🚨Winter creates a perfect storm for mold
🚨Sharp rise in mucormycosis cases due to corticosteroids in COVID-19 treatment🚨
🚨Lower immunity, more time indoors, higher indoor mold exposure — that can trigger or worsen mold-related sinus issues
🚨Widespread use of corticosteroids in COVID-19 treatment contributed to a sharp rise in mucormycosis cases
🚨The misuse of PCR tests — along with what I’ve outlined in my Substack — may have contributed to widespread misdiagnoses of COVID and Long COVID. The overlapping symptoms make it easy to confuse these cases with other conditions.
🚨That’s why doctors recommend steroid treatments for asthma — they open your lungs but don’t cure the condition. Steroid use promotes mold growth in the nasal cavities, which cause or worsen asthma. The perfect subscription model for profit.
Invasive Fungal Sinusitis (IFS):
🚨Lockdowns spiked IFS:
Outbreaks have occurred during environmental disasters or health crises (e.g., India’s 2021 COVID wave during spring/summer saw a surge in mucormycosis).
🚨Prior to the pandemic, India's estimated annual prevalence of mucormycosis was approximately 140 cases per million people, which is about 70 times higher than in many other countries. However, during the COVID-19 surge, by the end of June 2021, around 40,824 cases of COVID-associated mucormycosis were reported in India alone, with approximately 3,229 deaths. This represents a dramatic increase compared to the pre-COVID annual estimates. The convergence of factors such as high diabetes prevalence, widespread use of corticosteroids in COVID-19 treatment contributed to this sharp rise in mucormycosis cases during that period.
https://link.springer.com/article/10.1007/s12281-023-00464-2?utm_source
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2821%2900265-4/fulltext
Mold in the nasal cavities—especially if it's causing a fungal sinus infection—can lead to a range of symptoms, depending on the type and severity. Here are some common ones:
General Symptoms of Fungal Sinusitis (Mold in Sinuses):
Nasal congestion or stuffiness that doesn't improve
Facial pain or pressure, especially around the cheeks, forehead, or eyes
Thick, discolored mucus (yellow, green, or even blackish)
Post-nasal drip (mucus dripping down your throat)
Loss or reduced sense of smell
Chronic headaches or sinus pain
Frequent sinus infections
Cough, especially worse at night
Fatigue or brain fog
Bad breath or a foul smell in the nose
Sneezing or worsening allergies
More serious (but rarer) signs — usually with invasive fungal infections:
Swelling around the eyes or face
Vision changes
Fever
Severe facial pain
Nosebleeds
Black crusts inside the nose (can be a sign of mucormycosis — medical emergency)
Common Types of Mold-Related Sinusitis:
Allergic Fungal Rhinosinusitis (AFRS) – most common, especially in people with mold allergies.
Fungal Ball (Mycetoma) – a clump of mold in one sinus; not invasive but causes blockages.
Invasive Fungal Sinusitis – rare, but serious and needs urgent treatment (seen in immunocompromised people).
Immune Stress in Cold Weather
Cold weather can weaken immune responses, especially in the upper respiratory tract.
People get less sunlight, which lowers vitamin D — a key immune modulator.
Increased stress, poor sleep, and less fresh air during winter can reduce the body’s ability to manage infections or inflammation.
Those with underlying conditions (asthma, diabetes, allergies) may flare more easily when immune function dips — making them more vulnerable to mold-related symptoms.
Indoor Mold Exposure Increases in Winter
People spend more time indoors, where moisture builds up from heaters, showers, cooking, and poor ventilation.
Mold thrives in warm, damp, enclosed areas — basements, bathrooms, behind walls — and we breathe in more spores without realizing.
Buildings that trap condensation or lack airflow become mold havens, especially if there's a leak or hidden water damage.
Allergic Fungal Rhinosinusitis (AFRS):
Sometimes more noticeable in winter, but not strictly seasonal. Why?
AFRS is chronic, not an acute infection.
In some regions (like North India), mold spore levels spike during winter harvest, so people often develop or notice symptoms more in winter.
