Clinical Characteristics of Noncritical Patients with Coronavirus Disease 2019 (COVID-19): Lessons from Bangladesh

2020 ◽  
Vol 37 (2) ◽  
pp. 42-46
Author(s):  
Md Shahed Morshed ◽  
Abdullah Al Mosabbir ◽  
Prodipta Chowdhury ◽  
Sheikh M Ashadullah ◽  
Mohammad Sorowar Hossain

The scientific literatures on clinical manifestations of coronavirus disease 2019 (COVID-19) patients from South Asian countries including Bangladesh are limited. Documentation of clinical spectrum from various geographic locations is vital for future scientific studies and clinical management. This study is aimed to report the sociodemographic and clinical characteristics of noncritical patients with COVID-19 in Bangladesh. We conducted a cross-sectional study at three dedicated COVID-19 hospitals of Bangladesh. The severity of the COVID-19 cases was assessed based on the WHO interim guidance. Data were collected only from non-critical COVID-19 patients as critical patients required immediate management. A total of 103 real-time polymerase chain reaction (RT-PCR) confirmed noncritical COVID- 19 patients were included. Most of the patients (71.8%) were male. Mild, moderate and severe illness were assessed in 74.76%, 9.71% and 15.53% of patients respectively. Nearly 52.4% patients had a co-morbidity, with hypertension being the most common (34%), followed by diabetes mellitus (21.4%) and ischemic heart disease (9.7%). Fever (78.6%), weakness (68%) and cough (44.7%) were the most common clinical manifestations. Other common symptoms included loss of appetite (37.9%), difficulty in breathing (37.9%), loss of taste or smell (35.0%), headache (32%) and body ache (32%). The median time from onset of the first symptom to attending hospitals was 7 days (interquartile range: 4 - 10). This study will help both the clinicians and epidemiologists to understand the magnitude and clinical spectrum of COVID-19 patients in South Asian perspective including Bangladesh. Bangladesh J Microbiol, Volume 37 Number 2 December 2020, pp 42-46

2020 ◽  
Author(s):  
Md. Shahed Morshed ◽  
Abdullah Al Mosabbir ◽  
Prodipta Chowdhury ◽  
Sheikh Mohammad Ashadullah ◽  
Mohammad Sorowar Hossain

Bangladesh is in the rising phase of the ongoing pandemic of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The scientific literature on clinical manifestations of COVID-19 patients from Bangladesh is scarce. This study aimed to report the sociodemographic and clinical characteristics of patients with COVID-19 in Bangladesh. We conducted a cross-sectional study at three dedicated COVID-19 hospitals. The severity of the COVID-19 cases was assessed based on the WHO interim guidance. Data were collected only from non-critical COVID-19 patients as critical patients required immediate intensive care admission making them unable to respond to the questions. A total of 103 RT-PCR confirmed non-critical COVID-19 patients were enrolled. Most of the patients (71.8%) were male. Mild, moderate and severe illness were assessed in 74.76%, 9.71% and 15.53% of patients respectively. Nearly 52.4% of patients had a co-morbidity, with hypertension being the most common (34%), followed by diabetes mellitus (21.4%) and ischemic heart disease (9.7%). Fever (78.6%), weakness (68%) and cough (44.7%) were the most common clinical manifestations. Other common symptoms included loss of appetite (37.9%), difficulty in breathing (37.9%), altered sensation of taste or smell (35.0%), headache (32%) and body ache (32%). The median time from onset of symptom to attending hospitals was 7 days (IQR 4-10). This study will help both the clinicians and epidemiologists to understand the magnitude and clinical spectrum of COVID-19 patients in Bangladesh.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
M. Intriago ◽  
G. Maldonado ◽  
J. Cárdenas ◽  
C. Ríos

Objective. To compare the clinical characteristics of a group of men and women with rheumatoid arthritis (RA) and determine the differences between genders. Materials and Methods. A descriptive and comparative cross-sectional study was developed with a group of 50 men and a control group of 50 women with RA, from a rheumatology center in the city of Guayaquil, Ecuador. Data collected included clinical manifestations, comorbidities, treatment, and disease activity. Clinical and activity differences between sexes were analyzed. Results. Women were more devoted to housework (66%), while men consumed more tobacco (34%) and alcohol (38%). Fatigue (60%), loss of appetite (54%), and weight loss (44%) were more common in women. No differences were found in comorbidities or treatment. Women had higher values of DAS-28 (3.4 vs 2.5), HAQ-DI (1.1 vs 0.4), ESR (33.0 vs 23.2), painful joints (8 vs 3), swollen joints (6 vs 2), and overall physician assessment (3 vs 2). Conclusion. The results are similar to other publications that establish that women have a more aggressive disease with greater activity of the disease and disability.


