Rising black fungus cases among Covid-19 patients in Karnataka raises alarm

For 38-year-old Vishwanath (name changed), an autorickshaw driver in the city, surviving Covid-19 should have been cause for celebration. But even before he was discharged, he started to feel an unusual pain in his face and a swelling of his eye.

Doctors now say that he has developed a life-threatening fungal infection called mucormycosis (black fungus) which, if untreated, results in blindness followed by death.

Diabetics at risk

Similar infections had been reported during the first wave last year, But for two weeks now, such cases are being found in larger numbers among Covid-19 survivors with uncontrolled diabetes, they added.

There is concern that the surge of such cases could be the result of the new mutant B.1.617 variant of the novel coronavirus.

Dr V Ravi, eminent virologist and member of the State’s Technical Advisory Committee, acknowledged that this variant is “spreading fast” in Karnataka.

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“It is not that mucormycosis did not exist before Covid-19. Previously, I used to see one or two cases per year. In the last three weeks, I have seen 38 cases,” said Dr Deepak Haldipur, a senior ENT surgeon at Trust Well Hospital.

He stressed that the cases have been restricted to patients with uncontrolled diabetes. Vishwanath’s 16-year-old daughter, Aditi, told DH that in her father’s case, the mucormycosis had developed while he was still being treated for Covid-19 at a private hospital.

“On the day of his discharge we noticed that his right eye was swollen, but we thought it was an insect bite. A checkup one week later found that it was due to the fungal infection,” she said. She added that the family is now struggling to secure affordable treatment.

That the infection appeared while patients are still under Covid care is something new, pointed out Dr Anoop Amarnath, a member of the State’s Critical Care Support Unit (CCSU).

“Previously, this infection would roughly be seen 10 days after the patient was discharged. Now, we are seeing it in the active phase of Covid-19,” he said.

Water infection

Such trends have left the medical profession grappling to find the cause. One senior government official told DH that the infections are due to the poor quality of water used in humidified oxygen. “It is much like the fungus which develops on bread due to moisture, if kept for a long time,” the official said.

Dr Amarnath added that “a higher than normal ferritin level and a new strain of the novel coronavirus” could also potentially be responsible.

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It is suspected that the mutant B.1.617 of the novel coronavirus is the culprit. As per government data, the first disclosure of B.1.617 cases in Karnataka was on April 27 - roughly at about the same time that the mucormycosis cases started to increase.

“This mutant virus is not behaving like the previous virus variants. We are also realising that this novel coronavirus is doing something to the sinus immunity, which is also part of the breathing system,” Dr Haldipur said.