Clinical profile of COVID-19 patients: A review of diagnostic aids and clinical profile of COVID-19

The SARS-CoV-2 is a novel coronavirus which originated in the province Wuhan, China, in December 2019. It is the causative agent of COVID-19, an infection mainly presenting as mild upper respiratory tract infection, with patients presenting with fever, cough, breathlessness and fatigue. The virus predominantly spreads by a person to person contact, which is why it has spread very rapidly in a short span of time, so much so, that multiple countries are affected at present. The number of casualties is ever increasing. Even though our understanding of the novel coronavirus is improving, many countries, including India, are facing a situation which is not getting better with respect to controlling the pandemic. The number of new cases and deaths are ever increasing. There is a general state of panic among all the sections of the society and almost all are affected. With the number of tests being carried out every day, also increasing, a general idea about the signs and symptoms of the disease as well as the diagnostic criterion aids will further help us control the pandemic. This narrative review focuses on the clinical symptoms, diagnostic aids, risk factors, common clinical symptoms, laboratory findings and complications of COVID-19 and also on post COVID 19 Complications.

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Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9040941 ◽

2020 ◽

Vol 9 (4) ◽

pp. 941 ◽

Cited By ~ 136

Author(s):

Israel Júnior Borges do Nascimento ◽

Nensi Cacic ◽

Hebatullah Mohamed Abdulazeem ◽

Thilo Caspar von Groote ◽

Umesh Jayarajah ◽

...

Keyword(s):

Scoping Review ◽

Clinical Symptoms ◽

Meta Analysis ◽

Laboratory Data ◽

Gastrointestinal Symptoms ◽

Common Disease ◽

Imaging Data ◽

Laboratory Findings ◽

Number Of Patients ◽

Novel Coronavirus

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83–1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

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A A Multicentre ICET-A Study of Confirmed SARS-CoV-2 Infection in Patients with Hemoglobinopathies: Preliminary Data from 10 Countries

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2020.046 ◽

2020 ◽

Vol 12 (1) ◽

pp. e2020046 ◽

Cited By ~ 5

Author(s):

Vincenzo De Sanctis

Keyword(s):

Clinical Laboratory ◽

Clinical Symptoms ◽

Respiratory Infections ◽

Gastrointestinal Symptoms ◽

Thalassemia Major ◽

Absolute Number ◽

Laboratory Findings ◽

Radiologic Findings ◽

Novel Coronavirus ◽

Viral Respiratory Infections

Objectives: This study aims to investigate, retrospectively, the epidemiological and clinical characteristics, laboratory results, radiologic findings and outcomes of novel coronavirus disease-19 (COVID-19) in patients with transfusion dependent β thalassemia (β-thalassemia major-TM), non-transfusion dependent β thalassemia (β-thalassemia intermedia -TI) and sickle cell disease (SCD). Design, setting: A total of 17 Centers, from 10 countries, following 9,499 patients with hemoglobinopathies participated in the survey. Main outcome measures: Clinical, laboratory and radiologic findings and outcomes of patients with COVID-19 were collected from medical records and summarized. Results: A total of 13 patients, 7 with TM, 3 with TI and 3 with SCD, with confirmed COVID-19, were identified from 6 Centers from different countries. The overall mean age of patients was 33.7±12.3 years (range:13-66); 9/13 (69.2%) patients were females. The commonest symptoms in the 10 symptomatic patients were: fever (80%), cough (70%), headache (60%), fatigue (60%), gastrointestinal symptoms (diarrhea /vomiting/abdominal pain; 50%), tachypnea/dyspnea (40%), and sore throat (40%). Six patients had pneumonia (unilateral, bilateral or multiple opacity) and 4 needed oxygen therapy. An oxygen saturation ≤ 93% was documented in 3 patients at diagnosis. 6/10 patients had an exacerbation of anemia (2 with SCD, associated with back and chest pain in 1 patient), and 3 (<30%) had a decreased absolute number of lymphocytes. Increased C-reactive protein and D-dimers were the most common laboratory findings (66.6 %). Conclusions: The clinical presentation for COVID-19 in patients with β-thalassemia and SCD varies. Patients with mild/ordinary COVID-19 infection appear to have clinical symptoms and laboratory findings common to other viral respiratory infections. One 30 year old TM female patient with diabetes and chronic kidney disease. For a better understanding of COVID-19 in patients with hemoglobinopathies, further epidemiologic and clinical studies in a larger cohort of patients are required.

