Coronavirus Outbreak Explained: Do All COVID-19 Patients Need CT Scans?

New Delhi: There has been an ongoing debate  among the healthcare workers, on whether and when a COVID patient needs to get a CT scan done. AIIMS director Dr Randeep Guleria recently warned of the misuse of CT scans and biomarkers by patients having mild COVID-19 symptoms. He said that the overuse of CT scans increases exposure to radiation that in turn escalates the risk of cancer.

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A study showed that a CT scan of an asymptomatic person and found that 30-40 per cent asymptomatic patients also had patches in the lungs and recover on its own.

He further said that one CT scan is equivalent to 300-400 chest X-rays and this increases the risk of having cancer in later life, especially among the youth, as one is exposed to harmful radiation.

If you are in doubt, then go for a chest X-ray first. If necessary, the doctor will give proper advice whether a CT scan is needed or not, Dr Guleria had said.

NDTV spoke with Dr Mrinal Sircar, Head, Pulmonology at Fortis Hospital, Noida, about when is it necessary to get CT scans and whether doctors are advising it indiscriminately as suggested by Dr Guleria.

For mild COVID patients, there’s absolutely no indication that they need a CT Scan. Only severe patients who are admitted in the hospitals, some of them may need a CT scan as part of their treatment to decide how serious their disease is and if there are any complications. Mild cases getting a CT scan is completely unnecessary, in terms of both money and radiations that they are facing.

There are times when what is thought to be a mild case, turns out to be pneumonia or some serious lung patches, which is revealed in the CT scan. So people feel that it may help them fight the virus. To this concern, Dr Sircar says that a CT scan is not the only indicator for this. He explains,

I don’t think only the scan can help you identify the severity. Condition of the patient, factors like oxygen levels, temperature, breathlessness can say a lot about the case. CT scan is completely unnecessary people as it scares them and causes anxiety.

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NDTV also spoke to Dr Vijay Surase, Interventional Cadiologist, Jupiter Hospital, who says that most cases with the new mutation turn out to be negative in RTPCR tests, so they are forced to turn to CT scans. He said,

Only diagnostic test that can give you a clue about this viral illness today is through CT scan. But when experts say the CT scan is being overused, I think there is no other modality by which we can diagnose at this stage. But doing the CT scan for a person multiple times can expose a person to risk. This is one of the best test to properly diagnose this illness.

Dr Sircar says that a lot of misinformation floating around could also be behind the misuse of CT scans. He said,

When the pandemic is raging around us, and based on the simplest symptoms alone, we can treat this illness even while we wait for RT-PCR. I would like to assert that a CT scan is necessary only for severe patients.

Dr Surase says that the variant that has caused the second wave may be highly transmissible but is not as lethal.

The second wave is not very lethal but rapid change in the clinical picture is happening. But this time people are not getting the classical COVID-pneumonia or dangerous patches. It is similar to a common cold and those who feel breathless should be seeing physicians. Those who become very breathless, are the ones who may need a CT scans, he concluded.

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NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.