Does long-term use of steroids in diabetes patients with COVID-19 cause black fungus disease?

Question

Hi doctor,

I had COVID-19 a month before, and I was given Dexamethasone 4 mg twice daily from the second day for ten days. I am diabetic with an HbA1c of 7 percent as it is controlled diabetes. During those ten days of taking Dexamethasone, my blood sugar level was between 250 mg/dL to 325 mg/dL. Now almost it is back to normal. I am fine now and recovered. Now I am just worried about this new fungal infection called black fungus or mucormycosis. What are the signs and symptoms of this infection? Do I have to take any precautions? I read it is very deadly and happening to people who have diabetes and took steroids. Now it is two weeks since recovery. Can I get this fungal disease even now? What is the time frame to get this disease after recovering from COVID-19?

Answer 1

Hi,

Welcome to icliniq.com.

Mucormycosis is an opportunistic infection and occurs in patients with lowered immunity. There is no time frame regarding the COVID-19 (coronavirus disease 2019) contraction. It occurs due to a mold that is present in the environment that are especially damp. They can be present in the soil. However, it is rare. Therefore, you do not have to worry. Standard precautions related to COVID-19, hand hygiene, and clean and moisture-free surrounding should be enough. Symptoms are predominantly respiratory. It can cause cough, sputum production, bleeding in sputum, nasal congestion, bleeding from the nose, fever, etc. In later stages, it can involve eyes and may spread even further. Keeping a good check on blood sugar levels and boosting up immunity shall help.

Answer 2

Hi,

Welcome back to icliniq.com.

Ten days steroid course does not significantly affect your immunity and will not cause Cushing's syndrome. Since you are returning to normal, you only need good glycemic control. Follow a good diet, exercise regularly, and take precautions—no need to be over-anxious. Diabetics can be as healthy as non-diabetics provided they keep a check on blood sugar levels.

Answer 3

Hi,

Welcome back to icliniq.com.

You do not have to go for any advanced tests. However, we do quantitative serum immunoglobulin assays in specific cases when we suspect some strong immunodeficiency or immune hypersensitivity. You can go out after taking due precautions. It will help if you exercise regularly. Look for any severe cough, chest pain, hemoptysis, nasal blockade, blood-stained nasal discharge, eye pain, impaired vision, high-grade fever, etc. If you have such symptoms, revert soon.