Emergence of a medley of invasive fungal infections amidst the coronavirus disease 2019 (COVID-19) pandemic in India

• Published in: Antimicrobial stewardship & healthcare epidemiology : ASHE 2021-01, Vol.1 (1), p.e40-e40, Article e40
• Main Authors: Rackimuthu, Sudhan, Khan, Hiba, Mohan, Anmol, Hunain, Reem, Ghazi, Behram Khan, Hasan, Mohammad Mehedi, Costa, Ana Carla dos Santos, Ahmad, Shoaib, Essar, Mohammad Yasir
• Format: Article
• Language: English
• Subjects: Antifungal agents; Coronaviruses; COVID-19; Diabetes; Disease transmission; Drugs; Fungal infections; Fungi; Humidity; Letter to the Editor; Masks; Medical supplies; Mortality; Nosocomial infections; Oxygen therapy; Pandemics; Physicians; Prevention; Severe acute respiratory syndrome coronavirus 2; Steroids
• ISSN: 2732-494X; 2732-494X
• DOI: 10.1017/ash.2021.198

[...]fungi tend to manifest more commonly in individuals with uncontrolled diabetes.7 India has ∼77 million diabetic patients, and augmented by widespread noncompliance to medication, this vulnerability poses another serious concern.8 Contaminated water used in humidifiers for oxygen therapy, industrial oxygen, unsterilized medical equipment, prolonged use of the same masks, and tubing are also strongly believed to cause fungal infections.9 The unhygienic environment and poor living standards in the slums and rural areas of India likely play a role in this fungal outbreak. Recommendations for Prevention and Effective Management of Invasive Fungal Infections During the COVID-19 Pandemic 1 Using masks and wearing shoes, long trousers, long-sleeved shirts, and gloves while visiting construction sites or handling soil, moss, or manure 2 Maintaining personal hygiene by thorough scrubbing while taking a bath and maintaining a clean environment with preferably cool temperature with reduced humidity 3 Being aware of signs and symptoms of invasive fungal infections, especially in individuals who are diabetic, immunosuppressed or previously afflicted with COVID-19 4 Using of steroids with minimal required dose and duration as recommended by a physician 5 Maintaining sterile and clean water and piping for humidifiers and vents 6 Use of antifungals, zinc, and other drugs appropriately as part of the COVID-19 armamentarium, considering disease severity and implicated causative organism, as recommended by a physician 7 Mobilizing and increasing production of antifungal drugs to prevent shortages With cases of fungal and COVID-19 coinfections still being recorded all over India, it is imperative to exercise caution and to continue to adhere to preventive guidelines. Centers for Disease Control and Prevention website. https://www.cdc.gov/fungal/diseases/index.html.