Characteristics of fever in patients with COVID-19 at presentation and after initiation of treatment

ABSTRACT

Coronavirus-19 (COVID-19) infection presents in a many ways, from asymptomatic or mild symptoms to death or serious illness. Coughing, shortness of breath, and fever are the common symptoms. Other symptoms include weakness, muscle discomfort, lethargy, sore throat, breathing problems, and loss of smell and/or taste. COVID-19 is diagnosed using clinical indicators, CT scans or chest x-rays, serological tests, and molecular diagnostics of the viral genome using reverse transcription polymerase chain reaction. This study analyzes the duration of fever, the most important symptom of the disease, and its association with other patient characteristics. The cross-sectional study was conducted in Iraq's Al-Diwaniyah Province, located in the Mid-Euphrates region. The study included 99 COVID-19 cases, 50 males and 49 females aged 16–81 years. Age, gender, white blood cell (WBC) count, lymphocyte percent, lung involvement assessed by CT scan, duration of fever at the time of presentation, and duration until the fever subsides following initiation of treatment were the main variables studied, in addition to the presence of chronic medical illnesses such as diabetes mellitus, systemic hypertension, asthma, and pulmonary tuberculosis. The mean age of all patients was 50.38 ± 16.27 years, with no significant difference between males and females (P = 0.924). There was also no significant difference in mean WBC count and lymphocyte percent between males and females (P > 0.05). Lung involvement from CT scan ranged from 0 to 80% and the mean was 26.77 ± 21.43%, with no significant difference between males and females (P = 0.770). The mean duration of fever at the time of presentation was 6.61 ± 3.60 days and it ranged from 1 to 21 days. The duration of subsiding fever ranged between 2 and 25 days in all patients with a mean of 5.82 ± 3.53 days, with no significant difference between males and females (P = 0.214). The duration needed for the fever to subside was positively and significantly correlated to the WBC count, the duration of fever at presentation, and the presence of diabetes mellitus (P < 0.05). Longer duration of fever after diagnosis and treatment of COVID-19 can be predicted with a high WBC count. Patients with diabetes having a longer duration of fever are at high risk of developing severe complications and death.