Manifestations In COVID-19 Patients Research Articles

Orofacial Manifestations in COVID-19 Patients, Health Challenges and Dental Practice Recommendations during COVID-19 Pandemic: A Clinical Update

Orofacial Manifestations in COVID-19 Patients, Health Challenges and Dental Practice Recommendations during COVID-19 Pandemic: A Clinical Update

The impact of the COVID-19 pandemic on cardiovascular disease in the cardiovascular center of Kermanshah, in the west of Iran

BackgroundCardiovascular diseases (CVD) are known as the most common cause of mortality worldwide. Hence, exploring the impact of COVID-19 pandemic on CVD and its risk factors. This study aimed to explore clinical and echocardiographic characteristics and cardiac manifestations in COVID-19 patients. MethodsThis cross-sectional study was conducted on 386 patients with COVID-19 admitted to Imam Ali Hospital, the largest specialized cardiology hospital in western Iran. The checklist included information about age, gender, hypertension, BMI, diabetes, chronic renal disease, cigarette smoking, echocardiography and ECG findings, in-hospital MACE, venous and arterial thrombotic events. To analyze the data, SPSS23, paired-samples t-test, chi-square test and logistic regression analysis were used. ResultsOur findings showed 57 % of patients were male and 43 % were female. The paients' average age was 64.61 ± 14.21 years. Moreover, 25.9 % of patients had diabetes, 27.7 % had blood pressure, 11.7 % were cigarette smokers and 11.1 % had hyperlipidemia. The main electrocardiographic abnormalities were ST-T changes in 1.31 % of the patients, sinus tachycardia in 16.3 % and atrial fibrillation in 11.1 % of patients. Mild to moderate pericardial effusion was observed in 8.1 % and pleural effusion in 9.1 % of the sample. Common cardiac complications were ACS in 52.9 %, DHF in 24.4 %, and CHB in 4.4 % of patients. 19.4 % of patients died during hospitalization. Mild to moderate pericardial effusion (OR = 1.96, 95 % CI 1.18–2.14, P = 0.012) was an independent predictor of mortality in COVID-19 patients. ConclusionResults of the study showed it is essential to pay closer attention to elderly, diabetic and hypertensive patients, who are more prone to COVID-19 infection. Moreover, common cardiac complications were ACS and DHF, respectively.

Oral Manifestations in COVID-19-positive Patients: A Clinical Case Series

Abstract The development of oral lesions in COVID-19 patients can be attributed to a variety of factors. High viral load in saliva, the virus directly targeting the mucosa, association with dermal manifestations, use of corticosteroids, long hospital stay, intubation, and hospital-acquired infections are few possible causes. Evidence suggests that ACE2 receptors in salivary ducts, tongue, and other oral tissues have a high affinity for SARS-CoV-2. Therefore, it is important for clinicians to understand the different lesions that are most frequently seen in COVID-19 patients for proper management. In the present study, eight cases of oral manifestations in COVID-19 patients have been discussed along with their management. Tongue was found to be one of the most common sites due to the abundance of ACE2 receptors. Pigmentation, depapillation, hyperplastic papillae, benign migratory glossitis, and fungal overgrowth were noted on the tongue. Xerostomia, pigmentation, and fungal infection of oral mucosal surfaces, as well as oral ulceration, were other lesions.

Oral Manifestations in COVID-19 Patients: A Prevalence Study

Oral Manifestations in COVID-19 Patients: A Prevalence Study

S3608 Prevalence and Impact of Gastrointestinal Manifestations in COVID-19 Patients: A Systematic Review

S3608 Prevalence and Impact of Gastrointestinal Manifestations in COVID-19 Patients: A Systematic Review

Prevalence of self-perceived audiovestibular symptoms in Egyptian COVID-19 patients

