Fungal infection cases rising in second phase of pandemic, warn Maharashtra, Gujarat doctors

Cases of mucormycosis, a fungal infection, are rising among Covid-19 survivors, causing blindness or serious illness and even death in some cases, health officials in Maharashtra and Gujarat said on Saturday.

The cost of treatment for this disease is also a matter of concern, some doctors said.

Mathur Savani, chairman of Surat-based Kiran Super Multi-speciality Hospital, said mucormycosis patients are coming to his hospital from Surat district as well as other parts of Gujarat.

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"Fifty mucormycosis patients are being treated at our hospital and 60 more are awaiting (treatment). They all came to our hospital in the last three weeks and have recovered from Covid-19 recently," Savani told PTI.

Seven such patients lost eyesight, he said.

The civil hospital in Surat has set up a separate facility for such patients, said in-charge Resident Medical Officer (RMO) Dr Ketan Naik.

In Ahmedabad, at least five mucormycosis patients are being operated upon every day at the civil hospital at Asarva, a senior doctor said.

"We are receiving five to 10 such cases (daily), especially since the second wave of Covid-19 started," said Dr Devang Gupta, ENT specialist at the hospital.

"At least one out of five cases is related to eyes. Several of them are suffering from blindness," he said.

In Maharashtra, at least eight Covid-19 survivors have died due to mucormycosis while 200 others are being treated, said Dr Tatyarao Lahane, who heads the Directorate of Medical Education and Research of the state government.

"They survived Covid-19 but the fungal infection attacked their weakened immune system," Dr Lahane told PTI.

This disease is not new, but it is on rise among Covid-19 patients because the use of steroids elevates sugar level and some medicines suppress the immunity of these patients, he said.

"In such a situation, the fungus infects the patient easily. If it reaches the brain, it can prove fatal. In one such case, one of the eyes of a patient had to be removed permanently to save his life," Dr Lahane said.

The fungus, also called `black fungus', is present in the environment, but those with suppressed immunity or co- morbidities are more vulnerable to its infection, he said.

Symptoms of mucormycosis include headache, fever, pain under the eyes, nasal or sinus congestion and partial loss of vision, Dr Lahane said.

Speaking about treatment, he said, "A patient generally needs a type of injection for 21 days. The basic cost of this injection is around Rs 9,000 per day."

Dr Hetal Marfatia, professor and head of the ENT department at the government-run KEM hospital in Mumbai, said a surge in mucormycosis cases is being witnessed in the last two weeks. "On average, two or three such patients are visiting the hospital every day," he said.

Many of these patients come from outside Mumbai and cannot afford the treatment cost, he said.

During the first phase of the Covid-19 pandemic the fungal infection typically came to light a couple of weeks after patients were discharged, Dr Marfatia said.

"But now, some patients are contracting this infection while undergoing Covid-19 treatment," he added.

Niti Aayog Member (Health) V K Paul on Friday had said that mucormycosis cases were being found in patients with Covid-19.

"It is caused by a fungus named mucor, which is found on wet surfaces. It, to a large extent, is happening to people who have diabetes. It is very uncommon in those who are not diabetic. There is no big outbreak and we are monitoring it," he said at a press conference after a hospital in Delhi flagged rising cases.

"When a patient is on oxygen support, it should be ensured that water does not leak from the humidifier (to prevent the growth of the fungus)," he said, while also calling for "a rational usage" of steroids and medicines such as Tocilizumab to treat Covid-19 patients.