Corpus overview


Overview

MeSH Disease

Fatigue (35)

Fever (24)

Dyspnea (15)

Infections (14)

Myalgia (12)


Human Phenotype

Fatigue (37)

Cough (27)

Fever (25)

Myalgia (12)

Dyspnea (11)


Transmission

Seroprevalence
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    Lower Rate of COVID-19 in Lupus Patients Receiving Immunosuppressive Drug Regimens

    Authors: Mohammadrafi Damirchi; Gholamreza Roshandel; Mehrdad Aghaie; Sima Sedighi; Mohammadjavad Hassani; Nafiseh Abdolahi

    doi:10.21203/rs.3.rs-78704/v1 Date: 2020-09-16 Source: ResearchSquare

    Introduction Recently, due to the COVID-19 pandemic much concern has been raised about chronic diseases, which could possibly make patients more susceptible, and vulnerable to COVID-19. One of them, is Systemic Lupus Erythematosus HP Systemic Lupus Erythematosus MESHD( SLE MESHD). Objective This study has tried to find the prevalence SERO of COVID-19 in SLE MESHD patients in Golestan province of Iran, and to characterize the clinical course of COVID-19 in these patients. This study has also sought to find possible correlation between the incidence of COVID-19, its clinical manifestations and the medication taken by SLE MESHD patients. Methods We investigated patients who had been enrolled in our rheumatologic diseases MESHD registry system. Patients responded to a questionnaire which contained questions about their primary disease, comorbidities, medications, development of new symptoms, and medical services which they received, pertinent to COVID-19, during the period of COVID-19 outbreak. The data were analyzed using SPSS 16 software. Results This investigation found 25 (7%) COVID-19 positive patients out of the 355 responders. 8 (40%) of them were hospitalized, out of which 2 (8%) required intensive care and later expired. COVID-19 incidence was significantly lower in the immunosuppressed group (2.2% vs 10% P-value 0.005). We didn’t find a significant correlation between hydroxychloroquine consumption, and the incidence of COVID-19 in SLE MESHD patients. Fever HP Fever MESHD, fatigue HP fatigue MESHD, dyspnea HP dyspnea MESHD, and dry cough MESHD cough HP were the most common clinical symptoms.Conclusion Our research has shown that COVID-19 prevalence SERO was lower in immunosuppressed patients. However, broader studies should be conducted to clarify the role of immunosuppression in the development of COVID-19. More research is required.

    Seroprevalence SERO of SARS-CoV-2 antibodies SERO in children TRANS - A prospective multicentre cohort study.

    Authors: Thomas Waterfield; Chris Watson; Rebecca Moore; Kathryn Ferris; Claire Tonry; Alison P Watt; Claire McGinn; Steven Foster; Jennifer Evans; Mark D Lyttle; Shazaad Ahmad; Shamez Ladhani; Michael Corr; Lisa McFetridge; Hannah Mitchell; Kevin Brown; Gayatric Amirthalingam; Julie-Ann Maney; Sharon Christie; Angela Afonso; Marc Veldhoen; Matthew Harnett; Melody Eaton; Sandra Hatem; Hajra Jamal; Alara Akyatan; Alexandra Tabachnikova; Lora E. Liharska; Liam Cotter; Brian Fennessey; Akhil Vaid; Guillermo Barturen; Scott R. Tyler; Hardik Shah; Yinh-chih Wang; Shwetha Hara Sridhar; Juan Soto; Swaroop Bose; Kent Madrid; Ethan Ellis; Elyze Merzier; Konstantinos Vlachos; Nataly Fishman; Manying Tin; Melissa Smith; Hui Xie; Manishkumar Patel; Kimberly Argueta; Jocelyn Harris; Neha Karekar; Craig Batchelor; Jose Lacunza; Mahlet Yishak; Kevin Tuballes; Leisha Scott; Arvind Kumar; Suraj Jaladanki; Ryan Thompson; Evan Clark; Bojan Losic; - The Mount Sinai COVID-19 Biobank Team; Jun Zhu; Wenhui Wang; Andrew Kasarskis; Benjamin S. Glicksberg; Girish Nadkarni; Dusan Bogunovic; Cordelia Elaiho; Sandeep Gangadharan; George Ofori-Amanfo; Kasey Alesso-Carra; Kenan Onel; Karen M. Wilson; Carmen Argmann; Marta E. Alarcón-Riquelme; Thomas U. Marron; Adeeb Rahman; Seunghee Kim-Schulze; Sacha Gnjatic; Bruce D. Gelb; Miriam Merad; Robert Sebra; Eric E. Schadt; Alexander W. Charney