BackgroundAccording to National Institute for Health and Care Excellence (NICE), UK, common audiovestibular symptoms of COVID-19 include dizziness, tinnitus, and otalgia. The pathogenesis of otologic disorders ranges from direct damage to the inner ear structures to immune-mediated damage. Since the start of the pandemic, the prevalence of audiovestibular symptoms linked to COVID-19 has not been thoroughly investigated in Egypt. Our objective is to study and analyze the prevalence of the audiovestibular symptoms in the Egyptian population with history of COVID-19 infection.MethodsA cross-sectional study was conducted among Egyptian adults on the presence and nature of the audiovestibular manifestations in COVID-19 patients. An online questionnaire was used. The questionnaire was developed using Google Form. It was disseminated to the target population through social platforms from October 2021 till February 2022.ResultsData from 245 respondents were collected through online assessment of a convenient sample. The following de novo audiovestibular symptoms were experienced by the participants: Vertigo 20.8%, hearing loss 13.9%, tinnitus 12.7% and ear fullness 11.4%. No correlation was found between the investigations done (D-Dimer, CT chest) and the audiovestibular symptoms.ConclusionAudiovestibular symptoms are fairly common among COVID-19 patients, with higher prevalence, particularly of vertigo, in our study sample compared to the literature. It is recommended that patients with audiovestibular symptoms undergo early testing so that prompt interventions can be taken.

Oral Manifestations in COVID-19 Patients Associated with Oral Hygiene in Aceh, Indonesia: A Literature Review

COVID-19 became a pandemic because of its high-speed transmission via salivary and airborne droplet routes. Viruses can enter host cells through ACE-2 receptors in various human organs, including the oral cavity. The oral manifestations that arise include white plaque, ulceration, burning sensation, oral mucositis, depapillation of the tongue, dry mouth, halitosis, and loss of the sense of taste. Poor oral hygiene, comorbidities, decreased immunity, and stress can exacerbate these manifestations. This review study aimed to report various oral manifestations of COVID-19 related to oral hygiene. Relevant articles were identified from PubMed, ScienceDirect, Elsevier, and Google Scholar. Out of the 60 articles selected, only 36 could be reviewed. The World Health Organization recommends early detection for individuals with suspected exposure to the COVID-19 virus to control its spread, including checking for oral manifestations. Oral hygiene is an important factor affecting the manifestations of the oral cavity of COVID-19 patients, so examination of the condition of oral hygiene is recommended in the medical management of COVID-19 patients. To conclude, oral hygiene is related to the emergence of oral manifestation in COVID-19-infected patients.

Oral Manifestations in COVID-19 Patients Associated with Oral Hygiene in Aceh, Indonesia: A Literature Review

COVID-19 became a pandemic because of its high-speed transmission via salivary and airborne droplet routes. Viruses can enter host cells through ACE-2 receptors in various human organs, including the oral cavity. The oral manifestations that arise include white plaque, ulceration, burning sensation, oral mucositis, depapillation of the tongue, dry mouth, halitosis, and loss of the sense of taste. Poor oral hygiene, comorbidities, decreased immunity, and stress can exacerbate these manifestations. This review study aimed to report various oral manifestations of COVID-19 related to oral hygiene. Relevant articles were identified from PubMed, ScienceDirect, Elsevier, and Google Scholar. Out of the 60 articles selected, only 36 could be reviewed. The World Health Organization recommends early detection for individuals with suspected exposure to the COVID-19 virus to control its spread, including checking for oral manifestations. Oral hygiene is an important factor affecting the manifestations of the oral cavity of COVID-19 patients, so examination of the condition of oral hygiene is recommended in the medical management of COVID-19 patients. To conclude, oral hygiene is related to the emergence of oral manifestation in COVID-19-infected patients.

