Some Recovering Indian COVID-19 Patients Are Losing Their Eyes Due to a Fungal Infection

Doctors in India are concerned about the recurrence of a serious fungal infection that occurs in people who have been cured of or are recovering from Covid-19. Several people have already lost an eye to this “black fungus.” Soutik Biswas, an Indian correspondent for the BBC, reported on a story circulating in the international media.  People who are recovering or cured of Covid-19 are being infected with another potentially deadly infection called mucormycosis. This time the culprit is not a virus, but microscopic filamentous fungi belonging to the order Mucorales.

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Mucorales Fungi

Mucorales Fungi. Image Courtesy of Ran Yuping et al

These fungi are ubiquitous in the environment: in the soil, on plants and animals, on food and objects. So we are in constant contact with these fungi, we breathe in their spores without realizing it. In immunocompetent people, this has no effect, but in people with a weak immune system, it can cause infection. Mucorales can also infect us through the skin when the physical barrier of the skin is damaged or weakened, especially in burn victims and victims of accidents.

Diabetes and anti-covid treatments promote mucormycosis

According to information gathered by Soutik Biswas, the number of cases of mucormycosis has exploded since the pandemic began. Dr. Nair, who works at Sion Hospital in Mumbai, says he has treated 40 people for mucormycosis in two weeks, compared to less than 10 in the past two years. Most of these patients were infected with the coronavirus within 14 days of the onset of the fungal infection.

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Some of them already had diabetic ketoacidosis, a complication of type 1 diabetes (and to a lesser extent type 2 diabetes) that weakens the immune system. Add to that steroid anti-inflammatory drugs that help limit the damage caused by Covid-19, but still lower immunity. Together, these two conditions create an ideal breeding ground for mucormycosis.

Mucormycosis

Mucormycosis

Mucormycosis, a serious disease that is difficult to treat

This infection can be fatal and is characterized by necrosis of the nasal mucosa and sometimes the palate. The microscopic fungus can spread through the bloodstream to the eyes and brain. The infection causes pain, fever, necrosis, purulent secretions, eye, and brain damage.

In India, doctors report that by the time patients reach the hospital, the fungus has already reached their eyes. So far, eleven people in India have had to have an eye amputated to stop the spread of the “black fungus.” Mucormycosis is a difficult disease to treat. In addition to surgery, patients receive high doses of intravenous injections of antifungal drugs for eight weeks. At the moment, the Indian government is not talking about a mucormycosis epidemic. Doctors still do not yet fully understand why the number of cases of mucormycosis is increasing throughout India.

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References

Mucormycosis: The ‘black fungus’ maiming Covid patients in India

 

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