Black Fungus & Covid-19: Mucormycosis

We all know very well about this pandemic situation. This is a very tough time for many countries especially for India because it suffers from the second wave of COVID-19. During COVID-19, there is a fungal infection known as mucormycosis or black fungus which also affects people. According to the researches, this is a very serious but rare fungal infection, which is infected to patients who have low immunity power.

• A typically rare fungal infection called mucormycosis has surged in India recently, primarily affecting those people who recently recover from COVID-19.
• Experts say this type of fungal infection is extremely rare and that it may be affecting people whose immune systems have been damaged by the coronavirus.

What Is Black Fungus?

According to the Centers for Disease Control and Prevention (CDC), this black fungus infection is called mucormycosis and it is caused by a group of molds called mucormycetes that typically live in soil and decaying organic matter.

The infection can be life-threatening and has a mortality rate between 46–96 percent depending on severity.

According to the journal of future microbiology a review published by Russell E Lewis1 et al, patients with poorly controlled diabetes mellitus or transfusional/dyserythropoietic iron overload are also uniquely at risk for infection.

Mucormycosis mainly starts in the sinuses or the lungs after inhalation of fungal spores, causing an infection that is initially indistinguishable from common bacterial or fungal pathogens.

As the fungi multiply in the host, they invade through tissue and into blood vessels causing hemorrhage, thrombosis, and necrosis with eventual spread via the bloodstream to other organs, including the heart, kidney, and brain, and GI tract.

Types Of Fungi That Most Commonly Cause Mucormycosis

Rhizopus species, Mucor species, Rhizomucor species, Syncephalastrum species, Cunninghamella bertholletiae, Apophysomyces species, and Lichtheimia (formerly Absidia) species

Symptoms Of Black Fungus

The symptoms of mucormycosis depend on where in the body the fungus is growing. And there are various types of mucormycosis fungal infection:

If your brain and sinus are affected by the infection then you can experience these symptoms:

• One-sided facial swelling
• Headache
• Nasal or sinus congestion
• Black lesions on the nasal bridge or upper inside of the mouth that quickly become more severe
• Fever
• Ophthalmoplegia
• Fixed dilated pupil
• Rapid vision loss

If the infection grows into the lungs then you face these symptoms:

• Cough
• Chest pain
• Shortness of breath.

When mucormycosis attacks the digestive system, you may experience

• Abdominal pain
• Nausea and vomiting
• Gastrointestinal bleeding.

According to the researches, mucormycosis or black fungus do not spread from person to person. It is present in the environment which infects you, it has a very high mortality rate.

They easily infect COVID-19 patients because their immunity is low, and having inflammation locally in the sinus tract.

Which People Are At High Risk

According to the CDC, Mucormycosis is rare, but it’s more common in those people who have health problems or take medicines from a longer duration. Due to this, these people have lower immunity and their body have not more able to fight against germs and sickness.

People with this disease history are more susceptible to black fungus:

• Diabetes (Highly susceptible), especially with diabetic ketoacidosis
• Cancer
• Organ transplant
• Stem cell transplant
• Neutropenia (low number of white blood cells)
• Long-term corticosteroid use
• Injection drug use
• Too much iron in the body (iron overload or hemochromatosis)
• Skin injury due to surgery, burns, or wounds

Prevention And Treatment

Patient who takes long term medical treatment and take steroids, broad-spectrum antibiotics, and monoclonal antibiotics for the treatment of COVID-19 are at high risk during this pandemic.

Prevention

• Try to avoid areas with a lot of dust like construction or sites. If you can’t avoid these areas, wear an N95 respirator (a type of face mask) while you’re there. 
• Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters^. 
• Avoid activities that involve close contact with soil or dust
• Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening, yard work, or visiting wooded areas.
• Wear gloves when handling materials such as soil, moss, or manure.
• To reduce the chances of developing a skin infection, clean skin injuries with soap and water, especially if they have been exposed to soil or dust.
• Before touch your face or any other skin part wash your hand properly.

Both patient and physician should aware of this fungal infection. So it is necessary to those people who recover from COVID-19 take more care yourself and avoid roaming outside and bring mask even after recovery. And follow the COVID-19 guidelines till pandemic.

Antifungal Treatment

Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole. These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis. Doctors can also perform surgery if necessary.

Frequently Asked Questions (FAQ_S)

Is it a novel disease?

No, it’s not a novel disease.

Can it affect any person?

No, mucormycosis only affects those people who have low immunity and any other disease history like diabetes.

How dangerous it is?

This is a life-threatening disease. In severe cases, it could make you blind, and causing death.

Does it spread from one person to another person?

No, this is not a communicable disease. So, it is not spread from one person to another person.

Is there any precautionary medicine for this?

There is no precautionary medicine for this disease. The only precaution is to avoid an open environment and wear a mask even after recovery from COVID-19, maintain hygiene, avoid dusty areas.

Is it present in the air?

Yes, spores of mucormycosis could be present in the air. But it not affects that person who has good immune power. But these spores may affect recently covid recover patients.