Men are more prone to contracting mucormycosis – known colloquially as “black fungus” – according to a soon-to-be-published study conducted by four Indian doctors.
The study, titled “Mucormycosis in COVID-19: A Systematic Review of Cases Reported Worldwide and in India,” analyzed 101 cases of Covid-19 patients suffering from mucormycosis, a rare but serious fungal infection. It turned out that 79 of the infected were men. Diabetes mellitus was identified as the main risk factor, with 83 of the 101 suffering from it.
The study is to be published in the journal Elsevier. Dr. Awadesh Kumar Singh and Dr. Ritu Singh from GD Hospital and Diabetes Institute in Calcutta, Dr. Shashank Joshi from Lilavati Hospital in Mumbai and Dr. Anoop Misra of the National Diabetes, Obesity and Cholesterol Foundation in New Delhi examined a total of 101 patients, including 82 from India. 9 from the US and three from Iran.
Covid-19-associated mucormycosis has become a reportable disease. So far, maximum deaths (90) have been reported in Maharashtra.
The study registered 31 of the 101 people who died from the fungal infection. The data showed that 60 of the 101 people who developed mucormycosis had an active Covid-19 infection and 41 had recovered. While 83 of the 101 people had diabetes, three had cancer.
Dr. Shashank Joshi, also an endocrinologist, said they were looking at what treatment mucormycosis patients were taking for Covid-19. A total of 76 patients had a history of corticosteroid as an immunosuppressant, 21 received remdesivir and four received tocilizumab.
In one case, a 60-year-old man from Mumbai with diabetes was given both steroid and tocilizumab. He succumbed to the fungal infection. But a 38-year-old man in Mumbai survived without diabetes. The association of death and severity in diabetics with Covid-19 was found to be higher in the study.
Mucormycosis can affect the nose, sinuses, orbit, central nervous system, lungs, gastrointestinal tract, skin, jawbone, joints, heart, and kidney. The study showed that in most cases over 89, the fungus growth was found in the nose and sinuses. This could be because Covid-19 affects the airways the most.
The study also found that fungal mucorales spores spread in people with Covid-19 in an ideal environment of low oxygen (hypoxia), high glucose, acidic medium, and decreased white blood cell activity due to the use of immunosuppressants. While the global prevalence of this fungal infection is 0.005 to 1.7 per million people, it is 80 times higher in India due to a larger diabetic population.
Joshi said the study recommended “judicious evidence-based use of corticosteroids in patients” and monitoring of their blood sugar levels.
