Mucormycosis or black fungus infection has witnessed a sudden surge among patients affected with or recovering from COVID-19. It possesses extraordinarily fast Dissemination rates in the human body, and a delay of even a few hours could prove fatal.

COVID-19 patients, due to their lowered immunity become extremely vulnerable to secondary bacterial and fungal infections, which is further enhanced by the addition of immunosuppressing steroidal drugs to COVID-19 patients that can further debilitate their immunity. Steroidal drugs shoot up the blood sugar levels in diabetic patients which possess another vital risk factor for developing mucormycosis. 

Mucormycosis demands an iron-rich environment which is provided by the increased cytokine levels such as interleukin-6 in the COVID-19 patients that increases their ferritin level, thus making them even more vulnerable to mucormycosis infection. Additionally, the unsanitized oxygen cylinders and ventilators might also be held responsible to contribute to its spread. 

Removal of eyes can be the only option to halt the spread of the virus to the brain in the cases where the fungal infections have spread to the eyes. Immediate surgery is warranted in > 80% of the patients. 

Thus, management strategies should be the early diagnosis, controlling diabetes mellitus and other associated risk factors, treating patients with intravenous antifungal agents like amphotericin B, and surgical intervention if necessary. 

COVID-19 Patients or recovered must restrict themselves from exposure to any natural habitats of the fungus. 

Hospitals must maintain proper hygiene, especially oxygen cylinders, ventilators, and breathing pumps. Rational use of steroids should be done to prevent cytokine storms in COVID-19 patients. 

Source: Rahman FI, Islam MR, Bhuiyan MA. Mucormycosis or black fungus infection is a new scare in South Asian countries during the COVID-19 pandemic: Associated risk factors and preventive measures. J Med Virol. 2021 Jul 14. doi: 10.1002/jmv.27207. Epub ahead of print. PMID: 34260073.