Complications Due to Overuse of Steroid During COVID-19

Background: On February 11, 2020, the International Committee on Taxonomy of Viruses officially named the novel coronavirus SARS-CoV-2. The COVID-19 pandemic led to global health challenges and a shocking increase in secondary fungal infections, particularly mucormycosis (Black Fungus). Mucormycosis, caused by the fungi Zygomycetes, has especially been reported in immunocompromised COVID-19 patients treated with high steroid. Rhino-orbitocerebral mucormycosis has a high death rate and is now prevalent in countries like India. However, there is limited research on the exact role of steroid treatments in triggering fungal infections and the long-term effects of steroid-induced immunosuppression. Addressing these gaps is crucial for making treatment protocols and preventing similar outbreaks in the future. Objective: The objective of this review is to explore the overuse of steroids during COVID-19 treatment and its impact on the development of mucormycosis in affected patients. Methods: A literature review was conducted using databases such as Taylor and Francis, ScienceDirect, PubMed, Elsevier, and Google Scholar. The following keywords were used to gather relevant studies: Mucormycosis, Black Fungus, and COVID-19. Results: Pathogenic fungi such as Lichtheimia, Rhizomucor, Cunninghamella, Apophysomyces, and Rhizopus have been identified in Indian soils. Fungal spores enter the body through inhalation, consumption of contaminated food, or via skin abrasions, leading to various forms of infection, including rhino-orbito-cerebral, respiratory, digestive, or dermal mucormycosis. In India, rhinoorbito- cerebral mucormycosis was the most common form during the pandemic. Conclusion: The review highlights a significant rise in mucormycosis cases linked to the overuse of steroids during the COVID-19 pandemic. Different steroidal medications and their related symptoms were considered to understand the role they played in increasing the risk of fungal infections. This review underlines the need for cautious management of the use of steroids in COVID-19-affected patients to prevent secondary fungal infections.