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Clinical Features of Patients with Probable 2019 Novel Coronavirus Infected Pneumonia in Rasht, Iran: A Retrospective Case Series

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4755 ◽

2020 ◽

Vol 8 (T1) ◽

pp. 16-22

Author(s):

Samad Karkhah ◽

Mohammad Javad Ghazanfari ◽

Amir Shamshirian ◽

Latif Panahi ◽

Meysam Molai ◽

...

Keyword(s):

Clinical Features ◽

Clinical Laboratory ◽

Clinical Symptoms ◽

Case Series ◽

Symptomatic Treatment ◽

Retrospective Case ◽

Laboratory Findings ◽

Retrospective Case Series ◽

Case Series Study ◽

Novel Coronavirus

BACKGROUND: Coronavirus disease-19 (COVID-19) is the first pandemic infectious disease caused by a novel coronavirus. Viral pneumonia is a severe complication of COVID-19. AIM: Due to the high prevalence of this disease globally, especially in Iran, the aim of this study was to determine the clinical features of seven patients with probable COVID-19 infected pneumonia in Rasht, North Iran. MATERIALS AND METHODS: In this retrospective case series study, we described the clinical, laboratory, and radiological features of seven patients with probable COVID-19 infected pneumonia at Razi Hospital, Rasht, north of Iran, from February 27 to March 16, 2020. RESULTS: In this study, the most common clinical symptoms during hospitalization in patients with COVID-19 were poor appetite (seven cases), dehydration (seven cases), cough (six cases), dyspnea (six cases), fatigue (six cases), fever above 38°C (five cases), myalgia (five cases), Chills (five cases), feeling fever (five cases), sore throat (five cases), and nausea (five cases), respectively. The average body temperature in these patients was 39.32°C. In laboratory findings, erythrocyte sedimentation rate was elevated in three patients. Contrary to most of the evidence, C-reactive protein was not elevated in five patients. All patients received antibiotic and antiviral medications and received symptomatic treatment. Finally, four patients responded to the treatments and were discharged from the hospital; two patients were still hospitalized and only one patient died. CONCLUSION: Patients with COVID-19 associated pneumonia can be treated by evaluating and implementing appropriate therapeutic management. However, at the moment the disease progression for patients with COVID-19 cannot be accurately predicted.

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CLINICAL PROFILE OF LIVER ABSCESS: A HOSPITAL BASED PROSPECTIVE STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i6.1206 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Shwetabh Pradhan ◽

Keshri Amit ◽

Biant Singh

Keyword(s):

Liver Abscess ◽

Clinical Symptoms ◽

Clinical Profile ◽

Amoebic Liver Abscess ◽

Successful Outcome ◽

Percutaneous Catheter Drainage ◽

Elderly Age ◽

Laboratory Findings ◽

X Ray ◽

Abdomen Ct

Objectives: Liver abscess (LA) is defined as collection of purulent material in liver parenchyma which can be due to bacterial, parasitic, fungal, or mixed infection. The liver abscess is mainly classified into amoebic and pyogenic. This present study was to evaluate the aetiology, clinical profile, management and prognosis of liver abscess patients. Methods: A detail history, clinical examinations and relevant investigations were performed to all liver abscess patients. Investigations was performed like as routine blood investigations, chest x-ray, PA view, X-ray abdomen, AP view, ultrasound abdomen, CT scan abdomen (if needed). Culture and sensitivity of the aspirate was performed. Results: Data was analysed by using simple statistical methods with the help of MS-Office software. Conclusions: Liver abscess was commonly seen in elderly age groups. Male was more preponderance than females. Amoebic liver abscess was commonly found. Amoebic liver abscess was commonly seen in alcoholic patients. Abdominal pain, fever and abdominal distension were common clinical symptoms. Tenderness on right hypochondrial, intercostal region and hepatomegaly were the common clinical sign of liver abscess. Abscess was mostly seen in right lobe than left lobe. Most of the patients were managed by percutaneous single aspiration. If aspiration was failed, percutaneous catheter drainage was the choice for management of liver abscess. Hence, A very prompt recognition is important in instituting effective management and achieving good outcomes. Because of the nonspecific symptoms and laboratory findings, the presence of predisposing factors can be helpful in increasing the level of diagnostic suspicion. The key to successful outcome in the management of liver abscess is early diagnosis and appropriate therapy. Keywords: Liver abscess, age group, amoebic liver abscess, pyogenic liver abscess, alcoholic, management of liver abscess

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Atypical case of Wilson's disease with psychotic onset, low 24 hour urine copper and the absence of Kayser-Fleischer rings

Vojnosanitetski pregled ◽

10.2298/vsp130529049k ◽

2014 ◽

Vol 71 (12) ◽

pp. 1155-1158 ◽

Cited By ~ 1

Author(s):

