Mucormycosis in Covid-19 patients

Covid -19 patients suffering from uncontrolled diabetes and in prolonged intensive care unit (ICU) are detected with mucormycosis, a fungal infection. On Sunday, the Centre warned about this kind of disease and stated that it might lead to death if left unattended. This fungal infect ion is basically affecting the ones who are on medication that reduces the capacity the fight against the environmental pathogens.

The Indian Council of Medical Research (ICMR) and the Union health ministry released the evidence-based advisory for screening, diagnosis and management of the disease.

It stated, “Mucormycosis, if uncared for, may turn fatal. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air.”

The advisory exclaimed that the symptoms include pain and redness around the eyes and nose, fever, headache, coughing, shortness of breath, bloody vomits and altered mental status.

It pointed out that Covid patients who are suffering from diabetes and immune-suppressed people should take mucormycosis into account if there is sinusitis, one-side facial pain or numbness, blackish discoloration over the bridge of the nose or palate, toothache, blurred or double vision with pain, skin lesion, thrombosis, pain in the chest and worsening respiratory trouble.

The ICMR-health ministry advisory said that the main risk factors for this disease are uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged stay at ICU, malingnancy and voriconazole therapy.

It stated that in order to control the disease, after the discharge of Covid patients and also the ones with diabetes, blood glucose level should be closely examined; steroids should be wisely used in due time; dose and duration; humidifiers should use clean sterile water during oxygen therapy; and antibiotics and antifungal medicines should be used properly.

As per the advisory, the disease can be prevented by controlling diabetes, not using immunomodulating drugs, lessen the amount of steroid and extensive surgical debridement to remove all necrotic materials.

It stated that the treatment consists of installing peripherally inserted central catheter, maintaining sufficient systematic hydration, infusion of normal saline intravenously before Amphotericin B infusion and anti-fungal therapy for at least six weeks besides monitoring the patient clinically with radio imaging for response and to detect disease progression.