2021 ◽  
Vol 2 (2) ◽  
pp. 125-134
Author(s):  
Syahrizal Abdul Halim ◽  
Nor Azila Muhd Aris ◽  
Muhammad Zikri Fadzil ◽  
Husna Maizura Ahmad Mahir

   Background: A COVID-19 cluster named as Rengas Cluster was declared on 6th November 2020 after nine students from a boarding school in Padang Rengas, Perak diagnosed as positive COVID-19. Risk assessment was conducted and Targeted Enhanced Movement Control Order (TEMCO) was enforced at the school to contain the viral transmission. An investigation was carried out to analyze epidemiological data, clinical manifestations among cases and effect of TEMCO on this cluster.  Methods: A retrospective cross-sectional study was conducted from 2nd August 2021 until 3rd September 2021 using data that obtained from Kuala Kangsar District Health Office Crisis Preparedness and Response Centre (CPRC) Surveillance System through e-COVID notification system. The variables used in this current study include socio-demographic and clinical characteristics that include age group, gender, occupation, co-morbidities, symptoms and signs.  Results: There were 132 cases out of 324 exposed populations whereby most cases were students (87.9%) and aged between 11 and 20 years old (84.8%). More than half of cases were female (57.6%) with only one case had existing co-morbidity. Majority of cases were asymptomatic (64.4%). Those symptomatic mainly presented with cough (66%) and the strongest significant positive correlation were observed between anosmia and ageusia (r = 0.807, n = 47, p < 0.001). There was no significant association between age group and development of symptoms [χ2 (6, N = 132) = 6.014, p > 0.05]. An abrupt decline in number of cases was observed following TEMCO enforcement.  Conclusion: COVID-19 cases in Rengas Cluster were mostly among young students, asymptomatic and mildly symptomatic. This cluster was timely and effectively controlled by TEMCO enforcement which contributed towards early diagnosis, isolation and treatment for more effective control and preventive measures. 


2021 ◽  
Author(s):  
Toshihide Toriyama ◽  
Yoshiki Hanaoka ◽  
Tetsuyoshi Horiuchi

Abstract Background: The demographic and clinical characteristics of vestibular migraine (VM) based on the International Classification of Headache Disorders (ICHD)-III beta are not well documented, and the underlying pathophysiology remains largely unknown. Based on evidence that central sensitization is involved in VM pathogenesis, we hypothesized that cutaneous allodynia (CA), which is a clinical manifestation of central sensitization, and interictal widespread pressure hyperalgesia (IWPH), which may be an accelerator for central sensitization, are more frequently associated with VM patients compared with non-VM patients. The aim of this study was as follows: 1) to assess differences in demographic and clinical characteristics among VM patients, patients with migraine with vestibular symptoms not meeting VM criteria (MwVS), and patients with migraine without vestibular symptoms (MwoVS); and 2) to evaluate whether VM patients were more frequently associated with CA/IWPH compared with the other two groups.Methods: This cross-sectional study enrolled consecutive migraine patients, aged 18–65. The comprehensive interview form included diagnostic questions of migraine and VM, demographic characteristics, migraine-specific variables, migraine-associated symptoms, and CA. IWPH occurrence was investigated using a manual tender point survey and clinical parameters were compared.Results: A total of 245 episodic migraineurs (mean age = 39.5 ± 11.3 years, 81.2% women) were enrolled. Based on ICHD-III beta criteria, 65 (26.5%), 74 (30.2%), and 106 (43.3%) patients were assigned to the VM group, MwVS group, or MwoVS group, respectively. Pairwise comparisons demonstrated no significant differences between the VM and MwVS groups, except for higher occurrence of headache disability in the VM group. Compared with the MwoVS group, the VM group was significantly associated with aura, severe disability, depression, tinnitus, sleep disorders, multimodal CA, and IWPH.Conclusions: There were no significant differences in clinical features between VM and MwVS groups, except for disability, which was possibly caused by criteria selection bias. VM and MwVS may be on the same disease process spectrum. Widespread multimodal CA, including clinical manifestations of thalamic sensitization, was significantly associated with VM patients compared with MwoVS patients, which indicates that thalamic sensitization may play a key role VM pathogenesis. Furthermore, IWPH may enhance susceptibility to thalamic sensitization.


