Coronavirus Disease 2019 Symptoms Research Articles

Study of COVID-19 confirmed cases in isolation hospital in (Hurghada General Hospital)

Abstract Background and purpose The WHO declared the coronavirus disease 2019 (COVID-19) outbreak a global public health emergency on January 30, 2020, and the word ‘pandemic’ was first used to describe the disease’s global spread in March of that year. Chronic lung disease (19.2% was the most common co-occurring condition with COVID-19), at 20.8%, followed by chronic kidney disease (20.8%), and then cardiovascular disease (60.9%). This research aimed to assess the prognosis of COVID-19-confirmed cases receiving isolation care at Hurghada General Hospital. Study design An observational study that was retrospective and cross-sectional. Setting Isolation department in Hurghada General Hospital. Patients We included 122 patients with COVID-19 infection, and classified them into two independent groups: the improvement group (93 patients), and the morbidity (complication) and mortality group (29 patients). Methods Clinical data (COVID-19 symptoms and vital signs), laboratory data (complete blood count, C-reactive protein, ferritin level in the blood, hepatic and renal functions tests, coagulation profile, and level of D-dimer), radiological data (computed tomography of the chest), and drug and antibiotic data were collected from all patients. The following parameters were assessed in each patient: length of hospital stay, ICU admission, mechanical ventilation, morbidity (complication), mortality, improvement, and discharge. Results Patients’ average age in the sample was 55 ± 16.3 years. Regarding patients’ respective sexes, 55.7% of patients were females, while 44.3% were males. Regarding the final outcome data, the average length of hospital stay was 9.2 ± 6.2 days, with 33.6% of patients having ICU admission, 9% were ventilated, morbidity(16.4%) (complication) (4.9% psychological and neurological disorders, 3.3% post-COVID oxygen-dependent therapy, 8.2% renal impairment), and mortality (7.4%), while 76.2% had improved and discharged. Logistic regression results demonstrated that the increase in age, BMI, lactate dehydrogenase, D-dimer, computed tomography chest affection, and COVID-19 severity (according to clinical, laboratory and radiological data); added to the risk of needing to be admitted to a hospital’s ICU on its own (P<0.05, respectively). Decreases in oxygen saturation, urea, and prothrombin time were found to independently increase the likelihood of ICU admission in a logistic regression analysis (P<0.05). Conclusion We conclude that age and comorbidities such as diabetes, hypertension, ischemic heart disease, and lung fibrosis are strongly related to adverse outcomes in COVID-19 patients admitted to the Hurghada Isolation Hospital. It was also more likely that those patients would develop acute respiratory distress syndrome or severe pneumonia. Strict treatment protocol and isolation lead to better outcomes.

A Review of the Mechanism of Action and Role of Bradykinin in Severity of COVID-19 Symptoms

Over a year has passed since the diagnosis of the first coronavirus disease 2019 (COVID-19) case in Wuhan, China. After that, this disease spread worldwide and infected people with a spectrum of symptoms, the most important and fatal of which are respiratory symptoms. Kinins, particularly bradykinin, are responsible for many respiratory functions, including vasodilation, vasoconstriction, and regulating permeability in vessels and lung tissue. The present study aims to review the bradykinin synthesis and degradation process, its mechanism of action, and its contribution to pulmonary function. Also, we investigate the role of bradykinin in treating and reducing the severity of COVID-19 symptoms. Results indicate that engagement of angiotensin-converting enzyme 2 (ACE2), a factor contributing to vasomotion and vascular permeability, as a result of virus entrance and its failure to inactivate des-Arg9-bradykinin (DABK) along with infiltration of proinflammatory cytokines, leads to increased vascular permeability and pulmonary edema. Consequently, inhibition of DABK synthesis or activity through blockade of the type 2 bradykinin receptors can help manage pulmonary edema.