Correlation between Total Lymphocyte Count, C Reactive Protein, and Neutrophil Lymphocyte Ratio Levels with Gastrointestinal Manifestations in Covid-19 Patients Treated at Ulin Hospital, Banjarmasin

BACKGROUND: Coronavirus disease can affect the digestive system and cause gastrointestinal manifestations. The increase in C-reactive protein (CRP) correlates with the severity of the disease. The neutrophil-to-lymphocyte ratio (NLR) is a useful prognostic factor in the early screening of patients with COVID-19. A low lymphocyte count can also predict gastrointestinal involvement. AIM: This study aims to determine the correlation between TLC, CRP, and NLR levels on gastrointestinal manifestations in COVID-19 patients treated at Ulin General Hospital, Banjarmasin. METHODS: This study used a cross-sectional design. Data were taken consecutively using the medical records of confirmed COVID-19 patients with gastrointestinal manifestations. The number of subjects in this study was 88 patients. RESULTS: A decrease in TLC levels (<1740 g/dL) was not proven to have a significant correlation with gastrointestinal manifestations in COVID-19 patients (p = 0.176). Increased levels of CRP (>48 mg/L) had a significant correlation by 5.71 times compared to subjects who did not experience increased CRP (p < 0.00001). Increased levels of the NLR (>6 mg/L) had a significant correlation by 2.82 times compared to subjects who did not experience an increase in NLR (p = 0.032). CONCLISION: An increase in CRP levels >48 mg/L and levels of NLR >6, respectively, allowed the subject to experience gastrointestinal symptoms by 5.71 times and 2.82 times when infected with COVID-19, while a decrease in total lymphocyte count <1740 was not proven to have a significant correlation with gastrointestinal manifestations.

Ocular manifestations in COVID-19 Patients at Dr. Wahidin Sudiro Husodo General Hospital Mojokerto during January – June 2021

Coronavirus Disease (COVID-19) is a respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 can be found in ocular organs through direct inoculation, migration via the nasolacrimal duct, or hematogenous. This study aims to determine the clinical manifestations of eye disease in COVID-19 patients at Dr. Wahidin Sudiro Husodo Mojokerto General Hospital from January-June 2021. A cross-sectional retrospective observational study by collecting secondary data on patient medical records. The research sample was all outpatients and inpatients with a positive PCR test for COVID-19 who were consulted by an ophthalmologist at Dr. Wahidin Sudiro Husodo General Hospital Mojokerto in January-June 2021. A total of 861 cases of patients with positive PCR tests for COVID-19, a total of 67 patients were consulted to eye specialists with a median age of 42.6 years. Among 67 patients, 59 (88%) showed symptoms of conjunctival injection, 8 patients (12%) ciliary infusion with 7 patients diagnosed with keratitis, and 1 patient with ulcer redness. In conclusion, the main eye manifestation most commonly found in COVID-19 patients is conjunctivitis which is characterized by conjunctival hyperemia.

A single-center retrospective study of hospitalized COVID-19 patients: demographics, laboratory markers, neurological complications, ICU admission, and mortality.

This single-center retrospective study evaluated clinical and neurological sequelae, demographics, as well as laboratory markers, in hospitalized COVID-19 patients from January to September 2020. Among 1248 inpatients (median age: 68 years; 651 women), 387 (31%) were admitted to the ICU. Central nervous system (CNS) manifestations were present in 521 (41.74%) patients, while peripheral nervous system manifestations were observed in 84 (6.73%). COVID-19-related mortality occurred in 314 (25.16%) cases. ICU-admitted patients were predominantly male (P<0.0001), older (age≥60; P=0.037) and had more comorbidities such as diabetes (P=0.001), hyperlipidemia (P=0.043), and coronary artery disease (P=0.015). ICU patients exhibited more CNS manifestations (P=0.001), including impaired consciousness (P<0.0001) and acute cerebrovascular disease (P=0.023). Biomarkers linked to admission to the ICU included elevated white blood cell count, ferritin, lactate dehydrogenase, creatine kinase, blood urea nitrogen, creatinine, and acute phase reactants (e.g. erythrocyte sedimentation rate and C-reactive protein). ICU patients demonstrated lower lymphocyte and platelet counts compared to non-ICU patients. Those with CNS involvement in the ICU often exhibited elevated blood urea nitrogen, creatinine, and creatine kinase levels. Higher mortality from COVID-19 was observed in ICU patients (P<0.0001). Multiple serum biomarkers, comorbidities, and neurological manifestations in COVID-19 patients have been consistently documented and may be linked to increased morbidity, ICU admission, and mortality. Recognizing and addressing these clinical and laboratory markers is essential for effective COVID-19 management.

