Revelation of inherent trends in Mucormycosis resurgence in India: A comparative analysis of past prevalence (pre-Covid-19) and current outbreaks

Mucormycosis (MM), commonly referred to as ‘Black Fungus’ was a relatively lesser-known fungal infection until the onset of Covid-19 pandemic. However, amidst the global Covid-19 outbreak, it emerged as a widespread fungal infection causing significant morbidity and mortality. In India, the recorded incidence of MM was approximately 80% higher than in the rest of the world due to a higher prevalence of specific pre-disposing factors, causal organisms, clinical manifestations, and intriguing epidemiological trends. This study compared the MM case-control studies conducted in India before the Covid-19 pandemic and during the current pandemic to comprehend the impact of Covid-19 on the surge in MM cases. Our findings demonstrate that MM is a distinct condition which is not solely dependent on Covid-19. Interestingly, the trends of association of MM with comorbidities like diabetes and its greater prevalence in male gender remains consistent in both study periods. The increased occurrence of MM in India during the current pandemic appears to be more intricately linked to challenges in management and treatment of Covid-19, leading to emergence of novel predisposing factors. The indiscriminate use of steroids, immunosuppressants, and the resultant hyperglycemic condition, especially in a population already burdened with diabetes as comorbidity contributed significantly to the current MM havoc. The study suggests that raising general awareness about preventive measures, diabetes management and the regulation of steroid drug misuse can play a crucial role in curtailing the development and spread of deadly infections like MM in future.