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(IANS)
Since the beginning of the coronavirus pandemic, patients with diabetes have been of great concern for developing severe COVID-19 outcomes because of their increased risk. Now health experts have determined that diabetes combined with coronavirus infection could be one of the reasons for the sudden surge in mucormycosis, or “black fungus” infections, in the country.
India is known as the global capital for diabetes. Almost every sixth diabetic worldwide comes from India. The available scientific literature shows that diabetes damages the beta cells of the pancreas and leads to insufficient insulin production, resulting in hyperglycemia – a condition that leads to a dysfunctional immune response. In addition, diabetes drugs also suppress immune responses.
COVID-19 also decreases immunity and the drugs used for its treatment, such as steroids and IL-6 inhibitors (tocilizumab), resulting in further suppression of the immune system.
The second wave of the coronavirus was more deadly in India. The country has also seen more people with diabetes affected by the infection – nearly 76%, said Dr. V. Ramana Prasad, senior pulmonologist at KIMS Hyderabad Hospital, told IANS.
“COVID-19 itself is more common and severe in diabetics, and there is a high likelihood that diabetics who developed Covid will be admitted to the intensive care unit and need to take drugs like steroids and tocilizumab. Such drugs also lower immunity and make a person more prone to opportunistic infection such as mucormycosis, “Dr. Asmita Mehta, head of the respiratory medicine department at Amrita Hospital in Kochi.
Mucormycosis was present before Covid, but it is an opportunistic infection. The fungal infection is caused by a group of molds called mucormycetes. These molds live all over the environment. Mucormycosis mainly affects people with damaged tissues or decreased immunity.
India has a very high incidence of mucormycosis cases compared to other countries, even before Covid. The incidence of mucormycosis in India is 14 / 100,000 people, while that in Australia is 0.06 / 100,000 people. The reason for this is India’s hot, humid climate, where the slime spores survive longer.
However, it has become one of the fast-spreading infections seen in those recovering from COVID-19. India has so far reported approximately 8,848 cases of mucormycosis or black fungus.
Gujarat has reported a maximum of 2,281 mucormycosis cases, followed by Maharashtra (2,000), Andhra Pradesh (910), Madhya Pradesh (720), Rajasthan (700), Karnataka (5.00), Haryana (250), Delhi (197) and Punjab (95), Chhattisgarh (87), Bihar (56), Tamil Nadu (40), Kerala (36), Jharkhand (27), Odisha (15), Goa (12) and Chandigarh (8).
“94% of people who developed black fungus infection after COVID had diabetes and 67% had uncontrolled sugar,” Mehta told IANS.
“If sugar is not controlled, the increased sugar levels in the blood provide acidic media that provide a favorable environment for black mushroom growth. Hence, the reason for the increase in black mushroom cases now may be attributed to uncontrolled diabetes and drug use cause another decrease in immunity, “added Mehta.
The most common symptoms of this fungal infection are unilateral swelling of the face, loose teeth, headache, burning sensation in the nose, nasal congestion, blackish discharge from the nose, blurring or double vision. Few signs of a severe mucormycosis infection are visual disturbances, blindness, seizures or vomiting of blood, and an altered sensorium.
“Oculo-Rhino-Cerebral” mucormycosis occurs most frequently in post-Covid patients. Rhino-oculo cerebral mucormycosis (ROCM) is a rare, invasive, and rapidly progressing fungal infection that affects the nose, sinuses, and often extends to the orbit, brain, and roof of the mouth.
People with moderate to severe Covid disease need to avoid crowded places, visit construction sites, visit landfills, or indulge in gardening. You should wear masks properly and keep a safe distance when dealing with others.
Those with diabetes should try to keep their sugar levels under control. The judicial use of steroids and other immunomodulators in the treatment of COVID-19 has been recommended by all medical agencies, Mehta said.
Maintaining good hygiene and cleanliness is a must. Regular oral hygiene with mouthwash, povidone-iodine gargle must be done. During the administration of oxygen, the water to be humidified must be sterile and there must be no leakage from the humidifier, advised Prasad.
For those infected, however, early diagnosis is a crucial point when initiating treatment, as the fatal disease has a mortality rate of more than 50 percent, even with the best possible treatment. Early surgical debridement followed by antifungal drugs such as liposomal amphotericin B (3-5 mg / kg) is the mainstay of treatment.
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The above article was published by a wire agency with minimal changes to the headline and text.
