Doctors in Telangana who are already battling with COVID-19 are coming across another rare health crisis which could have serious impact on people. They have diagnosed some post-COVID patients with Mucormycosis — a rare form of fungal infection which could affect vision, and threatens life, if people do not get treated immediately after spotting its symptoms.
Around 50 such cases were detected at Apollo Hospitals, Jubilee Hills, alone in the past one month. Another five cases each came to light at Continental Hospitals and Aster Prime Hospitals in the city. Mucormycosis is also known as black fungus. Of the 50 cases at Apollo Hospitals, 16 patients are showing good progress, 6 patients have succumbed to the disease and the remaining are fighting with mucor in ICUs and wards. It was estimated that there could be more such cases at other major corporate hospitals
What is Mucormycosis?
“Mucormycosis is a fungal infection that mainly affects people who are on medication for other health problems, that reduces their ability to fight environmental pathogens. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air,” according to an advisory developed by National Task Force for COVID-19 and experts. The advisory states that Mucormycosis has to be suspected in COVID-19 patients, diabetics and immuno-suppressed individuals when they have sinusitis – nasal blockade or congestion, nasal discharge (blackish/bloody), local pain on the cheek bone. It further added, “One-sided facial pain, numbness or swelling. Blackish discolouration over bridge of nose or palate. Toothache, loosening of teeth, jaw involvement. Blurred or double vision with pain; fever, skin lesion; thrombosis & necrosis (eschar). Chest pain, pleural effusion, haemoptysis, worsening of respiratory symptoms”.
ENT surgeons from Aster Prime Hospitals were among the first who tried to create awareness about this crisis. Incidentally, ENT specialists from two more corporate hospitals sent awareness notes on Tuesday afternoon. Doctors pointed at link between indiscriminate use of steroids, high sugar levels, and activation of Black Fungi.
The doctors from the Apollo Hospital said that one of the major reasons for the exponential rise in cases among COVID patients is the excessive usage of steroids.
High sugar levels
“Steroids are leading to extremely uncontrolled sugar levels, which make it a fertile field for the black fungi to grow, multiply and invade at a rapid rate! Though on many occasions usage of steroids is invariably necessary, but the dosage, and duration needs to be reconsidered, especially for diabetic patients,” the Apollo Hospitals doctors said.
An ENT surgeon Dr Ajay Kumar Yadlapalli, said that steroids are used only in around 10% to 15% of COVID-19 patients who have high levels of inflammation. “When steroids are used, sugar levels go up. And the sugar levels further shoots up in patients with uncontrollable diabetes. So it should be used strictly under qualified doctors’ monitoring. Sugar levels have to be regularly monitored, and maintained,” Dr Ajay said.
Senior ENT consultant Dr K Rambabu said that all COVID patients who are given steroids have to be watchful of mucormycosis symptoms, especially people with diabetes. The specialist doctors stressed that indiscriminate usage of steroids has to be stopped.
Treatment includes aggressive surgery or radical debridement and exenteration of effected or blind eye, long term follow-up along with anti-fungal medications. Apart from surgery, prolonged anti-fungal treatment plays a major role in curing the patient.
