CT scan provides better diagnosis of COVID-19 over RT-PCR: Radiologist
Dr Abhishek Neral
Dr Abhishek Neral is the Director and Consultant Radiologist at Galaxy Vidarbha Diagnostic at Nagpur. He has completed Masters in Radio Diagnosis (MD) and has worked at various reputed hospitals including Guys & St.Thomas (London, UK), Conquest Hospital (Hastings UK), SMC Medical Center (Dubai), Breach Candy Hospital Trust (Mumbai) to name a few.
High Resolution Computed Tomography also known as HRCT or CT scan is a fast emerging tool now being widely used for better analysis of the lungs and COVID-19 among patients.
Why do we need HRCT scan for diagnosis of COVID-19?
COVID₹19 is a respiratory system illness that manifests as upper respiratory tract infection, which settles downs with pneumonia, consolidation, pulmonary infractions and eventually lung fibrosis.
In response to viral attack, the body tries to fight back by liberating various protective enzymes, which evolve inflammatory reaction. When body tries to counteract replicating viral load, it releases lots of Cytokinin called as cytokine storm as an immune response.
If the body fails to counteract this viral attack, it leads to multi-organ failure and eventually morbidity and mortality. To prevent these complications early diagnosis and treatment is the key. Given today’s scenario, the count of COVID₹19 cases is increasing at an unstoppable rate. Maharashtra is experiencing increasing number of cases by the day.
However there is no guarantee that the cases that are being reported are the same as actual number of COVID cases amongst the public. The major reason behind this fall back is the problem we are facing with the testing of COVID. Diagnosis is usually made with an RTPCR assay, also known as the SWAB test.
However, the RTPCR itself has limitations:
False negative results can occur because of incorrect sampling, location of the swab test, insufficient viral material in the specimen and test sample quality. The sensitivity of this test is considered as low as 59%₹71%, more importantly the shortage of test kits.
Also, RT-PCR takes hours or even days before the results are available. Such limitations and delays would lead to increase and transmission of infection. Due to these inaccuracies, dependency on RT-PCR cannot be continued for quick and accurate test results of the patients and hence treatment and recoveries.
How can HRCT san compensate for the above limitations
HRCT examinations, however, can compensate for the above limitations. HRCT scans can play a very important role in the diagnosis and management of COVID-19 patients. HRCT scan is more accurate (95% according to the recent reports). It decreases the chances of false-negative results. Many suspected patients with atypical CT findings but a negative RT-PCR test have been found to have this disease. HRCT scan process is relatively simple and quick and can be used as a rapid screening tool for suspected patients when RT-PCR results are negative and results are available right away.
This leads to early detection and early isolation and prevents transmission of the virus. HRCT findings are positive for viral pneumonia sometimes even before laboratory results are positive or in false-negative reports. A predictive model and scoring system combining both clinical and CT features are developed to enable high diagnostic efficiency for COVID-19.
Therefore, chest CT findings in particular high resolution computed tomography (HRCT), represents a valuable tool to identify patients with COVID-19 infection in early stage when clinical symptoms may be nonspecific or sparse. CO-RADS CLASSIFICATION The COVID-19 Reporting and Data System (CO-RADS) developed by the Dutch Radiological Society, (approved by ICMR) provides a framework for reporting HRCT. Clinicians for ease of communication and workflow optimisation readily embraced CO-RADS. It assesses the suspicion for pulmonary involvement on CT. Based on the CT findings, the level of suspicion of COVID-19 infection is graded from very low or CO-RADS 1 up to very high or CO-RADS 5 and hence the severity and stage of the disease is determined.
CT involvement score known as the CT severity score (CTSS) The severity of the lung involvement on the CT correlates with the severity of the disease. The method is by scoring the percentages of each of the five lobes that are involved. The total CT score is the sum of the individual lobar scores and can range from 0 (no involvement) to 25 (maximum involvement). There is another system to calculate with segmental involvement of count 40. Typical CT manifestations of COVID-19 have been described including Ground glass opacity (GGO), crazy-paving pattern, and multifocal lesions in a peripheral distribution.