Omega-3 Polyunsaturated Fatty Acids as Adjunctive Therapy for COVID-19 Management: Review

Patients with severe Coronavirus disease 2019 (COVID-19) experience thrombotic complications, cytokine storm, immune disorder, hypoxia, numerous disturbances in iron homeostasis, and increased oxidative stress. In addition to the appearance of the classic onset symptoms of COVID-19 which are cough fever and chest pain. Dietary supplements or nutraceuticals can be used as an adjunct treatment to improve patients' recovery. Omega 3-polyunsaturated fatty acids (ω-3PUFAs) in particular, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) exhibit anti-inflammatory, anticoagulant, and immunomodulatory properties that, when combined with the appropriate therapeutic intervention, may improve patient outcomes. Upon oxidation, EPA and DHA produce specialized pro-resolving lipid mediators (SPMs) that induce resolution of inflammation through inhibiting neutrophil migration, enhancing macrophage phagocytosis, and decreasing proinflammatory mediators which are risk factors for COVID-19 and increasing its severity. Moreover, ω-3PUFAs have many pathways to ameliorate various metabolic changes induced by viral infection. In this review, we attempted to summarize the available literature to understand the actual role of ω-3PUFAs that might improve or protect against COVID-19 and to determine whether it is possible to administer ω-3PUFAs as a co-therapy with conventional COVID-19 treatments.

Epidemiological application of the cycle threshold value of RT-PCR for estimating infection period in cases of SARS-CoV-2

Epidemiological control of coronavirus disease 2019 (COVID-19) is needed to estimate the infection period of confirmed cases and identify potential cases. The present study, targeting confirmed cases for which the time of COVID-19 symptom onset was disclosed, aimed to investigate the relationship between intervals (day) from symptom onset to testing the cycle threshold (CT) values of real-time reverse transcription-polymerase chain reaction. Of the COVID-19 confirmed cases, those for which the date of suspected symptom onset in the epidemiological investigation was specifically disclosed were included in this study. Interval was defined as the number of days from symptom onset (as disclosed by the patient) to specimen collection for testing. A locally weighted regression smoothing (LOWESS) curve was applied, with intervals as explanatory variables and CT values (CTR for RdRp gene and CTE for E gene) as outcome variables. After finding its non-linear relationship, a polynomial regression model was applied to estimate the 95% confidence interval values of CTR and CTE by interval. The application of LOWESS in 331 patients identified a U-shaped curve relationship between the CTR and CTE values according to the number of interval days, and both CTR and CTE satisfied the quadratic model for interval days. Active application of these results to epidemiological investigations would minimize the chance of failing to identify individuals who are in contact with COVID-19 confirmed cases, thereby reducing the potential transmission of the virus to local communities.

Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review.

Patients with coronavirus disease 2019 (COVID-19) present with a variety of oral manifestations. Therefore, we conducted a systematic review to estimate the prevalence of oral lesions among COVID-19 patients. An extensive literature search of several electronic bibliographic databases (PubMed, Scopus, Science Direct, Litcovid) was conducted to retrieve all articles published in the English language from January 1, 2020 to March 31, 2023 that reported the prevalence of oral manifestations among COVID-19 patients. A meta-analysis of pooled prevalence was performed using Jamovi ver. 2.3 (2022). The I2 and Q statistics were used to assess heterogeneity between studies, and p-values <0.01 were considered statistically significant. In total, 79 studies with data from 13,252 patients were included. The articles were predominantly published in 2020 (n=33), and Italy was the most common country (n=14). Most of the affected patients more than 50 years old and women (56.6%). The most common sites of involvement were the tongue (n=65), followed by the oral mucosa (n=37) and lips (n=19). High heterogeneity was found between studies. The most common oral manifestation was taste alteration, followed by xerostomia and ulceration, showing pooled prevalence rates of 48%, 35%, and 21%, respectively. COVID-19 patients show various oral manifestations that may help clinicians identify the disease promptly. Recognition of the signs and symptoms of COVID-19 is critical for an early diagnosis and better prognosis.

