COVID-19 recovered patients are suffering from post viral symptoms of Mucormycosis (MM) also known as Black Fungus which is making them blind. Heath experts say the Black Fungus is caused by the use of steroids during Covid-19 infection.
Dr Susheen Dutt (ENT Specialist, Fortis Hospital) shared the story of a 70-year-old Covid patient who was being treated with steroids.
“He did not have any history of diabetes mellitus. Towards the end of two weeks, though his covid symptoms improved, he had a nose block and there was swelling near his eyes.
Over the next three to four days, his vision deteriorated. He could not see even 12 inches from his face. That is when he came to us with a significant progression of Mucormycosis as observed in the MRI scan.
He underwent radical sinus debridement with removal of the right eye, followed by aggressive antifungal treatment in the form of intravenous Amphotericin B.”
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The number of such cases have been increasing. This issue is common among the Covid recovered patients who were on humidified oxygen and steroids or immunosuppressive medications, said Dr Rohit Udaya Prasad, ENT and Hearing Implantology, Aster RV Hospital.
According to AIIMS Chief Dr Randeep Guleria, excessive use of steroids during COVID-19 treatment knocksout your immune system and you are prone to get a secondary infection like Black Fungus.
What is Rhino Cerebral Mucormycosis?
This is an angioinvasive fungal infection and it involves brain, eye and nose. People with weak immunity get affected with it. Since it is fungal infection, it spreads fast. At times, it can be fatal.
Dr Srivatsa Lokeshwaran (Interventional Pulmonolog consultant at Aster CMI Hospital ) said:
“Yes, we have seen a rise in invasive fungal infections like mucormycosis which is associated with a high mortality rate and morbidity. It tends to involve the sinuses, the eye and the brain.
Covid itself beats down immunity. When combined with diabetes, in post-transplant patients, with malignancy as a co-morbidity and some medications may predispose people to such infections.
Other fungal infections like aspergillus which affects the lungs are also being increasingly picked up. These infections can significantly alter the course of the illness in patients recovering from covid 19, if not picked up earlier.”
Dr Prasad said, “Patients come with symptoms of facial pain, bloody nasal discharge, headache, blurring of vision and restricted eye movements. Antifungal therapy and surgical debridement is done as a treatment protocol.
Survival depends on the presentation of symptoms. The spread of the fungus towards the brain via the eyeball has poor outcomes and prolonged hospitalisation.
Due to the renal toxicity of the antifungal medications, patients may even need dialysis during treatment as the medications are given for a long duration.”
Dr Basavaraj Kuntoji (Consultant – Internal Medicine, Manipal Hospital, Malleswaram, Bengaluru) said:
“If steroids are used beyond 10 days or without good control of blood sugar, they can lead to bactsupportivend fungal infections and also can lead to diabetic ketoacidosis.”
Dr. Prasad suggested patients should take consultation from doctor early for better results in terms of survival. Steroid usage for Covid treatment should be done under the doctor’s supervision.
It is suggested to use distilled sterile water for humidified oxygen that should be changed every 4 hours.