Clinical Features and Upper Airway Symptoms in Association with Severity and Outcome in Patients with COVID-19

Objectives: To assess the relationship between the early occurrence of upper respiratory tract symptoms and the severity of SARS-COV-2 infection.Methods: A cohort observational study had been conducted on a total of 140 patients [60 mild, 40 moderate, 40 severe], diagnosed with SARS-CoV-2 between 4th of August and 31 of October 2020. Patients diagnosed by PCR or chest CT scan or both of them. A full history was taken from the patients and data including the age of the patient, gender, occupation, residence, height, weight, history of previous comorbidities {cardiovascular, Diabetes mellitus, Hypertension, chronic respiratory disease, chronic renal disease, malignancy, and other diseases}. Smoking and alcoholic history were also taken, clinical features {loss of smell/taste, sore throat, rhinorrhea, fever, cough, shortness of breath, headache, fatigue, myalgia, arthralgia, diarrhea, and vomiting} and temperature, SPO2, investigations, the need for respiratory support {O2, non-invasive ventilation, invasive ventilation} and any complications developed during illness.Results: Mean age of the patients was 51 (range: 17-82) Males were dominant; (57.1%) with male to female ratio of 1.33 to one, out of the 140 COVID-19 patients, 63 (45%) had upper respiratory symptoms. Regarding biomarkers of severity only S. LDH was significantly lower in cases who did have compared to those who did not have upper respiratory symptoms, 1.3 +/- 1.4 vs. 1.7 +/- 1.3, respectively. The mean SPO2% was significantly higher in patients with upper respiratory symptoms compared to those without. Percent of Pulmonary damage was significantly lower in patients with upper Respiratory symptom compared to those without. Mortalities were significantly lower in patients with upper respiratory symptoms compared to those without; among the 113 patients with upper respiratory symptom compared only 7 (6.2%) died compared to 7 out of 27 (25.9%) patients with no upper respiratory symptom.Conclusion: Early occurrence of upper respiratory tract symptoms predicts less severe form of the disease.