Thread by @DrEricDing

Doctors in India are concerned about an increase in a highly fatal fungal infection affecting cases & recently recovered from #COVID19. Mucormycosis, is a mold that attacks the respiratory tract, potentially eroding facial structures & harming the brain.🧵
nytimes.com/2021/05/09/wor…

2) “It is a fungus that has a strong relation to diabetes,” he added. “If the person is not diabetic, it is very uncommon that the person would have mucormycosis.”

3) Dr. K. Srinath Reddy, who leads the Public Health Foundation of India, said a large number of the recent reported mucormycosis cases were of hospitalized coronavirus patients who had been discharged after their recovery.

4) “You are using steroids to reduce the hyperimmune response, which is there in Covid,” Dr. Reddy said. “But you are reducing the resistance to other infections.”

5) “The condition is relatively rare, but doctors and medical experts say it seems to be infecting some Covid patients whose weakened immune systems and underlying conditions, particularly diabetes, leave them vulnerable.”

6) “Some experts attribute the fungal infections to an increased use of steroids to treat hospitalized patients. Another factor could be that, with hospitals overwhelmed, many families are self-medicating and applying oxygen therapy at home without the proper hygiene”

7) The fungal infection has a 50% overall mortality says doctors in India. Described in detail in this longer thread 🧵 below.

https://twitter.com/DrEricDing/status/1391528199868321795

8) It’s actually quite a common fungus. That’s the weird thing.

https://twitter.com/drericding/status/1391531516547772422

9) “Patients suffering from the fungal infection typically have symptoms of stuffy and bleeding nose; swelling of and pain in the eye; drooping of eyelids; and blurred and finally, loss of vision. bbc.com/news/world-asi…

10) “There could be black patches of skin around the nose.
Doctors say most of their patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain.

11) “In some cases, doctors in India say, patients have lost their vision in both eyes. And in rare cases, doctors have to surgically remove the jaw bone in order to stop the disease from spreading.

12) An anti-fungal intravenous injection which costs 3,500 rupees ($48) a dose and has to be administered every day for up to eight weeks is the only drug effective against the disease.

13) Here is the irony… "Diabetes lowers the body's immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire”

14) The diabetes & COVID & this fungal infection is interesting— because we already see evidence that #COVID19 exacerbates diabetes. Hence it could be vicious cycle here too, especially if steroid drugs used to prevent mortality in severe Covid. nature.com/articles/d4158…