Chief specialist in radiation and instrumental diagnostics of the Ministry of Health of the Russian Federation, Professor Igor Tyurin: "Computer tomography should not be performed for "asymptomatic" patients for prevention purposes

In many regions of Russia today there is a stir in diagnostic departments. In order to diagnose Covid-19 without waiting for a doctor's appointment, citizens want to take a computer tomography (CT) of the lungs. CT scans are good at detecting changes in the lungs, but they don't diagnose infections. This means that if particular patients with specific respiratory complaints have no changes in CT, this does not mean that they do not have a coronavirus infection. Because the presence or absence of Covid-19 can only be determined by laboratory diagnostics, only PCR reaction and subsequent immunological tests.

The most accurate, the most reliable, the first sign that a patient has a coronavirus infection is a PCR reaction, which is taken using a normal swab from the throat. And CT has nothing to do with the diagnosis of coronavirus infection in this sense. CT is not a screening method. This means that people who do not have any respiratory symptoms should not have CT scans for prevention purposes. This makes absolutely no sense, loads the health care system, and prevents everyone from working without exception.

If CT scans reveal any changes in the lungs, especially minimal ones, this does not mean that the patient has a coronavirus infection. Such changes can occur with any other respiratory disease, in particular, with the flu, the incidence of which is now, in the autumn-winter period, is also growing.

Specialists observe a whole group of patients who have a coronavirus infection that is asymptomatic, but they also have changes in the lungs that are detected with a coronavirus infection. Does this mean that we should examine all citizens of our country without exception to find all those infected? This is impossible, and it is absolutely harmful.

CT is a complex diagnostic method that is associated with a sufficiently high radiation load on the patient and is used for clarifying diagnostics. If a patient is suspected to have a coronavirus or respiratory infection and has been ill for 4-6 days, an x-ray should be taken. If there are no changes in the scan by the end of the first week of the disease, then there will be no changes in CT, and it makes no sense to do a CT scan for such a patient.

CT is a way to observe seriously ill patients who need to be hospitalized. But in order to conduct a competent, correct examination and hospitalize them if there are real indications, in some cases they need to perform a CT scan, sometimes even before hospitalization. However, this is only possible if prescribed by the attending physician, outpatient or ambulance physicians, and only if there are clinical indications.

CT is performed for two main groups of patients: those who have severe clinical symptoms of respiratory infection - patients with shortness of breath and an exceptionally high fever and patients who have signs of respiratory viral infection and have serious risk factors (severe diabetes, severe heart failure, overweight). In all other cases, CT is excluded as a diagnostic method, it is not perform for prevention, it is not perform for a mild course of the disease and the absence of risk factors. This is all written in the methodological recommendations, the latest version of which is available on the website of the Ministry of Health of Russia.

I urge citizens not to take a CT scan "just in case"! So we can quickly perform it to those who really need it for life reasons.