COVID-19 may cause a wide range of symptoms that can impact many organs, but for those hospitalized with the disease, respiratory distress is common and can cause lasting damage in the lungs. COVID-19 may lead to pneumonia and in the worst cases, may cause acute respiratory distress syndrome (ARDS) or sepsis.
When India experienced a devastating COVID-19 surge earlier this year, another deadly respiratory complication was observed in some patients, a fungal infection that is sometimes mistakenly called black fungus, and is technically a mucor fungi infection called mucormycosis. There have now been a few reports of mucormycosis in American patients. The fungus that causes the disease is normally not a problem for healthy people, whose immune systems can handle it. In some COVID-19 patients the severe infection wreaks havoc on the immune system; patients might be given immunosuppressant drugs to control the deadly inflammation that can be caused by the virus. But all those problems with the immune system gives the fungus in the environment an opportunity to move in, and another lung fungal infection to occur.
The CDC has reported that three clinicians in Arkansas have independently observed cases of mucormycosis in COVID-19 patients.
The Indian Ministry of Health and Family Welfare stated earlier this year that for COVID-19 patients impacted by mucormycosis, the naturally occurring fungus might enter the body through scrapes or cuts, and start as a small infection in the air pockets in the face, and between the eyes and teeth. That infection can spread, and might affect the jaw or brain. It can also cause vision problems, chest pain, or bloody coughs, they added.
An infection like that is very difficult to eliminate once it's established. Impacted tissue is typically removed, and patients may lose parts of their jaw or their eyes. A team of clinicians and specialists is usually required to manage these cases.
Researchers reported in the CDC's Morbidity and Mortality Weekly Report that nine of the ten affected individuals lived in Arkansas, all were white, their average age was 57, seven were men, and eight had diabetes, a mucormycosis risk factor. It's worth noting that none of these individuals had been vaccinated for COVID-19; if they had been, they would have prevented this serious complication from occurring. For most of the patients in Arkansas, the outcomes were not good.
The brain was impacted in three cases, and eight had experienced very severe cases of COVID-19 that required ventilation. Six of the ten patients died at the hospital or within a week of discharge.
Mucormycosis is extremely rare in Arkansas outside of this COVID-19-associated outbreak, which happened during a surge of infections of the SARS-CoV-2 Delta variant during the summer.
COVID-19 has also been linked to another opportunistic fungal infection caused by fungi in the environment that are normally harmless. Those infections are called COVID-19 associated pulmonary aspergillosis.
Sources: CDC, Morbidity and Mortality Weekly Report