Animal efficacy study of a plant extract complex (BEN815) as a potential treatment for COVID-19.

In a short time, several types of injectable and oral therapeutics have been developed and used to effectively manage patients with coronavirus disease 2019 (COVID-19). BEN815 is an improved mixture of three extracts (Psidium guajava, Camellia sinensis, and Rosa hybrida) recognized by the Ministry of Food and Drug Safety of Korea as a health food ingredient that alleviates allergic rhinitis. The current animal efficacy study was performed to assess its probability of improving COVID-19 symptoms. BEN815 treatment significantly increased the survival of K18-hACE2 transgenic mice and reduced viral titers in the lungs at 5 days post infection (DPI). Furthermore, the lungs of the treated mice showed mild tissue damage at 5 DPI and nearly complete recovery from COVID-19 at 14 DPI. BEN815 appears to be an effective and minimally toxic anti-SARS-CoV-2 agent in mice and has potential for clinical applications.

Assessment of vaccinations and breakthrough infections after adjustment of the dynamic zero-COVID-19 strategy in China: an online survey

ABSTRACT Coronavirus disease 2019 (COVID-19) cases in China has grown rapidly after adjustment of the dynamic zero-COVID-19 strategy. However, how different vaccination states affect symptoms, severity and post COVID conditions was unclear. Here, we used an online questionnaire to investigate the infection status of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among 11,897 participants, with 55.55% positive and 28.42% negative. The common COVID-19 symptoms were fatigue (73.31%), cough (70.02%), fever (65.25%) and overall soreness (58.64%); self-reported asymptomatic infection accounted for 0.7% of participants. The persistent symptoms at 1 month after infection included fatigue (48.7%), drowsiness (34.3%), cough (30.1%), decreased exercise ability (23.1%) and pharyngeal discomfort (19.4%), which was reduced by more than 200% at 2 months. Participants with complications such as chronic obstructive pulmonary disease, respiratory diseases, diabetes, hypertension, etc. have a higher proportion of hospitalization and longer recovery time (p < = 0.01). Multiple vaccination statuses reduced the infection (p < 0.001) and severity rates (p = 0.022) by varying degrees as well as reduced the risk of high fever (>39.1 °C), chills, diarrhea and ageusia/anosmia, respectively (p < 0.05). Vaccination may enhance some upper respiratory symptoms, including sore throat, nasal congestion and runny nose, respectively (p < 0.05). Participants who had been vaccinated within 3 months were better protected by helping reduce their risk of overall soreness, chills and ageusia/anosmia, respectively (p < 0.05). In conclusion, our work has updated the epidemic characteristics of the breakthrough infection (BTI) wave after the dynamic zero-COVID-19 strategy, providing data and insights on how different vaccination statuses affect COVID-19 symptoms and disease prognosis.

Period Prevalence of COVID-19 and Influenza Symptoms in 2022 Among Adults in Jazan, Saudi Arabia.

Seasonal influenza and the circulating new variants of coronavirus disease 2019 (COVID-19) were predicted to increase the risk of developing respiratory symptoms in 2022. The objective of this study was to estimate the period prevalence of respiratory symptoms associated with COVID-19 and influenza among adults in 2022. This cross-sectional study targeted adults in Jazan, Saudi Arabia. Data collection was performed in February 2023 and utilized an online approach. The assessment was performed via a self-administered questionnaire, which measured demographics, vaccination practices against COVID-19 and influenza, and the occurrence of respiratory symptoms in 2022. This study involved 625 participants, 65% of whom were women with a mean age of 23 years. Only 80 participants (13%) reported receiving the influenza vaccine in 2022. The most frequently reported symptoms were headache (55%), sore throat (43.7%), and fever (43%). Nearly 34% were diagnosed with influenza, 17% were diagnosed with COVID-19, and 8% reported coinfection of both diseases. Sixty-one percent reported the occurrence of symptoms more than once in 2022. The presence of a higher frequency of respiratory symptoms was associated with gender, age, social status, employment, asthma, and obesity (P < 0.05). A majority of the participants reported multiple occurrences of respiratory symptoms in 2022. The uptake of the influenza vaccine was low in the same year, suggesting a need for a targeted approach to enhance vaccination rates among vulnerable groups.

