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COVID-19 Triggered Mucormycosis: Everything You Need To Know

| Reviewed By Arya Krishnan

Mucormycosis, also known as black fungus, can turn dangerous if left untreated, doctors said on Friday amid reports of re-emergence of the rare deadly fungal infection among COVID-19 patients across hospitals in Delhi, Pune, and Ahmedabad.

Previously, doctors at a hospital in Delhi had found multiple cases of a deadly fungal infection "triggered by COVID-19" in recovering COVID-19 patients; due to which nearly half of them lost their eyesight.

According to recent reports, the infection is rare but not a new one. Mucormycosis, previously called zygomycosis is a serious but rare fungal infection caused by a group of moulds called mucormycetes [1]. However, mucormycosis triggered by COVID-19 indeed is a new one [2]. While there has been an outbreak of the infection in COVID-19 patients, it was prevalent even before the pandemic. Cancer patients and severe diabetics are prone to it.

Read on to know about COVID-19 Triggered Mucormycosis.

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What Is Mucormycosis?

As aforementioned, the rare infection is a deadly one and can be caused by different fungi. Mucormycosis can result in an acute, rapidly advancing, and occasionally fatal disease, and are diagnosed relatively infrequently. It mostly affects people with underlying medical conditions and health problems such as uncontrolled diabetics, low immunity etc. [3].

The deadly infection is also termed as Black Death and Zombie disease but has been disregarded by the medical fraternity as many health experts and doctors assert that such terms may cause misunderstandings between the patients, their families, and the public, and is not respectful to the person affected by it [4].

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What Causes Mucormycosis?

The moulds that cause this deadly infection are widely present in nature and occur in leaves, piles of compost, soil and rotting wood [5]. The fungus can also infect your skin via a cut or burn.

Not everyone who gets exposed to the moulds will get the fungal infection, but as mentioned before, you can be at an increased risk of contracting the infection if you have a weakened immune system.

What Are The Symptoms Of Mucormycosis?

The primary symptom of this fungal infection is a respiratory or a skin infection. Symptoms of a related respiratory infection may include cough, fever, headache, nasal congestion, and sinus pain.

In the case of a skin infection, the symptoms will arise at the site of skin trauma (injury/cut) and can quickly spread to another area [6]. A skin infection associated with the deadly function infection can cause symptoms such as fever, blisters, swelling, ulcers, skin tenderness, blackened skin tissue and redness [7].

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What Are The Risk Factors For Mucormycosis?

People who have health problems or take medicines that lower the body's ability to fight illnesses are at an increased risk of contracting the fungal infection. The following increases the risk of infection [8]:

  • Cancer
  • Diabetes
  • Organ transplant
  • Stem cell transplant
  • Long-term corticosteroid use
  • Too much iron in the body (hemochromatosis)
  • Low white-blood cell count (neutropenia)
  • Skin injury due to surgery, burns, or wounds
  • Prematurity and low birthweight
  • How Is Mucormycosis Treated?

    The deadly fungal infection is treated through an intravenous (IV) antifungal medications and having surgical debridement (cutting away all infected tissue); removing the infected tissues can help prevent the rapid spread of the infection [9]. Recovery from the deadly infection (if left untreated) depends on early diagnosis and treatment.

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What Is COVID-19 Triggered Mucormycosis?

In the last 15 days, ENT surgeons at Sir Ganga Ram Hospital, Delhi have seen 13 cases of Covid-19-triggered mucormycosis [10]. Over 50-per cent of Covid-19 patients have reported a loss of eyesight, and there has been a need for nose and jawbone removal to prevent the spread of the infection to other parts of the body.

The symptoms specific to Covid-19 triggered mucormycosis are face numbness, one-side nose obstructions or swelling of eyes, or pain. Mortality has been reported in the range of 50 per cent (five patients) and 50 per cent of the patients have lost their eyesight permanently and required critical care support due to associated complications.

The doctors at the Delhi hospital stated, "The frequency with which we are witnessing the occurrence of COVID-19 -triggered mucormycosis with high morbidity and mortality has never been seen before and is shocking and alarming" [11].

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On A Final Note…

The doctors added that early detection can prevent loss of eyesight, nose, or jaw through clinical intervention. "Orbital involvement (the bony cavity that contains the eyeball) is a grave development in the course of this disease, and points not only towards the possibility of permanent loss of eyesight but life as well because brain involvement is the leading cause of death in mucormycosis."

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Frequently Asked Questions

Is mucormycosis contagious?

Ans: No. Mucormycosis cannot spread between people or between people and animals.

Is it possible to prevent a mucormycosis infection?

Ans: Self-care measures are the best way to prevent this type of infection, such as wearing a mask while outdoors, bandaging the wounds and cuts, and taking extra measures during the summer season, when there is an increased amount of the fungi in the environment.

Can mucormycosis cause other conditions to develop?

Ans: If left untreated, the fungal infection can spread to the lungs or the brain, and cause brain infection, paralysis, pneumonia, or seizures, and in some cases death.

Arya KrishnanEmergency Medicine
MBBS
Arya Krishnan
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