August 19, 2021 2:17:49 pm
Even as Covid-19 cases have been declining steadily in the state, Vadodara’s two government-run hospitals continue to report new admissions to their mucormycosis wards — an average of three new cases a day. Doctors say that the patients include those who did not get Covid-19 or show symptoms.
The SSG Hospital in Vadodara analysed the data of 544 patients with mucormycosis during the second wave of the pandemic to understand the commonalities and causes. The hospital concluded that out of the 544 patients, 54 had no Covid-19 history with 397 having pre-existing diabetes. Only 263 patients were on oxygen support, while 354 patients were administered steroids — oral or injectable.
As of August 17, SSG Hospital had 16 patients admitted to the mucormycosis ward and one patient underwent orbital exenteration. Around 10 to 15 debridements are being done under local anaesthesia daily, despite the fact that the new Covid-19 cases are recorded in single digits in most parts of the state.
At Gujarat Medical Education and Research Society (GMERS)-run Gotri hospital, 10 mucormycosis patients are admitted on August 17 and nine debridements were done under local anaesthesia.
Medical Superintendent of SSG hospital, Dr Ranjan Aiyer, who is also the Head of Department (HOD) of the ENT department, told this newspaper that many cases who have been under treatment since the outbreak of mucormycosis infections require multiple sessions of debridements.
“The numbers do not indicate all new cases but also include those patients, who contracted the fungal infection during the second wave of Covid-19 and have undergone multiple debridements because the reoccurrence of the infection is common once a part has been infected. It needs complete scanning and checks for clearing any new growth for several weeks, depending on the severity of the infection. Many patients have needed even eight sessions of debridements,” Aiyer says.
Aiyer, however, says that now the new admissions at the hospital’s mucormycosis ward, mostly comprise patients who never underwent Covid-19 treatment.
“There are many patients, who have turned up with mucormycosis infection but have not reported a history of Covid-19. It also means that these patients were never on oxygen support and so the contaminated water or whatever cause that one attributes to oxygen therapy for mucormycosis can be named here. They were also not put on steroids but whatever be the intensity of the Covid-19 they contracted, it ended up compromising their immunity,” Aiyer said.
According to Aiyer, studies and local observations in mucormycosis cases were not able to establish an undeniable link between oxygen treatment for Covid-19 and mucormycosis, while the fungal infection has affected those with diabetes mostly before contracting Covid-19 or diagnosed with new diabetes after recovery.
“It is a fact that Covid-19 has resulted in more diabetic patients. The immunity has been compromised and several new diabetics are a result of Covid-19. The relation between mucormycosis and diabetes has been sufficiently established. It has come without warning, even to those who did not know they contracted Covid-19 and it secretly altered their glucose levels within. But being a rare disease, it will not affect a healthy person all of a sudden,” Aiyer said, adding that checking sugar levels is crucial in preempting any fungal infection.
“It barely gives any signs before it sets off but one must be cautious about sugar levels, whether one has suffered a known episode Covid-19 or not. It is also important to not ignore any discomfort in the jaw, tooth, or mouth and immediately have it checked by a doctor,” Aiyer suggests.
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