Published on March 24, 2021

AHMEDABAD: Coronavirus has Gujarat in its vicious grip once again. In 24 hours ending 5 pm on Tuesday, the state added 1,730 cases – record high daily cases reported in the pandemic yet — taking the total to 2.9 lakh. In a week, the state has registered an alarming rise of 81% in cases with an addition of total 10,328. In the preceding week, 5,529 cases were recorded.

City-based experts say there is reason to suspect a mutation might be at play in Ahmedabad which recorded 502 cases in a day, the highest for any city in the state during the pandemic – and state at large.

Dr Tushar Patel, a city-based pulmonologist and member of the state task force on Covid-19, said that the surge could only be understood in terms of mutation. “If we compare the profile of the patients in the past fortnight with those in the post-Diwali period, the severity and mortality is low. But the spread is much higher – something that is being observed in other parts of the country and elsewhere in the world,” he said.

Dr Maharshi Desai, a city-based critical care specialist and fellow task force member, said that the patients are younger compared to the past surge. “They are out for their jobs and the movement among the working population is higher. There is no data available for Gujarat but mutation could not be ruled out,” he said. He added that fewer patients are requiring hospitalization during this surge due to milder symptoms.

City-based pathologists are pointing at missing S-gene from several of the RT-PCR tests. Explaining its importance and meaning, Dr Urvesh Shah, professor of pathology at GCS Medical College, said that the kit tests the sample based on S, N and E genes along with RdRp gene.

“The kits detect the presence of two, three or all four genes based on its sensitivity. The experience we have in Ahmedabad at several of the labs indicate that S-gene is not found, but as other genes are present, the person is tested positive,” said Dr Shah. “We can interpret the result as mutation on the S gene – as the kits are designed based on the earlier variant.”

“Most of the positive cases are showing ‘S’ gene negative. This signifies the possibility of mutation in the `S’ gene in the new strain,” said Dr Bhavini Shah, consultant histopathologist and infection prevention and control specialist.

Dr DG Patel, a city-based pathologist, agreed with the theory. “Last year, patients gave history of severe symptoms in terms of fever, breathlessness or body ache. This month, symptoms are more cold-like symptoms or pain in the throat. Due to less severity, patients do not become aware of carrying the virus which explains it spread to most family members,’ he said.

Dr Patel added that neutrophil-lymphocyte ratio (NLR) along with C-reactive protein (CRP) used to be high in the Covid-19 positive patients. “The general range was 100-150. But for the past few days, we don’t see it beyond 50-60. Thus, we can say that the severity is less,” he said.

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