Two-fold rise in mucormycosis cases in a year

Aditi Tandon

Tribune News Service

New Delhi, June 6

Cases of mucormycosis more than doubled in India in late 2020 compared to the corresponding months of 2019 establishing a direct correlation between Covid-19 and the rising lethal black fungus viral infection now ravaging several states with cases nearing 7,000.

A significant new study on causes, prevalence and spread of mucormycosis in the country, published today in the Centers for Disease Control (CDC) journal “Emerging Infectious Diseases”, also vindicates the current evidence that diabetes, rampant steroid use and steroid induced non-obese diabetes among Covid patients were principal risk factors for black fungus and nothing else.

The multi-centre study at 16 Indian hospitals looked at both Covid-19-associated mucormycosis (CAM) and non-Covid mucormycosis (non-CAM) and found the overall mucormycosis case fatality rate at a high of 45.7 per cent at 12 weeks. Deaths were similar for both CAM and non-CAM patients. A higher proportion of mucormycosis patients — 74.6 per cent — were men.

Authors also found that newly detected diabetes mellitus was more frequent during the evaluation of mucormycosis among CAM than non-CAM indicating that many Covid infected may not have been aware of their diabetic condition when diagnosed with black fungus.

“Age, rhino-orbital-cerebral involvement and intensive care unit admission were associated with increased mortality rates among mucormycosis patients. Antifungal drug treatment improved mucormycosis survival. The Covid-19 pandemic has led to increase in mucormycosis in India, partly from inappropriate glucocorticoid (steroid) use. Uncontrolled diabetes mellitus was the most common underlying disease among CAM and non-CAM patients,” says the publication.

Among 287 mucormycosis patients studied, 187 (65.2 per cent) had CAM putting the prevalence of black fungus at 0.27 per cent among hospitalised Covid-19 patients. Covid-induced black fungus prevalence in ICUs was much higher (than the average 0.27 per cent) at 1.6 per cent.

More mucormycosis cases were identified during the 2020 study period (231 cases) than during the same time range in 2019 (112 cases), authors said warning of many more cases as Covid-19 continues.

“We noted a 2.1-fold rise in mucormycosis during the study period compared with 2019,” says the research.

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