6 updates on the 'black fungus' plaguing India's COVID-19 patients

More than 28,000 cases of mucormycosis, a deadly infection known as "black fungus," have been reported among COVID-19 patients in India. For hundreds, the only treatment option has been eye removal, The Washington Post reported June 23. 

"[Mucormycosis is] a form of flesh-eating fungus that destroys tissues as it grows," Dr. Akshay Nair, an oculoplastic surgeon treating mucormycosis patients in Mumbai, told the Post. "If it involves the sinus they have to be cleared. If it involves the eye — the eyeball, lids, muscles around the eye have to be removed, leaving behind the bare, bony socket."  

Five more updates: 

1. While the rare infection has long been around, physicians in India have seen significant upticks since January. In a typical year, Dr. Nair would treat 10 patients per year with the fungal infection. This year, he's seen about 100 such patients. 

2. For patients who develop a mucormycosis infection in the eye, the survival rate is 70 percent. If it spreads to the brain, the chances of survival drop between 10 percent and 15 percent, Dr. Nair told the news outlet. 

3. Those with weakened immune systems, including diabetic patients, are at highest risk for the infection. In May, an international health expert told USA Today that India has a high prevalence of uncontrolled diabetes fueled by a lack of routine screening. "Up to 75 percent of mucormycosis cases occur among COVID-19 patients," said Bhakti Hansoti, PhD, associate professor in the department of emergency medicine and international health at Baltimore-based Johns Hopkins Bloomberg School of Public Health. In about half of those cases, patients were previously undiagnosed with diabetes until showing up to the hospital with symptoms of the black fungus infection. 

4. Steroids are widely used in India to treat COVID-19 patients, another factor behind why the country has seen such high rates of the rare fungal infection, the Post reports. Immune-suppressing steroids can make patients more vulnerable to fungal infections by raising blood sugar levels. Complicating the situation is a shortage of amphotericin B, a pricey antifungal drug used to treat mucormycosis. The drug also must be administered three to five weeks after an eye removal surgery. 

5. For some COVID-19 patients, symptoms of the fungal infection arise within days of contracting the virus. For others, mucormycosis surfaces after being cleared of COVID-19 infection, according to patients' stories documented by the Post


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