Clinical features and upper airway symptoms in association with severity and outcome in patients with COVID-19
DOI:
https://doi.org/10.22317/jcms.v8i2.1206Keywords:
COVID-19, Anosmia, SARS-CoV-2, Pandemics, IraqAbstract
Objectives: To assess the relationship between the early occurrence of upper respiratory tract symptoms and the severity of SARS-COV-2 infection.
Methods: A cohort observational study had been conducted on a total of 140 patients [60 mild, 40 moderate, 40 severe], diagnosed with SARS-CoV-2 between 4th of August and 31 of October 2020. Patients diagnosed by PCR or chest CT scan or both of them. A full history was taken from the patients and data including the age of the patient, gender, occupation, residence, height, weight, history of previous comorbidities {cardiovascular, Diabetes mellitus, Hypertension, chronic respiratory disease, chronic renal disease, malignancy, and other diseases}. Smoking and alcoholic history were also taken, clinical features {loss of smell/taste, sore throat, rhinorrhea, fever, cough, shortness of breath, headache, fatigue, myalgia, arthralgia, diarrhea, and vomiting} and temperature, SPO2, investigations, the need for respiratory support {O2, non-invasive ventilation, invasive ventilation} and any complications developed during illness.
Results: Mean age of the patients was 51(range:17-82) Males were dominant; (57.1%) with male to female ratio of 1.33 to one, out of the 140 COVID-19 patients, 63 (45%) had upper respiratory symptoms. Regarding biomarkers of severity only S.LDH was significantly lower in cases who did have compared to those who did not have upper respiratory symptoms, 1.3 ± 1.4 vs. 1.7 ± 1.3, respectively. The mean SPO2% was significantly higher in patients with upper respiratory symptoms compared to those without. Percent of Pulmonary damage was significantly lower in patients with upper Respiratory symptom compared to those without. Mortalities were significantly lower in patients with upper respiratory symptoms compared to those without; among the 113 patients with upper respiratory symptom compared only 7(6.2%) died compared to 7 out of 27 (25.9%) patients with no upper respiratory symptom.
Conclusion: Early occurrence of upper respiratory tract symptoms predicts less severe form of the disease.
References
Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. “The continuing 2019-nCoVepidemic threat of novel coronaviruses to global health—The latest 2019 novel corona virus outbreak in Wuhan, China”. International Journal of Infectious Diseases. (February 2020) 91:264–266.
Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study [published correction appears in Lancet.[2020 Feb 4;]. Lancet. 2020;395(10225):689-697.
Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 pandemic: a comprehensive review of taxonomy, genetics, epidemiology, diagnosis, treatment, and control. J Clin Med 2020; 9(4):E1225.
Paules CI, Marston HD, Fauci AS. Coronavirus infections — more than just the common cold. JAMA 2020;323:707-8.
de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8): 523-534. doi: 10.1038/nrmicro.2016.81PubMedGoogle ScholarCrossref
Song Z, Xu Y, Bao L, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11(1):11. doi:10.3390/v11010059
Martinez-Rojas MA, Vega-Vega O, Bobadilla NA. Is the kidney a target of SARS-CoV-2. Am J Physiol Renal Physiol. 2020;318(6):F1454-F1462. doi:10.1152/ajprenal.00160.2020.
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends onACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181(2):271-280.e8
Baj, J., Karakuła-Juchnowicz, H., Teresiński, G., Buszewicz, G., Ciesielka, M., Sitarz, R., ... & Maciejewski, R. (2020). COVID-19: specific and non-specific clinical manifestations and symptoms: the current state of knowledge. Journal of clinical medicine, 9(6), 1753.
CW Lu, XF Liu, ZF Jia. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet, 395 (2020), p. e39,10.1016/S0140-6736(20)30313-5.
WG Carlos, CS Dela Cruz, B Cao, S Pasnick, S Jamil. Novel Wuhan (2019-nCoV) coronavirus. Am J Respir Crit Care Med, 201 (2020), pp. P7-P8, 10.1164/rccm.2014P7.
J Xia, J Tong, M Liu, Y Shen, D Guo. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol (2020 Feb 26), 10.1002/jmv.25725.
Fu L.; Wang B.; Yuan T.; Chen X.; Ao Y.; Fitzpatrick T.; Li P.; Zhou Y.; Lin Y.‐F.; Duan Q.; et al. Clinical characteristics of coronavirus disease 2019 (COVID‐19) in China: a systematic review and meta‐analysis. J Infect 2020;80:656–665.
Sun P.; Qie S.; Liu Z.; Ren J.; Li K.; Xi J. Clinical characteristics of hospitalized patients with SARS‐CoV‐2 infection: a single arm meta‐analysis. J Med Virol 2020;92:612–617.
Gane S.B.; Kelly C.; Hopkins C. Isolated sudden onset anosmia in COVID‐19 infection. A novel syndrome? Rhinology 2020;58:299-301. doi:10.4193/Rhin20.114.
Tong J.Y.; Wong A.; Zhu D.; Fastenberg J.H.; Tham T. The Prevalence of Olfactory and Gustatory Dysfunction in COVID‐19 Patients: a Systematic Review and Meta‐analysis. Otolaryngol Head Neck Surg 2020;163:3-11.
Aragão, M. D. F. V. V., Leal, M. C., Cartaxo Filho, O. Q., Fonseca, T. M., & Valença, M. M. (2020). Anosmia in COVID-19 associated with injury to the olfactory bulbs evident on MRI. American Journal of Neuroradiology, 41(9), 1703-1706.
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