The Mysterious Triangle: Diabetes, Mucormycosis, and Covid-19  

Mucormycosis is a serious but rare fungal infection caused by a group of molds called mucormycetes which live throughout the environment and tend to affect people with a weakened immune system. Mucormycosis develops in some patients with COVID-19, particularly in the backdrop of increased blood sugar levels. It occurs with sudden pain & redness around the eyes or nose, sinusitis, fever, headache, blurred vision, and blackish or bloody nasal discharge, and requires urgent medical attention.

The Plot:

Experts fear that COVID-19 patients are more prone to Mucormycosis as having COVID-19 in the background of diabetes and steroid use is a classic setting for triple immune suppression. In uncontrolled diabetes, the immune system is not able to work properly. In the case of severe diabetes, the function of pathogen-fighting cells like neutrophils gets impaired. This makes the patient vulnerable to contracting Mucormycosis. The high sugar level in itself is conducive to fungal growth. Fungus loves sugar, it loves trace metals like zinc, it also grows on dead tissue and until the body repairs the dead tissue, the fungus keeps growing and when the tissues die, they become black in colour. This is the reason why the name black fungus is used for Mucormycosis.

Dr. Manoj Chadha - Senior Endocrinologist, Mumbai has quoted that “Mucormycosis is a rare and lethal disease which occurs in an immune-compromised patient (e.g. Diabetes mellitus, malignancies especially leukemia & lymphoma, steroid-treated patients) in the face of hyperglycemia and acidosis. The sudden surge in cases of Mucormycosis in COVID-19 patients, is probably due to the rampant use of steroids, without due care to control hyperglycemia and acidosis. Probably there are other factors in play which we still need to decipher.”

Treatment

To overcome the risk of Mucormycosis, the doctor’s advice on higher antibiotics, steroids, and oxygen therapy, must be followed with utmost diligence. Surgical treatment along with anti-fungal medicine like amphotericin-B for 4-6 weeks in the early stages of Mucormycosis has shown better outcomes.

Prevention is better than cure

Periodic HbA1c testing in known Diabetics is the assured way to keep stringent control over blood sugar assuring one of the best preventive measures for acquiring Mucormycosis. Aim to maintain blood sugar supported by healthy habits, weight management, exercise, stress management, compliance with medicines, and regular check-ups. Ensure optimum levels of personal hygiene.