{"id":10487,"date":"2021-07-29T07:49:02","date_gmt":"2021-07-29T07:49:02","guid":{"rendered":"https:\/\/i3tk.org\/demo2\/?p=10487"},"modified":"2021-07-29T07:49:05","modified_gmt":"2021-07-29T07:49:05","slug":"double-trouble-covid-19-patients-with-diabetes-most-at-risk-of-mucormycosis","status":"publish","type":"post","link":"https:\/\/i3tk.org\/demo2\/world-news\/resources\/double-trouble-covid-19-patients-with-diabetes-most-at-risk-of-mucormycosis\/","title":{"rendered":"Double trouble: Covid-19 patients with diabetes most at risk of mucormycosis"},"content":{"rendered":"\n<p>New Delhi: Why do some Covid-19 patients develop mucormycosis and not others? Several hypotheses have been proposed to explain this in the past, but a new study conducted by AIIMS has listed surprising risk factors that leave an individual more susceptible to the deadly black fungus infection.<\/p>\n\n\n\n<p>Diabetes, the study suggests, is the biggest risk factor for mucormycosis infection, followed by the use of steroids. The study also says that prolonged use of surgical or cloth masks and repeated&nbsp;<a href=\"https:\/\/health.economictimes.indiatimes.com\/tag\/rt-pcr\">RT-PCR<\/a>&nbsp;tests, which involves taking nasal swab samples, also increase the odds of contracting black fungus.<br>Notably, oxygen supplementation or hospitalisation did not affect the risk of&nbsp;<a href=\"https:\/\/health.economictimes.indiatimes.com\/tag\/cam\">CAM<\/a>&nbsp;(coronavirus disease associated with mucormycosis), adds the study, published as a pre-print in medical journal MedRxiv and yet to be peer-reviewed. Zinc therapy, probably due to its utility in immune function, was also found to be protective.<br>Dr Naveet Wig, professor and head of medicine at AIIMS, told TOI that diabetes and steroids were known to be potential risk factors for mucormycosis. \u201cFor me, the surprising finding was that most Covid patients who developed mucormycosis used cloth and surgical masks for longer periods than those who did not. I think we need to spread awareness about the importance of using clean masks and changing them frequently to prevent the risk of secondary infections such as mucormycosis,\u201d Wig said.<br>When asked how repeated RT-PCR testing during illness increased the vulnerability to mucormycosis, a doctor explained that repeated trauma to the nasal lining during the swab collection can affect local immunity and the microbiome which gives protection against the growth of opportunistic infection in this area. \u201cRepeat tests should be avoided as much as possible during Covid treatment,\u201d he advised.<\/p>\n\n\n\n<p>For the study, the medicine department selected 352 patients diagnosed with Covid between April and May, the period when the second Covid wave was at its peak. Of them, 152 were under treatment for mucormycosis while the rest had recovered from Covid without suffering the fungal infection.<br>The patients and their families were asked about the various risk factors hypothesised to be responsible for mucormycosis. It was discovered that 92% of the patients who developed mucormycosis had diabetes. In the non-mucormycosis category, only 28% were diabetic.<br>A third (36%) of the patients with mucormycosis were newly diagnosed with diabetes during hospitalisation for Covid, based on raised blood sugar levels or abnormal HbA1c levels, researchers said. \u201cThe reason behind the increased vulnerability of diabetics to the fungal infection could be pre-existing low immunity worsened by use of steroids during the treatment. Therefore, control of co-morbidities is very important in such patients,\u201d said Dr Neeraj Nischal, associate professor, department of medicine.<br>When mucormycosis cases started escalating, it was hypothesised that lengthy oxygen therapy might have predisposed some patients to mucormycosis. However, the AIIMS study did not find such a link. Most of the patients in both groups had mild Covid and the requirement of hospitalised oxygen therapy was similar in both groups.<br>The researchers instead found that the use of cloth masks for more than four hours and of surgical masks for more than six hours were associated with a higher risk of CAM compared with the use of such masks for less than two hours or&nbsp;<a href=\"https:\/\/health.economictimes.indiatimes.com\/tag\/n95\">N95<\/a>&nbsp;masks for any duration. The study said the findings on the association between mask use and mucormycosis were similar even when healthcare workers \u2014 40 were included in the study \u2014 were excluded as confounders who were more limited to the control group of patients (recovered without developing mucormycosis) and used N95 exclusively.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-orig-src=\"https:\/\/etimg.etb2bimg.com\/photo\/84846218.cms\" alt=\"Double trouble: Covid-19 patients with diabetes most at risk of mucormycosis\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-orig-src=\"https:\/\/etimg.etb2bimg.com\/photo\/84846248.cms\" alt=\"Double trouble: Covid-19 patients with diabetes most at risk of mucormycosis\"\/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Study Points To Use of Steroids As Another Cause; No Link Found To Zinc, O2 Therapy<\/p>\n","protected":false},"author":1,"featured_media":10319,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[87,85],"tags":[],"class_list":["post-10487","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-resources","category-world-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v18.8 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Double trouble: Covid-19 patients with diabetes most at risk of mucormycosis - International Institute of Innovation and Technology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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