RESUMO
Background: Nowadays, the world is facing a coronavirus disease (COVID-19) pandemic, elicited by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the time of studying, five COVID-19 waves occurred in Iran. We aimed to evaluate the characteristics of patients with SARS-CoV-2 infection admitted to Vasei Hospital of Sabzevar, Iran during COVID-19 peaks. Methods: Clinical manifestations, laboratory findings, radiological findings, and underlying diseases of patients with COVID-19 were obtained from electronic medical records. Then, this information was compared in patients with SARS-CoV-2 infection to the peaks of COVID-19. Results: The highest and lowest respiratory involvements were observed in the third (74.6%) and fourth (38.8%) peaks, respectively. The most common radiological finding in all peaks was ground-glass opacity (28.98%), followed by consolidation, which was the highest (14.6%) in peak three. The lymphocyte count decreased in all peaks. Its highest reduction (16.12) occurred in the third peak. The SpO2 was lower than normal range in all peaks, except for the second (90.77%) and fifth (91.06%) peaks. Dyspnea (52.36%) was the most and dizziness (1.26%) and sore throat (0.6%) were the least frequent symptoms. The mortality rates were 14. 4%, 18.2%, 23%, 9.02%, and 9.4% in the first to fifth peaks, respectively. Conclusion: As different variants of the SARS-CoV-2 virus were predominant in each wave, COVID-19 patients had different features in various peaks. The fifth wave of COVID-19 had the highest number of hospitalized patients, while the first peak had the lowest number. Perhaps, the significant increase in testing capacity in the fifth wave and its long time period are the reasons for this growth. Most of the clinical symptoms were similar in all peaks, but the incidence was different. As patients hospitalized in the third peak had the highest rate of underlying disease, it can be a reason for the increase in the death rate of patients. We did not observe any significant differences in laboratory tests among the patients during different peaks. Thus, we should be vigilant in continuously studying the characteristics of the disease, and be able to modify treatments rapidly if necessary.
Antecedentes: Hoy en día, el mundo se enfrenta a una pandemia de enfermedad por coronavirus (COVID-19), provocada por el síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2). En el momento del estudio, se produjeron cinco olas de COVID-19 en Irán. Nuestro objetivo fue evaluar las características de los pacientes con infección por SARS-CoV-2 ingresados en el Hospital Vasei de Sabzevar, Irán, durante los picos de COVID-19. Métodos: Las manifestaciones clínicas, los hallazgos de laboratorio, los hallazgos radiológicos y las enfermedades subyacentes de los pacientes con COVID-19 se obtuvieron de los registros médicos electrónicos. Luego, esta información se comparó en pacientes con infección por SARS-CoV-2 a los picos de COVID-19. Resultados: Las afectaciones respiratorias más altas y más bajas se observaron en el tercer (74,6%) y cuarto (38,8%) picos, respectivamente. El hallazgo radiológico más frecuente en todos los picos fue la opacidad en vidrio esmerilado (28,98%), seguida de la consolidación, que fue la más alta (14,6%) en el pico tres. El recuento de linfocitos disminuyó en todos los picos. Su mayor reducción (16,12) se produjo en el tercer pico. La SpO2 estuvo por debajo del rango normal en todos los picos, excepto en el segundo (90,77%) y quinto (91,06%) picos. La disnea (52,36%) fue el síntoma más frecuente y el mareo (1,26%) y el dolor de garganta (0,6%) los síntomas menos frecuentes. Las tasas de mortalidad fueron 14,4%, 18,2%, 23%, 9,02% y 9,4% en los picos primero a quinto, respectivamente. Conclusión: Como en cada oleada predominaban diferentes variantes del virus SARS-CoV-2, los pacientes con COVID-19 tenían características diferentes en varios picos. La quinta ola de COVID-19 tuvo el mayor número de pacientes hospitalizados, mientras que el primer pico tuvo el número más bajo. Quizás, el aumento significativo en la capacidad de prueba en la quinta ola y su largo período de tiempo sean las razones de este crecimiento. La mayoría de los síntomas clínicos fueron similares en todos los picos, pero la incidencia fue diferente. Dado que los pacientes hospitalizados en el tercer pico tenían la tasa más alta de enfermedad subyacente, puede ser una de las razones del aumento de la tasa de mortalidad de los pacientes. No observamos diferencias significativas en las pruebas de laboratorio entre los pacientes durante los diferentes picos. Por tanto, debemos estar atentos al estudio continuo de las características de la enfermedad, y ser capaces de modificar los tratamientos rápidamente si es necesario.
RESUMO
Introduction: Novel coronavirus (COVID-19) and tuberculosis (TB) are the newest and one of the oldest global threats, respectively. In the COVID-19 era, due to the health system's focus on the COVID-19 epidemic, the national TB control program received less attention, leading to a worsening of the global TB epidemic. In this study, we will review the characteristics of TB patients coinfected with COVID-19. Material and Methods: Using Scopus, PubMed/Medline, Embase, and Web of Science databases, a systematic search was performed. Case reports and case series on TB/COVID-19 coinfection published from January 1, 2019 to February 24, 2021 were collected. There were no limitations regarding publication language. Results: Eleven case series and 20 case reports were identified from 18 countries, with the majority them being from India (N = 6) and China (N = 4). Overall, 146 patients (114 men and 32 women) coinfected with TB and COVID-19 enrolled. Smoking (15.1%), diabetes (14.4%), and hypertension (8.9%) were the most frequent comorbidities among these patients. The COVID-19 patients with TB mainly suffered fever (78.8%), cough (63.7%), and respiratory distress (22.6%). Hydroxychloroquine (64.0%) and lopinavir/ritonavir (39.5%) were the most common treatments for them. The mortality rate was 13.0% and the rate of discharged patients was 87.0%. Conclusion: Global prevalence of COVID-19-related deaths is 6.6%. Our results showed that 13.0% of patients with TB/COVID-19 died. Thus, this study indicated that coinfection of TB and COVID-19 can increase the mortality. The respiratory symptoms of TB and COVID-19 are very similar, and this causes them to be misdiagnosed. In addition, TB is sometimes diagnosed later than COVID-19 and the severity of the disease worsens, especially in patients with underlying conditions. Therefore, patients with TB should be screened regularly in the COVID-19 era to prevent the spread of the TB/COVID-19 coinfection.