Unveiling the Mysteries of Long COVID Syndrome: Exploring the Distinct Tissue and Organ Pathologies Linked to Prolonged COVID-19 Symptoms.

The ongoing battle against the coronavirus disease 2019 (COVID-19) pandemic has encountered a complex aspect with the emergence of long COVID syndrome. There has been a growing prevalence of COVID-19-affected individuals experiencing persistent and diverse symptoms that extend beyond the initial infection phase. The phenomenon known as long COVID syndrome raises significant questions about the underlying mechanisms driving these enduring symptoms. This comprehensive analysis explores the complex domain of long COVID syndrome with a view to shed light on the specific tissue and organ pathologies contributing to its intricate nature. This review aims to analyze the various clinical manifestations of this condition across different bodily systems and explore potential mechanisms such as viral persistence, immune dysregulation, autoimmunity, and molecular mimicry. The goal is to gain a better understanding of the intricate network of pathologies contributing to long COVID syndrome. Understanding these distinct pathological indicators provides valuable insights into comprehending the complexities of long COVID and presents opportunities for developing more accurate diagnostic and therapeutic strategies, thereby improving the quality of patient care by effectively addressing the ever-changing medical challenge in a more focused manner.

Exploring the mechanisms of long COVID: Insights from computational analysis of SARS-CoV-2 gene expression and symptom associations.

Long coronavirus disease(COVID) has emerged as a global health issue, affecting a substantial number of people worldwide. However, the underlying mechanisms that contribute to the persistence of symptoms in long COVID remain obscure, impeding the development of effective diagnostic and therapeutic interventions. In this study, we utilized computational methods to examine the gene expression profiles of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection and their associations with the wide range of symptoms observed in long COVID patients. Using a comprehensive data set comprising over 255 symptoms affecting multiple organ systems, we identified differentially expressed genesand investigated their functional similarity, leading to the identification of key genes with the potential to serve as biomarkers for long COVID. We identified the participation of hub genes associated with G-protein-coupled receptors (GPCRs), which are essential regulators of T-cell immunity and viral infection responses. Among the identified common genes were CTLA4, PTPN22, KIT, KRAS, NF1, RET, and CTNNB1, which play a crucial role in modulating T-cell immunity via GPCR and contribute to a variety of symptoms, including autoimmunity, cardiovascular disorders, dermatological manifestations, gastrointestinal complications, pulmonary impairments, reproductive and genitourinary dysfunctions, and endocrine abnormalities. GPCRs and associated genes are pivotal in immune regulation and cellular functions, and their dysregulation may contribute to the persistent immune responses, chronic inflammation, and tissue abnormalities observed in long COVID. Targeting GPCRs and their associated pathways could offer promising therapeutic strategies to manage symptoms and improve outcomes for those experiencing long COVID. However, the complex mechanisms underlying the condition require continued study to develop effective treatments. Our study has significant implications for understanding the molecular mechanisms underlying long COVID and for identifying potential therapeutic targets. In addition, we have developed a comprehensive website (https://longcovid.omicstutorials.com/) that provides a curated list of biomarker-identified genes and treatment recommendations for each specific disease, thereby facilitating informed clinical decision-making and improved patient management. Our study contributes to the understanding of this debilitating disease, paving the way for improved diagnostic precision, and individualized therapeutic interventions.

Relationship of Anxiety, Depression, Stress, and Post-Traumatic Stress Disorder Symptoms with Disease Severity in Acutely Ill Hospitalized COVID-19 Patients.

