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      Symptomatology and Demographic Profile of COVID-19 Patients Admitted to a Tertiary Care Center in India: A Hospital Record-Based Study

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      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: sars-cov-2, india, kerala, symptoms, epidemiology, covid-19

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          Abstract

          Introduction: Since its arrival in late 2019, COVID-19 has caused more than 760 million cases and nearly seven million deaths worldwide. As a novel infection research is still underway to understand the epidemiology of COVID-19. The present study was conducted in a tertiary care center in south India to understand the symptomatology of the disease in a local context.

          Methods: Information for the study was retrieved from the hospital records of the Kunhitharuvai Memorial Charitable Trust (KMCT) COVID Hospital, Kerala, India, of patients admitted from 1st May 2021 to 31st October 2021 (six months). Data on their clinico-demographic profile and treatment outcomes were collected and entered into a proforma.

          Results: Out of the 2744 patients included in the study, the proportion of males and females was comparable. About 38.6% of patients were above 60 years of age. The most common presenting complaints were fever, cough, and breathlessness. About 2.7% were asymptomatic. The mortality rate during the study period was 4.8% (132 deaths).

          Conclusion: The present study highlights differences in the symptomology and other demographic features of COVID-19 patients admitted to a hospital in Kerala, India, compared to other regional, national, and international studies. Despite limitations, these differences may have important implications for diagnosing and managing COVID-19 patients in the region.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis

            Leiwen Fu, Bingyi Wang, Tanwei Yuan … (2020)
            Objective To better inform efforts to treat and control the current outbreak with a comprehensive characterization of COVID-19. Methods We searched PubMed, EMBASE, Web of Science, and CNKI (Chinese Database) for studies published as of March 2, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I2 . Publication bias was assessed using Egger's test. Results 43 studies involving 3600 patients were included. Among COVID-19 patients, fever (83.3% [95% CI 78.4–87.7]), cough (60.3% [54.2–66.3]), and fatigue (38.0% [29.8–46.5]) were the most common clinical symptoms. The most common laboratory abnormalities were elevated C-reactive protein (68.6% [58.2–78.2]), decreased lymphocyte count (57.4% [44.8–69.5]) and increased lactate dehydrogenase (51.6% [31.4–71.6]). Ground-glass opacities (80.0% [67.3–90.4]) and bilateral pneumonia (73.2% [63.4–82.1]) were the most frequently reported findings on computed tomography. The overall estimated proportion of severe cases and case-fatality rate (CFR) was 25.6% (17.4–34.9) and 3.6% (1.1–7.2), respectively. CFR and laboratory abnormalities were higher in severe cases, patients from Wuhan, and older patients, but CFR did not differ by gender. Conclusions The majority of COVID-19 cases are symptomatic with a moderate CFR. Patients living in Wuhan, older patients, and those with medical comorbidities tend to have more severe clinical symptoms and higher CFR.
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              Clinical and Epidemiological Characteristics of 1,420 European Patients with mild‐to‐moderate Coronavirus Disease 2019

              Jerome R. Lechien, Carlos M Chiesa-Estomba, Sammy Place … (2020)
              Abstract Background The clinical presentation of European patients with mild‐to‐moderate Covid‐19 infection is still unknown. Objective To study the clinical presentation of Covid‐19 in Europe. Methods Patients with positive diagnosis of Covid‐19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analyzing the relationship between outcomes. Results 1,420 patients completed the study (962 females, 30.7% of health care workers). The mean age of patients was 39.17±12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by on 45.4%. The mean duration of Covid‐19 symptoms of mild‐to‐moderate cured patients was 11.5±5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose, and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild‐to‐moderate Covid19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. Conclusion The clinical presentation of mild‐to‐moderate Covid‐19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild‐to‐moderate Covid‐19 that needs to be recognized as such by the WHO.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 19 June 2023
                Publication date (Electronic, collection): June 2023
                Volume: 15
                Issue: 6
                Electronic Location Identifier: e40636
                Affiliations
                [1 ] Community Medicine, Kunhitharuvai Memorial Charitable Trust (KMCT) Medical College, Kozhikode, IND
                [2 ] Pharmacology, Kunhitharuvai Memorial Charitable Trust (KMCT) Medical College, Kozhikode, IND
                Author notes
                Article
                DOI: 10.7759/cureus.40636
                PMC ID: 10355227
                SO-VID: df367c9a-76f5-4a64-a048-f522d80d686a
                Copyright © Copyright © 2023, Anupama et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 19 June 2023
                Categories
                Subject: Preventive Medicine
                Subject: Public Health
                Subject: Epidemiology/Public Health

                Keywords: sars-cov-2,india,kerala,symptoms,epidemiology,covid-19
                Data availability:
                Keywords: sars-cov-2, india, kerala, symptoms, epidemiology, covid-19

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