Ever since COVID-19’s second wave hit India things have taken unpredictable turns leading to several complications in the ones who are actively infected and also the ones who have recovered from the virus.
In recent days, Mucormycosis (Black Fungus) has been the biggest scare. Several states have already declared it as an epidemic after a spike in the number of cases related to black fungus. After black fungus, two new varieties of fungus have appeared as complications in COVID-19 cases which are White Fungus and Yellow Fungus.
According to Dr. Vivek Pravin Dave, who is a Consultant Ophthalmologist and Retina Specialist at L.V. Prasad Prasad Eye Institute, Hyderabad, “white fungus is rare and people should not panic. However, it is important to be watchful of the symptoms and to take timely treatment.”
Dr. Dave explained that white fungus affects the retina in the eye and if left untreated, can lead to vision loss. Black shadow or floaters in front of the eye with variable degrees of vision loss are some of the symptoms. The eye can be mildly red with minimal pain and can occur either concurrent to the COVID-19 infection or in the early post-recovery phase. These symptoms can be seen within one to three months of COVID-19 recovery.
Patients with co-morbidities, poorly controlled diabetes, long-term steroids, and indwelling IV are the ones at more risk. Treatment for the eye involves intraocular surgery and intraocular injections. Unlike mucormycosis, the impact of the white fungus is largely known to be restricted within the eyeball and does not need any facial and sinus surgery.
The most common species of white fungus which causes infections is scientifically known as ‘Candida Albicans’. It is a type of yeast that naturally lives on the inside or the outside of one’s body. The outgrowth of this can lead to various health complications. While black fungus affects tissues around the eyes, white fungus mainly affects tissues inside the eye. Especially, the vitreous gel and the retina.
The condition of white fungus infection is life-threatening if it spreads to the whole body. That too is only a possibility in the patients who are severely debilitated and immunocompromised. Dr.Dave emphasized that there is no data to compare black fungus versus white fungus as the cases of white fungus are currently very rare.
Explaining the causes of fungal infection in coronavirus cases, Dr.Dave informed that COVID-19 management requires judicious but a high dose of steroid usage in those patients whose lungs have got affected. While the usage of steroids helps to bring down the COVID-19 related damage, the counter effect has a huge impact. They suppress the body’s immune mechanisms making it more vulnerable to these kinds of fungal infections.
“The treatment includes intraocular surgery, antifungal injections within the eye, and oral antifungal agents” he added.
Addressing the issue of fungus, Randeep Guleria (Director of All India Institute of Medical Sciences) said, “there are three types of fungus that are mostly seen – Mucormycosis, Candida and Aspergillosis. Mucormycosis has been found in cases where COVID-19 is compounded with steroids and diabetes. It is usually seen in sinuses and we call it rhino-orbital cerebral mucormycosis. They are found in the nose, sinuses and may also enter the brain. Rarely, they are found in lungs, which is pulmonary mucormycosis and sometimes in the gastrointestinal tract.”
He also said that it is not a communicable disease. 90-95% of patients have diabetes or usage of steroids. A few cases have also been seen in cases of patients who were treating themselves at home. Hygiene is important, especially in people who have diabetes. General hygienic measures such as regular washing of hands, clean tubes for oxygen, and usage of sterile water for humidification are important.
What is Yellow fungus?
Experts suggest that yellow fungus infection, unlike the two other infections, could be much scarier because of the manner in which it affects the body’s internal organs.
Unlike the two other infections, yellow fungus starts off internally, causes pus leakage, slow healing of wounds, and, in serious cases, can also cause devastating symptoms such as organ failure and acute necrosis. Therefore, it remains critical that patients seek help for their infection as soon as they start observing symptoms. According to reports, the first case of yellow fungus infection has been detected in Ghaziabad, Uttar Pradesh.
According to Guleria, it is important to use the correct name. There are cases in which the same fungus could grow in various parts of the body and show up in different colors which is causing great confusion.
Also addressing mental health, he said – “There is a lot of stress and anxiety in the general public. Everyone has lost someone or the other. We must all come together to support everyone as a society, as individuals, and as people collectively.”, he added. Kids may not have been impacted so much as they have had mild infections; however, young adults have had collateral damage. All of us should come together and address these issues. This will help us to dwell up and support young children and everyone else, he said.