E-Paper
Data analysis of black fungus cases questions blame being put on Covid-19 treatment protocols
PUNE The Pune district health office has analysed 620 reported cases of mucormycosis in the district since December 2020
PUNE The Pune district health office has analysed 620 reported cases of mucormycosis in the district since December 2020.
The analysis shows that in May alone, 538 cases, which account for 91% of the reported cases minus duplications.
The analysis also provides insights on the type of treatment these patients received during their Covid-19 treatment. Mucormycosis has become a major challenge for the administration which is now struggling to treat patients for both the infections, mucormycosis and Covid-19.
The analysis of all the cases registered on the health office portal gives the number of people who have received steroid therapy and oxygen support, necessary during the treatment of Covid-19. These treatment protocols are now being questioned as possible causes of mucormycosis. Mucormycosis, which is a fungus, has now become a major challenge because of the number of infections reported.
The infection is primarily caused due to two reasons; one when fungi enters the body, and second, when immunity is suppressed.
There have been demands to study whether contamination of industrial oxygen which is repurposed for medical use could lead to the introduction of the fungus, or if excessive use of steroids during the course of treatment on Covid-19 patients, could lead to suppression of immunity. However, the data analysis of the cases in Pune shows that close to half the number of mucormycosis patients did not receive any steroid therapy, and similarly, close to half did not receive any oxygen support during the course of their Covid-19 treatment.
The analysis shows that of the 620 cases, 351 did get steroid therapy, while 269 did not get steroid therapy. Similarly, 302 people did not receive oxygen support prior to the onset of mucormycosis. The data also showed that of the 620 cases, 380 had diabetes. This was followed by 105 who had an immunocompromised status and 69 who had a comorbidity.
The district administration, in its report, also stated that due to the duplication of names, about 29 cases have been repeated. Of the total 591 actual cases, 92 are from out of Pune district, like from Ahmednagar (32), Solapur (17) and Satara (17).
On Tuesday, state health minister Rajesh Tope said, “Currently there are 2,245 active cases of mucormycosis in the state and of that, 1,007 are undergoing treatment through the MPJAY scheme. We are also getting 60,000 vials of Amphotericin B injection through a global tender which will reach the state directly by the first week of June.”
Dr Halikar Sudhir, ENT specialist from Noble Hospital, said, “I have treated about 40-42 patients for mucor in the second wave alone. In 40 patients I saw that 15 did not report diabetes, while seven-eight were being treated at home so they had very mild to moderate symptoms during their Covid-19 treatment. They required only small doses of steroids and possibly no oxygen therapy. So this entire debate about contaminated oxygen or excessive use of steroids is questionable based on the data from the district administration and my own experience.”
“We need to now study that whether this new strain is compromising the immunity of the host to such an extent that the fungus is having a strong impact. This is because we did not see so many cases of mucor in the first wave. Another thing to notice is that mucormycosis is a very commonly present fungus in our homes and even in the hospitals, so the fungus enters everyone’s body; but only those with compromised immunity face severe symptoms. Even among my patients I found that non-diabetic mucormycosis patients had milder symptoms than those who had diabetes,” Dr Sudhir said.