Prevalence and Impact of Gastrointestinal Manifestations in COVID-19 Patients: A Systematic Review.

The aim of this study is to systematically analyze and summarize the implications of COVID-19 on the digestive system by quantitatively evaluating the prevalence of gastrointestinal symptoms such as nausea, vomiting, abdominal pain, constipation, diarrhea, anorexia. reported in COVID-19 cases. We simultaneously investigated other variables to determine the association of such symptoms in COVID-19 patients which can potentially influence the disease prognosis and outcome. This systematic review presents an updated literature on the issue as it requires more scientific discussion in order to better inform the medical community and authorities so that appropriate measures can be taken to control the virus outbreak. MEDLINE database was searched to identify relevant articles. Data was analyzed and synthesized from the 16 eligible studies which exclusively reported GI symptoms in COVID-19 patients along with the disease prognosis. A meta-analysis of studies having adequate information regarding the prevalence of specific GI symptoms in association with other relevant independent variables was performed. From the search strategy, we identified 16 articles which fit our eligibility criteria comprising of 10 cross-sectional studies, 2 cohort study, 1 RCT and 3 observational studies. From these pooled studies, 6 articles exclusively talked about COVID-19 patients in which GI symptoms were reported and adequately discussed. In a total of 3646 patients, GI symptoms were documented in (16.2%-10.1%) patients. The most prevalent GI symptom was diarrhea (47%) but the most common clinical manifestation reported was fever (77.4%). Among the adult patients, hypertension (11.6%) was the most frequently reported comorbidity. Presence of viral RNA in stool sample was noted in 16.7% patients with GI symptom. In patients who complained of having GI symptoms, an abnormal liver function was largely observed, with an elevated ALT level in (10.9%) and an elevated AST in (8.8%) of the patients. Evidence of vertical transmission (14.2%) was reported in one study which highlights the extent and mode of viral transmission. It was observed that a great majority of the patients in the 6 studies reporting specifically on patients with GI symptoms were on antiviral therapy (68.6%) as the standard disease management protocol but the eventual disease outcome as in this case died (8.4%), discharged (45.6%) was not linked to just one therapeutic factor but other indicators of disease severity such as positive chest CT findings (87.82%) have led to a poor disease prognosis which was noted in (28.9%) severe patients with GI symptoms compared to (71.1%) non-severe COVID-19 patients with GI symptom. Presence of GI symptoms in COVID-19 patients has shown to have a positive association with the poor disease prognosis likely as a result of direct viral toxicity. It is important for the physicians to recognize digestive symptoms as an important characteristic in COVID-19 patients. Hence, precise and targeted documentation of GI symptoms and viral stool sample investigations should be performed in order to understand the rapidly evolving disease symptomology.

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

The role of neutrophil granulocytes (NG) in the pathogenesis of COVID-19 is associated with the NG recruitment into inflammatory foci, activation of their functions and enhanced formation of neutrophil extracellular networks (NETs). In this review, we analyzed a large body of scientific literature devoted to the features of developing NETs, their role in the COVID-19 pathogenesis, a role in emerging immunothrombosis, vasculitis, acute respiratory distress syndrome, cytokine storm syndrome, and multi-organ lesions. Convincing data are presented clearly indicating about a profound role of NETs in the COVID-19 immunopathogenesis and associated severe complications resulting from intensified inflammation process, which is a key for the course of SARS-CoV-2 virus infection. The presented role of NGs and NETs, along with that of other immune system cells and pro-inflammatory cytokines, is extremely important in understanding development of overactive immune response in severe COVID-19. The scientific results obtained available now allow to identify an opportunity of regulatory effects on hyperactivated NGs, NETosis at various stages and on limiting a negative impact of pre-formed NETs on various tissues and organs. All the aforementioned data should help in creating new, specialized immunotherapy strategies designed to increase the odds of survival, reduce severity of clinical manifestations in COVID-19 patients as well as markedly reduce mortality rates. Currently, it is possible to use existing drugs, while a number of new drugs are being developed, the action of which can regulate NG quantity, positively affect NG functions and limit intensity of NETosis. Continuing research on the role of hyperactive NG and NETosis as well as understanding the mechanisms of regulating NET formation and restriction in severe COVID-19, apparently, are of high priority, because in the future the new data obtained could pave the basis for development of targeted approaches not only for immunotherapy aimed at limiting education and blocking negative effects already formed NETs in severe COVID-19, but also for immunotherapy, which could be used in combination treatment of other netopathies, primarily autoimmune diseases, auto-inflammatory syndromes, severe purulent-inflammatory processes, including bacterial sepsis and hematogenous osteomyelitis.