    doi:10.1101/2020.08.31.20183095 Date: 2020-09-02 Source: medRxiv

    Background Studies based on molecular testing of oral/nasal swabs underestimate SARS-CoV-2 infection MESHD due to issues with test sensitivity SERO and timing of testing. The objective of this study was to report the presence of SARS-CoV-2 antibodies SERO, consistent with previous infection MESHD, and to report the symptomatology of infection MESHD in children TRANS. Design This multicentre observational cohort study, conducted between 16th April - 3rd July 2020 at 5 UK sites, aimed to recruit 900 children TRANS aged TRANS 2 to 15 years of age TRANS. Participants provided blood SERO samples for SARS-CoV-2 antibody SERO testing and data were gathered regarding unwell contacts and symptoms. Results 1007 participants were enrolled, and 992 were included in the final analysis. The median age TRANS of participants was 10.1 years. There were 68 (6.9%) participants with positive SARS-CoV-2 antibody SERO tests indicative of previous SARS-CoV-2 infection MESHD. Of these, 34/68 (50%) reported no symptoms. The presence of antibodies SERO and the mean antibody SERO titre was not influenced by age TRANS. Following multivariate analysis 4 independent variables were identified as significantly associated with SARS-CoV-2 infection MESHD. These were: known infected household contact TRANS; fatigue HP fatigue MESHD; gastrointestinal symptoms; and changes in sense of smell or taste. Discussion In this study children TRANS demonstrated similar antibody SERO titres in response to SARS-CoV-2 irrespective of age TRANS. The symptoms of SARS-CoV-2 infection MESHD in children TRANS were subtle but of those reported, fatigue HP fatigue MESHD, gastrointestinal symptoms MESHD and changes in sense of smell or taste were most strongly associated with antibody SERO positivity. Registration This study was registered at https://www.clinicaltrials.gov (trial registration: NCT04347408) on the 15/04/2020.

    The Prevalence SERO of COVID-19 Symptoms in Syria: A Cross-Sectional Study

    Authors: MHD Bahaa Aldin Alhaffar; Ghadir Abbas; Jihad Abou Nassar

    doi:10.21203/rs.3.rs-64941/v1 Date: 2020-08-24 Source: ResearchSquare

    Introduction: The corona virus disease 2019 is a disease caused by the newly discovered human infecting SARS-Co V-2 virus. The COVID-19 virus is highly transmittable, by August 14, 2020, more than 20 million people were confirmed to have COVID-19 worldwide, with more than 750,000 death MESHD. Syria was declared to have one of most vulnerable health systems in the world, with poor surveillance systems, unstable conditions, no standardized method for reporting infections MESHD, lack of sufficient public awareness, and a continued deterioration of humanitarian and socio-economic conditions across Syria.Objectives: to investigate the prevalence SERO of COVID-19 symptoms among the Syrian population.Methods: this is a cross sectional study in Damascus – Syria, data were collected during August, 2020 using an online questionnaire that contained 3 section (demographic variables, awareness of COVID-19, symptoms of COVID-19) and analyzed using SPSS v.22.Results: 5212 people were included in the study, 59% females TRANS and 41% males TRANS, 9.6% had chronic medical conditions. 63.4% reported experiencing COVID-19 symptoms during the past 6 months, symptoms lasted 6.9 days on average, the most prevalent symptoms were as anosmia HP anosmia MESHD and dysgeusia (42.2%), headache HP headache MESHD (67.1%), fatigue HP fatigue MESHD (70%). Symptoms were significantly more prevalent in the past 14 days (P=0.000).Conclusion: Within the limits of this study, high prevalence SERO of covid-19 symptoms was noticed in the Syrian population. Significant correlation was made between the severity and duration of the symptoms. Measures to slow down spread of COVID-19 need to be taken immediately.

