Prakash Chandra, 59, did not have any symptoms of Covid-19 but got himself tested after his son tested positive. His report came positive. When his doctor insisted on a CT scan after his blood tests revealed high sugar levels and inflammatory markers, it was found that 50% of his lung was involved. His oxygen saturation too had dipped to 85. All this on Day-1 itself. He is now admitted to the hospital with his son whose scan has revealed nearly 60% damage to his lungs by the virus.

Even as the debate on importance of HRCT rages on after the statement of AIIMS-D director Dr Randeep Guleria that HRCT did not serve any purpose in mild and home isolated Covid-19 patients, city-based radiologists are busy with high number of infected and suspected patients lining up for high-resolution CT (HRCT) of thorax (chest and lungs) to understand the lung involvement and severity of the infection. Doctors say CT score of lungs is helping save many lives especially in the current wave when the strain seems to be attacking lungs more ferociously than ever.

Pulmonologist Dr Rahul Jalan, a city-based pulmonologist, said that in the post-Diwali wave in 2020, the average HRCT score (counted out of 25 based on each segment of lungs) was 6 to 8. “This time, it’s as high as 12 to 14 for average patients. It’s not all – even at the lower score, the patients report hypoxia (deprivation of adequate oxygen supply) this time, pointing at the change in the virus profile,” he said.

“Current strain seems to attack lungs more furiously. More young patients are found to have moderate to severe lung disease compared to earlier waves,” said senior radiologist Dr Hemant Patel.

Radiologist Dr Amit Gupta said the average HRCT score has nearly doubled in the patients compared to the last wave Gujarat had seen in November. “Infectivity has increased – from 60% showing lung involvement in 2020, today 80% have lung damage” he said.

What are its implications?

The HRCT thorax – which shows clear (black) to completely infected (white) and has ground-glass opacity in between – also indicates lung capacity. Dr Manoj Singh, a city-based pulmonologist, said that this time around, the oxygen requirement has increased manifold due to higher involvement of lungs. “Majority of the patients require oxygen support from day 1. It was not the case in the last surge – at least for the majority of patients,” he said.

Dr Sahil Shah, a city-based radiologist and joint secretary of Ahmedabad Medical Association (AMA), said that the virus mutation has surely resulted in higher lung infection. “Several patients report lung infection right from the onset, which earlier used to take about five-six days. We however recommend the patients to wait for five days for the diagnosis if their symptoms are not very severe,” he said.

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