Mucormycosis cases in Covid patients: AIIMS chief warns against misuse of steroids

New Delhi, May 15: "Covid-19 is a risk factor for Mucormycosis, also known as black fungus," said AIIMS director Randeep Guleria, adding that uncontrolled diabetes and irrational use of steroids increases the risk of the fungal infection.

Amid reports of the coronavirus pandemic spreading to rural areas, he said that COVID management should reach out to all parts of the country.

"It should now reach out to all parts, especially the rural areas. The Ministry of Health and AIIMS started a programme for COVID management in rural areas from April 30 to May 13 for national institutes of excellence at regional levels where we held webinars on home isolation, medication for home isolation, ICU management, testing, diabetes management...

"These regional centres have to themselves do more webinars in their areas and train doctors, so that even in rural areas COVID management is ideal and of international standards," Guleria said.

He also warned against the increase in the number of fungal infections that are being reported from across the country and said that it is of paramount importance that hospitals follow protocols of infection control practices.

"It has been seen that secondary infections whether fungal or bacterial are causing more mortality. This disease, mucormycosis, can affect the face, infecting nose, orbit of eye, or brain, which can even cause vision loss. It can also spread to the lung," Guleria said.

He also said that the misuse of steroids is a major cause behind the spread of this infection.

"Chances of fungal infection increase in the patients who are diabetic, COVID positive and are taking steroids. To prevent it, we should stop the misuse of steroids," he said.

According to Guleria, mucormycosis spores are found in soil, air and even in food, but they are of low virulence and usually don''t cause infection.

"Even before COVID, this disease could be seen mostly in diabetic patients, transplant and cancer patients, but it was rare among the general public. Now a large number of cases are being reported due to COVID treatment," he said, recommending close monitoring of blood sugar levels to prevent the infection.

At AIIMS, he said 23 cases of such infection were reported among COVID patients. Out of them, 20 are still COVID-19 positive while the rest are negative.

Guleria said that many states have reported more than 500 cases of mucormycosis.

He also advised against using steroids in the early stages of coronavirus and said that if the patient has mild symptoms, steroids would do him more harm than good.

"Data shows that 5-10 days steroids are needed for the majority of COVID patients," he said.

Niti Ayog member VK Paul too raised concerns over mucormycosis and appealed to people to control their diabetes as the disease is seen to spread among such patients more widely.

"Control your diabetes. Even when you have COVID, please ensure you don''t forget to have your medicines. Another aspect of this is to use steroids judiciously," he said.

Paul said that while steroids are part of the treatment for COVID, it is important to prescribe it at the right time and in the right dosage, otherwise it could lead to secondary infections like mucormycosis.

"Steroids should not be prescribed lightly... This disease has to be prevented," he said.

India recorded 3,26,098 more COVID-19 cases that took the total number of infections to 2,43,72,907, while 3,890 new fatalities pushed the death toll to 2,66,207, according to Union Health Ministry data updated on Saturday morning.

The active cases have reduced to 36,73,802 and comprise 15.07 per cent of the total infections, while the national recovery rate has improved to 83.83 per cent, it stated.