Emergency Medicine Journal COVID-19 monthly top five

Abstract

[ ]while the D-dimer test may not have a high negative predictive value for PE in COVID-19, occult thrombosis may still exist in the pulmonary microvasculature or elsewhere beyond the lung Bottom line Prophylactic anticoagulation administered to inpatients with COVID-19 appears to reduce in-hospital and 30-day mortality 3 Timing of corticosteroids impacts mortality in hospitalised patients with COVID-19 Topic—Treatment Rating—Head turner While the RECOVERY trial produced convincing results on the mortality benefit of corticosteroids, at present there is no consensus on the most appropriate time to commence steroid therapy 4 This retrospective observational study aimed to assess the optimal timing for corticosteroid therapy in patients with COVID-19 admitted to eight American hospitals in March 2020 Data of 1461 consecutive COVID-19–positive patients (confirmed by RT-PCR nasopharyngeal swab) admitted over a 31-day period were analysed with the authors using propensity score methods to minimise confounding [ ]42 1% (615) received steroid therapy compared with 57 9% (846) who did not Bottom line This study recommends delaying steroid therapy when admitting COVID-19–positive patients unless symptom onset was >7 days or the patient requires mechanical ventilation 5 Effect of vitamin D3 on hospital length of stay in moderate–severe COVID-19 Topic—Treatment Rating—Head turner Vitamin D for the prevention or treatment of COVID-19 has been a focus for high-profile controversy during the pandemic