Diabetics suffering from COVID-19 who are being given steroids have a high chance of being affected by mucormycosis or "black fungus", All India Institute of Medical Sciences (AIIMS) Director Randeep Guleria said on Saturday, as hospitals report a rise in the rare but potentially fatal infection.
"Mucormycosis spores are found in soil, air and even in food. But they are of low virulence and usually do not causes infection. There were very few cases of this infection before Covid. Now a large number of cases are being reported due to Covid," he said at a news briefing.
Flagging "a misuse of steroids" as a major cause behind the cases, Dr Guleria urged hospitals to follow protocols of infection control practices since secondary infections - fungal and bacterial - can be increasingly seen in COVID-19 cases, causing more deaths.
"Misuse of steroids is a major cause behind this infection. Chances of fungal infection increase in the patients who are diabetic, Covid positive and those who are taking steroids. To prevent it, we should stop the misuse of steroids," Dr Guleria said.
"As COVID-19 cases are increasing, it's of paramount importance that we follow protocols of infection control practices at hospitals. It is been seen that secondary infections - fungal and bacterial - are causing more mortality," the AIIMS director said.
At AIIMS, 23 patients are being treated for this fungal infection. Out of them, 20 are still COVID-19 positive and the rest are negative. Many states have reported more than 500 cases of mucormycosis, said Dr Guleria.
"Mucormycosis can affect the face, infecting nose, the orbit of the eye, or brain, which can cause even vision loss. It can also spread to the lungs," he said.
The state-run Indian Council of Medical Research (ICMR) has said that doctors treating COVID-19 patients, diabetics and those with compromised immune systems should watch for early symptoms including sinus pain or nasal blockage on one side of the face, one-sided headache, swelling or numbness, toothache and loosening of teeth to guard against black fungus infections.
The disease, which can lead to blackening or discolouration over the nose, blurred or double vision, chest pain, breathing difficulties and coughing blood, is strongly linked to diabetes. And diabetes can in turn be exacerbated by steroids such as dexamethasone, used to treat severe COVID-19.
The government has not published national data on mucormycosis but has said there is no major outbreak. Media reports have pointed to cases in Maharashtra and Gujarat. Experts believe the high concentration of diabetics in India can be one of the causes for the large number of cases.