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1.
Pain ; 162(12): 2832-2840, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1522382

ABSTRACT

ABSTRACT: This study investigated the association between COVID-related myalgia experienced by patients at hospital admission and the presence of post-COVID symptoms. A case-control study including patients hospitalised due to COVID-19 between February 20 and May 31, 2020, was conducted. Patients reporting myalgia and patients without myalgia at hospital admission were scheduled for a telephone interview 7 months after hospital discharge. Hospitalisation and clinical data were collected from medical records. A list of post-COVID symptoms with attention to musculoskeletal pain was evaluated. Anxiety and depressive symptoms, and sleep quality were likewise assessed. From a total of 1200 hospitalised patients with COVID-19, 369 with and 369 without myalgia at hospital admission were assessed 7.2 months (SD 0.6) after hospital discharge. A greater proportion (P = 0.03) of patients with myalgia at hospital admission (20%) showed ≥3 post-COVID symptoms when compared with individuals without myalgia (13%). A higher proportion of patients presenting myalgia (odds Rratio 1.41, 95% confidence interval 1.04-1.90) exhibited musculoskeletal post-COVID pain when compared to those without myalgia. The prevalence of musculoskeletal post-COVID pain in the total sample was 38%. Fifty percent of individuals with preexisting musculoskeletal pain experienced a worsening of their symptoms after COVID-19. No differences in fatigue, dyspnoea, anxiety/depressive levels, or sleep quality were observed between myalgia and nonmyalgia groups. The presence of myalgia at hospital admission was associated with preexisting history of musculoskeletal pain (OR 1.62, 95% confidence interval 1.10-2.40). In conclusion, myalgia at the acute phase was associated with musculoskeletal pain as long-term post-COVID sequelae. In addition, half of the patients with preexisting pain conditions experienced a persistent exacerbation of their previous syndromes.


Subject(s)
COVID-19 , Musculoskeletal Pain , Case-Control Studies , Hospitalization , Hospitals , Humans , Musculoskeletal Pain/epidemiology , Myalgia/epidemiology , Myalgia/etiology , SARS-CoV-2
3.
J Korean Med Sci ; 36(27): e196, 2021 Jul 12.
Article in English | MEDLINE | ID: covidwho-1308263

ABSTRACT

BACKGROUND: This is an observational study to analyze an emergency department (ED) utilization pattern of coronavirus disease 2019 (COVID-19) vaccinated in-hospital healthcare workers (HCWs). METHODS: We included 4,703 HCWs who were administered the first dose of the COVID-19 vaccine between March 4 and April 2, 2021, in a tertiary hospital in Korea where fast-track and post-vaccination cohort zone (PVCZ) were introduced in ED. We analyzed data of participants' age, sex, occupation, date and type of vaccination, and their clinical information using SPSS v25.0. RESULTS: The sample comprised HCWs, who received either the ChAdOx1 (n = 4,458) or the BNT162B2 (n = 245) vaccines; most participants were female (73.5%), and 81.1% were under 50 years old. Further, 153 (3.3%) visited the ED and reported experiencing fever (66.9%) and myalgia (56.1%). Additionally, 91 (59.5%) of them were in their 20s, and 106 (67.5%) were assigned to the PVCZ. Lastly, 107 (68.2%) of the patients received parenteral management. No patient required hospitalization. CONCLUSION: In conclusion, vaccinated HCWs who visited the ED with adverse events had a high incidence of fever and a low likelihood of developing serious illnesses. As the COVID-19 vaccination program for Korean citizens continues to expand, strategies to minimize unnecessary ED overcrowding should be put into effect.