We aimed to investigate depression, anxiety, stress, and PTSD symptoms and their relationship with disease severity in acutely ill hospitalized Coronavirus disease 2019 (COVID-19) patients. A single-center cross-sectional observational survey study screening for psychiatric symptoms using the Depression, Anxiety and Stress Scale-21 Items (DASS-21) and the Impact of Events Scale-Revised (IES-R) questionnaires was performed including a total of 169 acutely ill COVID-19 patients. All patients were adults and of white race and developed respiratory insufficiency during hospitalization. Demographic, clinical and laboratory data were evaluated as predictors of psychiatric symptoms. We hypothesized that higher intensity of COVID-19 symptoms and higher oxygen requirement would be associated with occurrence of depression, anxiety, stress, and PTSD symptoms. Depressive symptoms were absent in 29%, mild in 16%, moderate in 27.8%, severe in 10.7% and extremely severe in 16.6% patients. Anxiety symptoms were absent in 43.8%, mild in 6.5%, moderate in 17.2%, severe in 5.3% and extremely severe in 27.2% patients. Stress symptoms were absent in 78.7%, mild in 4.7%, moderate in 7.1%, severe in 7.7%, and extremely severe in 1.8% patients. A total of 60.9% patients had no PTSD symptoms, 16% had undiagnosed symptoms, and 23.1% met the criteria for a PTSD diagnosis. All psychiatric symptoms were more pronounced in female patients, depression and anxiety symptoms were associated with prior chronic obstructive pulmonary disease. Only depressive symptoms were significantly associated with higher intensity of COVID-19 symptoms and higher oxygen requirement. Acutely ill hospitalized COVID-19 patients presented a high prevalence of emergent psychiatric sequelae, especially in females, and more severe COVID-19 influenced mostly the severity of depressive symptoms.

Outpatient Treatment with AZD7442 (Tixagevimab/Cilgavimab) Prevented COVID-19 Hospitalizations over 6 Months and Reduced Symptom Progression in the TACKLE Randomized Trial.

We assessed effects of AZD7442 (tixagevimab/cilgavimab) on deaths from any cause or hospitalizations due to coronavirus disease 2019 (COVID-19) and symptom severity and longer-term safety in the TACKLE adult outpatient treatment study. Participants received 600 mg AZD7442 (n = 452) or placebo (n = 451) ≤ 7days of COVID-19 symptom onset. Death from any cause or hospitalization for COVID-19 complications or sequelae through day 169 (key secondary endpoint) occurred in 20/399 (5.0%) participants receiving AZD7442 versus 40/407 (9.8%) receiving placebo [relative risk reduction (RRR) 49.1%; 95% confidence interval (CI) 14.5, 69.7; p = 0.009] or 50.7% (95% CI 17.5, 70.5; p = 0.006) after excluding participants unblinded before day 169 for consideration of vaccination). AZD7442 reduced progression of COVID-19 symptoms versus placebo through to day 29 (RRR 12.5%; 95% CI 0.5, 23.0) and improved most symptoms within 1-2weeks. Over median safety follow-up of 170days, adverse events occurred in 174 (38.5%) and 196 (43.5%) participants receiving AZD7442 or placebo, respectively. Cardiac serious adverse events occurred in two (0.4%) and three (0.7%) participants receiving AZD7442 or placebo, respectively. AZD7442 was well tolerated and reduced hospitalization and mortality through 6months, and symptom burden through 29days, in outpatients with mild-to-moderate COVID-19. Clinicaltrials.gov, NCT04723394. ( https://beta. gov/study/NCT04723394 ).

