Published on May 20, 2021

AHMEDABAD: Compared to other countries, post-Covid mucormycosis has become a major issue for some Indian states including Gujarat, where more than 600 cases are currently under treatment. Why has the state witnessed more cases of the fungal infection compared to other states and the earlier Covid surge?

Experts said factors such as a high number of diabetic patients, indiscriminate use of steroids and negligence of oral and nasal hygiene during Covid treatment are some of the major reasons.

Dr Rajesh Vishwakarma, a senior city-based ENT surgeon, said Gujarat is considered the diabetes capital of India. “Pre-Covid, the only patients who used to come with the fungal infection were diabetic. The Covid infection not only aggravates the condition, but also increases blood sugar levels of those who don’t have a history,” he said. “The fungus, commonly found on kitchen waste and rotting wood, enters the human body as microscopic spores, and start proliferating in a conducive host with low immunity.”

“Another factor is negligence towards oral and nasal hygiene,” said Dr Neeraj Suri, an ENT surgeon with Gandhinagar Civil Hospital. “Gargling is sometimes ignored when patients are on a ventilator or BiPAP. This gives a way for the fungus to grow. Likewise, distilled water used in assistive breathing is sometimes not changed which can worsen nasal hygiene,” she said, adding that all medical equipment used for Covid patients must be cleaned regularly.

It has also to do with the indiscriminate use of steroids, especially in the early phase of the Covid infection, said Dr Ruchir Shah, a city-based ENT surgeon. “We have seen in some patients that the prescription meant for one patient based on his or her condition is termed standard and circulated on platforms such as WhatsApp. This practice should stop, as steroids are not advisable for all,” he said. “Compared to the last surge, the use of steroids has increased manyfold. This time around, patients of mucormycosis are coming from almost all adult age groups.”

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