Facial, speech problems among after-effects of mucormycosis post recovery: ICMR study

The Hindu

2 days ago

People who suffered from mucormycosis and recovered continue to battle long-term health effects of the fungal infection, such as facial disfigurement and speech difficulty, found an ICMR study.
There was an uptick in cases of mucormycosis, a rare infection also known as 'Black Fungus', during the COVID-19 pandemic.
Published last month in Clinical Microbiology and Infection, a leading microbiology journal, the study found that 14.7 per cent of 686 hospitalised mucormycosis patients died within a year, with most deaths occurring during initial hospitalisation. Critical predictors of poor survival included involvement of the brain or eyes, intensive care admission, poor glycaemic control, and comorbid conditions.
Conversely, patients who received both surgical treatment and combination antifungal therapy (particularly Amphotericin-B formulations with Posaconazole) had significantly higher survival rates, said Dr Rizwan Suliankatchi Abdulkader, from ICMR's National Institute of Epidemiology (NIE), the lead author of the study.
"But survivors often faced disfigurement and psychological distress, with more than 70 per cent reporting at least one clinical sequela (complication or disability) and a substantial proportion experiencing loss of employment," Rizwan said.
'These are not abstract complications. Facial disfigurement, impaired speech, anxiety, and loss of livelihood are lived realities for many survivors. It is time for India to move beyond life-saving interventions and focus on life-restoring systems of care, including mental health support and rehabilitation,' he said.
Led by Rizwan and the All-India Mucormycosis Consortium, the study assessed survival, treatment outcomes, and post-recovery quality of life among hospitalised patients in India.
This large-scale study, covering 686 patients from 26 tertiary hospitals across the country, is the first of its kind to offer long-term, prospective data on this critical public health concern.
As a part of the study, 686 patients who had contracted mucormycosis between March and July 2021 were followed up for one year. Of the 686, 80 per cent (549) also had COVID-19.
The prevalence of mucormycosis varies significantly, from 0.01 to 2 cases per million in developed countries to 140 cases per million in India and similar nations, with incidence approximately 80 times higher in India. Despite advances in medical care, mucormycosis remains a highly lethal and debilitating condition.
'This study reinforces the pressing need to ensure access to timely diagnosis, surgical interventions, and combination antifungal therapy in all parts of India," said Dr Manoj Murhekar, Director of Chennai-based ICMR-NIE.
"We cannot overstate how essential high-quality, multidisciplinary care is for patients battling mucormycosis, especially given the irreversible complications they face if treatment is delayed," said Murhekar, a senior author of the study.
Spanning the length and breadth of India, the study involved institutions from nearly every region, capturing a diverse and realistic picture of mucormycosis management in both urban and rural populations.
Rizwan stressed, 'This is not just a story of numbers. Behind every data point is a person who struggled with pain, disfigurement, and long-term disability. Our duty as clinicians and public health professionals is to reduce not just mortality but also the suffering that comes with survival.
"India has a disproportionately high burden of this disease. Our health systems must be better prepared.' The research comes at a time when India is still grappling with the long-term fallout of the COVID-19 pandemic, during which mucormycosis surged dramatically.
As the global community turns its attention to pandemic preparedness and health system resilience, the study serves as a sobering reminder of the challenges posed by neglected fungal diseases.
'We hope our findings will serve as a call to action for policymakers, hospital administrators, and clinicians. Mucormycosis is not just a complication of COVID-19. It is a disease that demands long-term clinical attention, public health surveillance, and above all, compassion in care," Rizwan said.