    Prevalence SERO and correlation of symptoms and comorbidities in COVID-19 patients: A systematic review and meta-analysis

    Authors: Mohammad Meshbahur Rahman; Badhan Bhattacharjee; Zaki Farhana; Mohammad Hamiduzzaman; Muhammad Abdul Bake Chowdhury; Mohammad Sorowar Hossain; Mahbubul H Siddiqee; Md. Ziaul Islam; Enayetur Raheem; Md. Jamal Uddin

    doi:10.1101/2020.08.19.20177980 Date: 2020-08-22 Source: medRxiv

    Background: The COVID-19 affected millions of people, and the patients present a constellation of symptoms and comorbidities. We aimed to chronicle the prevalence SERO and correlations of symptoms and comorbidities, and associated covariates among the patients. Methods: We performed a systematic review and meta-analysis [PROSPERO registration: CRD42020182677]. Databases [PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer] were searched for clinical studies published in English from January 1 to April 20, 2020. The pooled prevalence SERO of symptoms and comorbidities were identified using the random effect model, and sub-groups analysis of patients age TRANS and locations were investigated. A multivariable factor analysis was also performed to show the correlation among symptoms, comorbidities and age TRANS of the COVID-19 patients. Findings: Twenty-nine articles [China (24); Outside of China (5)], with 4,884 COVID-19 patients were included in this systematic review. The meta-analysis investigated 33 symptoms, where fever HP fever MESHD [84%], cough HP cough MESHD/dry cough HP [61%], and fatigue HP fatigue MESHD/weakness [42%] were found frequent. Out of 43 comorbidities investigated, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) [61%] was a common condition, followed by hypertension HP hypertension MESHD [23%] and diabetes MESHD [12%]. According to the patients age TRANS, the prevalence SERO of symptoms like fatigue HP fatigue MESHD/weakness, dyspnea HP dyspnea MESHD/shortness of breath, and anorexia HP anorexia MESHD were highly prevalent in older adults TRANS [[≥]50 years] than younger adults TRANS [<50 years]. Diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and COPD MESHD/ lung disease MESHD were more prevalent comorbidities in older adults TRANS than younger adults TRANS. The patients from outside of China had significantly higher prevalence SERO [p<0.005] of diarrhea HP diarrhea MESHD, fatigue HP fatigue MESHD, nausea HP nausea MESHD, sore throat, and dyspnea HP dyspnea MESHD, and the prevalent comorbidities in that region were diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and ARDS MESHD. The multivariable factor analysis showed positive association between a group of symptoms and comorbidities, and with the patients age TRANS. Interpretation: Epitomizing the correlation of symptoms of COVID-19 with comorbidities and patients age TRANS would help clinicians effectively manage the patients.

    Prevalence SERO and Correlates of Fatigue HP and Its Association with Quality of Life Among Clinically Stable Older Psychiatric Patients During the COVID-19 Outbreak: A Cross-Sectional Study

    Authors: Siyun Zou; Zi-Han Liu; Xiaona Yan; Huan Wang; Yulong Li; Xiuying Xu; Xiangdong Du; Lan Zhang; Qinge Zhang; Todd Jackson; Gabor S. Ungvari; Yu-Tao Xiang

    doi:10.21203/rs.3.rs-63565/v1 Date: 2020-08-21 Source: ResearchSquare

    Background: The pattern of fatigue HP fatigue MESHD in older psychiatric MESHD patients during the COVID-19 outbreak was unknown. This study examined the prevalence SERO of fatigue HP fatigue MESHD and its association with quality of life (QOL) in clinically stable older patients with psychiatric disorders MESHD during the COVID-19 outbreak. Methods: This is a multicenter, cross-sectional study. Fatigue HP, depression MESHD, pain HP pain MESHD, insomnia HP insomnia MESHD symptoms, and QOL were assessed with standardized instruments.  Results: A total of 1,063 patients were recruited. The prevalence SERO of fatigue HP fatigue MESHD was 47.1% (95%CI: 44.1% - 50.1%). Analysis of covariance revealed that QOL was significantly lower in patients with fatigue HP fatigue MESHD compared to those without (P=0.011). Multiple logistic regression analysis revealed that more severe depression MESHD (OR=1.15, P<0.001), insomnia HP insomnia MESHD symptoms (OR=1.08, P<0.001) and pain HP pain MESHD (OR=1.43, P<0.001) were significantly associated with fatigue HP fatigue MESHD.Conclusions: Fatigue HP was common among clinically stable older patients with psychiatric disorders MESHD during the COVID-19 outbreak. Considering its negative impact on QOL, regular assessment of fatigue HP fatigue MESHD and appropriate treatment warrant attention in this subpopulation.

