Sharma Archana, Bedi Megha, Patel Prachi, Singh Arora Amarpreet
Department of Environmental Science and Engineering, Marwadi University, Rajkot 36004, Gujarat, India.
Department of Civil and Environmental Engineering, University of Pittsburgh, Pittsburgh 15261, PA, USA.
Gondwana Res. 2023 Feb;114:117-123. doi: 10.1016/j.gr.2021.12.016. Epub 2022 Feb 5.
The deadly second wave of COVID-19 has seen an unprecedented surge in mucormycosis associated mortality in India, overwhelming the heath authorities with challenges beyond measure. Also known as black fungus, this life-threatening fungal infection usually manifests in the nose, spreads to the eyes, and in some cases also to the brain. Immune suppression, pre-existing conditions, prolonged and indiscriminate use of steroids, and unhygienic environments are some of the widely recognized risk factors for contracting black fungus in individuals recovered from COVID-19. However, diagnosis of the infection remains insufficient due to the lack a holistic understanding of the possible risks, symptoms, and exposure pathways and therefore no definite protocol exists for managing this fatal infection. Here, we synthesize the current state of knowledge on black fungus outbreak in India and identify key gaps in its understanding with respect to potential risk factors leading to the widespread infection. We looked at 3354 black fungus cases in India, enlisting ailment history (particularly diabetes) and steroid usage in COVID-19 patients as the key factors responsible for exacerbating risks associated with the disease. However, we also press on the possibilities that other less studied non-traditional risk factors may also have a role in causing the infection. Black fungus is therefore a reality of COVID-19, with or without diabetes or steroid use needs to be investigated. We believe such a review is imperative for making informed decisions specially around timely diagnosis and channelizing efforts in controlling the spread of COVID-19 associated mucormycosis.
在新冠疫情致命的第二波中，印度毛霉菌病相关死亡率出现前所未有的激增，给卫生当局带来了难以估量的挑战。这种危及生命的真菌感染也被称为黑真菌，通常在鼻子中出现，扩散到眼睛，在某些情况下还会扩散到大脑。免疫抑制、既有疾病、长期无差别使用类固醇以及不卫生的环境是从新冠中康复的个体感染黑真菌的一些广泛认可的风险因素。然而，由于缺乏对可能的风险、症状和传播途径的全面了解，对该感染的诊断仍然不足，因此不存在管理这种致命感染的明确方案。在此，我们综合了印度黑真菌爆发的当前知识状态，并确定了在对导致广泛感染的潜在风险因素的理解方面的关键差距。我们研究了印度的3354例黑真菌病例，将疾病史（特别是糖尿病）和新冠患者中类固醇的使用列为加剧与该疾病相关风险的关键因素。然而，我们也强调其他研究较少的非传统风险因素也可能在导致感染方面起作用的可能性。因此，无论是否有糖尿病或使用类固醇，黑真菌都是新冠疫情的一个现实情况，需要进行调查。我们认为这样的综述对于做出明智的决策至关重要，特别是在及时诊断以及引导控制新冠相关毛霉菌病传播的努力方面。
