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IS IT A CASE OF GROSS MEDICAL NEGLIGENCE?EFFECTS OF USE OF CORTICOSTEROIDS ON COVID-19 PATIENTS


Introduction: Cases of mucormycosis are in rise in India which was never heard of before except in South Asia. The surge has taken up an offshoot and is mainly being discovered in patients who suffered from Covid-19.


The terms "black fungi" or "dematiaceous fungi" are practical tags that recall the early days of mycological classification. At the beginning of the 19th century the grouping of anamorphic fungi relied on characters that were easy to observe with minimal optical equipment, such as colour mycelial. Since these times, and till today, hyphomycetes producing olive-grey, brown or black pigment in their cell wall or conidia are classified as "dematiaceous fungi" (referring to the meanwhile obsolete genus Dematium, originally introduced for black, clumpy fungi). The dark pigments are presumed to be DHN-like (dihydroxynaphthalene) melanins, although biochemical and structural characterization has not always been achieved and may involve various precursor molecules.


It has now become clear that black fungi do not comprise a single phylogenetic lineage, but stem from divergent branches of the fungal tree of life. The lineages share production of melanin-like pigments, which has had profound evolutionary consequences for these groups. In human- and phytopathogenic fungi melanins are linked to increased virulence. Melanins also provide protection from a broad range of environmental stress conditions.


With their adaptive potential to uncommon habitats, black fungi have raised increasing interest of mycologists in medical sciences as well as in environmental ecology. It has become clear that a comprehensive understanding of black fungal evolution, ecology and functionality requires a synergic interdisciplinary approach, supported by a cooperative effort among specialists. A first step to bundle the interests in black fungi and to create a common forum was the foundation of a Working Group "Black Yeasts" under auspices of the International Society for Human and Animal Mycology (ISHAM). A small-scale meeting was held in Graz, Austria (May 30–June 1, 2006), and focused on the extremophilic ecology of black fungi. The growing interest in the topic was reflected in the second workshop held in Utrecht, The Netherlands (April 26–28, 2007), jointly with the ISHAM-affiliated Working Group on "Chromoblastomycosis", with 55 participants from 19 countries.

Recommendation by WHO: Understanding the recommendations:


Recommendation 1: We recommend systemic corticosteroids rather than no corticosteroids for the treatment of patients with severe and critical COVID-19 (strong recommendation, based on moderate certainty evidence)

Recommendation 2: We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 (conditional recommendation, based on low certainty evidence).

(Ref: Corticosteroid for Covid-19. Living guidance, 2nd September, 2020 by World Health Organization)


Systemic steroids treat conditions such as lupus and multiple sclerosis. While corticosteroids can be called steroids, they're not the same as anabolic steroids.

The class of medicines prescribed and used by the Doctors for controlling the patients from Covid-19 include drug which is Corticosteroid. One such drug which has been prescribed by Doctors is Methylprednisolone. Methylprednisolone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.


What are the ultimate impacts of steroids on human body? It can never be ruled out and wisely said that Doctors while prescribing drugs more particularly Corticosteroid would not be aware of the impacts. Not only is it left to this extent. But the doctors have prescribed the Corticosteroid i.e. Methylprednesolone to patients who did not have signs of Covid-19 but prescribed this drug along with Fabiflu which is a normal drug for fever.


We thus divide the research in 3 segments

  • Corticosteroid Drug

  • Lupus

  • Mucromycosis

It is necessary to know here what actually is Corticosteroid drug and the consequences of Corticosteroid drug.

Corticosteroids: What Are They


What are corticosteroids?

Corticosteroids are a class of drug that lowers inflammation in the body. They also reduce immune system activity. Because corticosteroids ease swelling, itching, redness, and allergic reactions, doctors often prescribe them to help treat diseases like:

  • asthma

  • arthritis

  • lupus

  • allergies

Corticosteroids resemble cortisol, a hormone naturally produced by the body’s adrenal glands. The body needs cortisol to stay healthy. Cortisol is a major player in a wide range of processes in the body, including metabolism, immune response, and stress.


When are they prescribed?

Doctors prescribe corticosteroids for a number of reasons, including:

  • Addison’s disease. This occurs when your body doesn’t make enough cortisol. Corticosteroids can make up the difference.

  • Organ transplants. Corticosteroids help suppress the immune system and reduce the likelihood of organ rejection.

  • Inflammation. In cases when inflammation causes damage to important organs, corticosteroids can save lives. Inflammation occurs when the body’s white blood cells are mobilized to protect against infection and foreign substances.

  • Autoimmune diseases. Sometimes the immune system doesn’t work correctly, and people develop inflammatory conditions that cause damage instead of protection. Corticosteroids decrease the inflammation and prevent this damage. They also affect how white blood cells work and reduce the activity of the immune system.

They’re often used to treat these conditions as well:

  • asthma

  • hay fever

  • hives

  • chronic obstructive pulmonary disease (COPD)

  • lupus

  • inflammatory bowel disease

  • multiple sclerosis

Types of corticosteroids

Corticosteroids can be systemic or localized. Localized steroids target a specific part of the body. These can be applied through:

  • skin creams

  • eye drops

  • ear drops

  • inhalers to target the lungs

Systemic steroids move through the blood to assist more parts of the body. They can be delivered through oral medications, with an IV, or with a needle into a muscle.

Localized steroids are used to treat conditions like asthma and hives. Systemic steroids treat conditions such as lupus and multiple sclerosis.

While corticosteroids can be called steroids, they’re not the same as anabolic steroids. These are also called performance enhancers.

Common corticosteroids

There are a number of corticosteroids available. Some of the most common brand names include:

  • Aristocort (topical)

  • Decadron (oral)