Updated: June 18, 2021 7:19:11 pm
Just 15 days after a 27-year-old South Mumbai resident was discharged from KEM hospital after a month-long Covid-19 treatment, he was readmitted with symptoms of mucormycosis, a fungal infection. Even while he remains admitted, for at least another month at a special mucormycosis ward in KEM hospital, he was found to be sleepless and anxious. Soon, doctors realised not only he but also his family requires psychiatric support.
Since May-end, KEM hospital has begun a dedicated psychiatric unit for patients in its 60-bedded mucormycosis ward and has, so far, treated 122 such patients, of whom 97 are currently admitted at the hospital. At the unit, the 27-year-old man’s family was also counselled on how they could support the patient while he was being regularly visited at the ward by a psychiatrist.
A rapidly spreading fungal infection, mucormycosis is now commonly found as a secondary infection in Covid-19 patients. It is associated with high mortality — sometimes patients have had to undergo amputation or physical disfigurement to restrict the fungus from spreading.
In Maharashtra, over 7,000 such cases have been recorded, of whom more than 600 patients have succumbed till June 10.
Dr Hemant Deshmukh, the dean in KEM, said, “The sudden loss of a body part can be traumatising. We not only need to counsel the patient but also their family to cope with such physical disability.” Their experience with Covid patients over the last year, Deshmukh said, helped them realise the importance of psychiatric care for patient support.
“The need arose because the prognosis of mucormycosis is grave. We have appointed eight psychiatrists for this ward. Sometimes we need to prepare a patient to accept the possibility of disfigurement because the severity of the infection is so high,” he said, adding that if patients require amputation, their kin is also counselled before the surgery.
According to experts, if the fungus spreads to the eye, it could even lead to its removal. Some patients may require plastic surgery when some infected parts have to be surgically removed. A multi-speciality team of ophthalmologists, medicine specialists, anaesthetists, plastic surgeons and ENT is hence required.
Dr Siddhesh Shere, assistant professor in the psychiatry department, said the most common complaints are of insomnia, anxiety and depression amongst these patients, especially in ones who underwent hospitalisation for several months. The ward at KEM hospital has had few patients living there for two months too.
“The difference between Covid-associated mucormycosis and any other chronic illness is that former’s onset is sudden and prognosis is severe. A person does not get time to cope. For them the first shock is of Covid-19 and next of mucormycosis,” he said. Shere added they had also noticed one of the side-effects of steroid use was behavioural change.
In a particular case, a person with obsessive-compulsive disorder contracted Covid-19 and later mucormycosis. Now admitted at KEM hospital, the patient has shown signs of slipping into depression. “We have put him on a stronger dose of anti-depressants,” Shere said.
KEM doctors said patients have also complained of the stigma associated with mucormycosis — several people believe the fungal infection spreads through close contact and some patients face ostracisation after discharge.
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