Usefulness of High-Resolution Computed Tomography in Early Diagnosis of Patients with Suspected COVID-19.

BACKGROUND: Diagnosis of coronavirus disease 2019 (COVID-19) is mainly based on molecular testing. General population studies have shown that chest Computed Tomography (CT) can also be useful. OBJECTIVE: The study aims to examine the usefulness of high-resolution chest CT for early diagnosis of patients with suspected COVID-19. DESIGN AND SETTING: This is a cross-sectional study from May 1, 2020, to August 31, 2021, at the COVID Hospital, Mexico City. METHODS: This study examined the clinical, high-resolution chest CT imaging, and laboratory data of 160 patients who were suspected to have COVID-19. Patients with positive Reverse Transcription- Polymerase Chain Reaction (RT-PCR) testing and those with negative RT-PCR testing but clinical data compatible with COVID-19 and positive antibody testing were considered to have COVID-19 (positive). Sensitivity and specificity of CT for diagnosis of COVID-19 were calculated. p < 0.05 was considered significant. RESULTS: Median age of 160 study patients was 58 years. The proportion of patients with groundglass pattern was significantly higher in patients with COVID-19 than in those without COVID (65.1% versus 0%; P = 0.005). COVID-19 was ruled out in sixteen (11.1%). Only four of the 132 patients diagnosed with COVID-19 (3.0%) did not show CT alterations (p < 0.001). Sensitivity and specificity of CT for COVID-19 diagnosis were 96.7% and 42.8%, respectively. CONCLUSIONS: Chest CT can identify patients with COVID-19, as characteristic disease patterns are observed on CT in the early disease stage.

25-Hydroxyvitamin D level is associated with mortality in patients with critical COVID-19: a prospective observational study in Mexico City.

BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.