Subject(s)
COVID-19 Vaccines/adverse effects , Emergency Service, Hospital/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Personnel, Hospital/statistics & numerical data , Vaccination/adverse effects , Adult , Antiemetics/therapeutic use , Antipyretics/therapeutic use , COVID-19 Testing/statistics & numerical data , Chills/chemically induced , Chills/epidemiology , Clinical Protocols , Emergency Service, Hospital/organization & administration , Female , Fever/chemically induced , Fever/drug therapy , Fever/epidemiology , Headache/chemically induced , Headache/epidemiology , Humans , Male , Middle Aged , Myalgia/chemically induced , Myalgia/epidemiology , Nausea/chemically induced , Nausea/drug therapy , Nausea/epidemiology , Patient Readmission/statistics & numerical data , Republic of Korea , Retrospective Studies , Software Design , Tertiary Care Centers/statistics & numerical data , Triage , Young Adult
4.
Infect Dis Now ; 51(6): 556-559, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1230513

ABSTRACT

A broad-based SARS-CoV-2 testing program for all symptomatic healthcare workers (HCWs) was implemented in Tenon hospital, Paris, France. From February 26 to April 22, 2020, 701 symptomatic HCWs were screened, of whom 247 (35.2%) tested positive for SARS-Cov-2. Myalgia, fever, anosmia and ageusia were associated with RT-PCR positivity. Testing of HCWs is an essential step toward control of the epidemic. Further studies could establish clinical algorithms for SARS-CoV-2 diagnosis to compensate for RT-PCR test and chest CT limits or unavailability.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Health Personnel , Hospitals , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Ageusia/epidemiology , Anosmia/epidemiology , COVID-19/epidemiology , Female , Fever/epidemiology , France , Humans , Infection Control/methods , Male , Middle Aged , Myalgia/epidemiology , Paris , Primary Health Care , Risk Factors , Young Adult
5.
Acta Myol ; 40(1): 1-7, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1191085

ABSTRACT

Objective: To investigate both muscular manifestations and CK levels in a large cohort of patients with COVID-19 infection and to determine whether hyperckemia is associated with morbidity and mortality. Methods: Data of 615 patients discharged from ASST Ovest Milanese (Milan, Lombardy, Italy) with final diagnosis of COVID-19 infection were retrospectively extracted from electronical medical records from 21 February to 1 May 2020. Patients were descriptively analyzed with respect to the following variables: sex, age, muscular manifestations (myalgia and/or arthralgia), fatigue, respiratory involvement (SARS pneumonia or respiratory failure) and history of falls. Association between patients' characteristics and CK levels was investigated. In addition, the proportion of patients who died following access to the ER was calculated. Finally, the effect of CK levels and other patients' features on mortality was estimated using a logistic regression model. Results: 176 (28.6%) patients had raised serum CK levels. CK levels were significantly associated with history of falls, male gender, SARS pneumonia, respiratory failure and in-hospital death. No correlation was found between hyperckemia and muscular manifestations. Conclusions: Our study provides preliminary evidence that hyperckemia is associated with respiratory failure and fatal outcome in patients with COVID-19 infection.In these patients, among other testing, CK dosage is recommended.


Subject(s)
Arthralgia/blood , COVID-19/complications , COVID-19/mortality , Creatine Kinase/blood , Hyperkalemia/blood , Hyperkalemia/mortality , Myalgia/blood , Aged , Arthralgia/epidemiology , Biomarkers/blood , COVID-19/epidemiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Myalgia/epidemiology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/mortality , Retrospective Studies , SARS-CoV-2
6.
J Intern Med ; 290(2): 421-429, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1140273

ABSTRACT

OBJECTIVE: To investigate the clinical features of patients who had two demonstrated coronavirus disease 2019 (COVID-19) episodes. METHODS: Data of patients with both COVID-19 episodes were recruited from 22 March to 27 December 2020. The following outcomes were studied: epidemiological, comorbidities, prevalence and severity of general and otolaryngological symptom, olfactory, aroma, and gustatory dysfunctions. A comparison between first and second episodes was performed. RESULTS: Forty-five patients reported having two confirmed COVID-19 episodes. The majority of patients had mild infections in both episodes. The second clinical episode was significantly similar to the first. The symptom duration of the second episode was shorter than the first. The occurrence of loss of smell was unpredictable from the first to the second episode. CONCLUSION: The recurrence of COVID-19 symptoms is associated with a similar clinical picture than the first episode in patients with initial mild-to-moderate COVID episode. The pathophysiological mechanisms underlying the development of second episode remain uncertain and may involve either true reinfection or virus reactivation from sanctuaries.


