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When should COVID-19 patients get an HRCT report ?

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20 May 2021

The urging pandemic has struck everyone's life to an hault , questioning what humanity is ? With every now and then mutating itself it's becoming difficult to eradicate this virus.Where people usually run behind jobs, colleges, schools are now running behind beds, oxygen, ventilators. The worst of it's ever is seen in these days. The second wave of Covid-19 has hit everyone so bad, especially India with a total of 20.6 million confirmed cases and 2,26,000 deaths have seen till date. The usual tests done to detect Covid-19 are the PCR-RAT(Rapid Antigen Test) and RT-PCR(Real Time Polymerase Chain Reaction). They are done by collecting samples through swabs from nose or throat, but many patients are getting a negative report inspite having all the symptoms. This can be because of faulty testing or premature incubation period. Due to mutation of virus the new strain has been seen effecting lungs at an early stage itself. As the infection increases the air sacs are filled with fluid leaking from tiny blood vessels into the lungs. This is eventually leading to shortness of breath and can cause acute respiratory distress syndrome(ARDS) a type of lung failure. While the normal pneumonia affected people recover without any lasting lung damage but pneumonia associated with COVID-19 can be severe. Even after the patient recovers, the lung injury may result in breathing problems which may take months to improve. When a person is effected with covid virus the body's immune system fights hard against the virus leaving the body more vulnerable that other virus or bacteria may affect the body along with COVID-19 leading to superinfection.

The people who get a negative report but still have symptoms should go to CT scans instead of going for retesting. As the number of COVID-19 cases increases we see that the demand for tests are also increasing but while going through a CT scan one must remember it has high radiations which is advisable to get done least times. High Resolution Computed Tomography (HRCT) is another way of detecting the viral infection in the body. HRCT is a diagnostic test which involves imaging of lungs. As this new mutant can damage the lungs at early state, lung imaging test provide more accurate information of the severity and spread of infection which could be directed by proper coarse of treatment. HRCT scans are not only done for confirmation of infection but are also ordered by doctors to COVID-19 patients who showcase symptoms like congestion along with mild covid symptoms. HRCT tests are interpreted via CORAD scores and measures CT scores. The CT score is different from the CT value detected in RT-PCR tests. CORAD scoring is done on basis of 1-6, wherein 1 signifies negative covid and normal lung function, score 2-4 signifies suspected viral involvement and reading of 5 means classic COVID-19. A CORAD score 6 is given to a person who has been detectable with ground opacities in lungs and is said to be at higher risk of COVID severity. Basis on this, additional respiratory tests or blood work can also be done and treatment followed. Apart from CORAD , HRCT scan shows CT severity score that tells about actual lung involvement. Different labs go by different readings but a higher score usually represents grater lung involvement and high COVID severity.

As the HRCT gives more accurate detection of spreading covid infection in the body many people instantly are rushing through to get the chest and lung scan done when they identify the first symptom without taking the PCR tests. But it is not necessary for every COVID patient to get this tests. It is adviced that if a person with symptoms and classic respiratory signs, tests negative on RT-PCR tests, then a HRCT scan would be helpful. And some patients who test positive on RT-PCR, are advised to go for a HRCT scan towards the end of first week if there is no respite in symptoms. Not everyone who gets a high score needs to be hospitalized. Some patients with mildest symptoms can easily get recovered at home with due guidance and treatment. Injection, steroids, and steam inhalation therapies are also advised for mild to moderate case of infection. The need for hospitalization and specific treatment should be done based on this pre-existing illnes or case history.


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