Health Ministry Adds CT Scan, X-ray in Diagnosis of COVID-19

According to clinicians, the use of chest X-ray s and CT scans will help identify cases that would have undetected with PCR tests

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The Ministry of Health has revised the diagnostic tests for COVID-19 and included radiological equipment like chest X-rays and CT scans.

According to the World Health Organization-WHO, the effective way to test for COVID-19 is by using a Polymerase Chain Reaction(PCR) test that has a high sensitivity to detecting the viral load of the virus. However due to the first progression of the disease in patients with the delta variant, at times PCR tests fail to detect the disease on time. As such, some cases go undetected.

Previously, the treatment protocol necessitated severe COVID-19 patients to have a positive PCR test before they could be admitted into the ICU in case their condition worsened. Patients who were critical but lacked a positive test were not given priority.

Now, clinicians will be able to use CT scans as one of the main diagnostic equipment for COVID-19. According to clinicians, the use of X-rays or chest CT scans will help doctors identify possible COVID-19 patients that would otherwise go undetected and lead to avoidable deaths.

Dr Misaki Wayegera, the chair of the ministerial COVID-19 Scientific task force says the use of X-rays are part of new clinical diagnostic measures that the health ministry has adopted.

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According to Dr Misaki, in addition to having a positive PCR test, patients seeking care in hospitals will also need to present a chest CT scan or X-ray. Results from both testing methods will then be used to determine how sick a patient is.

Prof Pontiano Kaleebu, the Executive Director of the Uganda Virus Research Institute says the radiological equipment is needed because the COVID-19 virus gets flashes out of the body fast.

" The virus leaves the body at a very fast rate. We estimate that within 10 days, the virus is no longer traceable in the nasopharyngeal passage. However it would have damaged other parts of the body like the lungs that can indicate whether one is infected or not depending on the damage that results from testing positive for the disease," he said.

Dr Rosemary Byanyima, the Deputy Executive Director of Mulago National Referral Hospital and also the head of the COVID-19 treatment unit says that the use of radiological equipment will enable them to pick cases that would go undetected but continue spreading the disease.

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Dr Fred Nakwagala, the Clinical Head of Directorate of Medicine at Mulago Hospital says that it is high time the health ministry included the use of x-rays and CT scans as diagnostic tools for the disease.

"We have patients who have presented with negative COVID-19 PCR tests but had all other symptoms of COVID-19. They had difficulty breathing and radiological diagnosis showed they had COVID but could not be admitted to the ICUs because they didn't have a positive PCR test," Nakwagala said.

In addition to using chest x-rays to determine COVID-19 positive cases, Dr Wayengera says they will also be using new criteria to determine the cause of deaths of suspected COVID cases.

According to pathologists from Mulago National Referral, postmortem carried out have shown that persons who succumb to COVID-19 have congestion in the lungs, bleeding in multiple organs, solid beefy lungs (instead of spongy feel/appearance) and scared kidneys. In addition to this, the lungs are three times heavier than their normal weight of around 1000g.