Mucormycosis emerging as a ‘new worry’ for healthcare practitioners

A potentially life-threatening fungal infection, mucormycosis can lead to severe complications such as brain infection, vision loss or even death if left untreated. The incidence of this invasive fungal infection has witnessed a sudden spurt in recent months, particularly among people who have recovered from COVID-19. Healthcare experts are terming it “a new worry” in the COVID-19 scenario.

While the incidence of mucormycosis has traditionally been low in India, cases have seen a sudden rise across various cities recently. People with weakened immune systems are the most at risk from this fungal infection. These include people with diabetes, AIDS, certain cancers and long-term use of steroids.

The use of immunosuppression in transplant recipients, immunomodulatory agents including corticosteroids and different invasive procedures are some of the risk factors associated with an increase in IFIs. However, off late, many hospitals in India have reported the emergence of mucormycosis cases in COVID-19 recovered patients.

Referring to this rare but serious form of invasive fungal infection as the “new worry”, COO, Bharat Serums and Vaccines (BSV), Vishwanath Swarup noted. “Many factors have postulated its rise, such as the use of corticosteroids and the presence of uncontrolled diabetes (co-morbid condition) in COVID-19 patients. This leads to a higher chance of IFI particularly ‘mucormycosis’ infecting affected persons. Our Critical Care division operates in niche products and services and IFIs have become an important therapeutic area for the division. BSV is indigenously developing and manufacturing the formulation of Amphotericin B including Liposomal Amphotericin B and Lipid Complex Amphotericin B – the anti-fungal medications that have been recommended for use in life-threatening fungal infections such as mucormycosis. Also, BSV is the first Indian company to get the regulatory approval of Liposomal Amphotericin B”.

Caused by a group of moulds called mucormycetes, mucormycosis mainly affects people who are suffering from health complications such as uncontrolled diabetes, certain cancers or those taking medicines such as corticosteroids that lower the body’s ability to fight germs.  The infection manifests itself through symptoms such as sinus congestion, headache, fever and facial swelling, swelling in the eyes and dark scabs in nasal cavities or mouth.
According to the company’s issued release, BSV is the first company in India to get a Drugs Controller General of India (DCGI) approval for Liposomal Amphotericin B, the anti-fungal medication used in the treatment of this condition.

Dr Swashraya Shah, BSV’s Chief Medical officer said, “Treatment of mucormycosis involves a combination of surgical removal of affected tissues and use of antifungal therapy, usually intravenous Liposomal Amphotericin B (LAmB). Several international clinical guidelines have recommended LAmB in the management of various invasive fungal infections including mucormycosis. A few recently published reports mention successful clinical recovery of patients suffering from mucormycosis following the treatment with LAmB. “

BSV is also marketing Liposomal Amphotericin B in India and exporting it to many other countries. Lipid complex Amphotericin B has also been recommended by international clinical guidelines for the management of IFIs including Pulmonary Aspergillosis. Lipid Emulsion Amphotericin B is recommended for the treatment of Visceral Leishmaniasis.

The condition most commonly affects the sinuses or lungs after fungal spores are inhaled from the air. However, it can occur in nearly any part of the body. Mucormycosis, which is increasing currently in the COVID-19 pandemic, starts in the nasal area, sinuses, and quickly spreads to the eyes and the brain. If left untreated, this can result in a brain abscess, blindness or even death.