Patients incidentally tested +ve on admission: PGI doc

Tribune News Service

Naina Mishra

Chandigarh, January 23

The city lost 23 patients, who were also Covid positive, this month. Dr Ashutosh Aggarwal from the Pulmonary Medicine Department, PGI, who is handling Covid-dedicated ward in the hospital, said most of the patients, who died at the PGI, were incidentally found to have Covid-19 at the time of admission to the hospital. They did not have clear features of lung involvement due to Covid.

A 67-year-old Covid positive woman died at the PGI on Saturday. She was also found to be suffering from chronic kidney disease and hypertension. Several Covid patients who died at city hospitals had some or the other comorbidities involved like the above-mentioned case.

“Several patients at the PGI are dying because of their underlying medical or surgical conditions, rather than Covid complications. Most of the patients who died at the hospital were incidentally found to have Covid at time of admission to the PGI. They did not have clear features of lung involvement due to Covid. We are hardly seeing casualties directly related to severe Covid-related lung injury and refractory oxygen desaturation, although one cannot be sure if Covid indirectly contributed to some way to these deaths,” said Dr Aggarwal.

In the recent genomic sequencing results, 20 samples were detected with the variant of concern. Ten samples each were of Delta and Omicron variants. While the third wave is believed to be fuelled by the Omicron variant, experts have noticed lesser hospitalisation and severity of disease in this wave. Delta, on the contrary, had led to the situation wherein hospitals ran out of Covid ICU beds and the city suffered from shortage of medical oxygen as well.

Asked about the role of variants in Covid deaths, Dr Aggarwal said: “Admissions and deaths at the PGI are spread across all spectrum of ages, from children to elderly, and a clear age pattern is still not discernable, unlike that was observed during the previous waves. In the absence of any firm virological data, we are still not sure how much Delta or Omicron variants are relatively contributing to our hospitalisations and mortality.”

Lesser CT chest requirement

PGI radiologist Dr Mandeep Garg said: “We are getting few requisitions for CT chest in the current wave despite the number of Covid patients being so high. The main reason behind this is that the disease manifestations are certainly milder as compared to the second wave leading to lesser hospitalisations. This is primarily because of vaccination and previous exposure to Covid infection. Moreover, now we all are aware about the role of CT scan in Covid and this has prevented the indiscriminate use of CT chest in the current wave.”

“Generally, Covid patients being referred for CT scan are for other indications rather than Covid pneumonia per se; and a miniscule number who get CT chest done for Covid are usually those who have associated comorbidities and where CT is expected to change the management of patients. Lung involvement is much lesser in this wave. Majorly, it is involving the upper respiratory tract. Regarding the pattern of lung involvement, it has the same Covid pneumonia pattern on CT scan,” said Garg.

Docspeak

Several patients at the PGI are dying because of their underlying medical or surgical conditions, rather than Covid complications. Most of those who died at the hospital were incidentally found to have Covid at the time of admission to the PGI. They didn’t have clear features of lung involvement due to Covid. — Dr Ashutosh Aggarwal, Pulmonary Medicine Department, PGI

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