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Zinc and Mucormycosis

- 9 min read
written by Shield Connect

Zinc is the most essential in human body and plays a major role inproper functioning of the immune systemand preserving cell integration.

Zinc is the most essential in human body and plays a major role inproper functioning of the immune systemand preserving cell integration. Evidence from various studies suggests that Covid-19 is more common in people with compromised immunity. Zinc is essential for normal development and function of cells mediating innate immunity, neutrophils, and Natural Killer cells.

Zinc and Mucormycosis

Since Zinc is an essential nutrient, it cannot be produced in the body and needs to be supplemented through diet. On an average an Indian adult needs 10-15 mg of Zinc per day to meet the recommended dietary allowance.
While the country is still stumbling under the rising cases of COVID-19, a deadly fungal infection called mucormycosis widely called as black fungus has triggered a new health challenge in the Indian Healthcare system. Huge number of black fungal infection cases have been reported from different parts of the country, pushing the state governments to declare this disease as an epidemic.

Zinc is thought to be accumulating iron in the body which can create a breeding ground for mucormycetes. This is a hypothesis which is circulating in the newspapers but no confirmed scientific data available and no clinical trials available. In the year 2021 the number of covid patients are 5-6 times higher than the last year and the Mucormycosis cases are also high and increasing.

Mucormycosis is basically a fungal disease. It rarely affects the common people and commonly infects people who are immunocompromised. The infection spreads rapidly from the nose and sinuses to the face, jaw, eyes, and brain. When the individual gets infected, the fungus blocks the blood flow, which supplies tissue, and this dead, or necrotic, tissue that causes the characteristic black discoloration of people’s skin, rather than the fungus itself.

How Is Black Fungus Diagnosed?
The diagnosis of the disease is simple, it can be seen through endoscopy and the confirmation can be done by stain, culture, or biopsy. Imaging, CT scans are very important for diagnostic, in some cases even MRI is done, as it can tell you the extent of the disease in the patient.

Cause of Mucormycosis
Recently Experts have raised up alarm over the use of zinc in treating Covid-19 patients. It has been Proposed that presence of zinc and iron in the body provides a favourable environment for a group of molds called mucormycetes. This is a hypothesis which has been circulated in the newspapers and social media, but there is no clinical evidence yet, to establish the link between the two. Unfortunately, In the second wave number of covid patients are 5-6 times higher than the last year and the mucormycosis cases are also high and increasing.
It does not mean that if you are taking Zinc as supplement, you will get this disease. To get infected with black fungus, there are a lot of other factors as well. Let us discuss one by one.

1. COMPROMISED IMMUNITY

Our immune system is usually more stronger for the fungi, but an “anomalous situation” like COVID-19, can weaken a person’s immunity to such an extent that these microorganisms can gain a foothold.
COVID patients with pre-existing comorbidities and those patients post chemotherapies, those on long-term immunosuppressive drugs are the most at risk.

2. UNCONTROLLED DIABETES

Diabetes not only increases a person’s risk of severe COVID-19 but also provides conditions in which fungal infections can thrive.
Uncontrolled diabetes which suppresses immunity, have been identified as the primary factors behind the cases of black fungus or mucormycosis.

3. DRUGS USED IN TREATMENT OF COVID-19

The cocktail of antibiotics – Azithromycin, Doxycycline and Carbapenem- can increase the risk of fungal infection.

The role of steroids in mucormycosis cannot be denied. Starting oral or intravenous corticosteroids too earlyor using higher doses than recommended, or using it for longer periods than recommended can increase the risk of infections.

In some of the reported cases,people who had contracted black fungus had self-medicated themselves on steroids, after their oxygen concentration levels had dropped, making them susceptible to this ailment.

4. STEAM INHATATION

Steam in excess can damage the delicate mucus layer and even cause burns along the mucosa, making it easy for fungus to breach our natural defence.

5.USE OF INDUSTRIAL OXYGEN

With the rise in the demand for oxygen supply in the country, a large amount of industrial oxygen had been diverted for medical purposes
Industrial oxygen cylinders with polluted water and soil from inside can also lead to the growth of fungus.

6. ADDITIONAL CAUSES

  • The use of tap water instead of distilled water in a humidifier of oxygen concentrators
  • Use distilled water or normal saline in humidifier chambers for safety reasons. Tap water can do more harm than good.
  • Avoid the reuse of masks or cannulas
  • Improper mask hygiene can increase chances of getting the fungal infection
  • Using a mask for 2-3 weeks continuously could be a cause for the development of black fungus
  • Last but not the least the country’s climate is also a factor, the fungus can grow anywhere in the form of a mold, but in tropical countries like India with the humidity it tends to fester.”

HOW TO TACKLE MUCORMYCOSIS?

Prevention is always Better than Cure.

  • If you get diagnosed with Covid-19, please keep a watch on your blood sugars level
  • Avoid any therapy that does not have a proven role in treating Covid-19, no matter how innocuous it may seem. Follow your treating doctor’s advice
  • Extra caution needs to be exercised among patients with co-existing immunosuppressive conditions such as chronic liver disease, kidney disease, or autoimmune diseases and malignancies.
  • Always Follow Hygienic Protocols which are recommended by the Health Experts

To conclude, there are multiple causes of occurrence of Mucormycosis in Covid -19 disease. There is no scientific evidence or data available about association of zinc and Mucormycosis in Covid -19 disease.

Dr Nikhil Varge Dr Nikhil Varge
MBBS MD (Internal Medicine)
Consultant: Acharya Shri Nanesh Hospital in Belapur, Navi Mumbai

 

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