Cannabis-based medicinal products (CBMPs) for the treatment of Long COVID symptoms: current and potential applications

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can result in a range of persistent symptoms impacting everyday functioning for a considerable proportion of patients, a condition termed Long coronavirus disease (COVID) or post COVID-19 syndrome. The severity and set of symptoms vary between patients, and include fatigue, cognitive dysfunction, sleep disturbances, palpitations, tachycardia, pain, depression, and anxiety. The high prevalence of Long COVID combined with the lack of treatment approaches has resulted in considerable unmet clinical needs. There is a growing body of evidence that cannabis-based medicinal products (CBMPs) can be used to treat symptoms including pain, anxiety, depression, fatigue, sleep, headaches, and cognitive dysfunction, which are commonly reported in Long COVID. This article provides an overview of the pathophysiology of Long COVID and discusses preliminary pre-clinical, clinical trials, and real-world evidence (RWE) for CBMPs in the context of Long COVID. This review summarises current clinical trials and studies exploring CBMPs in Long COVID. The current evidence provides a rationale to further explore CBMPs as a treatment for Long COVID symptoms. In addition to further randomised controlled trials (RCTs), the increasing availability of CBMPs globally, coupled with the continued prevalence of Long COVID in the population, also highlights the value of real-world data in the research of CBMPs in Long COVID. Critically, there is an evident need for multidisciplinary approaches of CBMPs and Long COVID in real-world clinical practice settings.

Essential oils for COVID-19 management: A systematic review of randomized controlled trials

Essential oils can be a beneficial adjuvant therapy in managing coronavirus disease 2019 (COVID-19). This systematic review aims to evaluate the efficacy of essential oils in ameliorative COVID-19-related symptoms. Published studies reporting the efficacy of essential oils as adjuvant therapy for COVID-19 were screened on Scillit, Scopus, SciFinder, and PubMed (December 7th, 2022). Inclusion criteria include the randomized controlled trials (RCTs) participated by those diagnosed with COVID-19 and treated with essential oils as adjuvant therapy. Quality assessment was carried out using Cochrane ‘risk-of-bias’ 2.0 tool. A total of 2112 records were retrieved from the initial screening, which was reduced to four publications (n=344 individuals). The foregoing studies reported that essential oils could improve the recovery rate, alleviate post-COVID-19 fatigue, and prevent disease progression. Regarding their potential antiviral activity, better designed studies are needed. In conclusion, essential oils as adjuvant therapy are beneficial in ameliorating mild COVID-19 symptoms.

Corona virus disease 2019 lesion segmentation network based on an adaptive joint loss function

Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease with strong contagiousness, strong variability, and long incubation period. The probability of misdiagnosis and missed diagnosis can be significantly decreased with the use of automatic segmentation of COVID-19 lesions based on computed tomography images, which helps doctors in rapid diagnosis and precise treatment. This paper introduced the level set generalized Dice loss function (LGDL) in conjunction with the level set segmentation method based on COVID-19 lesion segmentation network and proposed a dual-path COVID-19 lesion segmentation network (Dual-SAUNet++) to address the pain points such as the complex symptoms of COVID-19 and the blurred boundaries that are challenging to segment. LGDL is an adaptive weight joint loss obtained by combining the generalized Dice loss of the mask path and the mean square error of the level set path. On the test set, the model achieved Dice similarity coefficient of (87.81 ± 10.86)%, intersection over union of (79.20 ± 14.58)%, sensitivity of (94.18 ± 13.56)%, specificity of (99.83 ± 0.43)% and Hausdorff distance of 18.29 ± 31.48 mm. Studies indicated that Dual-SAUNet++ has a great anti-noise capability and it can segment multi-scale lesions while simultaneously focusing on their area and border information. The method proposed in this paper assists doctors in judging the severity of COVID-19 infection by accurately segmenting the lesion, and provides a reliable basis for subsequent clinical treatment.