Angina Bullosa Haemorrhagica in COVID 19: A Diagnostic Conundrum. Case Report and Review of Literature

Oral manifestations of COVID-19 are amongst the most obscure and ill-reported. Of these, angina bullosa haemorrhagica is amongst the rarest. Only 2 cases of angina bullosa haemorrhagica in COVID-19 patients have been reported in literature. Angina bullosa haemorrhagica (ABH) is an enigmatic, abstruse condition represented by sudden onset of painful subepithelial, mucosal blood-filled vesicles and bullae in the oral cavity. It is not attributed to any systemic conditions, blood dyscracias or other well-known dermatological pathologies. The occurrence of these lesions in patients of COVID-19 suggests that the underlying pathology of the latter may predispose to ABH and thus help in shedding some light onto the pathogenesis of this obscure disease. Herein we present 2 cases of ABH in patients of COVID-19 within a few weeks of the resolution of the latter. Both patients reported that they had never had this condition before and that this was the first presentation of the symptom. A review of literature shows that the etiopathogenesis of ABH is ambiguous at best and that the pathology underlying the oral manifestation of COVID-19 may well be applicable to ABH as well. Various mechanisms have been proposed to cause oral manifestations in COVID-19 patients. These include imbalance in the RAS pathway causing mucosal disruption, immune dysregulation, deranged cellular immune mechanism and disruption of local immune mechanisms. Since ABH has been reported in COVID 19, it is plausible that some of the mechanisms underlying the pathogenesis of oral manifestations may explain the pathogenesis of ABH.

COVID-19 Associated Neurological Manifestation.

At the end of 2019, COVID-19 was first detected in Wuhan. In March 2020, COVID-19 became a pandemic globally. Saudi Arabia registered the first case of COVID-19 on March 2, 2020. This research aimed to identify the prevalence of different neurological manifestations of COVID-19 and to assess the relation of the severity, vaccination state, and continuity of symptoms to the occurrence of these symptoms. Cross-sectional retrospective study was done in Saudi Arabia. The study was conducted on previously diagnosed COVID-19 patients by random selection using a predesigned online questionnaire to collect data. Data was entered through Excel and analyzed through SPSS version 23. The study showed that the most common neurological manifestations in COVID-19 patients are headache (75.8%), changes in sense of smell and taste (74.1%), muscle pain (66.2%), and mood disturbance (depression, anxiety) (49.7%). Whereas other neurological manifestations such as weakness of the limbs, loss of consciousness, seizure, confusion, and vision changes are significantly associated with older individuals, this may lead to increased mortality and morbidity in these patients. COVID-19 is associated with many neurological manifestations in the population of Saudi Arabia. The prevalence of neurological manifestations is similar to many previous studies, where acute neurological manifestations such as loss of consciousness and convulsions are seen more in older individuals which may lead to increased mortality and worse outcomes. Other self-limited symptoms such as headache and change in smell function i.e., anosmia or hyposmia were more pronounced in those <40 years. This mandates more attention to elderly patients with COVID-19, to early detect common neurological manifestations associated with it, and to apply preventive measures known to improve the outcome of these symptoms.

