Black, White & Yellow Fungus: Post-Covid Risk & Prevention

Patients infected with Covid-19 are more prone to complications like Black, White, and Yellow Fungus. Read how these fungal infections present, in patients affected by Covid-19, along with their prevention and treatment.

When the world first started encountering patients infected with the SARS-COVID-19 virus, those were very unprecedented times. Even though we had previously experienced global pandemics like the Spanish Influenza of 1918-1920, with all the changes that have occurred in the world since then, the effects of a pandemic and the methods to deal with these issues are completely different. And it has been less than two years since this disease came along and we have already seen so many changing variations in the virus and resulting symptoms. In the first wave everywhere senior citizens were the most affected. Also, those in their late 50s and inflicted with preexisting health disorders like diabetes, cardiovascular disorders, hypertension, and already weakened immunity were more prone to covid. But in the second wave, a high number of individuals in their late 20s to early 40s started getting the virus and despite good health and no prior conditions, succumbed to it. There have emerged different variants of the virus in different parts of the world, which further made it tough to detect and treat them all.

Having brutally suffered the wrath of the second wave, with the shortage of beds, oxygen, and other medical attention, it seems we haven’t really learned the lesson. Many of us are choosing to let go of the required precautions of proper sanitization, masks, and social distancing, and go out partying, and vacationing. With more and more of us relaxing on preventive measures as the country (and world) unlocks, I fear, the third wave will hit us sooner than we think! 🙁 Remember, Covid-19 in itself is only half the problem, it is the post-covid trauma drama that really kills!

As time passes, and the infection rate rises again, with Delta Plus and its related variants already making rounds, we may soon be looking at patients with dire complications again. There are short-term side effects like extreme fatigue, shortness of breath, joint and chest pains, etc. But there are also instances of serious long-term effects like long-lasting damage to heart muscles, damage to air sacs in the lungs, and even the possibility of developing seizures or increased risk of Alzheimer’s. In India, this extensive list has been joined by fungal infections, mainly Mucormycosis. There has been an increased number of cases of this infection, some even turning out to be fatal. People are surviving Covid only to succumb to a fungal infection.

While initially, only cases of Mucormycosis were observed, the post-covid complications list quickly added black and white fungus as well. Despite being quite rare, black, white, and now yellow fungi can turn deadly if not diagnosed and treated early on.

Black Fungus vs White Fungus

Mucormycosis or Black Fungus is caused by a life-threatening, invasive, and opportunistic group of fungi called mucormycetes; which includes Mucor and Absidia. These are generally omnipresent in the air, soil, fallen leaves, and decaying compost, but only infect humans when a person’s immunity is compromised.

White fungus includes mainly Aspergillus. We see this most commonly in molding foods. This is the most common type of fungal infection and many times gets cured even without medication. It is not as fatal as a black fungus but in covid patients, post-recovery can still cause considerable damage.

Spread Of Black And White Fungus

Both black and white fungi have spores that help them propagate, spread, and grow. As these spores are microscopic, they can be spread through the air, by direct contact with damaged skin, or consumption of infected foods. The fungal spores present in the air can be inhaled and then they can infect the lungs and the respiratory system. If the spores are ingested with contaminated food then it infects the stomach and the gastrointestinal tract. The fungal spores can also infect wounded skin areas. Though these three are the main methods for the spread of fungi, the major vector is still air. And hence masks and social distancing are still key precautionary measures.

Causes Of Black Or White Fungal Infection

Both Black and White fungi, are opportunistic pathogens. This means they won’t normally infect a healthy person even if present in the environment in abundance. But when a person’s immunity is already compromised with Covid-19 or other co-morbidities like diabetes and terminal renal failure, or those on immunosuppressants, the infection can happen at an alarming speed.

Rampant use of steroids in the treatment of Covid-19 also helped create the ideal environment for the fungi to flourish in an already immunocompromised patient. Mucormycosis is on the rise in India and not in other countries, as Indian citizens have been taking their medical advice from social media platforms like Facebook and WhatsApp, and ingesting copious amounts of zinc supplements (fungi are known to grow well in zinc-rich environments); overuse of antibiotics which effectively kill bacteria making space for the growth of fungi, and excessive steam inhalation which might create a moisture-rich environment ideal for fungal growth. The use of industrial-grade oxygen for serious covid patients, non-potable water used in humidifiers, and the reuse of infected masks are also thought to be some of the reasons behind increased cases of Mucormycosis.

Symptoms Of Black Fungus

Depending upon the path of entry into the body and the subsequent site of infection, the symptoms can be observed differently.

Rhinocerebral Mucormycosis: The infection is airborne and affects the sinus and brain. The patient’s experience includes toothache, blurry or double vision, nasal congestion, fever, headache, partial swelling of the face, swelling of the eyes and nose, and formation of black-colored lesions on the bridge of the nose and around the eyes. These black-colored lesions are where this fungus gets its name from, not from the color of the fungus itself.

Pulmonary Mucormycosis: The fungal infection spreads throughout the lungs and respiratory system. Symptoms include fever, cough (with or without blood), chest pain, shortness of breath, and black lesions formed in the lung tissue.

Cutaneous Mucormycosis: Here the fungus affects the skin, most probably through infecting wounds on the body. Symptoms include black lesions around infected skin areas and blisters or ulcers.

Gastrointestinal Mucormycosis: The fungus enters the body through the ingestion of contaminated food and infects the gastrointestinal tract. Symptoms include abdominal pain, nausea, vomiting, stomach ulcers, and gastrointestinal bleeding.

Symptoms Of White Fungus

Unlike black fungus, white fungus affects multiple organs like skin, stomach, kidney, brain, and reproductive organs, at the same time. Symptoms include headache, body pains, cough, fever, diarrhea, reduced oxygen level, swellings of different body parts, white spots, and patches on the tongue and oral cavity, thus the name ‘White fungus’.

White fungus infections can either be superficial, where the infection is mild and many times is cured easily, sometimes even without treatment; or it can be a systemic infection, occurring in immunocompromised individuals and with severe symptoms.

Yellow Fungus

In the last few weeks, cases of Yellow fungus have also been reported. This is presented to be even worse than black or white fungus as it starts internally and is not easy to detect. It is caused mainly due to unhygienic conditions. Recovering and immunologically weak covid patients are at risk. Its symptoms range from laziness, loss of appetite, and sunken eyes to slow healing or leaking wounds, and even necrosis in some extreme cases.

Preventive Measures for Black, White, and Yellow Fungus:

• If you are diabetic, then have a tight leash on your sugar levels. High sugar levels create the perfect nutritious environment for the growth of fungi.
• Restrict the use of steroids in any kind of medical treatment, to avoid compromising your immunity even further. Never self-medicate with steroids.
• If you are taking oxygen supplemented with a humidifier, then make sure that the water used in it is sterile and is emptied, cleaned, and refilled regularly.
• Maintain good and impeccable hygiene.
• Avoid contact with moist places and any close contact with soil or manure.

Treatment

If a recovering covid patient gets a fungal infection, then it is imperative to act fast. Being on the lookout for symptoms and early testing with a biopsy can help start early treatment. Once the fungus takes root, it progresses very rapidly. Fast and aggressive medications can help rein in the damage to tissues and also help cure already infected areas. Depending on the type and severity of the infection, treatment can be medicinal or surgical, or both. If the patient is diabetic, blood sugar level control is of priority. If the patient is on steroid treatment, then they are discontinued. Broad-spectrum antifungal medicines may be administered to slow down fungal growth. But it goes without saying that no treatment should be undertaken without the guidance of a medical doctor.