ABSTRACT
Since the start of the pandemic, the number of cases has been increased rapidly. Due to asymptomatic and mild cases and restricted testing in many geographic locations, the overall number of actual COVID-19 cases is likely significantly higher than the number of verified cases. Several COVID-19-related comorbid diseases impair immune system function, which has an impact on COVID-19 responsiveness. So, we evaluated the immune response to SARS-CoV-2 after the third wave of COVID-19 and assessed the effect of comorbid diseases on this immune response. The current cross-sectional study was conducted in August 2021 after the third wave of COVID-19. The study included 287 participants. All participants were asked about their epidemiological data, comorbid diseases, data suggesting COVID-19 infection, and precautions measures to minimize the exposure to the disease. Of the 278 participants, 50% had a positive IgG response to COVID-19. Regarding comorbid diseases, the IgG antibody titer was significantly lower in patients with chronic kidney diseases (CKD) on dialysis, ischemic heart disease, and chronic obstructive lung diseases than other participants (p= 0.01, p= 0.02, p= 0.005, respectively). Neither precaution measures nor comorbid diseases had a role in risk factors of COVID-19 infections in our participants. In conclusion, high seroprevalence (50%) of SARS-CoV-2 IgG antibody after the third wave of COVID-19 was observed in the current study. Comorbid conditions as hypertension, chronic cardiac diseases, chronic chest problems, and CKD on dialysis could decrease the immune response against COVID-19 infection. Copyright© by the Egyptian Association of Immunologists.
ABSTRACT
Introduction: The global spread of the SARS-CoV-2 virus has resulted in a worldwide pandemic with important socio-health repercussions. Current clinical experience and several published retrospective studies suggest that digestive symptoms are common in infected patients. [1][2] The aim of this study was to evaluate the frequency of gastrointestinal (GI) symptoms and complications in patients with COVID-19 disease managed on an outpatient basis. Aims & Methods: International, multicenter, prospective cohort study was conducted in 18 centers from Latin America, Asia, Africa and Europe. Subjects ≥18 years old, with COVID-19 disease, managed on an outpatient basis were included. Followed up period was 6 months. Baseline characteristics, comorbidities, GI symptoms or complications, hospital admission, ICU admission and mortality data were collected. A descriptive analysis of the study results was performed. A multivariate analysis was carried out, evaluating the association of GI symptoms and complications with age, baseline characteristics, comorbidity and COVID-19 treatments received. The adjusted Odd Ratio (ORa) was calculated assuming a significance level of p <0.05. Results: The preliminary analysis included a total of 436 patients. The median age was 35 years, interquartile range (IQR) 27-48 years. Two hundred and ten patients (48.2%) were male. The median of age-adjusted Charlson Comorbidity Index was 0 (IQR 0-1). The most frequent GI symptoms were anorexia 216 (49.5%), diarrhea 207 (47.5%), nausea 134 (30.7%), abdominal pain 122 (28%) and abdominal distension 121 (27.8%). At 4-week follow- up, symptoms resolved in most cases. Multivariate analysis showed that nausea was associated with Ivermectin treatment ORa 3.24 (95% CI 1.11-9.43) p= 0.030;abdominal pain was associated with Hydroxychloroquine treatment ORa 5.27 (95% CI 1.52-18.19) p= 0.009;diarrhea was associated with age ORa 0.966 (95% CI 0.93-0.99), p= 0.020 and Hydroxychloroquine treatment ORa 6.9 (95% CI 1.55-30.79), p= 0. 011;abdominal distension was associated with body mass index ORa 1.147 (95% CI 1.05-1.24), p< 0.001 and Hydroxychloroquine treatment ORa 7.6 (95% CI 2.00-29.51), p= 0.003. Digestive complications were infrequent (1 gastritis, 2 duodenitis, 1 jejunal ulcer, 3 hypertransaminasemia, 1 enteritis, 1 colitis). Twenty-three patients (5.3%) required hospital admission, of whom 4 (0.9%) required ICU admission and 2 (0.5%) died. Conclusion: Anorexia, diarrhea, nausea, abdominal pain and abdominal bloating were common symptoms in patients with COVID-19 disease managed on an outpatient basis. GI complications were infrequent in patients with COVID-19 who do not require hospitalization. Treatment with Hydroxychloroquine and Ivermectin was associated with more GI symptoms in COVID-19 outpatients.