COVID-19 taught us judicious use of steroids, says infectious disease expert at science meet

Indiscriminate use of steroids during the COVID-19 pandemic was a key factor behind the spurt in cases of mucormycosis, a serious but rare fungal infection, among coronavirus survivors in the country in 2021, said an infectious disease expert at the ongoing Indian Science Congress here on Wednesday.

The pandemic taught several lessons, including the need to keep the environment clean and judicious use of drugs like steroids, said Dr Tanu Singhal, a paediatrician and infectious disease specialist at Mumbai’s Kokilaben Dhirubhai Ambani Hospital.

She made the comments while giving a presentation on ‘COVID-19 associated secondary infections’ at the five-day science meet which started on Tuesday.

Speaking to PTI on the sidelines of the congress, Dr Singhal said India had recorded over 50,000 COVID-19-associated mucormycosis patients till May 2021.

As per the US public health agency Centers for Disease Control and Prevention, mucormycosis is a serious but rare fungal infection and mainly affects people with compromised immunity. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air.

Dr Singhal said Maharashtra, Gujarat, Karnataka and Andhra Pradesh had recorded most of the cases of mucormycosis or ‘black fungus’ infection among states and the reasons for this were many.

“One of the factors was our the environment where the fungal spore count is high due to decaying garbage, tropical climate and humidity,” she said.

The infectious disease expert said makeshift COVID-19 centres, set up in the wake of the pandemic, and hospitals did not have good ventilation and had high fungal spore counts.

“COVID-19 patients with reduced immunity, underlying diabetes, high doses of steroids and uncontrolled blood sugars could not clear these fungal spores and went on to develop mucormycosis. Due to all these reasons, we had this outbreak,” she said.

The use of oxygen cylinders, face masks, water in humidifiers and burning of cow dung were not behind the rise in cases of black fungus, said Dr Singhal.

“Fungal spores will not survive in pure oxygen as hyperbaric oxygen therapy itself is used to treat infections. Similarly, mucor spores do not thrive in fluid but on moist solid matter,” she said.

Asked whether mucormycosis cases were being reported even now when the pandemic has waned in India, Dr Singhal said, “There are hardly any new cases as the virus (coronavirus) is less virulent, people are vaccinated, severity of the disease (COVID-19) is less and use of steroids has declined. There is greater awareness among people and doctors relating to doses of steroids and the importance of good blood sugar control.”