Subject(s)
COVID-19/epidemiology , Reinfection/epidemiology , Adult , Asthenia/epidemiology , Comorbidity , Dyspnea/epidemiology , Europe/epidemiology , Female , Fever/epidemiology , Headache/epidemiology , Hospitalization/statistics & numerical data , Humans , Immunoglobulin G/blood , Male , Myalgia/epidemiology , Olfaction Disorders/epidemiology , Severity of Illness Index , Taste Disorders/epidemiology
7.
Med Sci Monit ; 27: e930447, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1134483

ABSTRACT

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.


Subject(s)
COVID-19/complications , Cost of Illness , Medically Unexplained Symptoms , Myalgia/epidemiology , Sleep Wake Disorders/epidemiology , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Myalgia/diagnosis , Myalgia/etiology , Myalgia/physiopathology , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Prognosis , Prospective Studies , Quarantine/statistics & numerical data , Risk Assessment/statistics & numerical data , SARS-CoV-2/isolation & purification , Self Report/statistics & numerical data , Severity of Illness Index , Sleep/physiology , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology
8.
Emerg Infect Dis ; 27(2): 385-395, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1076427

ABSTRACT

To improve recognition of coronavirus disease (COVID-19) and inform clinical and public health guidance, we randomly selected 600 COVID-19 case-patients in Colorado. A telephone questionnaire captured symptoms experienced, when symptoms occurred, and how long each lasted. Among 128 hospitalized patients, commonly reported symptoms included fever (84%), fatigue (83%), cough (73%), and dyspnea (72%). Among 236 nonhospitalized patients, commonly reported symptoms included fatigue (90%), fever (83%), cough (83%), and myalgia (74%). The most commonly reported initial symptoms were cough (21%-25%) and fever (20%-25%). In multivariable analysis, vomiting, dyspnea, altered mental status, dehydration, and wheezing were significantly associated with hospitalization, whereas rhinorrhea, headache, sore throat, and anosmia or ageusia were significantly associated with nonhospitalization. General symptoms and upper respiratory symptoms occurred earlier in disease, and anosmia, ageusia, lower respiratory symptoms, and gastrointestinal symptoms occurred later. Symptoms should be considered alongside other epidemiologic factors in clinical and public health decisions regarding potential COVID-19 cases.


Subject(s)
COVID-19/complications , COVID-19/epidemiology , Inpatients/statistics & numerical data , Outpatients/statistics & numerical data , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/virology , Child , Child, Preschool , Colorado/epidemiology , Cough/epidemiology , Cough/virology , Disease Progression , Dyspnea/epidemiology , Dyspnea/virology , Fatigue/epidemiology , Fatigue/virology , Female , Fever/epidemiology , Fever/virology , Humans , Infant , Male , Middle Aged , Myalgia/epidemiology , Myalgia/virology , Symptom Assessment , Young Adult
9.
Iran J Allergy Asthma Immunol ; 19(6): 570-588, 2020 Dec 19.
Article in English | MEDLINE | ID: covidwho-1068115

ABSTRACT

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: ("novel coronavirus" Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.


Subject(s)
COVID-19/physiopathology , Conjunctivitis/physiopathology , Exanthema/physiopathology , Fever/physiopathology , Gastrointestinal Diseases/physiopathology , Shock/physiopathology , Systemic Inflammatory Response Syndrome/physiopathology , Abdominal Pain/physiopathology , Acute Kidney Injury/physiopathology , COVID-19/epidemiology , COVID-19/therapy , Cheilitis/physiopathology , Cough/physiopathology , Diarrhea/physiopathology , Dyspnea/physiopathology , Headache/physiopathology , Humans , Meningism/physiopathology , Myalgia/epidemiology , Prognosis , Respiration, Artificial , Sex Distribution , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/therapy , Vomiting/physiopathology
10.
J Neurol Sci ; 423: 117283, 2021 04 15.
Article in English | MEDLINE | ID: covidwho-988477

ABSTRACT

OBJECTIVE: We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry. METHODS: We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms. RESULTS: A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed (n = 51), but positive results for SARS-CoV-2 were only found in one case. CONCLUSIONS: The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.


