No Black Fungus or Deep Vein Thrombosis reported in recovered covid patients of Barak Valley till now

The pathogen SARS-CoV-2 has wreaked havoc globally since its alleged zoonosis from bats and pangolins as intermediary agents in Wuhan, China to humans. There’s no country in the world unaffected by covid making it one of the most infamous pandemics in history next only to the Spanish Flu in terms of mortality and spread. The huge pool of humans worldwide is basically a testing laboratory for the virus where it can alter its nature to form new variants that may be successful to evade antibodies induced from previous infection or currently available first-generation vaccines.

While most patients recover from covid within a short period of time, there are immunocompromised individuals who might have a prolonged hospitalisation spanning three to six months or even a year in a few rare cases. As per researchers, selection or adaptive pressure due to the use of plasma therapy and anti covid medications in immunocompromised patients suffering from pre-existing conditions like cancer or HIV may lead to the formation of new coronavirus variants. To their amazement and awe, the virus was evolving infront of their eyes showing a remarkable degree of resistance as they administered therapeutic drugs to the patients over a prolonged stay at the hospital.

The first variant to get identified through genome sequencing was the D614G strain of coronavirus which replaced the original Wuhan strain. Every single time the virus spreads, it mutates. All mutations are not significant, some maybe even harmful for the virus itself to spread. But over time, the mutations which benefit the virus may accumulate creating a new strain different from the previous one. Simply put, variants occur frequently but only the ones which exhibit a changed behaviour are termed as strain. Globally, the World Health Organisation (WHO) has designated four variants of coronavirus as Variants of Concern (VOC) since the outbreak. They include – B.1.1.7, which was first detected in the U.K. and is the most prevalent strain currently circulating throughout the U.S.; B.1.351, first detected in South Africa; P.1 variant, first detected in Brazil and recently the B.1.167 strain also dubbed as the Indian Double Mutant first found in Maharashtra’s Vidharba region. Three sub-lineages of the Indian Double Mutant have been detected now worldwide.

The Indian mutant is thought to be one of the reasons behind the monstrous surge of covid cases in the country since the past month added with laxity in following covid appropriate behaviour. Cases of people getting reinfected or even getting infected post-vaccination have emerged. In some cases, deaths have also occurred in double vaccinated individuals suggesting the strain might have conferred some evolutionary advantage to the virus giving it a certain degree of immune escape mechanism.

However, the medical consensus is that the vaccines available in India, as well as worldwide, still work in majority of individuals against all variants of the virus with reduced efficacy and antibody neutralisation in some cases, according to the prevalent strain. The vast majority of breakthrough infections post-vaccination are thought to be mild as the common flu. Vaccines will be more efficacious when the whole population is immunised with it leading to a low rate of transmission as in countries like Israel. The lower the transmission, the lesser are the chances of mutation and new strain formation. It is therefore in the best interest of an individual to get vaccinated. The bottom line is no is safe until everyone is. Pharmaceutical companies are already preparing booster shots against the new variants of concern and they’re expected to hit the market within this year.

With the rise in cases during the second wave, secondary bacterial and fungal infections after making covid recovery have also increased manifold. Youngsters are reporting prolonged fatigue after recovering from covid. Cases of blood clotting clinically termed as Deep Vein Thrombosis (DPV) and a rare black fungal infection termed as Mucormycosis are also on the rise in metro cities like Mumbai and Delhi. The black fungal infection was seen during the previous wave as well however the frequency has increased this time in proportion to the gigantic rise in covid cases. Anticoagulant medicines are used in covid patients to prevent the blood from getting clotted. However, in case of Mucormycosis, not much can be done if timely medical intervention is not taken.

For the time being, Barakians can heave a sigh of relief as no black fungal case has been reported till now in the Valley as per Dr Bhaskar Gupta, Vice Principal of Silchar Medical College and Hospital (SMCH).

As per Dr. Gupta, “Black fungal cases are mainly seen in individuals who are on immunosuppressive drugs and have a prolonged hospital stay due to covid. The black fungus is present in the environment and it won’t affect a normal person having a good immune system. During covid, people usually recover in a short span of time without much medical intervention. However, when steroids and medications like Tocilizumab are used for controlling the cytokine storm in severe covid cases, the fungus may opportunistically infect those individuals sometimes. The patients in SMCH till now have made recovery or succumbed to covid in a short time. No one was on long term steroids. So we don’t have black fungal cases till now.”

Basically, cytokines are small signalling molecules or proteins which mediate and regulate immunity in the body. While fighting off a severe coronavirus infection, in some individuals, a cytokine storm may set in when the body goes into self destruct mode killing its own cells in the process. It fails the ability to distinguish between healthy and infected cells in an urge to completely wipe off the infection leading to multi-organ failure and Acute Respiratory Distress Syndrome (ARDS). The immense hyper-inflammatory reaction of the immune system is a major reason for death for many covid patients as it is the body that kills itself and not covid.

Recovered covid patients who were on steroids or immunosuppressive drugs should watch out for Black Fungus symptoms. Special care should also be taken in case of patients who’re diabetic. Besides, there should be a clean hospital environment for preventing fungal infection. If non-sterile water is used in a humidifier bottle connected to an oxygen tube then loads of microorganism can grow into it and pass into the body, causing infection in immune-compromised patients.

The symptoms of Black Fungus include :

1) One-sided facial swelling or paralysis

2) Headache

3) Nasal or sinus congestion

4) Black lesions on nasal bridge or upper inside of mouth that quickly become more severe

5) Fever

6) Not being able to see with eye/(s)

The secondary fungal disease is more severe than covid with a mortality as high as 50% if left untreated and can lead to serious life-threatening complications. The eyesight might get impaired for life and surgery might have to be performed for removing nose or jawbone for stopping its spread to vital organs like the brain. Only early detection and immediate treatment can help minimise it’s impact.