Anxiety in adults with asthma during the coronavirus disease 2019 pandemic: a Canadian perspective

BackgroundAsthma is a chronic airway inflammatory disease that affects millions of Canadians and often contributes to higher levels of anxiety among patients. Since the coronavirus disease 2019 (COVID-19) pandemic was a time of increased anxiety and fear among the Canadian population, it was thought that those with asthma may experience heightened anxiety levels due to uncertain access to care, the potential to misinterpret asthma symptoms for symptoms of COVID-19 (or vice versa), and the concern about being treated differently by those around them when experiencing asthma symptoms. Therefore, this study sought to perform a cross-sectional analysis of the asthma-anxiety relationship in adults with and without asthma in the unique context of the COVID-19 pandemic from a Canadian perspective.MethodsThis study employed the COVID-19 Associated Anxiety in Allergic Rhinitis and Asthma patients Experiencing Symptoms (CAAARES) survey, consisting of COVID-19-specific questions, the Generalized Anxiety Disorder Assessment-7 (GAD-7) and the Asthma Control Questionnaire-6 (ACQ-6). Data collection occurred through the Qualtrics XM platform and data analyses were conducted with the IBM SPSS Statistics 28 software.ResultsA total of 741 valid responses were collected (asthma group, n = 244; control group, n = 497). 31.6% and 26.2% of respondents in the asthma and control groups, respectively, met the diagnostic criteria for GAD. There was no significant difference (p = .067) in mean GAD-7 scores between the two groups. A Hierarchal Multiple Regression (HMR) model was developed, and neither asthma status nor ACQ-6 score had a significant predictive effect on the GAD-7 score. There was a statistically significant (p < .001) weak positive correlation (r = .22) between GAD-7 and ACQ-6 scores. In a simple mediation (SMM) model, perceived COVID-19 stress of others was not identified as a significant mediator of the relationship between ACQ-6 and GAD-7 (indirect effect β = 0.014).ConclusionOur study of a Canadian cohort demonstrates elevated levels of anxiety overall, amongst both asthma and control groups. While AR status was significantly greater in the asthma group, it was not a significant predictive variable of GAD-7 score. Our data suggests that COVID-19-specific factors appear to have a greater contribution to anxiety than asthma status or control.

Prevalence of Liver Injury, Gastrointestinal Tract Symptoms, and H. Pylori Infection in Patients of Coronavirus Disease 2019 (COVID-19)

Background COVID-19 most commonly presents with respiratory symptoms, including cough, shortness of breath, sore throat with characteristics of loss of smell and taste. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease. Objective To estimate the rate of GI symptoms, liver enzyme levels outside reference ranges, and fecal tests for H. Pylori antigen among patients with the suspected or proven COVID-19. Patients and Methods The research performed on 70 Egyptian patients who have suspected COVID-19 symptoms included in this study. The patients are divided into four groups. Asymptomatic group, group with respiratory symptoms, group with digestive symptoms, and group with respiratory and digestive symptoms. Results The asymptomatic patient was 10%, gastrointestinal symptoms with or without respiratory symptoms 24.3%, digestive symptoms only 11.8% of COVID-19, and H. pylori present in 50% of the digestive group of COVID-19 patients. The use of corticosteroids in the low effective dose for ten days to 2 weeks and anticoagulant play an important role in the management of COVID-19, especially in moderate cases. Conclusion The prevalence of gastrointestinal symptoms in COVID-19 increase up to 24.3% and the prevalence of patients with digestive symptoms only was 11.4%. In some cases, the digestive symptoms, particularly diarrhea, can be the initial or only presentation of COVID-19.

Long Coronavirus Disease 2019 Sequel among Cohorts Admitted to a Tertiary Care Hospital, Hyderabad