Subject(s)
COVID-19/complications , Nervous System Diseases/etiology , SARS-CoV-2 , Adult , Aged , Anosmia/epidemiology , Anosmia/etiology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Cardiovascular Diseases/epidemiology , Causality , Comorbidity , Diabetes Mellitus/epidemiology , Female , Headache/epidemiology , Headache/etiology , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/etiology , Middle Aged , Myalgia/epidemiology , Myalgia/etiology , Nervous System Diseases/cerebrospinal fluid , Nervous System Diseases/diagnostic imaging , Nervous System Diseases/epidemiology , Neuroimaging , Neurologic Examination , Neuromuscular Diseases/epidemiology , Neuromuscular Diseases/etiology , Registries , SARS-CoV-2/pathogenicity , Spain/epidemiology , Stroke/epidemiology , Stroke/etiology , Treatment Outcome , Virulence
11.
Brain Behav Immun ; 88: 11-16, 2020 08.
Article in English | MEDLINE | ID: covidwho-935435

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) represents a novel pneumonia leading to severe acute respiratory syndrome (SARS). Recent studies documented that SARS-Coronavirus2 (SARS-CoV2), responsible for COVID-19, can affect the nervous system. The aim of the present observational study was to prospectively assess subjective neurological symptoms (sNS) in patients with SARS-CoV2 infection. METHODS: We included patients hospitalized at the University Hospital of Rome "Tor Vergata", medical center dedicated to the treatment of patients with COVID-19 diagnosis, who underwent an anamnestic interview about sNS consisting of 13 items, each related to a specific symptom, requiring a dichotomized answer. RESULTS: We included 103 patients with SARS-CoV2 infection. Ninety-four patients (91.3%) reported at least one sNS. Sleep impairment was the most frequent symptom, followed by dysgeusia, headache, hyposmia, and depression. Women more frequently complained hyposmia, dysgeusia, dizziness, numbeness/paresthesias, daytime sleepiness, and muscle ache. Moreover, muscle ache and daytime sleepiness were more frequent in the first 2 days after admission. Conversely, sleep impairment was more frequent in patients with more than 7 days of hospitalization. In these patients we also documented higher white blood cells and lower C-reactive protein levels. These laboratory findings correlated with the occurrence of hyposmia, dysgeusia, headache, daytime sleepiness, and depression. CONCLUSIONS: Patients with SARS-CoV2 infection frequently present with sNS. These symptoms are present from the early phases of the disease. The possibly intrinsic neurotropic properties of SARS-CoV2 may justify the very high frequency of sNS. Further studies targeted at investigating the consequences of SARS-CoV2 infection on the CNS should be planned.


Subject(s)
Coronavirus Infections/physiopathology , Depression/physiopathology , Dysgeusia/physiopathology , Headache/physiopathology , Olfaction Disorders/physiopathology , Pneumonia, Viral/physiopathology , Sleepiness , Adult , Aged , Betacoronavirus , C-Reactive Protein/immunology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Depression/epidemiology , Dizziness/epidemiology , Dizziness/physiopathology , Dysgeusia/epidemiology , Female , Headache/epidemiology , Hospitalization , Humans , Hypesthesia/epidemiology , Hypesthesia/physiopathology , Italy/epidemiology , Leukocyte Count , Male , Middle Aged , Myalgia/epidemiology , Myalgia/physiopathology , Olfaction Disorders/epidemiology , Pandemics , Paresthesia/epidemiology , Paresthesia/physiopathology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , SARS-CoV-2 , Sex Distribution , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/physiopathology
12.
Neurol Sci ; 42(1): 39-46, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-928489

