1,700 active mucormycosis cases in Maharashtra, protect Covid patients, say experts
More than 1,700 patients with mucormycosis — an invasive fungal infection — are currently under treatment in Maharashtra. State health authorities have expressed concern and have advised doctors to take utmost care in order to reduce the possibility of Covid-19 patients catching this opportunistic infection.
“The fatality rate in mucormycosis is more than 20%,” additional chief secretary (health) Pradeep Vyas said in an online conference, which was attended by chief minister Uddhav Thackeray and health authorities from across the state. “The surgery often involves removal of eyes and mandible, and causes disfigurement. The overall cost of treatment of mucormycosis is also very high,” he said, adding that mucormycosis cases go up when Covid-19 is not treated properly.
Commonly known as black fungus, mucormycosis is caused by a group of molds called mucormycetes that are present in the environment. These fungi attack humans who are battling illnesses such as Covid-19, when the body’s immunity is at its lowest. A large number of mucormycosis cases have been seen in Covid-19 patients, who had undiagnosed diabetes or had uncontrolled sugar levels while undergoing the treatment.
Nurse-driven sugar control protocols for mucormycosis
“Nearly 80% of patients who have contracted mucormycosis had poor sugar control,” said Dr Rahul Pandit from Fortis Hospital who is a member of the Covid-19 task force.
“In our unit, we did not use a lot of steroids and we ensured good sugar control of patients. Due to these measures, we did not have a single case of mucormycosis between March 2020 and May 2021,” he said.
The medicines given as standard in Covid-19 care, including steroids, contribute to increasing blood sugar level. Pandit advises that hospitals should have “nurse-driven sugar control protocols” for intensive care units (ICU) and high dependency units. Nurses should be trained to constantly monitor and update sugar fluctuations in patients and alert doctors.
Covid-related mucormycosis cases so far
Maharashtra has recorded 10,104 cases and 1,328 deaths due to mucormycosis so far. Of the 1,718 patients currently undergoing treatment, the highest number of cases is in Nagpur at 467.
Many patients travel to bigger cities for mucormycosis surgeries as hospitals in rural areas don’t have specialists and advanced surgical setups.
For instance, nearly half of the mucormycosis patients treated at the civic-run KEM Hospital in Mumbai were from outside Mumbai. “One-third of the patients required at least three surgeries to remove the infected tissues,” said Dr Hemant Deshmukh, dean of KEM Hospital. The hospital currently has 24 patients on treatment. During the peak in May, there were 124 mucormycosis patients being treated at one point in time.