KOCHI: The pandemic has thrown up yet another challenge for the healthcare sector, with isolated cases of an unusual fungal infection being reported from some among those being treated for COVID-19. Mucormycosis, a rare fungal infection affecting immuno-compromised people, has been reported from amongst those battling, and those recently recovered from COVID-19, in many parts of the country.
Though no cases have been reported in Kerala so far, instances of this infection being identified in those from other states, including Tamil Nadu, have been reported recently. Experts opine that those administered with high dosage of steroids and Tocilizumab tabs, as also those with uncontrolled diabetes, are more prone to the risk of this fungal attack. Instances of this rare infection have been reported from many cities, including Ahmedabad, Bengaluru, and Delhi.
“No local cases have been reported in the state so far, but we are getting a few cases from Tamil Nadu. Most of those patients are being referred to the Medical College Hospital in Thiruvananthapuram,” said an official with the Integrated Disease Surveillance Programme (IDSP) in the state.
This December, a 41-year-old man from Nagercoil, who recovered from COVID-19 in October, was admitted to a major private hospital in Kochi following the fungal infection. He sought treatment at a private hospital in Nagercoil after he developed a toothache. Later, he was diagnosed with the fungal infection, and was referred to Kochi.
According to the doctors who treated the patient at the hospital, he had to undergo three surgeries and one of his facial bones had to be removed. “He was an uncontrolled diabetic. The peculiarity of this infection is that it eats through whichever part of the body it affects. In this case, the fungus ate through the bone and therefore the tissues had to be removed”.
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In another similar case, a 45-year-old man - a native of Tamil Nadu who recovered from COVID-19 in November- is presently undergoing treatment in Thiruvananthapuram with breathing issues. As per sources, the infection has affected his lungs. The fungus can affect any organ, but most commonly sinus, eyes, lungs, and brains are affected.
“This fungus is very common in the environment; the infection happens because the body’s inherent immunity is suppressed with medications, like high-dose steroids. We should be judicious in using medicines like steroids and Tociluzimab during COVID treatment. The medicines should be used in recommended doses and for a minimum duration. In lots of places, especially in North India, they use high dose of steroids and Tociluzimab. Patients with diabetes are at high risk. While undergoing treatment, sugar control is also extremely important,” said Dr Anup R Warrier, Infectious Disease expert. “Following a healthy diet with immunity boosters and keeping diabetes under control are vital, to fight this fungal infection,” said Dr Anup.
A recent review published by ‘Journal of Fungi’ last year, on the ‘Global Epidemiology of Mucormycosis’, states that in the period from 2000 to 2017, 851 cases have been reported globally. “This fungal infection is quite rare and immuno-compromised people, like those with HIV, transplants, diabetes, and cancer, have been found to be prone to it. It is very rare for COVID patients to get fungal infections in a normal scenario,” said Dr Tinku Joseph, a pulmonologist based in Kochi.