Another Curse of COVID-19; Black Fungus

"The issue is when people don’t have a strong enough immune system to fight off these fungi that are really fairly widespread in the environment."

"It can be really lethal. It is a pretty nasty fungus."

"Once it’s inside the body, it can then spread throughout the bloodstream and affect all kinds of organs."

"The use of steroids can be absolutely life saving, but it also creates these huge risks and vulnerabilities. Doctors need to be very, very careful with how they’re monitoring those kind of treatment regimens."

"It's expensive, it's damaging, it's toxic, it requires IV every day for up to eight weeks and often, it's not curative [antifungal drug called amphotericin B]."

"That can happen in the brain, right in the eye. There’s this really common issue now with having to remove the eye of these patients to save their lives."

"There's a much bigger field and a lot more money behind antibacterials and antivirals than there are supporting antifungal research. So we think there's a really huge, huge and growing unmet medical need here."

Leah Cowen, professor and Associate Vice President, Research, University of Toronto

A health worker tries to adjust the oxygen mask of a patient at the BKC jumbo field hospital, one of the largest COVID-19 facilities in Mumbai, India, Thursday, May 6, 2021.  (AP Photo/Rafiq Maqbool)

"The situation here has improved in terms of numbers of COVID-19 patients requiring admission, but mucormycosis is now playing absolute havoc."

"[The survival rate for Mucormycosis, also called black fungus, significantly increases with early diagnosis and treatment]."

Dr.Prashant Rahate, chairman, SevenStar Hospital, Nagpur, India

The devastating second wave of COVID-19 that has placed India to the unenviable fore of countries overwhelmed by the novel coronavirus and struggling to contain its contagion in the wake of a colossal death count that has challenged the capacity of the nation's hospitals to accommodate the dire needs of seriously ill COVID patients, as well as the ability of its crematoria to keep pace with the disposal of dead bodies. 

 

India has been reporting over 300,000 new infections daily for the past twenty days. Predictions are that by August it will surpass one million COVID-related deaths. And in the midst of this horrible turmoil has come a new threat related to the SARS-CoV-2 virus to focus the mind, a deadly fungus with a mortality rate of 50 percent (according to the U.S.Centers for Disease Control and Prevention).

 

The common name for the fungus calls on the imagination to visualize a fungal invasion that turns the human interior black, mortally wounding human cells and organs (necrosis) to cause death. Its formal name, mucomycosis identifies an extremely rare infection caused by mucor mould exposure. The mould is found in soil, plants, manure and decaying produce. "It is ubiquitous and found in soil and air and even in the nose and mucus of healthy people", explained Dr. Akshay Nair, an eye surgeon based in Mumbai.

Severely immunocompromised people like those with cancer, or people with HIV/AIDS, as well as people with diabetes are at high risk for their lives being threatened by the fungus that affects the sinuses, the brain and the lungs. It is in recovering COVID-19 patients that the rare disease has been cropping up in astonishing numbers, leading to life-saving surgeries to remove affected areas and preventing deadly spread.

Steroids, administered for the purpose of reducing inflammation in the lungs of people with COVID-19 are used as an aid to help to reduce some of the tissue damage that occurs on occasion when the body's immune system goes berserk in an effort to fight off the invading coronavirus. Those same steroids, unfortunately, also have the effect of reducing immunity, and work to push up blood sugar levels both in diabetics and non-diabetics with COVID-19. The hypothesis is that the reduction in immunity may act as an invitation for mucomycosis to invade.

Steroids are an essential life-saving drug for Covid patients   Getty images

"Diabetes lowers the body's immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire", Dr.Nair explains. The Sion Hospital in Mumbai has had 24 cases of the fungal infection in two months, a marked increase from the usual six cases annually. Of the total, eleven lost an eye, six died. Most were middle-aged people with diabetes who developed the fungal infection two weeks following recovery from COVID. 

Health workers wearing personal protective equipment suits attend to COVID-19 coronavirus patients inside a temporary COVID care facility in New Delhi on May 2, 2021.  Tauseef Mustafa/AFP via Getty Images

"We are already seeing two to three cases a week here. It's a nightmare inside a pandemic", said Dr.Renuka Bradoo, head of the hospital's ear, nose and throat wing. Leading hospitals right across India now see multiple cases of black fungus on a daily basis. If attending physicians examining the condition in patients diagnose that the mucor will spread to the brain, invasive surgery is called for, as a final recourse, Indian surgeons forced to remove the infected jawbone, nose and eyes of patients.