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These days a slight fever is enough to launch panic attacks and sleepless nights. After all isn’t that how covid-19 begins? But what if we told you just fever might not be enough to the presence of covid-19. At least that’s what a report from All India Institute of Medical Sciences claims.
A recent study observed 144 covid-19 patients admitted in the AIIMS Trauma Centre in Delhi, Jhajjar and Haryana only to find that fever might not be a typical symptom of covid 19. The findings of the study were published in the Indian Journal of Medical Research by the Indian Council of Medical Research.
The study stated that: “Fever was present in only 17% of our patients, which was far less compared to other reports across the globe, including the Chinese cohort in whom 44% had fever at the time of presentation and 88% developed fever during the hospital stay.” The researchers also added that, “more than 44% of the hospitalised patients were asymptomatic at the time of hospital admission and remained so throughout”.
“Thus, overemphasis on fever as a predominant symptom may lead to several cases being missed. This may be a cause of concern as these asymptomatic patients are potential transmitters of infection in the community,” the researchers said.
According to the study, 44.4% of the “significant proportion” of patients were asymptomatic, and only 34.7% of the symptomatic patients reported cough, which was followed by 17.4% reporting fever, and 2% showing nasal symptoms.
Over the time many new symptoms have been recognised in the Indian Health Ministry’s clinical protocol which include loss of smell and taste, diarrhoea, and muscle pain as signs of covid-19.
The study describes the clinical demographic characteristics and in-hospital outcomes of a group of covid-19 patients in north India.
No correlations with smoking
Conducted between the months of March and April, the research has had some interesting findings. No association between age, gender, or even smoking habits was found with the covid-19 patients. Neither there was an association with TLC (total lung capacity) grading or lymphopenia.
“However, a significant association was observed between severe disease at presentation and Neutrophil-to-Lymphocyte [N-L] Ratio,” the study said. The N-L Ratio is used to ascertain inflammation in the body.
Nine of the patients were smokers. However under the due course of the study, they weren’t found to have a more severe case as compared to other patients, neither were they responding to the treatment differently. The study also clarified: “However, according to a recent systematic review and meta-analysis, smoking appears to be a risk factor for covid-19 progression with higher prevalence of smoking among Covid-19 patients with severe, progressive disease or intensive care admission.”
What were the treatment protocols like
Undergoing symptomatic treatment, most of these patients were treated with supportive care alone. About 48.6% were treated with antihistamines, 47.2% with vitamin C, and 20.8% with paracetamol. Azithromycin was prescribed to 29 (20.1%) patients, HCQ was administered to 27 (18.7%) patients and 11 (7.6 per cent) received both HCQ and azithromycin. One patient was prescribed antitubercular therapy on a clinicoradiological basis.
As far as ventilation is concerned, none of the patients were treated with non-invasive ventilation or even high-flow nasal cannula. However, just one patient had to be provided with mechanical ventilation. And five of them required oxygen supplementation.