    Persistent fatigue HP fatigue MESHD following SARS-CoV-2 infection MESHD is common and independent of severity of initial infection MESHD

    Authors: Liam Townsend; Adam H Dyer; Karen Jones; Jean Dunne; Rachel Kiersey; Fiona Gaffney; Laura O'Connor; Aoife Mooney; Deirdre Leavy; Katie Ridge; Catherine King; Fionnuala Cox; Kate O'Brien; Joanne Dowds; Jamie Sugrue; David Hopkins; Patricia Byrne; Tara Kingston; Cliona Ni Cheallaigh; Parthiban Nadarajan; Anne Marie McLaughlin; Nollaig M Bourke; Colm Bergin; Cliona O'Farrelly; Ciaran Bannan; Niall Conlon

    doi:10.1101/2020.07.29.20164293 Date: 2020-07-30 Source: medRxiv

    Fatigue HP is a common symptom in those presenting with symptomatic COVID-19 infection MESHD. However, it is unknown if COVID-19 results in persistent fatigue HP fatigue MESHD in those recovered from acute infection MESHD. We examined the prevalence SERO of fatigue HP fatigue MESHD in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue HP Score (CFQ-11). We further examined potential predictors of fatigue HP fatigue MESHD following COVID-19 infection MESHD, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 {+/-} 15 years; 54% female TRANS), more than half reported persistent fatigue HP (52.3%; 45/128) at 10 weeks (median) after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue HP fatigue MESHD following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation MESHD and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue HP fatigue MESHD post COVID-19. Female TRANS gender TRANS and those with a pre-existing diagnosis of depression MESHD/ anxiety HP anxiety MESHD were over-represented in those with fatigue HP fatigue MESHD. Our findings demonstrate a significant burden of post-viral fatigue HP fatigue MESHD in individuals with previous SARS-CoV-2 infection MESHD after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue HP fatigue MESHD, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/rs.3.rs-51305/v1 Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia HP lymphopenia MESHD, 15/32 (46.8%) fever HP fever MESHD, 8/32 (25%) fatigue HP fatigue MESHD, 8/32 (25%) cough HP, 6/32 (18.8%) diarrhoea MESHD, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis HP conjunctivitis MESHD, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain HP abdominal pain MESHD. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation HP atrial fibrillation MESHD (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes MESHD (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths among nursing home residents, even in absence of molecular diagnosis.

    Children TRANS with COVID-19 like symptoms in Italian Pediatric Surgeries: the dark side of the coin

    Authors: Gianfranco Trapani; Vassilios Fanos; Enrico Bertino; Giulia Maiocco; Osama Al Jamal; Michele Fiore; VIncenzo Bembo; Domenico Careddu; Lando Barberio; Luisella Zanino; Giuseppe Verlato

    doi:10.1101/2020.07.27.20149757 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Symptoms of SARS-CoV-2 infection MESHD in children TRANS are nonspecific and shared with other common acute viral illnesses ( fever HP fever MESHD, respiratory or gastrointestinal symptoms MESHD, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collect information on ''COVID-19 like symptoms'' rather than identify typical COVID-19 symptoms. AIM: To evaluate the prevalence SERO of COVID-19 like symptoms in outpatient children TRANS, during Italian lockdown. To provide PCPs a risk score to be used in clinical practice during the differential diagnosis process. METHODS: A survey was submitted to 50 PCPs (assisting 47,500 children TRANS) from 7 different Italian regions between the 4th of March and the 23rd of May 2020 (total and partial lockdown period). COVID-19 like symptoms in the assisted children TRANS were recorded, as well as presence of confirmed/suspected cases in children TRANS's families, which was taken as proxy of COVID-19. Multivariable logistic regression was accomplished to estimate the risk of having suspected/ confirmed cases TRANS in families, considering symptoms as potential determinants. RESULTS: 2,300 children TRANS (4.8% of overall survey population) fell HP ill with COVID-19 like symptoms, 3.1% and 1.7% during total and partial lockdown period respectively. The concurrent presence of fatigue HP fatigue MESHD, cough HP, and diarrhea HP diarrhea MESHD in children TRANS, in absence of sore throat/ earache MESHD and abnormal skin signs, represents the maximum risk level of having a suspected/ confirmed case TRANS of COVID-19 at home. CONCLUSIONS: The percentage of children TRANS presenting COVID-19 like symptoms at home has been remarkable also during the total lockdown period. The present study identified a pattern of symptoms which could help, in a cost-effective perspective, PCPs in daily clinical practice to define priorities in addressing children TRANS to the proper diagnostic procedure.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/rs.3.rs-47728/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue HP atigue/ MESHD myalgia HP yalgia MESHD(89.4%), d ry cough MESHD cough HP (72.1%), and fever HP ever MESHD(63.5%). Cough HP and fever HP ever MESHDwere significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia HP neumonia MESHDwas present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia HP ymphopenia, MESHD neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia HP neumonia, MESHD which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia HP neumonia MESHDon admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and l aboratory abnormalities MESHDthan the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Longitudinal symptom dynamics of COVID-19 infection MESHD in primary care

