Comparison of chest HRCT severity score in PCR positive and PCR negative clinically suspected COVID-19 Patients.

Background: The limitations and false-negative results of Real-time Polymerase chain reaction (RT PCR) in diagnosing COVID-19 infection demand the need for imaging modalities such as chest HRCT to improve the diagnostic accuracy and assess the severity of the infection. Objectives: The study aimed to compare the chest HRCT severity scores in RT-PCR positive and negative cases of COVID-19. Methods: This cross-sectional study included 50 clinically suspected COVID-19 patients. Chest HRCT and PCR testing of all 50 patients were done and the chest HRCT severity scores for each lung and bronchopulmonary segments were compared in patients with positive and negative PCR results. Chi-square and Mann Whitney U test were used to assess differences among study variables. Results: Chest HRCT severity score was more in PCR negative patients than in those with PCR positive results. However, the difference was not significant (p=0.11). There was a significant association in severity scores of the anterior basal segment of the left lung (p=0.022) and posterior segment upper lobe of right lung (p=0.035) with PCR results. This association was insignificant for other bronchopulmonary segments (p>0.05). Conclusion: CR negativity does not rule out infection in clinically suspected COVID-19 patients. The use of chest HRCT helps to determine the extent of lung damage in clinically suspected patients irrespective of PCR results. Guidelines that consider clinical symptoms, chest HRCT severity score and PCR results for a confirmed diagnosis of COVID-19 in suspected patients are needed.

Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is the ongoing pandemic with multitude of manifestations and association of ABO blood group in South-East Asian population needs to be explored. METHODS: It was a retrospective study of patients with COVID-19. Blood group A, B, O, and AB were identified in every participant, irrespective of their RH type and allotted groups 1, 2,3, and 4, respectively. Correlation between blood group and lab parameters was presented as histogram distributed among the four groups. Multivariate regression and logistic regression were used for inferential statistics. RESULTS: The cohort included 1067 patients: 521 (48.8%) participants had blood group O as the prevalent blood type. Overall, 10.6% COVID-19-related mortality was observed at our center. Mortality was 13.9% in blood group A, 9.5% in group B, 10% in group C, and 10.2% in AB blood group (p = 0.412). IL-6 was elevated in blood group A (median [IQR]: 23.6 [17.5,43.8]), Procalcitonin in blood group B (median [IQR]: 0.54 [0.3,0.7]), D-dimers and CRP in group AB (median [IQR]: 21.5 [9,34]; 24 [9,49], respectively). Regarding severity of COVID-19 disease, no statistical difference was seen between the blood groups. Alteration of the acute phase reactants was not positively associated with any specific blood type. CONCLUSION: In conclusion, this investigation did not show significant association of blood groups with severity and of COVID-19 disease and COVID-19-associated mortality.

Association of hypothyroidism with acute COVID-19: a systematic review.

OBJECTIVE: There is an increasing body of literature on the impact of COVID-19 on the pituitary-thyroid axis. Therefore, we conducted a systematic review to assess the prevalence of hypothyroidism in patients with COVID-19. METHODS: A literature review was conducted using LitCOVID for study selection in PubMed and MEDLINE till May 2021. All relevant original articles evaluating thyroid dysfunction were included and information regarding the prevalence of hypothyroid disease in COVID-19 was retrieved from the eligible articles. RESULTS: Out of 32 articles, six articles qualified for the final analysis which included 1160 patients. There was significant heterogeneity among the included articles. Most of the patients had lower mean triiodothyronine (T3) and normal or low thyroid-stimulating hormone (TSH). Increased TSH ranged from 5.1% to 8% while low T3 was present in up to 28% of the patients. In these studies, the prevalence of altered thyroid hormones was significantly more in COVID-19 patients as compared to control groups. A positive correlation between low mean T3 and clinical severity of COVID-19 was reported. CONCLUSION: This systematic review reveals a significant proportion of hypothyroidism associated with COVID-19. Therefore, routine assessment of thyroid function is warranted in hospitalized COVID-19 patients.

Physician Preparedness in Response to the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study From a Developing Country.

Background December 2019 marked the inception of a global pandemic, with cases being reported worldwide. In the developing nations with scarce healthcare resources, the reliance on healthcare workers who are amply prepared to withstand the prevailing scenario is indispensable. Our study aimed to assess the level of preparedness of doctors working in various hospitals across Pakistan to combat coronavirus disease 2019 (COVID-19). Methods We conducted an online questionnaire-based survey in May 2020 to estimate the level of preparedness of doctors working in various departments of various private and public hospitals across Pakistan. The survey comprised 36 questions, with items evaluating the provision of adequate protective equipment, training, mental health resources, and sound collaboration between healthcare workers and the hospital management during the COVID-19 crisis. Results A total of 346 doctors responded to the survey, among whom 56.4% were working in public sector hospitals and 46.5% were working more than five days per week. Of those included, 87.6% were being provided with disposable gloves, but 72.8% and 43.4% of respondents professed to having no access to eye protective equipment and gowns, respectively. Only 35.3% of respondents claimed to be trained regarding the use of personal protective equipment and 28.95% were being tested. Of the physicians, 43.4% claimed to have no proper triage system for the suspected patients and 98.3% were concerned about transmitting the disease to their family members. Of the doctors, 53.5% reported that there was sound collaboration between the hospital management and healthcare staff. Conclusion The survey provided evidence of inadequate delivery of personal protective equipment and training to doctors working in various hospitals across Pakistan. A sound collaboration between the hospital management and departments needs to be addressed.