Indoor environments in winter (closed windows, heating systems) can increase mold exposure — especially in damp areas.
That said, AFRS can develop anytime, especially in humid regions where mold thrives year-round.
Mold-Related Sinus Conditions: Frequency & Occurrence Patterns
Allergic Fungal Rhinosinusitis (AFRS)
How common: AFRS is a relatively uncommon subtype of chronic rhinosinusitis (CRS) but accounts for a significant minority of cases. It is estimated to represent about 5–10% of CRS cases requiring surgery (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem). Some series report a prevalence around 6–9% among CRS patients, particularly those with nasal polyposis (The prevalence of allergic fungal rhinosinusitis in sinonasal polyposis - PubMed). AFRS tends to affect adolescents and young adults (mean age ~22 years) (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem), often in immunocompetent individuals with an atopic background (e.g. >60% have allergic rhinitis; ~50% have asthma) (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem).
Geographic & climate trends: The incidence of AFRS appears higher in warm, humid regions where environmental mold exposure is high (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem). In the United States, it is reported most frequently in the Southeast, the Mississippi River basin, and parts of the Southwest (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem). Internationally, AFRS is also common in tropical and subtropical areas; for instance, in rural north India, ~56% of chronic fungal sinusitis cases were AFRS (Epidemiology of chronic fungal rhinosinusitis in rural India). Areas with heavy agricultural activity (e.g. wheat farming in North India) show high airborne mold spore counts and correspondingly higher rates of AFRS (Epidemiology of chronic fungal rhinosinusitis in rural India) (Epidemiology of chronic fungal rhinosinusitis in rural India). By contrast, in cooler or arid climates, AFRS is less prevalent and other forms of sinusitis dominate.
Seasonal patterns: Because AFRS results from chronic colonization and allergic inflammation, it is not strictly seasonal, but environmental mold levels can influence its occurrence. Regions with distinct “mold seasons” may see more new or worsening cases when spore counts peak. For example, in North India a spike in Aspergillus spore burden during the winter harvest season coincided with many patients reporting symptom onset in winter (Epidemiology of chronic fungal rhinosinusitis in rural India) (Epidemiology of chronic fungal rhinosinusitis in rural India). Similarly, in temperate climates, outdoor mold spore levels are highest from mid-summer into fall, which could trigger allergic sinusitis symptoms (Mold Allergy - Symptoms, Prevention, and Treatment). Overall, AFRS can present year-round, but mold-rich months might contribute to initial development or flares.
Risk factors: Key risk factors for AFRS include atopy and chronic nasal inflammation with polyps. The majority of AFRS patients have a personal or family history of allergies – about 90% show IgE antibodies to one or more fungi, and many have coexisting asthma (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem). Unlike invasive fungal infections, AFRS occurs in immunocompetent people. It is often considered an upper-airway analog of allergic bronchopulmonary aspergillosis. Some data suggest certain ethnic groups may be more affected (e.g. a study in California found African American patients made up 26% of AFRS cases, far above their proportion of the CRS population) (Allergic Fungal Sinusitis: Practice Essentials, History of the Procedure, Problem), possibly due to genetic or environmental factors.
Regional data: Prevalence can vary widely by region. In India, studies have found an exceptionally high burden – one community survey found that 27.5% of all chronic sinusitis cases were fungal (mostly AFRS) (Epidemiology of chronic fungal rhinosinusitis in rural India) (Epidemiology of chronic fungal rhinosinusitis in rural India). By contrast, in Europe AFRS is relatively infrequent, and non-fungal CRS is more common. Nevertheless, across many regions AFRS remains the single most common form of fungal sinusitis overall (Fungal Sinusitis - StatPearls - NCBI Bookshelf). Improved recognition in recent decades has led to more diagnoses in diverse climates, but it is still primarily encountered in mold-abundant environments.
