In Depth

What is the ‘black fungus’ killing Covid patients?

India reporting surge in fatal mucormycosis infections in people who have recovered from coronavirus

A rare “black fungus” that kills around half of all infected people is being reported in a growing number of former Covid-19 patients in India. 

The fungus can spread rapidly, with some patients forced to have their jaw bone, nose or eyes removed in order to prevent it from reaching their brain.

What is it?

The medical name for the rare fungal infection is mucormycosis, which is caused by moulds called mucormycetes. This group of fungi “are present throughout the environment, particularly in soil and in association with decaying organic matter, such as leaves, compost piles, and animal dung”, says the US Centers for Disease Control and Prevention (CDC).

According to the health agency, the infection commonly affects the sinuses or lungs after spores are inhaled, but can also enter the body through a cut, burn or other type of skin injury.

The fungus “grows incredibly fast”, says David Denning, a professor of infectious diseases at the University of Manchester and chief executive of the Global Action Fund for Fungal Infections (Gaffi).

And “once it gets in, it just marches through the tissue and doesn’t respect tissue planes, so it can go straight from ordinary tissue through into bone, into nerves”, he told The Telegraph.

Symptoms include a stuffy and bleeding nose, pain and swelling in the eyes, blurred vision and sometimes black patches around the nose.

Before the coronavirus pandemic, mucormycosis was “extremely rare” in India, with just a few cases annually, the paper reports. But now “leading hospitals across India are now seeing multiple cases daily”.

Why is it affecting Covid patients?

Experts say that mucormycosis mainly affects people who are in poor health or have taken medication that lowers their body’s ability to fight off germs and sickness.

In former Covid patients, the infection has been linked to “the use of steroids”, the BBC reports. While the drugs are “a life-saving treatment” for people battling severe cases of the coronavirus, the resulting drop in immunity is thought to be triggering cases of mucormycosis.

People with diabetes are also much more likely to become infected with the black fungus, and steroids can push up blood sugar levels. “Diabetes lowers the body’s immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire,” Dr Akshay Nair, a Mumbai-based eye surgeon, told the broadcaster.

Another possible reason for the rise in cases may be that, with hospitals overwhelmed, “many families are self-medicating and applying oxygen therapy at home without the proper hygiene”, says The New York Times.

The BBC reports that an anti-fungal intravenous injection that “has to be administered every day for up to eight weeks is the only drug effective against the disease”. But many people in India cannot afford the jabs, which cost 3,500 rupees (£33.75) per dose.

Dr Renuka Bradoo, head of the ear, nose and throat wing in Mumbai’s Sion Hospital, told the broadcaster that of 24 mucormycosis patients who she had treated in the past two months, 11 had to lose an eye and six died.

“It’s a nightmare inside a pandemic,” Bradoo said.

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