Symptomatology and Epidemiologic Characteristics of COVID 19 Patients in Kerala, India

BACKGROUND The wide range of symptoms of COVID-19 has brought out extensive researches across the world to enable early case detection. Very few studies in India give an overall view of the case scenario of any state. Our study aims to look into the symptomatology and epidemiological characteristics of COVID-19 patients of Kerala. METHODS A cross sectional study was conducted among the COVID-19 patients reported in Kerala till 31st March 2020. Contact details of patients were obtained from Kerala State Disaster Management Authority (KSDMA). Patients were contacted over phone to obtain consent and to collect information regarding demography, contact and symptomatology. RESULTS Among 202 patients in this study, 154 (76.2 %) were foreign returnees and 48 (23.8 %) acquired disease by local transmission. The mean age was 36.5 (13.9) years and majority were males (80.2 %). The most common symptoms reported were fever (n = 90, 45 %), cough (n = 54, 27 %), sore throat (n = 44, 22 %), diarrhoea (n = 29, 14.5 %) and anosmia (n = 24, 12 %), while 39 (19.3 %) patients were asymptomatic. Presumptive median incubation period was 6 (IQR = 4) days and median duration of symptoms was 4 (IQR = 6) days. The proportion of asymptomatic, mild, moderate and severe cases were 19.3 %, 68.8 %, 8.9 % and 3 % respectively. Hypertension (adjusted OR = 3.5, (1.1 11.2), p = 0.03) and locally acquired infection (adjusted OR = 2.8, (1.1 7.1) p = 0.03) were significant predictors of severity of the disease on logistic regression. Case fatality rate was 0.99 %. CONCLUSIONS Mild and nonspecific symptoms and short duration of illness should not be overlooked in COVID-19 and high suspicion should be maintained as a large segment of infections are asymptomatic. The focus should be on insulating the elderly and those with comorbid conditions.