AIIMS Director Advises X-Ray Instead Of Many CT Scans

Amid the tense and anxious situation of the second wave of the pandemic, we have two types of people who are causing the unnecessary crowd at the hospitals. The first type is someone who gets easily frightened as soon as they find mild symptoms. All they have to do is take an online doctor consultation and start eating healthy with a lot of recommended rest while following simple home remedies.

The second type is someone who delays even after finding strong symptoms like fever, cough, loose motions and body pains. They plan to visit the hospital after 6 or 7 days of contracting the virus, which is again harming the surroundings. AIIMS Director Dr Randeep Guleria on Monday warned people getting posthaste about CT scans and unrequired tests besides indiscriminate prescription of steroids.

Guleria said hospitals were seeing mild patients who had consumed steroids, triggering virus replication and causing a drop in oxygen levels. “We need to comprehend that taking steroids at the early stage can give more stimulus to virus replication. In many cases, mild cases are becoming severe and patients are reporting severe pneumonia. Steroids have no role in the first five days of illness,” Guleria said.

If in moderate condition, Gulaeria said only three specific treatments are effective.“First is oxygen therapy; second, when the illness is moderate and oxygen saturation is low, then there is a role for steroids; third is anticoagulants because we know Covid-19 pneumonia is a little different from viral pneumonia and promotes the clotting of blood. There could be blood clots in the lungs resulting in a drop in blood saturation. Again, in mild illness, there is no role for anticoagulants,” Guleria said.

In the case of mild symptoms, the AIIMS Director also said not to rush for CT scans and biomarker tests. “Patients must undertake these tests only when they have a moderate illness and on the basis of advice by doctors. There is a possibility of over-treatment due to unnecessary reliance on biomarkers. Many people are getting CT scans done on getting a positive report”.

Guleria expressed concern over how people are scans done every three-four days and explained how frequent body exposure to radiation can cause cancers later in life. “Studies have shown that in 30-40% of asymptotic patients, some patches will show in CT reports, however, they recover on their own without any treatment. One CT scan is equal to getting 300-400 chest X-rays. There is data from the International Atomic Energy, which deals with radiation protection and medicine, that conducting CT scan multiple times increases the risk of cancer in later life, especially in the younger age group.”

On biomarkers, the AIIMS Director said, “Those testing positive are undergoing blood tests for C-reactive protein (CRP), complete blood count, D dimer. Again for mild illness and when oxygen saturation is under control, there is no requirement for these blood tests. These only cause a panic reaction. These biomarkers are for acute phase reactants, which means that whenever there is inflammation, these will increase. We don’t come to know if the infection is spreading. People think they should take steroids if CRP is more, this causes more damage.”