washed regularly. Those who are taking steroids should keep checking their blood sugar levels. COVID positive patients with a history of diabetes or those having a mild form of the fungal infection should strictly avoid immoderate intake of steroids. Fungal spores found in the air can easily enter the body through the nose, which makes masking even more crucial to keep mucormycosis at bay. These simple methods can help the prevention of the black fungal infection among COVID positive patients as well as recovered individuals. - written by Srinidhi.I, Sneha.N, Sriya Mohanty