ABSTRACT

BACKGROUND: A wide range of neurological manifestations has been described in COVID-19. METHODS: In this nationwide retrospective observational study, patients in Tunisia diagnosed with COVID-19 between the 2nd of March and the 16th of May 2020 were contacted by telephone. We collected demographic and clinical data and specified characteristics and evolution of main neurological symptoms. RESULTS: Of 1034 confirmed COVID-19 patients, 646 were included (mean age 42.17 years old) and 466 (72.1%) had neurological symptoms. Neurological symptoms were isolated 22.7% (n = 106). Headache was the most frequent neurological symptom (n = 279, 41.1%): mainly frontotemporal (n = 143, 51.1%) and mild or moderate (n = 165, 59.1%). When associated with fever (n = 143, 51.3%), headache was more likely to be severe and present at onset. Recovery was reported in 83.2%. Smell and taste impairment were found in 37.9% (n = 245) and 36.8% (n = 238) respectively. Among them, 65.3% (156/239) were anosmic and 63.2% (146/231) were ageusic. A complete improvement was found in 72.1% (174/240) of smell impairment and in 76.8% (179/233) of taste impairment. Myalgia (n = 241, 37.3%) and sleep disturbances (n = 241, 37.3%) were also frequent. Imported cases had more neurological symptoms (p = 0.001). In 14.5%, neurological symptoms preceded the respiratory signs (RS). RS were associated with more frequent (p = 0.006) and numerous (p < 0.001) neurological symptoms. CONCLUSIONS: Neurological symptoms in COVID-19 are frequent, can be isolated and present at onset. A total recovery is the most recorded outcome. RS are predictive of neurological symptoms. Studies in to virus and host genetics should be considered to understand the different phenotypes.


Subject(s)
Ageusia/etiology , COVID-19/complications , Headache/etiology , Myalgia/etiology , Olfaction Disorders/etiology , Sleep Wake Disorders/etiology , Adult , Aged , Ageusia/epidemiology , Ageusia/physiopathology , COVID-19/epidemiology , Female , Headache/epidemiology , Headache/physiopathology , Humans , Male , Middle Aged , Myalgia/epidemiology , Olfaction Disorders/epidemiology , Olfaction Disorders/physiopathology , Retrospective Studies , Sleep Wake Disorders/epidemiology , Tunisia/epidemiology , Young Adult
13.
Sci Rep ; 10(1): 16496, 2020 10 05.
Article in English | MEDLINE | ID: covidwho-834909

ABSTRACT

This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992-0.998]) and hemoglobin (OR 0.984, 95% CI [0.972-0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1-4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.


Subject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Coronavirus Infections/blood , Pneumonia, Viral/blood , Adult , Age Factors , Aged , Biomarkers/blood , COVID-19 , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Fatigue/epidemiology , Female , Hemoglobins/analysis , Humans , Male , Middle Aged , Myalgia/epidemiology , Pandemics , Patient Admission/statistics & numerical data , Platelet Count , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Survival Analysis
14.
J Korean Med Sci ; 35(37): e333, 2020 Sep 21.
Article in English | MEDLINE | ID: covidwho-789268

ABSTRACT

BACKGROUND: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. METHODS: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. RESULTS: Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days). CONCLUSION: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.


Subject(s)
Asymptomatic Infections/epidemiology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adult , Aged , Betacoronavirus , COVID-19 , Comorbidity , Cough/epidemiology , Diarrhea/epidemiology , Female , Fever/epidemiology , Hospitalization , Humans , Korea/epidemiology , Male , Middle Aged , Myalgia/epidemiology , Pandemics , Prevalence , Real-Time Polymerase Chain Reaction , Retrospective Studies , SARS-CoV-2 , Symptom Assessment , Treatment Outcome
15.
Scott Med J ; 65(4): 127-132, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-719517

