Can laboratory evaluation differentiate between coronavirus disease-2019, influenza, and respiratory syncytial virus infections? A retrospective cohort study.

AIM: To identify clinical and laboratory parameters that can assist in the differential diagnosis of coronavirus disease 2019 (COVID-19), influenza, and respiratory syncytial virus (RSV) infections. METHODS: In this retrospective cohort study, we obtained basic demographics and laboratory data from all 685 hospitalized patients confirmed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus, or RSV from 2018 to 2020. A multiple logistic regression was employed to investigate the relationship between COVID-19 and laboratory parameters. RESULTS: SARS-CoV-2 patients were significantly younger than RSV (P=0.001) and influenza virus (P=0.022) patients. SARS-CoV-2 patients also displayed a significant male predominance over influenza virus patients (P=0.047). They also had significantly lower white blood cell count (median 6.3×106 cells/µ) compared with influenza virus (P<0.001) and RSV (P=0.001) patients. Differences were also observed in other laboratory values but were insignificant in a multivariate analysis. CONCLUSIONS: Male sex, younger age, and low white blood cell count can assist in the diagnosis of COVID-19 over other viral infections. However, the differences between the groups were not substantial enough and would probably not suffice to distinguish between the viral illnesses in the emergency department.

Adverse pregnancy outcomes including gestational diabetes and preeclampsia: Do primary care physicians refer to them in their medical files?

Aims: Pregnancies complicated with gestational diabetes mellitus (GDM) or preeclampsia should be considered risk factors for subsequent morbidity later in a women's life. Appropriate screening tests have been recommended for these women. We sought to evaluate whether primary care physicians document diagnoses of GDM or preeclampsia in the medical files during the post-partum period and to elicit whether appropriate screening tests were performed.Materials and methods: The medical records of 352 women discharged from the maternity ward with a diagnosis of GDM or preeclampsia were examined 12 weeks post-partum. We recorded whether a primary care visit occurred, if a relevant diagnosis was documented and if screening tests were conducted.Results: In our cohort, 89.2% of the GDM group and 81.0% of the preeclampsia group visited a primary care physician at least once. About 12.9% (n = 25) of the GDM group and 12.7% (n = 20) of the preeclampsia group were given a correct diagnosis; 40.7% of the GDM group underwent a diabetes screening test and 27.8% of the preeclampsia group underwent a blood pressure measurement.Conclusion: We concluded that diagnoses of GDM and pre-eclampsia are not well-documented by primary physicians and that recommended screening tests are not being sufficiently performed.