2015 ◽  
pp. 86-92
Author(s):  
Van Ai Luu ◽  
Tam Vo

Background: Rheumatoid arthritis is an autoimmune disease with complex pathophysiological mechanisms, in which cytokines plays an important role. Currently, based on the understanding of the cytokines, the treatment of rheumatoid arthritis with biological agents had changed the course of the disease. Objectives: Study the clinical characteristics and determine the concentrations of autoantibodies (RF, Anti CCP) and cytokines (IL-1α,IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, VEGF, IFN-γ, TNF-α, MCP1, EGF) in patients with rheumatoid arthritis, simultaneously, evaluate the correlation between the cytokines concentrations and levels of autoantibodies in patients with rheumatoid arthritis treated at Cho Ray Hospital.Subjects and Methods: Descriptive cross-sectional study conducted in 76 patients with rheumatoid arthritis treated at Cho Ray Hospital form June 2013 to April 2014.Results: - Clinical and laboratory characteristics: The most common clinical manifestations are arthritis (98.7%), symmetry joint damage (96.1%), morning stiffness over 1 hour (90.8%). Subcutaneous nodule is accounted for 3.9%. The most common joints involved in rheumatoid arthritis are wrist (93.4%), MCP and knee (90.8%), PIP (76.3%) and ankle (67.1%), the least common is the hip (14.5%). The percentage of autoantibodies and cytokines: rheumatoid arthritis patients with positive results of anti – CCP is accounted for 86%. rheumatoid arthritis patients with increased IL-1α concentrations is accounted for 40,8%; increased IL-1β concentration in 48.7%; increased IL-2 concentration in 32,9%; increased IL-4 concentration in 86%; increased IL-6 concentration in 100%; increased IL-8 concentration in 39,5%; increased IL-10 concentration in 81,6%; increased VEGF concentration in 51,3%; increased IFN-γ concentration in 67,1%; increased TNF-α concentration in 61,8%; increased MCP1 concentration in 30,3%; increased EGF concentration in 39,43%. The average concentrations of cytolines in rheumatoid arthritis patients is as followings: IL-1α (57.36 ± 196.43), IL-1β (123.77± 532.51), Il-2 (279.93 ± 945.04), IL-4(279.93 ± 945.04), IL-6(91.35 ± 170.52), IL-8(270.84 ± 445.45), IL-10(134.58 ± 496.14), VEGF(638.87 ± 540.18), IFN-γ(136.43 ± 338.68), TNF-α(106.27 ± 265.57), MCP1(292.34 ± 265.52), EGF(152.62 ± 123.64).RF is correlated with IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, IFN-γ, and TNF-α. Anti – CCP is correlated with IL-1α, IL-6. Key words: Rheumatoid arthritis, cytokines


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Farshid Abedi ◽  
Frozan Salguqie ◽  
Effat Alemzadeh

Background: Human brucellosis, also known as Malta fever, is an acute systemic zoonotic disease in several parts of the world. The most pathogenic Brucella specie is Brucella melitensis that occurs in the human population of all age groups and of both sexes. Objectives: The present study aimed to investigate human Brucella infection in Afghanistan. Methods: The participants in this cross-sectional study were 44 patients diagnosed with Brucella infection during eight months and confirmed using Wright test by physicians of Iran Clinic Hospital. For data analysis, a statistical model was used through SPSS. Results: The most affected patients were female housewives (40.9%) and students (18.18%). The most frequent clinical manifestations were recurrent attacks of fever (95.34%), weight loss (81.39%), loss of appetite (79.06%), musculoskeletal pain (69.76%), boredom (67.44%), and lethargy (60.46%). A total of 41 (93.18%) patients mentioned the consumption of unpasteurized milk as the source of infection. Conclusions: The study results revealed that the main route of Brucella transmission in Afghanistan is the consumption of contaminated dairy products. The highest prevalence of brucellosis was observed among the young and middle-aged populations and housewives.


2020 ◽  
Vol 103 (5) ◽  
pp. 465-471

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kelly Huang ◽  
Shu-Wen Lin ◽  
Wang-Huei Sheng ◽  
Chi-Chuan Wang

AbstractThe coronavirus disease of 2019 (COVID-19) has caused a global pandemic and led to nearly three million deaths globally. As of April 2021, there are still many countries that do not have COVID-19 vaccines. Before the COVID-19 vaccines were developed, some evidence suggested that an influenza vaccine may stimulate nonspecific immune responses that reduce the risk of COVID-19 infection or the severity of COVID-19 illness after infection. This study evaluated the association between influenza vaccination and the risk of COVID-19 infection. We conducted a retrospective cross-sectional study with data from July 1, 2019, to June 30, 2020 with the Claims data from Symphony Health database. The study population was adults age 65 years old or older who received influenza vaccination between September 1 and December 31 of 2019. The main outcomes and measures were odds of COVID-19 infection and severe COVID-19 illness after January 15, 2020. We found the adjusted odds ratio (aOR) of COVID-19 infection risk between the influenza-vaccination group and no-influenza-vaccination group was 0.76 (95% confidence interval (CI), 0.75–0.77). Among COVID-19 patients, the aOR of developing severe COVID-19 illness was 0.72 (95% CI, 0.68–0.76) between the influenza-vaccination group and the no-influenza-vaccination group. When the influenza-vaccination group and the other-vaccination group were compared, the aOR of COVID-19 infection was 0.95 (95% CI, 0.93–0.97), and the aOR of developing a severe COVID-19 illness was 0.95 (95% CI, 0.80–1.13). The influenza vaccine may marginally protect people from COVID-19 infection.


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