Comparing the sensitivity and specificity of lung CT-scan with RT-PCR for diagnosis of COVID-19.

BACKGROUND: The lung is one of the major organs affected by the SARS-CoV-2 virus. Lung CT scan and RT-PCR are the most valuable diagnostic methods in the early diagnosis and management of COVID-19. Due to the possible inconsistency of the false-negative results for the RT-PCR test, in this study, we aimed to evaluate the sensitivity and specificity of lung CT-scan as an accurate diagnostic method of COVID-19. METHOD: In this cross-sectional study, patients suspected of COVID-19 and referred to Shahid Beheshti Hospital in Qom city from February 26 to April 13, 2020, were enrolled. For a definitive diagnosis of COVID-19, chest CT scan and RT-PCR testing was performed for 644 patients, and both sensitivity and specificity of lung CT scan were evaluated. RESULTS: According to the findings, and comparing to the RT-PCR test as the standard gold, sensitivity, specificity as well as, positive predictive and negative predictive values of lung CT-scan were found as follow; 94.47% (95% CI:90.73 - 97.02%), 24.71% (95% CI:20.70 - 29.07%), 40.73% (95% CI:36.58 - 44.99%), 89.08% (95% CI: 82.4 - 94.05%), respectively. CONCLUSION: According to the findings, the lung CT scan has a better diagnostic value than RT-PCR in symptomatic patients who were referred to the hospital for COVID-19 diagnosis. Performing lung CT-scan in patients with negative RT-PCR test should be assessed.

Clinical Manifestations of Gastrointestinal Symptoms in COVID-19 Patients: An Integrative Review.

After the outbreak of novel coronavirus disease 2019 (COVID-19) in Wuhan, China, its spread to other countries is rapidly increasing. In this integrative review, we report the prevalence of gastrointestinal symptoms in patients with COVID-19. For this purpose, available articles on gastrointestinal manifestations in patients with COVID-19, which were reported from China, were reviewed. All reviewed articles were searched from December 11, 2019, to June 20, 2020, based on specific key words. Related findings in these articles show that the main target of COVID-19 is lung tissue, as after the virus enters the body, it mainly causes respiratory symptoms in affected patients. But in addition to respiratory symptoms, it is possible that, over time, these patients present with other symptoms, the most obvious of which are gastrointestinal symptoms. It is well documented that diarrhea and vomiting are the most common gastrointestinal symptoms in COVID-19 patients. As part of this report, we also look at the incidence and frequency of gastrointestinal symptoms in COVID-19 patients in Iran. The results can be used by providers as a guideline for better management of gastrointestinal symptoms in these patients.

Evaluation of invasive ventilation (intubation) prognosis in patients with Covid-19 symptoms.

BACKGROUND: Coronavirus 2019 (COVID 19) has been reported as a pandemic by the world health organization. Increasing number of cases and associated mortality have demanded the need for clinical studies and researches. OBJECTIVE: The aim of this study is to evaluate intubation prognosis of the COVID 19 patients referred to Shahid Beheshti hospital in Qom city. METHOD: COVID 19 patients referred to (XXX)were included in this study. Clinical sign and symptoms were recorded for each patient in a questionnaire. The diagnosis was made using real time polymerase chain reaction and chest CT scans. Lab findings from renal and liver function tests, blood count, c-reactive protein and electrolytes were also recorded. Shortness of breath was measured using oxygen saturation levels in these patients. The data was recorded in the electronic form and was analyzed using SPSS v21. RESULT: Of 317 patients included in this study, the average age of COVID 19 patients were 59.71 ± 16.46 years. The need of ventilation among the patients older than 50 years was significantly higher than younger patients, p = 0.013. Smoking status, gender and drug addiction was not associated with the need of invasive mechanical ventilation, p = 0.73, p = 0.44 and p = 0.76. Patients need invasive mechanical ventilation compared to those receiving non-invasive ventilation were significantly older, p = 0.001. CONCLUSION: The need of mechanical ventilation is significantly greater in advanced age COVID-19 patients.

Clinical Manifestation of Patients Who Died Due to COVID-19; A Retrospective Study from Qom-Iran.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has become a pandemic health problem worldwide. In this study, we attempted to explain the clinical and laboratories characteristics of non-surviving patients, to identify the probable factors affecting disease progression. METHODS: In a retrospective study, we assessed the data from dead adult patients who were hospitalized and laboratory diagnosed with COVID-19 during March 2020. The data were obtained from electronic medical records. Moreover, a checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each one of the patients. In case of lack of information, a member of the research team contacted the first-degree relatives via phone. RESULTS: Totally, 50 patients were enrolled in this study. The mean age was 68.0 ± 14.1 years. Of them, 29 (58%) patients were male. Notably, the median (IQR) hospitalization time was 4.0 (2.7-6.2) days and the duration between the first symptoms to death was 10.0 (5.0-14.5) days. Also, pre-existing morbidity was reported in 42 (84%) patients, and hypertension was the most common one with 28 (54%) patients. Interestingly, body temperature more than 37.5°C was reported in only 20 (40%) patients. Nevertheless, neutrophilia (≥7109/L) and lymphopenia (<1.0 109/L) were observed in 27 (54%) and 29 (58%) patients, respectively. Also, elevated levels of creatinine, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were common, which may be indicators of aggravation of the patients' status. CONCLUSION: Besides age and underlying diseases, elevated creatinine level, neutrophil count, and the inflammatory indices along with the reduced lymphocyte count can be considered as indicators of disease progression. Hence, they should be considered for admission and surveillance of patients.