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

Answered by
Dr. Syed Tehmid
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 27, 2021

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?

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#

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.

Hi doctor,

Thanks for the reply.

I am taking Vitamin C and Zinc tablets. I am trying to stay indoors as much as possible. Do I need to get a CBC test done? Also, is my sugar level now in control? As of now, I do not have any symptoms like that. How do I know if Dexamethasone weakened my immunity? I have attached the reports of the blood test which I took 15 days ago. My WBC count is 7100 per cubic mm, but does Dexamethasone increase the WBC level? If we check the WBC levels, can we get to know the immune status of our body? Also, can ten days of use of Dexamethasone cause Cushing's syndrome? Is there anything to worry about?

#

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.

Hi doctor,

Thanks for the reply.

Is there any method to check my immunity status due to steroid use? Can I do some test to check my immunity level? Is CBC apt for it? Should I exercise regularly now, as I have a gym at home? Should I go out or avoid for two to three weeks? As I read that only weakened immune system due to COVID-19, steroid use, and diabetes, these serious fungal infections occur. Also, what symptoms should I check?

#

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.


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