ABSTRACT

BACKGROUND: The first case of a novel coronavirus (COVID-19) infection was detected in Wuhan, fever and respiratory symptoms have been frequently reported in patients infected with this virus. AIM: It was aimed to compare the symptoms of patients with COVID-19 positivity and patients without COVID-19 positivity hospitalized with suspicion of COVID-19. METHODS: Patients presenting to the Sakarya University Training and Research Hospital with suspicion of COVID-19 were included in the study. Samples were obtained from the patients and PCR tests were performed; the patients were grouped as COVID-19 positive and COVID-19 negative; these two groups were questioned for 15 symptoms and the results were compared. RESULTS: A total of 297 patients with suspicion of COVID-19 were included in the study. COVID-19 was positive in 143 patients and negative in 154 patients. The most common symptoms in the COVID-19 positive group were: cough (56.6%), weakness (56.6%), taste disorder (35.7%), myalgia (34.3%), and fever (33.6%); and in the COVID-19 negative group: cough (63%), weakness (45.5%), dyspnea (29.9%), headache (27.3%) and fever (24.7%). When these two groups were compared, taste disorder, smell disorder and diarrhea were significantly higher in the COVID-19 positive group (p = <0,00001, p = 0,00001 and p = 0,02). CONCLUSION: Our study showed that taste and smell disorders and diarrhea were important markers in COVID-19 infection.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/therapy , Cough/epidemiology , Cough/virology , Diarrhea/epidemiology , Diarrhea/virology , Female , Fever/epidemiology , Fever/virology , Hospitalization , Humans , Male , Middle Aged , Muscle Weakness/epidemiology , Muscle Weakness/virology , Myalgia/epidemiology , Myalgia/virology , Olfaction Disorders/epidemiology , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral/therapy , Retrospective Studies , SARS-CoV-2 , Symptom Assessment , Taste Disorders/epidemiology , Taste Disorders/virology , Turkey
16.
Neurol Sci ; 41(8): 2029-2031, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-621530

ABSTRACT

INTRODUCTION: Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK). METHODS: We consecutively enrolled hospitalized COVID-19 patients. A structured questionnaire concerning typical and neurological symptoms, focusing on headache, dizziness, ODs, taste disorders (TDs), and muscle pain, was administrated by telephone interviews. RESULTS: Common neurological symptoms were reported in the early phase of the disease, with a median onset ranging from 1 to 3 days. Headache showed tension-type features and was more frequently associated with a history of headache. Patients with ODs less frequently needed oxygen therapy. Inflammatory indices did not significantly differ between patients with and without ODs. Muscle pain did not show any association with CK level but was more frequently associated with arthralgia and headache. CONCLUSION: In our cohort, ODs were an early symptom of COVID-19, more frequently reported by patients with milder forms of disease. Headache in association with arthralgia and muscle pain seems to reflect the common symptoms of the flu-like syndrome, and not COVID-19 infection-specific.


Subject(s)
Coronavirus Infections/complications , Headache/virology , Myalgia/virology , Olfaction Disorders/virology , Pneumonia, Viral/complications , Taste Disorders/virology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Creatine Kinase/blood , Female , Headache/epidemiology , Humans , Male , Middle Aged , Myalgia/epidemiology , Olfaction Disorders/epidemiology , Pandemics , Prevalence , Surveys and Questionnaires , Taste Disorders/epidemiology , Young Adult
17.
J Intern Med ; 288(3): 335-344, 2020 09.
Article in English | MEDLINE | ID: covidwho-618315

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 analysing the relationship between outcomes. RESULTS: A total of 1,420 patients completed the study (962 females, 30.7% of healthcare 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 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 COVID-19 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.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Headache/epidemiology , Olfaction Disorders/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Taste Disorders/epidemiology , Adult , Age Factors , Bayes Theorem , COVID-19 , Coronavirus Infections/enzymology , Europe , Female , Humans , Male , Middle Aged , Myalgia/epidemiology , Pandemics , Pneumonia, Viral/enzymology , Prevalence , SARS-CoV-2 , Sex Factors , Symptom Assessment
18.
J Neurovirol ; 26(2): 143-148, 2020 04.
Article in English | MEDLINE | ID: covidwho-343416

