According to state data, in these 37 deaths, there have been instances of Covid coinfections with monsoon diseases. The number could be underreported as district collectors have been asked to collate details of more such cases and report them. Among coinfections, the highest deaths have been seen with malaria—17—followed by dengue (11).
Doctors said Covid symptoms, including fever, cough, breathlessness, can overlap with many infectious diseases that are caused by other pathogens. “We are still analysing these deaths and trying to understand how the diseases interacted and how they contributed to the deaths. We have asked districts that have reported these cases to provide more information,” said Dr Pradeep Awate, state’s surveillance officer. He, however, said that the deaths in such cases were not overwhelmingly high. Maharashtra has seen over 40,000 Covid deaths so far.
Mumbai was among the first in the state to report Covid-malaria and Covid-dengue coinfection cases. In August, a 27-yearold from G-North ward, which covers Dadar, Mahim and Shivaji Park, and a 40-year-old from M-East ward, which comprises Deonar, Govandi and Mankhurd areas, had succumbed to Covid-malaria, making them the first two victims of coinfection. Thereafter, cases were found in Gadchiroli too, another malaria-endemic area.
Dr Abdul Ansari, critical care expert at Nanavati Hospital, said they have treated a 20-yearold man with serious malaria and Covid coinfection. “The patient had come to us with high creatinine and low platelet levels, but none of the usual respiratory signs. When he was detected with malaria, we thought the diagnosis was done. But he tested positive for Covid before dialysis,” he said.
Dr Ansari said that coinfections do complicate treatment in serious cases. “One also has to be mindful of giving too many immunomodulators as the other infection may flare up,” he said, adding that detecting the dominant disease becomes important here.
Consultant Dr Pratit Samdani said he has seen five cases of Covid with malaria and Covid with dengue. “The key is early identification of coinfections with Covid for appropriate and timely management,” he said.
Dr Milind Nadkar, professor and head of medicine, KEM Hospital, said they have treated quite a few patients of vivax malaria and even leptospirosis developing breathing difficulty and taking a severe turn. “But they tested negative for Covid,” he said in a live chat show.