Center issues advice on managing fungal infections in Covid-19 patients

Mucormycosis is a fungal infection that primarily affects people taking other health medications and reduces their ability to fight environmental pathogens. According to the center, infections found in COVID-19 patients with uncontrolled diabetes and long-term stays in the intensive care unit (ICU) can be fatal if left untreated.

The recommendations also state that fungal infections primarily affect people taking drugs that reduce their ability to fight environmental pathogens.

Evidence-based recommendations for disease screening, diagnosis and management have been published by the Indian Medical Research Council (ICMR) and the Federal Ministry of Health.

“Mucormycosis can be fatal if not taken care of. After fungal spores are inhaled from the air, the sinuses or lungs of such individuals are affected,” he said.

When to suspect (COVID-19 patients, diabetics, or immunosuppressed patients):

Warning symptoms include pain and redness around the eyes and nose, fever, headache, cough, shortness of breath, vomiting of blood, and changes in mental status.

In COVID-19 diabetics and immunosuppressed patients, if there is sinusitis, unilateral facial pain or numbness, dark discoloration on the nasal or palatal bridge, toothache, painful blurring or diplopia, mucor disease Should be suspected, skin lesions, thrombosis, chest pain, worsening respiratory symptoms.

Key risk factors for the disease include uncontrolled diabetes mellitus, steroid immunosuppression, prolonged ICU stay, malignancies, and voriconazole therapy, the ICMR Department of Health recommends.

How to prevent fungal infections:

Blood glucose levels after COVID discharge and in diabetics should be monitored to prevent illness. Steroids should be used with caution at the right time, dose and duration. Clean sterile water should be used for humidifiers during oxygen therapy. It said that antibiotics and antifungals should be used correctly.

According to the advisory, the disease can be controlled by controlling diabetes, discontinuing immunomodulators, reducing steroids, performing extensive surgical wound resection, and removing all necrotic material. The advisory contains the following precautions:

-Use a mask when visiting a dusty construction site

-Wear shoes, long pants, long-sleeved shirts and gloves when handling soil (gardening), moss and fertilizer.

-Maintain personal hygiene, including thorough scrubbing

Treatment includes placement of a peripherally inserted central vein catheter, maintenance of proper systemic hydration, intravenous infusion of normal saline prior to amphotericin B injection, and antifungal therapy for at least 6 weeks. Said.

Here’s what you can do to prevent infection:

-Control hyperglycemia

-Monitor blood glucose levels after COVID-19 excretion and in diabetics

-Use steroids with caution-the right timing, the right dose and duration

-Use clean, sterile water for the humidifier during oxygen therapy

-Careful use of antibiotics / antifungals

Here’s what you shouldn’t do:

-Don’t miss the warning signs and symptoms

-Do not consider all cases of nasal congestion as cases of bacterial sinusitis, especially in the context of COVID-19 patients who are using immunosuppressive and / or immunomodulators.

-Don’t hesitate to seek aggressive investigation (KOH staining and microscopy, culture, MALDI-TOF) as needed to detect the etiology of the fungus.

-Do not lose significant time to start treatment for mucormycosis

How to manage infections:

-Control diabetic and diabetic ketoacidosis

-Reduce steroids for immediate discontinuation (if the patient is still on)

-Discontinue immunomodulators

-No antifungal prevention required

-Extensive Surgical Debridement-To Remove All Necrotic Substances:

i) Treatment

ii) Attach a peripheral inserted central venous catheter (PICCline)

iii) Maintain proper systemic hydration

iv) Inject normal saline IV before injecting amphotericin

v) Antifungal therapy for at least 4-6 weeks (see guidelines below)

vi) Clinically monitor the patient, monitor the response with wireless images, and detect the progression of the disease

Earlier, health officials in Maharashtra and Gujarat stated that cases of mucormycosis were increasing among COVID-19 survivors, causing blindness, serious illness and even death.

Mator Sabani, chairman of the Surat-based Kiran Super Multi-Specialty Hospital, said patients with mucormycosis came to his hospital from the Surat district and other parts of Gujarat.

“50 patients with mucormycosis are being treated at our hospital and another 60 are waiting (treatment). All have visited our hospital in the last 3 weeks and have recently recovered from COVID-19.” Savani told PTI.

He said seven such patients had lost sight.

In Maharashtra, at least eight COVID-19 survivors have died of mucor disease and 200 are being treated, said Dr. Tatyarao Lahane, director of medical education and research at the state government.

“They survived COVID-19, but the fungal infection attacked their weakened immune system,” Dr. Rahane told PTI.

As cases of zygomycosis or “black jellyfish” infection increase among COVID-19 survivors, the Government of Gujarat has begun to set up separate wards in hospitals for such patients and will be used to treat them. We have procured 5,000 vials of medicine.

Gujarat has reported more than 100 cases of zygomycosis so far. This is a serious but rare fungal infection that causes many patients to lose their eyesight and cause other serious problems.

Currently, 19 patients are being treated at Ahmedabad Municipal Hospital, according to the state government.

With input from PTI