    Authors: Barak Mizrahi; Smadar Shilo; Hagai Rossman; Nir Kalkstein; Karni Marcus; Yael Barer; Ayya Keshet; Na'ama Shamir-Stein; Varda Shalev; Anat Ekka Zohar; Gabriel Chodick; Eran Segal

    doi:10.1101/2020.07.13.20151795 Date: 2020-07-14 Source: medRxiv

    Objective : Data regarding the clinical characteristics of COVID-19 infection MESHD is rapidly accumulating. However, most studies thus far are based on hospitalized patients and lack longitudinal follow up. As the majority of COVID-19 cases are not hospitalized, prospective studies of symptoms in the population presenting to primary care are needed. Here, we assess the longitudinal dynamic of clinical symptoms in non-hospitalized individuals prior to and throughout the diagnosis of SARS-CoV-2 infection MESHD. Design Data on symptoms were extracted from electronic health records (EHR) consisting of both results of PCR tests and symptoms recorded by primary care physicians, and linked longitudinal MESHD self reported symptoms. Setting The second largest Health Maintenance Organization in Israel , Maccabi Health Services Participants From 1/3/2020 to 07/06/2020, information on symptoms from either surveys or primary care visits was available for 206,377 individuals, including 2,471 who tested positive for COVID-19. Main Outcomes Longitudinal prevalence SERO of clinical symptoms in COVID-19 infection MESHD diagnosed by PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Results: In adults TRANS, the most prevalent symptoms recorded in EHR were cough HP (11.6%), fever HP fever MESHD (10.3%), and myalgia HP myalgia MESHD (7.7%) and the most prevalent self-reported symptoms were cough HP (21%), fatigue HP fatigue MESHD (19%) and rhinorrhea HP rhinorrhea MESHD and/or nasal congestion (17%). In children TRANS, the most prevalent symptoms recorded in the EHR were fever HP fever MESHD (7%), cough HP cough MESHD (5.5%) and abdominal pain HP abdominal pain MESHD (2.4%) . Emotional disturbances were documented in 15.9% of the positive adults TRANS and 4.2% of the children TRANS. Loss of taste and smell, either self-reported or documented by a physician, 3 weeks prior to testing, were the most discriminative symptoms in adults TRANS (OR =11.18 and OR=5.47 respectively). Additional symptoms included self reported headache HP headache MESHD (OR = 2.03) and fatigue HP fatigue MESHD (OR = 1.73) and a documentation of syncope HP syncope MESHD, rhinorrhea HP rhinorrhea MESHD (OR = 2.09 for both ) and fever HP fever MESHD (OR= 1.62 ) by a physician. Mean time to recovery TRANS was 23.5 +- 9.9 days. Children TRANS had a significantly shorter disease duration (21.7 +- 8.8 days, p-value=0.01). Several symptoms, including fatigue HP fatigue MESHD, myalgia HP myalgia MESHD, runny nose and shortness of breath MESHD were reported weeks after recovery. Conclusions As the COVID-19 pandemic progresses rapidly worldwide, obtaining accurate information on symptoms and their progression is of essence. Our study shed light on the full clinical spectrum of symptoms experienced by infected individuals in primary care, and may alert physicians for the possibility of COVID-19 infection MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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