Covid-19: Despite growing need, Karnataka govt hospitals test only inpatients for clots, inflammation

BENGALURU: Many people with coronavirus infection are requesting tests that detect signs of blood clots and inflammation, Covid-related complications that can cause a heart attack or a stroke, but government hospitals are conducting these tests for mostly admitted patients.

Patients in home isolation and those who have recovered from the disease and want to rule out future complications are discouraged from seeking free inflammatory marker assessment, including the D-dimer test, at government hospitals.

This policy is a hurdle for people who want to ascertain health risks, forcing them to seek costly solutions at private medical facilities. Experts favour an accommodative testing approach at public hospitals, especially since most of the current Covid-19 cases are in home isolation.

The D-Dimer test costs Rs 1,500 to Rs 2,500. Covid-19 patients in the ICU and high dependency units at government hospitals are not charged for it. Queries related to the inflammatory marker tests have increased in recent weeks as physicians are advising many home-isolation and recovered patients to undergo these check-ups as part of risk assessment.

A 68-year-old doctor tested positive for Covid-19 recently and had mild symptoms. He was diagnosed with the disease 15 days after his mother died because of the infection. After the report, he immediately requested a D-dimer test at a government hospital. But he was informed that only patients in the ICU are tested for clotting and inflammation risk.

Jayanagar General Hospital conducts D-dimer tests for only certain groups of patients. Those in the OPD are not included. At KC General Hospital, tests are done for inpatients. “Outpatients, unless they have a BPL card, will have to pay for these tests,” said Dr B R Venkateshaiah, medical superintendent, KC General.

The Rajiv Gandhi Institute of Chest Diseases (RGICD) conducts the D-dimer test for all needy patients who are admitted. It sends blood samples to a private diagnostic lab in Jayanagar. “We conduct the test for Covid inpatients who need it. Currently, it’s not done for outpatients,” said Dr C Nagaraja, director, RGICD.

Dr CN Manjunath, a member of the state Covid-19 task force, said that government hospitals should also conduct inflammatory marker tests for patients in home isolation. “Whether the patient is admitted to a hospital or is in home isolation with mild symptoms, risk assessment needs to be done to triage them,” said Dr Manjunath, who is also the director of Sri Jayadeva Institute of Cardiovascular Sciences and Research Institute.

Health commissioner Pankaj Kumar told STOI that the government had discussed the feasibility of conducting these tests for patients in home isolation. “The problem lies in the practicality of carrying out these tests. Collecting blood samples of home-isolated patients involves logistical issues. It will be tough to do it for all such patients. But we want to consider it for vulnerable ones,” he added.

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