Dragan Krstic ◽

Jadranka Antonijevic ◽

Zeljko Spiric

Keyword(s):

Genetic Analysis ◽

Wilson’S Disease ◽

Clinical Symptoms ◽

Psychiatric Symptoms ◽

Molecular Genetic ◽

Signs And Symptoms ◽

Wilson's Disease ◽

Molecular Genetic Analysis ◽

Laboratory Findings ◽

Atypical Case

Introduction. Wilson's disease is typically manifested in two clinical forms, neurological and hepatic and in rare cases it starts with psychiatric symptoms exclusively. We presented a rare atypical case of Wilson's disease with psychotic onset. Case report. A 22-year-old male patient was initially presented with predominant signs and symptoms of psychiatric disorder and then later with the development of neurological signs and symptoms. Neuroimaging, detected metal deposits in central nervous system (CNS) but not in peripheral organs, while serum analysis excluded pantothenate-kinase associated neurodegeneration (PKAN) and aceruloplasminemia. In favor of the diagnosis of Wilson's disease there were reduced concentrations of copper and ceruloplasmin concentrations and metal deposits in CNS, but other pathognomonic signs and symptoms were absent: in-creased copper in urine, Kayser-Fleischer rings in Descemet?s corneal membrane and deposits of copper in liver. Introduction of penicillamine treatment resulted in improvement in mental and general health of the patient. Molecular genetic analysis definitely confirmed the diagnosis of Wilson's disease. Conclusion. Wilson's disease can remain undetected for a long period of time if masked with dominant or exclusive psychiatric symptoms. If clear clinical symptoms and signs, and unambiguous laboratory findings are not present, it is necessary to perform molecular genetic analysis to confirm the definitive diagnosis.

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Laboratory findings, signs and symptoms, clinical outcomes of Patients with COVID-19 Infection: an updated systematic review and meta-analysis

10.1101/2020.03.25.20043703 ◽

2020 ◽

Cited By ~ 4

Author(s):

Mina Ebrahimi ◽

Amal Saki Malehi ◽

Fakher Rahim

Keyword(s):

Early Stage ◽

Meta Analysis ◽

Signs And Symptoms ◽

Specific Pattern ◽

Laboratory Findings ◽

Cross Sectional ◽

Current Survey ◽

The One ◽

Novel Coronavirus ◽

First Time

AbstractBackground and AimCoronaviruses disease 2019 (COVID-19), for the first time detected in Wuhan, China, rapidly speared around the world and be a Public Health Emergency of International Concern (PHEIC). The aim of the current survey is collecting laboratory findings, analysis them and reporting a specific pattern for help to COVID-19 diagnosis.MethodsTo collect laboratory characteristics, we searched “PubMed” electronic database with the following keywords: “COVID-19” “2019 novel coronavirus” “laboratory findings” “clinical characteristics”.ResultsOnce the initial searches 493 studies were yielded. After removing duplicates studies 480 studies were remained. The 12 studies obtained from the literature, of which 58.3% (7) of studies were case-control (8–14), and 41.7% (5) remaining studies were designed as cross-sectional (1,15–18)ConclusionThe result of the current study showed that in the early stage of COVID-19 infection, maybe there are not significant laboratory findings, but with disease progression, the one or more than signs include increasing AST, ALT, LDH, CK, CRP, ESR, WBC, neutrophil, and decreasing Hemoglobin, lymphocyte count, eosinophil count can be seen. Elevating D-dimer and FDP are associated with ARDS development and can be used as prognostic factors.

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Road Map to Understanding SARS-CoV-2 Clinico-Immunopathology and COVID-19 Disease Severity

Pathogens ◽

10.3390/pathogens10010005 ◽

2020 ◽

Vol 10 (1) ◽

pp. 5

Author(s):

Deepmala Karmakar ◽

Basudev Lahiri ◽

Piyush Ranjan ◽

Jyotirmoy Chatterjee ◽

Pooja Lahiri ◽

...