Fungal Ball (Sinus Mycetoma)
How common: Fungal balls (mycetomas) of the sinus are a non-invasive fungal accumulation within a sinus cavity. They are relatively rare in the general population, but have become an increasingly recognized cause of chronic sinus infection, especially in older adults. Studies from surgical series indicate that roughly 3–7% of patients undergoing sinus surgery for chronic rhinosinusitis have a fungal ball present () ( Medicine ). For example, a 20-year review in South Korea found ~6.9% of sinus surgery patients had a fungal ball (usually in a single sinus) ( Medicine ).
Geographic & demographic patterns: Fungal balls occur worldwide and are often noted as a leading form of fungal sinusitis in regions with older populations. In European studies, maxillary sinus fungus ball is reported as the most common type of chronic fungal rhinosinusitis in adults (). Typically, patients are middle-aged to elderly (most in their 50s–70s) (), and there is a slight female predominance (around 60% of cases) (). The condition is usually unilateral – affecting one sinus (most often the maxillary sinus in ~80–90% of cases) (). Unlike AFRS, there is no strong association with allergic history or systemic illness; patients are immunocompetent and generally not more atopic than the average population.
Seasonal patterns: There are no clear seasonal or monthly patterns for sinus fungal balls. These infections develop slowly over time as fungal debris accumulates, so incidence is not linked to a particular season. While ambient mold exposure is necessary for a fungus ball to form, once established it grows indolently and is not known to flare seasonally.
Risk factors: Local factors in the sinuses are thought to predispose individuals to fungal ball formation. A history of sinus disease or anatomical variations that impair sinus drainage (e.g. obstruction of the sinus ostia) can create conditions for fungi to colonize (). Notably, dental procedures involving the upper jaw (such as root canals or implants that invade the maxillary sinus area) are reported in about 50% of cases, suggesting an entry point or catalyst for fungal growth in the sinus (). Fungal balls most often involve Aspergillus species (especially A. fumigatus or A. flavus), but the fungus remains localized in the sinus lumen without invading the tissue () (). The increasing use of CT imaging and awareness of this condition have contributed to more frequent diagnoses in recent years ().
Regional data: In some regions, sinus fungal balls constitute a significant fraction of chronic sinusitis cases requiring surgery. Reports from France and other European countries noted that fungus balls had become a common cause of unilateral chronic rhinosinusitis (). East Asian countries (e.g. South Korea, China) have also documented growing numbers of cases, possibly related to environmental factors and aging populations. Overall, the condition is relatively infrequent in very dry or cold climates, but it can occur anywhere given the ubiquitous presence of mold spores and local predisposing factors.
Invasive Fungal Sinusitis (IFS)
How common: Invasive fungal sinusitis is the least common but most aggressive mold-related sinus condition. It generally occurs in a small subset of high-risk individuals rather than in the general healthy population. Overall incidence is very low – on the order of only a few cases per million people ( Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic - PMC ). For example, one estimate puts the global incidence of mucormycosis (a primary cause of acute invasive sinusitis) at ~0.005–1.7 cases per million population ( Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic - PMC ). Developed countries typically report only a handful of IFS cases per year (the U.S. saw roughly 1,140 mucormycosis-related hospitalizations in 2019, corresponding to ~3 per million population) (Data and Statistics on Mucormycosis | Mucormycosis | CDC). In contrast, countries with a high prevalence of risk factors have higher rates – India’s estimated prevalence of mucormycosis is about 140 per million (approximately 80 times higher than in the U.S.) ( Mucormycosis ).
Geographic & climate trends: IFS can occur in any geographic region, but tends to be more common where underlying risk factors are prevalent and where environmental exposure to molds is high. India has historically seen a high baseline rate of invasive sinus fungal infections, partly due to the large number of people with uncontrolled diabetes and a tropical environment rich in fungal spores ( Mucormycosis ). In some tropical/subtropical areas of Africa and Asia, a chronic granulomatous invasive sinusitis (often due to Aspergillus flavus) is recognized even in immunocompetent individuals (Epidemiology of chronic fungal rhinosinusitis in rural India) (Epidemiology of chronic fungal rhinosinusitis in rural India). This indolent invasive form has been reported chiefly in regions like Sudan, Pakistan, and India (Epidemiology of chronic fungal rhinosinusitis in rural India). By contrast, in North America and Europe, most IFS cases are acute infections seen in severely immunocompromised patients, with no particular regional concentration (aside from hospital centers) and no consistent seasonal pattern.