ABSTRACT

A pandemic due to novel coronavirus arose in mid-December 2019 in Wuhan, China, and in 3 months' time swept the world. The disease has been referred to as COVID-19, and the causative agent has been labelled SARS-CoV-2 due to its genetic similarities to the virus (SARS-CoV-1) responsible for the severe acute respiratory syndrome (SARS) epidemic nearly 20 years earlier. The spike proteins of both viruses dictate tissue tropism using the angiotensin-converting enzyme type 2 (ACE-2) receptor to bind to cells. The ACE-2 receptor can be found in nervous system tissue and endothelial cells among the tissues of many other organs.Neurological complications have been observed with COVID-19. Myalgia and headache are relatively common, but serious neurological disease appears to be rare. No part of the neuraxis is spared. The neurological disorders occurring with COVID-19 may have many pathophysiological underpinnings. Some appear to be the consequence of direct viral invasion of the nervous system tissue, others arise as a postviral autoimmune process, and still others are the result of metabolic and systemic complications due to the associated critical illness. This review addresses the preliminary observations regarding the neurological disorders reported with COVID-19 to date and describes some of the disorders that are anticipated from prior experience with similar coronaviruses.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Encephalitis, Viral/epidemiology , Meningitis/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Stroke/epidemiology , Angiotensin-Converting Enzyme 2 , Betacoronavirus/genetics , Betacoronavirus/metabolism , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Encephalitis, Viral/complications , Encephalitis, Viral/diagnosis , Encephalitis, Viral/virology , Headache/complications , Headache/diagnosis , Headache/epidemiology , Headache/virology , Host-Pathogen Interactions/genetics , Humans , Meningitis/complications , Meningitis/diagnosis , Meningitis/virology , Myalgia/complications , Myalgia/diagnosis , Myalgia/epidemiology , Myalgia/virology , Myositis/complications , Myositis/diagnosis , Myositis/epidemiology , Myositis/virology , Nervous System/pathology , Nervous System/virology , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Protein Binding , Receptors, Virus/genetics , Receptors, Virus/metabolism , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism , Stroke/complications , Stroke/diagnosis , Stroke/virology , Virus Internalization
19.
Clin Res Hepatol Gastroenterol ; 44(3): 282-283, 2020 06.
Article in English | MEDLINE | ID: covidwho-125349

ABSTRACT

In a retrospective study in the Nord Franche-Comté hospital conducted between March 1st and March 17th 2020, and compared to the review of Li et al., diarrhea was a main symptom in patients with COVID-19. Out of the 114 patients, 55 (48%) had diarrhea; it was the fifth most common symptom. In the group of patients with diarrhea, the median age was 56 years (±18) and 32 (58%) were female. Only 2 patients (3.6%) had a past history of inflammatory bowel disease. Fifty-six percent of patients (n=30/54) were hospitalised. Diarrhea appeared 4.5 days (±1.8) after the onset of the first other symptoms in COVID-19. Of the 55 patients with diarrhea, 29 (52.7%) had at least one simultaneous gastrointestinal (GI) symptom other than diarrhea. Twenty-five patients (45.5%) had nausea, 19 patients (34.5%) had abdominal pain and 9 (16.3%) had vomiting. Myalgia, sore throat, sneezing and the other GI symptoms were statistically more frequent in the group with diarrhea than in the group without diarrhea (P<0.05).


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Diarrhea/etiology , Pneumonia, Viral/complications , Abdominal Pain/epidemiology , COVID-19 , Coronavirus Infections/diagnosis , Diarrhea/epidemiology , Female , Gastrointestinal Diseases/epidemiology , Humans , Male , Middle Aged , Myalgia/epidemiology , Nausea/epidemiology , Pandemics , Pneumonia, Viral/diagnosis , Retrospective Studies , SARS-CoV-2 , Sex Distribution , Symptom Assessment , Vomiting/epidemiology
20.
Eur Arch Otorhinolaryngol ; 277(8): 2251-2261, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-34916

ABSTRACT

OBJECTIVE: To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. METHODS: Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). RESULTS: A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). CONCLUSION: Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.


Subject(s)
Ageusia/etiology , Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Cough/etiology , Myalgia/etiology , Olfaction Disorders/etiology , Pneumonia, Viral/diagnosis , Smell , Taste , Adult , Ageusia/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Cough/epidemiology , Europe/epidemiology , Female , Humans , Male , Middle Aged , Myalgia/epidemiology , Nutrition Surveys , Olfaction Disorders/epidemiology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Prevalence , SARS-CoV-2 , Taste Disorders
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