Mucormycosis and COVID-19 an epidemic in a pandemic?

Abstract

Mucormycosis and aspergillosis are rare, invasive and life-threatening infections. The causative agents being namely: Aspergillus fumigatus and Rhizopus arrhizus. The case fatality rates being over 50% respectively. Invasive Aspergillosis and Mucormycosis have been established and recognized as a complication of the SARS-CoV-2 infection. These cases have been intimately linked and related to prior corticosteroid therapy. With the new B.1.617.2 and B.1.617.2.1 or AY.1 strain of the coronavirus running rampant throughout India causing unprecedented death tolls, a new crisis is evolving. Invasive “black fungus” (Mucormycosis) is creating an epidemic within a global pandemic. The unique socio-economic, genetic and health status of India’s population culminates into a melting pot which sustains the viable triad for the “black fungus” infection to gain a stronghold. Diabetes mellitus, immunosuppression and the current COVID-19 global pandemic with its massive surges in the country have produced the “perfect storm.” Eye surgeons from around India are registering a surge in invasive Mucormycosis cases with a rise in orbital compartment syndrome often calling for radical procedures such as enucleation surgeries. The “black fungus” pandemic and invasive Mucormycosis occurring in COVID-19 patients in India is a depiction of the sinister secondary infections and complications intimately linked with the virus. It is therefore of the upmost importance that countries surrounding India in particular Nepal and other Asiatic nations take great cognizance of this indolent “black fungus killer” and ensure new screening and testing protocols are put into place.