Abstract Introduction: Long COVID is commonly encountered by many individuals during the coronavirus 2019 pandemic. It is best diagnosed by a history consistent with acute coronavirus disease 2019 (COVID-19) followed by a prolonged recovery. An attempt has been made to enlist the sequel of long COVID clinically and to assess their risk factors. Materials and Methods: Confirmed COVID-19 patients admitted to our hospital were enquired about their persistent symptoms following infection after 3– 12 weeks for acute symptoms and after 12 weeks for chronic symptoms through the predesigned questionnaire schedule about their manifestations and followed up every month for 6 months. Results: A total of 152 patients were included in our study and found acute long COVID symptoms related to neurological (72.2%), respiratory (64.7%), and musculoskeletal (61.4%) system being most commonly affected. Chronic symptoms were comprised predominantly musculoskeletal (63.1%) followed by fatigue (43.4%) and neurological (29.6) manifestations. Risk factors estimate of postacute COVID-19 symptoms showed that females had increased risk with odds ratio (OR) (and 95% confidence intervals) (OR) of 2.412 (1.239–4.692), sedentary lifestyle OR 1.775 (1.345–2.762), body mass index (BMI) &gt;23 OR 3.877 (1.613–6.144), and presence of comorbidities OR 2.526 (1.277–4.997). Similarly, risk factor estimate of Postchronic COVID-19 symptoms showed that females had increased risk with OR 1.879 (0.952–3.709), sedentary lifestyle OR 5.091 (2.853–9.085), BMI &gt;23 OR 2.082 (1.005–4.134), and presence of comorbidities OR 1.851 (0.925–3.705). Conclusions: Long COVID symptoms noted were mainly related to musculoskeletal disorders, neurological, respiratory, and fatigue. This enumeration will help us to bring the further pathway to include this long COVID entity for preventive strategies in our regular setup at the primary care level.

Prevalence, pathogenesis and spectrum of neurological symptoms in COVID-19 and post-COVID-19 syndrome: a narrative review.

Neurological symptoms are not uncommon during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reflect a broad spectrum of neurological disorders of which clinicians should be aware. The underlying pathogenesis of neurological disease in coronavirus disease 2019 (COVID-19) may be due to four mechanisms of nervous system dysfunction and injury: i) direct viral neurological invasion; ii) immune dysregulation; iii) endothelial dysfunction and coagulopathy; and iv) severe systemic COVID-19 disease. Neurological manifestations of acute COVID-19 include headache, peripheral neuropathies, seizures, encephalitis, Guillain-Barré syndrome, and cerebrovascular disease. Commonly reported long term neurological sequelae of COVID-19 are cognitive dysfunction and dysautonomia, which despite being associated with severe acute disease are also seen in people with mild disease. Assessment of cognitive dysfunction after COVID-19 is confounded by a high prevalence of comorbid fatigue, anxiety, and mood disorders. However, other markers of neuroaxonal breakdown suggest no significant neuronal injury apart from during severe acute COVID-19. The long term impact of COVID-19 on neurological diseases remains uncertain and requires ongoing vigilance.

Cerebrospinal fluid cytokines in COVID-19: a review and meta-analysis.

Neurological involvement can occur in patients with SARS-CoV-2 infections, resulting in coronavirus disease 2019 (COVID-19). Cytokine alterations are associated with neurological symptoms in COVID-19. We performed a review of cytokines in the cerebrospinal fluid (CSF) of patients with COVID-19. Two reviewers independently searched PubMed for all relevant articles published prior to November 11, 2022. Active SARS-CoV-2 infection and CSF cytokine analyses were required for inclusion. Three-hundred forty-six patients with COVID-19 and 356 controls from 28 studies were included. SARS-CoV-2PCR was positive in the CSF of 0.9% (3/337) of patients with COVID-19. Thirty-seven different cytokines were elevated in the CSF of patients with COVID-19 when compared to controls and the standards set forth by individual assays used in each study. Of the 37 cytokines, IL-6 and IL-8 were most commonly elevated. CSF IL-6 is elevated in 60%, and CSF IL-8 is elevated in 51% of patients with COVID-19. Levels of several inflammatory cytokines are elevated in the CSF of patients with COVID-19, and SARS-CoV-2 PCR is often not isolated in the CSF of patients with COVID-19. Many patients with COVID-19 have neurological symptoms and given the cytokine elevations in the absence of detectable viral RNA in cerebrospinal fluid; further study of the CSF cytokine profiles and pathogenesis of neurological symptoms in COVID-19 is needed.