Keyword(s):

Disease Severity ◽

Severe Form ◽

World Health ◽

Upper Respiratory Tract ◽

Health Crisis ◽

Road Map ◽

Molecular Aspects ◽

Novel Coronavirus ◽

Health Organization ◽

Almost All

SARS-CoV-2, a novel coronavirus, was first identified in Wuhan, China in December 2019. The rapid spread of the virus worldwide prompted the World Health Organization (WHO) to declare COVID-19 a pandemic in March 2020. COVID-19 discontinuing’s a global health crisis. Approximately 80% of the patients infected with SARS-CoV-2 display undetectable to mild inflammation confined in the upper respiratory tract. In remaining patients, the disease turns into a severe form affecting almost all major organs predominantly due to an imbalance of innate and adaptive arms of host immunity. The purpose of the present review is to narrate the virus’s invasion through the system and the host’s reaction. A thorough discussion on disease severity is also presented regarding the behavior of the host’s immune system, which gives rise to the cytokine storm particularly in elderly patients and those with comorbidities. A multifaceted yet concise description of molecular aspects of disease progression and its repercussion on biochemical and immunological features in infected patients is tabulated. The summary of pathological, clinical, immunological, and molecular accounts discussed in this review is of theranostic importance to clinicians for early diagnosis of COVID-19 and its management.

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Novel Coronavirus 2019 Outbreak: A Global Epidemic

Letters in Drug Design & Discovery ◽

10.2174/1570180817999200802033916 ◽

2020 ◽

Vol 17 (12) ◽

pp. 1458-1464

Author(s):

Sweta Kamboj ◽

Rohit Kamboj ◽

Shikha Kamboj ◽

Kumar Guarve ◽

Rohit Dutt

Keyword(s):

World Health ◽

Upper Respiratory Tract ◽

Global Epidemic ◽

The Public ◽

The Government ◽

Tract Disease ◽

The 1960S ◽

Novel Coronavirus ◽

Health Organization ◽

The Impact

Background: In the 1960s, the human coronavirus was designated, which is responsible for the upper respiratory tract disease in children. Back in 2003, mainly 5 new coronaviruses were recognized. This study directly pursues to govern knowledge, attitude and practice of viral and droplet infection isolation safeguard among the researchers during the outbreak of the COVID-19. Introduction: Coronavirus is a proteinaceous and infectious pathogen. It is an etiological agent of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Coronavirus, appeared in China from the seafood and poultry market last year, which has spread in various countries, and has caused several deaths. Methods: The literature data has been taken from different search platforms like PubMed, Science Direct, Embase, Web of Science, who.int portal and complied. Results: Corona virology study will be more advanced and outstanding in recent years. COVID-19 epidemic is a threatening reminder not solely for one country but all over the universe. Conclusion: In this review article, we encapsulated the pathogenesis, geographical spread of coronavirus worldwide, also discussed the perspective of diagnosis, effective treatment, and primary recommendations by the World Health Organization, and guidelines of the government to slow down the impact of the virus are also optimistic, efficacious and obliging for the public health. However, it will take a prolonged time in the future to overcome this epidemic.

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Novel Coronavirus Disease (COVID-19): A Narrative Review Based on Current Status

Anti-Infective Agents ◽

10.2174/2211352518999201020202540 ◽

2020 ◽

Vol 18 ◽

Author(s):

Rina Das ◽

Dinesh Kumar Mehta ◽

Meenakshi Dhanawat

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Clinical Symptoms ◽

Virus Disease ◽

Relevant Literature ◽

World Health ◽

Current Status ◽

Future Research ◽

Treatment And Prevention ◽

First Case ◽

Novel Coronavirus

Abstract:: A novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appeared and expanded globally by the end of year in 2019 from Wuhan, China, causing severe acute respiratory syndrome. During its initial stage, the disease was called the novel coronavirus (2019-nCoV). It was named COVID-19 by the World Health Organization (WHO) on 11 February 2020. The WHO declared worldwide the SARS-CoV-2 virus a pandemic on March 2020. On 30 January 2020 the first case of Corona Virus Disease 2019 (COVID-19) was reported in India. Now in current situation the virus is floating in almost every part of the province and rest of the globe. -: On the basis of novel published evidences, we efficiently summarized the reported work with reference to COVID-19 epidemiology, pathogen, clinical symptoms, treatment and prevention. Using several worldwide electronic scientific databases such as Pubmed, Medline, Embase, Science direct, Scopus, etc were utilized for extensive investigation of relevant literature. -: This review is written in the hope of encouraging the people successfully with the key learning points from the underway efforts to perceive and manage SARS-CoV-2, suggesting sailent points for expanding future research.

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Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

Journal of Child Science ◽

10.1055/s-0040-1717077 ◽

2020 ◽

Vol 10 (01) ◽

pp. e137-e140

Author(s):

Mosaad Abdel-Aziz ◽

Nada M. Abdel-Aziz ◽

Dina M. Abdel-Aziz ◽

Noha Azab

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Clinical Course ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Angiotensin Converting Enzyme 2 ◽

Compulsory Vaccination ◽

Specific Factors ◽

Novel Coronavirus ◽

Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

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