Seasonal patterns: There is no strong seasonal variation for invasive fungal sinusitis, because its occurrence is tied more to sporadic exposures and patient immunological status than to climate cycles. However, clusters of cases can follow environmental events that increase exposure to molds or cause injuries. For instance, community-onset outbreaks of mucormycosis have been documented after natural disasters that dispersed mold-contaminated debris or caused trauma (allowing fungi to enter tissue) (Data and Statistics on Mucormycosis | Mucormycosis | CDC). A recent example on a large scale was during the COVID-19 pandemic in India: following a spring 2021 COVID wave, thousands of cases of COVID-associated mucormycosis (an invasive rhino-orbital fungal infection) were reported, creating a surge in late spring and early summer 2021. This surge was primarily driven by factors like steroid use and diabetes in COVID patients rather than the season itself, though it happened to coincide with hot, dry months in that region.
Risk factors: IFS almost always arises in the context of significant host risk factors that impair immune defenses or tissue integrity. Major risk factors include:
Uncontrolled diabetes mellitus – particularly diabetic ketoacidosis, which greatly increases susceptibility to mucormycosis ( Mucormycosis ).
Immunosuppression – for example, patients with hematologic malignancies, organ or stem cell transplant recipients, those with prolonged neutropenia, or advanced HIV/AIDS are at high risk ( Mucormycosis ). In invasive aspergillosis of the sinuses, nearly all patients are severely immunocompromised.
Corticosteroid use or other immunomodulating drugs – high-dose or long-term steroid therapy (as seen in severe COVID-19 or autoimmune disease treatment) can precipitate invasive fungal infections by dampening the immune response ( Mucormycosis ).
Iron overload or deferoxamine therapy – excess iron availability in tissues (e.g. in hemochromatosis or dialysis patients on deferoxamine) predisposes individuals to rapid mucormycosis ( Mucormycosis ).
Trauma and environmental exposure – in certain settings, otherwise healthy people can develop IFS after traumatic injuries introduce soil or plant material into the sinuses. Notably, one study found trauma to be the most common precipitant of mucormycosis in Asian countries, whereas immunosuppression was the main cause in developed countries (Fungal Sinusitis - StatPearls - NCBI Bookshelf).
These risk factors strongly influence the frequency of IFS. In populations where diabetes is common and poorly controlled, or during events where large numbers of people receive immunosuppressants (e.g. corticosteroids during a COVID-19 surge), IFS cases can rise dramatically ( Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic - PMC ). By comparison, among otherwise healthy individuals with intact immunity, IFS is exceedingly rare.
Regional data: The burden of IFS varies by region in line with the prevalence of the above risk factors. India, for example, has an exceptionally high incidence: one review estimated India’s mucormycosis prevalence at ~0.14 per 1000 population (roughly 80× higher than in developed countries) ( Mucormycosis ). During the COVID-19 second wave in 2021, over 14,800 cases of COVID-associated mucormycosis were reported in India by late May 2021 ( Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic - PMC ), prompting health authorities to declare it an epidemic in several states ( Rampant Increase in Cases of Mucormycosis in India and Pakistan: A Serious Cause for Concern during the Ongoing COVID-19 Pandemic - PMC ). Other South Asian and Middle Eastern countries (such as Pakistan, Iran, and Egypt) have also reported higher-than-average rates of invasive fungal sinusitis, often linked to local risk factors like uncontrolled diabetes or widespread steroid use. In North America and Europe, IFS remains uncommon; cases that do occur are usually isolated incidents in hospitals among patients with severe immunosuppression. Indeed, national surveillance data in the U.S. are limited, but in 2019 only ~1,140 hospitalizations were attributed to mucormycosis nationwide (Data and Statistics on Mucormycosis | Mucormycosis | CDC). This highlights that in most developed regions, mold-related invasive sinus infections are rare, opportunistic diseases – a stark contrast to the more frequent occurrences seen in certain high-risk populations elsewhere.