Typical and atypical chest computed tomography manifestations in COVID-19 patients

Typical and atypical chest computed tomography manifestations in COVID-19 patients

A massive stroke in a pregnant woman following COVID-19 infection: A case report

Background and aims: COVID-19 infection increases the risk of pathological thrombotic events in venous and arterial circulation. COVID-19 patients are reported, a wide range of neurovascular symptoms is highlighted, such as cerebral vascular accidence. This study aimed to report a massive stroke in a pregnant woman with COVID-19 infection. Case Report: We report a 41-year-old pregnant woman, gravid 5 para 2 living 2 abortion 2 at gestational age 22 weeks and 4 days with Covid-19 infection, which developed into a massive stroke in the Basilar artery despite receiving a therapeutic dosage of Enoxaparin Sodium. Conclusion: The possibility of thrombosis should be considered in COVID-19 patients with symptoms indicating an increase in intracranial pressure (ICP) such as decreased consciousness, strabismus, and agitation. Considering the higher risk of thrombotic events in COVID-19 patients, cerebral venous sinus thrombosis (CVST) could be a possible consequence. Thus, the precise observation of neurologic manifestations in covid-19 patients, especially in pregnant women, is recommended.

Risk factors for the development of hepatic manifestations in COVID-19 patients with digestive symptoms

Background: Abnormalities in liver function tests (LFTs) are found in 14%–53% of hospitalized COVID-19 patients. These could occur in patients with or without previous chronic liver diseases. Knowing the risk factor of liver manifestations in COVID-19 subjects is crucial for the proper management of these patients. Objectives: We aimed to identify the risk factors for liver manifestations as well as other risk factors in COVID-19 subjects who complained of digestive manifestations. Materials and Methods: COVID-19 patients with and without liver manifestations at the Emergency Department of Al Fallujah Teaching Hospital were enrolled in this study. This study covered a period from September 15, 2022, to April 22, 2022. Comparisons between patients with or without abnormal LFTs were made. The possible risk variables connected to abnormal LFTs and hepatic manifestation were investigated using univariable and multivariable logistic regression analysis. Results: Out of 100 COVID-19 patients, there were 64 suffering from mild gastrointestinal (GI) symptoms. There were 26 mild cases with abnormal LFTs (40.6%). Although there were nine (total number 22) and seven (total number 14) of the moderate and severe cases with liver involvement, there was no statistically significant difference between the digestive manifestations severity and liver involvement. Increased alanine aminotransferase (ALT) levels were linked to a greater incidence of LFTs, according to multivariable analysis (odds ratio [OR]: 45.05; P &lt; 0.0001), elevated aspartate aminotransferase (AST; OR: 3.462; P = 0.00041), elevated direct bilirubin (DBIL) (OR: 3.643; P &lt; 0.001), and elevated d-dimer levels [OR]: 2.690; P &lt; 0.0137) in liver involvement group compared with non-involvement patients. Conclusions: Elevated ALT, AST, DBIL, and d-dimer are potential risk factors for liver manifestations in COVID-19 patients with digestive symptoms.

Prevalence of Cutaneous Manifestations in COVID-19 Patients and Their Relationship With Disease Severity

At the beginning of COVID-19 pandemic, highly accurate information about the clinical manifestations of the disease was not available, and the reported symptoms were non-specific and more related to respiratory symptoms such as fever, dry cough, fatigue, and sputum production. As time has passed, skin manifestations have been proposed as one of the clinical manifestations of COVID-19 in some patients. Among all reported lesions, livedoid lesions appeared simultaneously with the symptoms of SARS-CoV-2, mainly in elderly people with severe infections, and were associated with the highest risk of the mortality of all skin lesions. Knowledge of the skin manifestations that may be the only symptoms of COVID-19 may help in early diagnosis and specific treatment. In the current review, the skin findings of patients in association with COVID-19 were summarized into the categories of maculopapular or morbilliform lesions, urticarial lesions, chilblain-like lesions, vesicular lesions, petechiae or purpura lesions, and livedoid lesions.

Neurological manifestations in COVID-19 patients at the Husada Utama hospital emergency room

Neurological manifestations in COVID-19 patients at the Husada Utama hospital emergency room