Pune: A combination of diabetes, Covid-19, and a unified approach to steroid use has led to an increase in invasive fungal infections during the pandemic.
Most of Pune’s major hospitals said they treat at least one case of an invasive fungal infection called mucormycosis or aspergillosis each day.
Experts said rational use of steroids in diabetics, the use of nasal anti-germ solutions like betadine, and raising awareness of those who have recovered from Covid via red flags after infection can avoid lengthy treatments.
“Steroids can raise blood sugar levels. These levels need to be controlled to avoid secondary bacterial and fungal infections, ”said Parikshit Prayag, an infectious disease expert at Deenanath Mangeshkar Hospital.
The hospital had more than 75 cases of mucormycosis and over 100 cases of aspergillosis (mostly referred from other hospitals) since last March. Both are invasive yeast infections.
“A stable Covid patient without hypoxia (blood oxygen drops below 92%) should not be treated with steroids. It should also be the lowest dose for the shortest possible duration. When oxygen levels are normal, steroids can do more harm than good, ”said Prayag.
The role of an oral and dental surgeon is very important in diagnosing mucormycosis in patients discharged after an extended stay in hospital.
“Most Covid patients get this fungal infection due to the low immunity in intensive care units in hospitals,” said oral surgeon JB Garde.
Garde said mucormycosis usually sets in when discharged Covid patients are home isolated for a few more days. These recovered patients initially experience congestion or nasal blockages.
“And slowly they get pain in the upper jaw area. This is the stage when other sinuses get involved, “Garde said.
Unfortunately, patients and doctors often reject these signs as regular symptoms after Covid. In addition, most recovered patients seek advice over the phone.
“Patients are not aware of the problem until the infection reaches the eye and consumes most of the inside of the upper jaw,” Garde said. Mucormycosis treatment is also very expensive.
“Antifungal drugs like amphotericin cost nearly 25,000 rupees a day,” added Garde.