Durgesh Nandan Jha TNN December 15, 2020, 05:06 IST
New Delhi: Low immunity among people recovering from Covid-19, either due to the infection or medicines administered, is leading to a unique crisis.
Doctors at Sir Ganga Ram Hospital (SGRH), one of the leading city hospitals, say many patients are developing mucormycosis, a rare-but-deadly fungal infection.
It has been a cause of death in patients requiring prolonged ICU stay. However, it is the rapid increase in the numbers seen in unsuspected recovering Covid-19 patients that is causing the grave concern, SGRH states.
“In the last 15 days, we have seen 13 cases of Covid-19-triggered mucormycosis. Five have died. At least three patients have suffered vision loss and have had to undergo removal of the nose and jaw bone to prevent the spread of infection. One of them is a 32-year-old,” Dr Manish Munjal, senior ENT surgeon, said. “Usually, we see one to two cases of mucormycosis in a month,” he added.
Similar instances of mucormycosis in Covid-19-recovered patients have also been reported from hospitals in Ahmedabad, Gujarat.
“The mainstay of Covid-19 treatment in patients with severe symptoms is steroid administration. We also give medicines to suppress the immune system because the infection can lead to a cytokine storm where the body starts to attack its own cells. However, this leaves the patients at risk to develop opportunistic fungal infections. Mucormycosis is one of them,” the SGRH doctors said.
They added that the fungal infection was mostly hospital-acquired and seen in admitted patients. “Early clinical suspicion on symptoms such as nose obstruction, swelling in the eye or cheeks, and black dry crusts in the nose should immediately prompt the conduct of a biopsy in the OPD and start of the antifungal therapy as early as possible,” said Dr Varun Rai, consultant ENT surgeon at SGRH.
Mucormycosis presents mostly as a sinus infection that is accompanied by nasal congestion, nasal discharge and sinus pain. A fever and headache can also occur. The doctors say the infection spreads in tissues and causes disintegration of the thin wall of cartilage and bone that divides the nostrils among others.
According to National Organisation of Rare Disorders (NORD), sometimes, there is bluish discolouration of the skin near the sinuses or the eye socket due to lack of oxygen. “If unrecognised and untreated, significant tissue death (necrosis) can occur and the infection can significantly damage facial structures. It can also affect the brain,” says NORD.
The only available treatment for mucormycosis is antifungal medication and symptom management. Despite that, doctors claim that 50% patients succumb.