A fungal epidemic in viral pandemic
Author(s): Dr. Vemulapally Lavanya, Nimmagadda Venkata Sri Rithish, Dr. Samaleti Bharath Kumar and Dr. Miryala Swamy
Abstract: Introduction: Covid 19 pandemic continues to be a major health problem worldwide. Despite being more than one year into pandemic, the treatment remains controversial and systemic steroids have shown some benefit. On the flip side rampant use of glucocorticoids has potentially resulted in secondary bacterial and fungal infection. In the early part of pandemic less than 1 % cases were fungal. In 2nd wave of pandemic it has been increasing as an opportunistic infection in covid 19 recovered patients. Mucormycosis infection typically effects immunocompromised individuals, uncontrolled diabetics mellitus, acquired immunodeficiency syndrome, malignancy. Here i report association of covid19, diabetes mellitus, steroid risk in mucormycosis.
Material and methods: A retrospective observational study conducted at tertiary centre, involving all patients with mucormycosis during may 2021 to july 2021.Twenty patients diagnosed with mucormycosis were included in this study. The demographic features, predisposing conditions, clinical features, radiological manifestation and patients outcome were collected from medical records.
Results: Predisposing factors were identified in 20 patients- 5 patients are female, 15 patient are male with diabetics in 17 patients with history of covid in 14 patients, 3 patients non covid. History of covid in 17 patients, 3 non covid patients. Steroids usage was seen in 15 patients of which 14 patients are diabetic and 1 non-diabetic, 11 patients had uncontrolled diabetics.1 patient had ckd. All patients tissue samples collected and submitted for histopathological examination showed fungal hyphae. All our patients MRI was done and extent of involvement of sinuses involvement in 12 patients, rhino orbital in 6 patients, rhino orbital cerebral in 2 patients.18 patients were recovered and 2 patients were expired.
Discussion: Diabetes mellitus directly contributes to mucormycosis risk by hyperglycation of iron sequestering upregulation of cell receptors, defects in phagocytic function and expression of receptors that mediate host cell invasion. Covid 19 has been shown to affect the beta cells of pancreas, causing metabolic derangement leading to diabetes mellitus. Overuse, misuse and rampant use of steroids in covid 19 patients have a increased chance of mucormycosis. Diabetes mellitus when combined with SARS cov 2 virus and steroid therapy, appears to be a vicious cycle of hyperglycemia and immunosuppression, which leads to mucormycosis
Conclusion: The second wave of covid 19 in India has led to more deaths than first wave and in just few weeks.b.1.617.2 delta variant became dominant strain, more infectious and somehow promoting entry of mucorales in to patients. It was declared as epidemic on 21 st may 2021 as there were huge rise in cases. Strict glycemic control, proper sanitization and covid preventive measures should be strictly followed to prevent this deadly fungal infection.
DOI: 10.22271/27069567.2021.v3.i2f.263Pages: 330-332 | Views: 781 | Downloads: 242Download Full Article: Click HereHow to cite this article:
Dr. Vemulapally Lavanya, Nimmagadda Venkata Sri Rithish, Dr. Samaleti Bharath Kumar, Dr. Miryala Swamy.
A fungal epidemic in viral pandemic. Int J Adv Res Med 2021;3(2):330-332. DOI:
10.22271/27069567.2021.v3.i2f.263