GGO and consolidation are two main signs of COVID-19 lesions on CT images.
HRCT is an important investigation for diagnosis, grading, severity and prognosis of the disease. Positive results can determine whether patient needs immediate hospitalisation or not. Follow up study reveals progression or resolution of disease. HRCT displays various lung patterns in COVID-19 positive cases. HRCT is necessary for accurate diagnosis; scan procedure is simple and sensitivity is as high as 95%. Moreover, reports and results are available right away. HTCT can also be used as a follow-up tool to monitor the evolution and severity of the virus in the patients. It is perhaps a great tool for management and patient care considering the on-going scenario.
(Views are personal)
Nagpur doctor invited as key speaker at Joint American Homeopathic Conference 2023 in US
Homeopath from Nagpur Dr Kavita Chandak, who has two Golden Book Of World Records for treating kidney disorders and success in a case of Mucor mycosis in her name, has been invited as a keynote speaker at the Joint American Homeopathic Conference 2023 based on the theme, Homeopathy in 21st century at San Antonio in United States.
In society, we get to see many cases where child born with mental or physical defects such as congenital heart defects, mental retardation, Down’s syndrome, Cleft palate, ADHD, Autism etc. though born from healthy parents. What could be the reason behind it?
Could homeopathy offer something for it? Dr. Chandak will deliver a 90 minutes session on March 26 on ‘Advancing a Healthier Generation with Homeopathy: Preventative measures for healthy birth and treatment approaches for unimpaired growth.’
She will throw light on the pre-birth causes in mother disturbing the birth of healthy baby creating mental and physical defects as well the preventive measures for initiating the creation of strong generation with Homeopathy.
Dr Chandak is an international trainer and speaker who has specialised in autism, psychiatric and behavioural disorders, kidney diseases and cancer. She has authored eight books and 294 health articles. She will be a keynote speaker in upcoming international congresses of Russia, Romania, Greece and the World Congress of Homeopathy, Colombia.
Also read: Ahead of C20, Ramdaspeth’s polluted Nag River concealed…
CAMIT Chief Dipen Agrawal nominated as member in CGSTGRC Nagpur zone
Dr Dipen Agrawal, President – Chamber of Associations of Maharashtra Industry & Trade (CAMIT) has been nominated as member in Central Goods & Service Tax Grievance Redressal Committee (CGST GRC) Nagpur Zone.
At the outset Dr Dipen Agrawal while thanking Ramchandra Sankhla Chief Commissioner CGST, Vijay Rishi Commissioner Nagpur – 1 and Shri Abhay Kumar Commissioner Nagpur – 2 for giving representation to CAMIT in the recently reconstituted GRC for Nagpur Zone, said, the GRC has enabled revenue officers to have first-hand feedback on various policy initiatives undertaken by government. It also helped in ironing out the difficulties faced by trade in implementing provisions of GST, and to make GST a Grievance-free System of Taxation.
Dr Dipen Agrawal has appealed to fellow traders to forward/share their issues on [email protected] so as to get them addressed in the GRC Meetings. Active and quality participation of trade and professional associations in the committee will achieve the goals of resolving all grievances and issues faced by the tax collectors i.e. traders.
GRC is a platform to voice their grievances including procedural difficulties and IT related issues pertaining to GST and redressal at local level added Dr Agrawal.
Also read: NMC spends ₹20 crore on lighting trees for C20 in Nagpur
NMC spends ₹20 crore on lighting trees for C20 in Nagpur
Ahead of the C20 meet, Nagpur Municipal Corporation (NMC) has spent a staggering ₹20 crore on the lighting of trees on both sides of the roads of airport road, Wardha Road, Walker’s Street, airport road to RBI Square to name a few.
Also, over one lakh nails were hammered on 3000 trees for the installation of lights leaving several activists and residents irked. The C20 meet is scheduled for March 20 and 21 where hundreds of participants from 20 countries would be arriving in the city for a summit.
Also read: Ahead of C20, Ramdaspeth’s polluted Nag River concealed…