Prevalence Of Typical Symptoms Research Articles

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

BackgroundThe ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms.MethodsInternational, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms.Results‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country.InterpretationThis international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men.

REVIEW OF 5 YEARS RESULTS AFTER SURGERY FOR GASTRO-OESOPHAGEAL REFLUX DISEASE: NISSEN VS TOUPET

Abstract INTRODUCTION Multiple studies attempt to demonstrate the superiority of Toupet fundoplication over the classic Nissen technique in the treatment of gastro- oesophageal reflux disease (GERD). In our study we compared the results of both techniques. MATERIAL AND METHODS A retrospective descriptive study of patients operated because of GERD using laparoscopic Nissen and Toupet fundoplication in our centre between January 1, 2015 and December 31, 2019. RESULTS 80 patients were operated, 56 Nissen (70%) versus 24 Toupet (30%). Both groups are comparable in terms of mean age, distribution by sex, obesity, toxic habits, the prevalence of typical symptoms, DeMeester, and presurgical lower oesophagal sphincter pressure; although there are differences regarding the presence of associated hiatal hernia and within them the type. A similar surgical time (136.59 vs 132.71 minutes) and mean stay (4.02 vs 5 days) were observed. In the Nissen group, 12 patients (21.42%) presented initial postoperative dysphagia, requiring 2 endoscopic dilations and 5 reoperations, compared to 5 patients (20.83%) in the Toupet group, that did not require dilation and with 1 reoperation. The conversion and mortality rate was 0% in both groups, with a variable follow-up of 22.08 versus 14.45 months. CONCLUSIONS Both techniques present similar results, including the rate of postoperative dysphagia, which is one of the most feared complications. However, it would be necessary to increase the size and longer follow-up to establish long-term results.

Establishment of Diagnostic Protocols for COVID-19 Patients.

Objective:To evaluate the oscillation of laboratory parameters among indoor patients infected with COVID-19.Methods:This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from 01 March 2020 to 20 May 2020. Three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included. Prevalence of typical symptoms of coronavirus disease cough, fever, sore throat and shortness of breath was recorded.PCR was repeated after seven days of admission, if declared negative, another executed on consecutive day. Discharge Criteria was two consecutive negative PCR.Results:A total of 392 patients enrolled in the study with age range 9-45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. 296(75.5%) did not have a cough whereas 96(24.5%) presented with the trait. 296 (75.5%) patients did not have associated fever whereas 96(24.5%) manifested with fever. Chest x-ray had a bilateral patch in 96 (24.5%) patients only. Ferritin was raised in 96 (24.5%) patients however were recorded within normal limits in 296(75.5%) patients. Coagulation Profile was deranged in 64(16.3%) patients whereas was within range in 328(83.7%) patients. Serum Bilirubin, Serum Alkaline phosphatases, Serum Albumin, Serum Urea, Serum Potassium were essentially in typical tolls in 392(100%) patients. However Serum Alanine Aminotransferase was raised in 32(8.2%), Serum C reactive Protein was elevated in 48(12.2%). An exaggerated values of serum creatinine and serum sodium were noticed in 24(6.1%) and 16(4.1%) respectively.Conclusion:Routine haematological tests, biochemical tests, serological tests, and radiographic tests are crucial to conclusion, foundation and progression of ailment in COVID-19 contaminated patients.

Characteristics of Pulmonary Tuberculosis in Elderly People

Results: There was no difference in the prevalence of typical symptoms between the younger and the elderly group. Dypsnea was the only symptom that occurred more frequently in the elderly group (16.8% vs 5.5%, p=0.008). On radiological study, pneumonic infiltration type was more common in the elderly group (28.6% vs 16.8%, p=0.035). Sputum Acid fast bacilli smear positivity rate was si milar between the 2 groups. Elderly patients with anti-tuberculosis medication had more frequent adverse drug reactions; however, there was no significant difference between the 2 groups in the number of patients required to stop medication due to an adverse drug reaction. There were more patients lost to follow-up in the elderly group (22/112, 19.6% vs 11/113, 9.7%, p=0.036). Conclusion: The majority of elderly patients did not complete the treatment, resulting in a poorer outcome. Therefore, we need to make an effort to support the continued screening of elderly patients by making this economically feasible.