COVID-19 Is Triggering Mucormycosis Cases In India

Doctors at a leading private facility in Delhi have identified several cases in the recovery of coronavirus patients who have been diagnosed with a deadly fungal infection, which was triggered by their previous by COVID-19 infection, causing nearly half of them to lose their sight, hospital authorities announced Monday.

While hospitals in Delhi and Mumbai reported some cases, Ahmedabad in Gujarat recorded at least 44 cases of mucormycosis, in which 9 patients unfortunately died. In the last 15 days, ENT surgeons at Sir Ganga Ram Hospital (SGRH) reported having 13 cases of "COVID-19-triggered mucormycosis".

An uncommon, but very severe fungal infection, Mucormycosis is caused by a group of molds called mucormycetes, which can enter the body through the air, usual by fungal spores, or in the skin through an exposed injury. Mucormycosis isn't able to spread between people or between people and animals directly.

Mucormycosis is the general term for any fungal infection caused by various genera of the class Zygomycetes. Mucormycosis can lead to an acute, rapidly progressing, and occasionally lethal disease caused by various fungi that are often in soil, or the surrounding environment.

There are various fungi that can cause mucormycosis; infections with the Mucoraceae family of fungi predominate as causes; hence, many investigators use the term mucormycosis instead of zygomycosis.

Symptoms and signs usually occur first in the infected area of the body and can occur as follows: fever, headache, reddish and swollen skin over the nose and sinuses, dark abrasions in the nose, vision problems, swelling of the eye, facial pain, coughing sometimes with bloody or dark fluid production, shortness of breath, diffuse abdominal pain, bloody and sometimes dark vomiting, abdominal stretching, flank pain, an ulcer with dark center and sharply defined edges, and changes in mental state may occur. Nearly all patients require surgical debridement of infected tissue, and antifungal drugs (mainly amphotericin B).

The results of mucormycosis infections ranges from fair to bad; there is a mortality rate of about 50%, which rises to about 85% in rhinocerebral and GI infections.

Mucormycosis, also called Black Fungus, has been a cause of disease and death of patients in transplants, and ICU and immunodeficient individuals for some time. Now there is a dramatic climb in the cases seen in patients recovering from COVID-19 that is creating the pressing matter, the SGRH said in a statement.

"In the last 15 days, ENT surgeons have seen 13 cases of COVID-19-triggered mucormycosis in over 50% patients, with loss of eyesight, and removal of nose and jaw bone needed," SGRH said.

The ENT and Eye Team at Sir Ganga Ram had to perform resections in about 10 patients in the last 14 days, with about 50% sadly losing their vision permanently after the procedure.

Five of these patients needed intensive care due to other complications related with the disease. So far, there also have been five unfortunate mortalities in this subgroup, according to the official version of Ganga Ram Hospital.

One retinal and ophthalmic surgeon had stated that five cases of mucormycosis had been identified in Ahmedabad. According to the report, two patients have already died, while two surviving patients lost their vision.

Usually it takes mucormycosis about 15-30 days to spread, but for people infected after contracting COVID-19, the spread occurs within just 2-3 days.

Research was already showing mucormycosis infections increasing, especially with immunosuppressed individuals. Now results are revealing that COVID-19 patients are more vulnerable to this fungus. It is said that it's a ubiquitous fungus found in plants, animals and the air, but it attacks patients who have recovered from COVID because they have been given steroids and suffer from co-morbidities, which is even worse.