New Delhi: Niti Aayog member (health) V.K. Paul said at a briefing Saturday that a link between steroid use for Covid treatment and mucormycosis or black fungus, a disease being widely reported among patients who have recovered from coronavirus, could not be denied.
However, a former president of the Indian Medical Association’s Cochin chapter has said that the government must widen its search for the cause of the sudden black fungus outbreak, which has been declared an epidemic by several states. In a Twitter thread, Dr Rajeev Jayadevan, a gastroenterologist, named three potential causes to be investigated: Antibiotics, zinc, and steaming.
In the thread, he cited an analysis of 210 patients — conducted by Dr V.P. Pandey of Mahatma Gandhi Memorial Government Medical College, Indore — to state there are factors beyond steroid use and diabetes (also believed to be a risk factor) in the emerging cases of mucormycosis.
According to Jayadevan, Dr Pandey analysed 210 cases of mucormycosis across 4 hospitals in Indore — Maharaja Yeshwantrao Hospital, Sri Aurobindo Institute of Medical Sciences, Choithram Hospital and Research Centre, and Bombay Hospital. Of these, steroids were not used on 14 per cent of the patients, while 100 per cent were on antibiotics.
The first series on “Black Fungus” mucormycosis courtesy Prof. VP Pandey Indore. 210 patients.
Antibiotics had been used in 100% patients, steroids NOT used in 14%, 21% were NOT diabetic, 36% were @ home, oxygen only by 52%, Zinc status not checked.
See thread for details. 1/n pic.twitter.com/c1PI2oxonu
— Rajeev Jayadevan (@RajeevJayadevan) May 23, 2021
Jayadevan said 21 per cent of the patients studied by Dr Pandey were not diabetic. Just about 52 per cent of the patients were on oxygen, he added. Incorrect administration of oxygen has been cited as one of the possible causes of mucormycosis.
Other possible causes
Citing a study by Italian researchers, Dr Jayadevan said the use of antibiotics for a viral infection like coronavirus ought to be investigated for causing “superinfections in Covid-19”.
“Azithromycin, Doxycycline, even carbapenems are seen on prescriptions. Antibiotics are known to increase risk of fungal infections,” Dr Jayadevan wrote.
Flagging the possibility of zinc being a factor, he said “fungi thrive in zinc-rich environment, and mammalian cells try to keep zinc away from fungus to avoid infection”.
As for steam, he said an excess of it “can damage the delicate mucus layer and even cause burns along the mucosa, making it easy for fungus to breach our natural defence”. “Burns caused 10-20% of past mucormycosis in India,” he added.
Steaming has emerged as a popular home remedy for its supposed benefits for Covid prevention and treatment. While steaming is useful to relieve congestion or a cold in the upper respiratory tract, it does not help with pneumonia or any condition of the lung, or help treat an infection in any way, experts say.