Mucormycosis – The Rare Fungal Infection & Post-Covid-19 Complication Affecting Older Adults

Here’s all you need to know about Mucormycosis, a rare fungal infection that is affecting older adults who have survived Covid-19. 

2020 was not a healthy year for Leelamma (name changed), 52, an acute diabetic from Bangalore. Despite taking adequate precautions and maintaining social distancing, she contracted Covid-19, the deadly virus that made the world ailing. Her family was relieved when she overcame the virus successfully after battling for three weeks. However, that was not the end of her misery. Within a few months of recovery from Covid-19, Leelamma complained of headache, pain in the eyes and face. On reaching a city hospital, she was diagnosed with Mucormycosis, a not so common fungal infection that causes an invasive disease resulting in the destruction of all kinds of tissues including those in the bones, skin, eyes and brain. Leelamma underwent repeated surgeries and took some time to get well.

Mucormycosis could also lead to fatal complications. 70-year-old Santosh (name changed) with co-morbidities like diabetes and heart disease succumbed to a stroke and cardiac complications within a week of recovering from the fungal infection. The reason was Mucormycosis.

Over the last few months, Mucormycosis, AKA black fungus has emerged to be a concerning post-Covid-19 complication, especially among the older adults, observe the doctors. Manipal Hospitals, Old Airport Road, Bangalore has seen about 10 such cases in the last two months.

Dr Neha Mishra, Consultant, Infectious Disease, Manipal Hospitals, Old Airport Road, says: “Patients who get infected with Covid-19 and have underlying risk factors like uncontrolled diabetes, chronic kidney disease, cardiac conditions are at a much greater risk of developing this rare fungal infection. Those who have received steroids and other immunosuppressive medication for Covid-19 or any other conditions are also more prone to Mucormycosis. The early symptoms that one must keep an eye on are headache, facial pain, pain in the eye with or without swelling, dental pain, swelling over cheeks, nose blockage and more.”

Why older adults who have recovered from Covid-19 get it?

Because their immunity is feeble, they are loaded with immunosuppressive medications and are at greater risk of contracting fungal infections like Mucormycosis. “Covid 19 is caused by SARS-CoV-2 and is seen to affect people with low immunity. It also causes severe inflammatory changes in the lungs and cardiovascular system. It lowers the immunity of a person and makes the body more prone to secondary infections. An elderly person is more likely to have co-morbid conditions like diabetes, hypertension, thyroid disorders, renal issues, etc. thus making them more prone to opportunistic fatal fungal infections like mucormycosis. While it is not a common condition, many cases have been reported in Delhi and Ahmedabad recently and we have found few cases in Bengaluru also,” says Dr Honey Ashok, Senior Consultant – ENT, Sakra World Hospital, Bengaluru.

“The widespread use of steroids, and antibodies to cure COVID-19 and therefore the change in one’s innate immunity may lead to the development of Mucormycosis,” adds Dr Suchismitha Rajamanya, Internal Medicines, Manipal Hospitals, Whitefield.

How does it affect older adults?

“It could affect the eyes and cause pain in them, protrusion of eyeballs and even blindness. It could affect the mouth and result in swelling of the cheeks. It could affect the brain and lead to the inability to think clearly or concentrate,” says Dr Rajamanya.

Is there a cure?

Yes, Mucormycosis could be treated through surgical removal of all the dead tissues which harbour the fungus. “It is of utmost importance that all the dead tissues are chucked off completely as otherwise, they may clog the blood vessels. Multiple procedures may be required for that. Additionally, an intravenous antifungal medication called Amphotericin B and oral antifungal medications like Posaconazole are also given for a few weeks till the fungus is fully controlled,” says Dr Ashok.

Tips to prevent it

1)Fungal spores are present in our surroundings especially in damp areas, in the dust, soil and closed dingy non-aerated rooms. Avoid such areas.

2)Wear a mask.

3)Wash hands regularly.

4)Do not touch or pick the nose, rub the eyes or scratch the skin as we might inoculate these spores into the tissues.