Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comt e Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19e98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p ¼ 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p ¼ 0.001), diarrhea (40% vs 20%,p ¼ 0.021), frontal headache (26% vs 9%,p ¼ 0.021) and bilateral cracklings sounds (24% vs 9%,p ¼ 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p ¼ 0.010), dyspnea (59% vs 34%,p ¼ 0.007), sore throat (44% vs 20%,p ¼ 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p ¼ 0.004), vomiting (22% vs 3%,p ¼ 0.001) and rhonchi sounds (17% vs 1%,p ¼ 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the cocirculation of influenza and SARS-CoV-2.
Background: New loss of smell or taste was not included among the common symptoms of COVID-19 until March 2020 when the pandemic started in Western countries. We aim to describe the prevalence and features of anosmia and dysgeusia in COVID-19 patients. Methods: We retrospectively investigated the clinical features of confirmed cases of COVID-19 in Nord Franche-Comté Hospital, Trevenans, France, between March, 1st and March, 14th 2020. We used SARS-CoV-2 real-time RT-PCR in respiratory samples to confirm the cases. Results: Of the 70 patients enrolled, the mean age was 57.0 years, and 29 patients (41%) were men. Median Charlson comorbidity index was 1.70 (AE2.5). Twenty-seven (39%) patients had pneumonia. Fatigue (93% [65]), cough (80%[55]), and fever (77%[54]) were the three main symptoms. Neurologic symptoms were present in more than half of the patients: anosmia (53%[37]) and dysgeusia (48%[34]). The mean duration of anosmia was 7.4 (AE5, [1-21]) days, and 51% (36/70) of patients recovered before 28 days of evolution. Only one patient with anosmia had not recovered at the end of the follow-up. Patients with anosmia had pneumonia less often (10/37 vs 17/33, p = 0.036), were hospitalized less often (13/37 vs 20/33, p = 0.033), and needed oxygen therapy less often (6/37 vs 17/33, p = 0.002) than patients without anosmia. There were no statistically significant differences for viral load between patients with anosmia and patients without anosmia (5.5 [2.0À8.6] vs 5.3 [2.1À8.5] log copies/mL respectively, p = 0.670). The fatality of COVID-19 in our study was 6%, with four deaths. Conclusions: Anosmia and dysgeusia are present in half of COVID-19 patients. The mean duration of anosmia was 7 days, and the outcome seems favorable in less than 28 days.
(1) Background. Post-COVID-19 syndrome is defined as the persistence of symptoms after confirmed SARS-CoV-2 infection. (2) Methods. ANOSVID is an observational retrospective study in Nord Franche-Comté Hospital in France that included adult COVID-19 patients confirmed by RT-PCR from 1 March 2020 to 31 May 2020. The aim was to describe patients with post-COVID-19 syndrome with persistent symptoms (PS group) and to compare them with the patients without persistent symptoms (no-PS group). (3) Results. Of the 354 COVID-19 patients, 35.9% (n = 127) reported persistence of at least one symptom after a mean of 289.1 ± 24.5 days after symptom onset. Moreover, 115 patients reported a recurrence of symptoms after recovery, and only 12 patients reported continuous symptoms. The mean age of patients was 48.6 years (19–93) ± 19.4, and 81 patients (63.8%) were female. Patients in the PS group had a longer duration of symptoms of initial acute SARS-CoV-2 infection than patients in the no-PS group (respectively, 57.1 ± 82.1 days versus 29.7 ± 42.1 days, p < 0.001). A majority of patients (n = 104, 81.9%) reported three or more symptoms. The most prevalent persistent symptoms were loss of smell (74.0%, n = 94), fatigue (53.5%, n = 68), loss of taste (31.5%, n = 40), and dyspnea (30.7%, n = 39). These were followed by pain symptoms (26.8% (n = 34), 26.0% (n = 33), 24.4% (n = 31); headache, arthralgia, and myalgia, respectively). More than half of patients reporting persistent symptoms (58%, n = 73) were healthcare workers (HCWs). Among outpatients, this population was more present in the PS group than the no-PS group ((86.6%) n = 71/82 versus (72.2%) n = 109/151, p = 0.012). Post-COVID-19 syndrome was more frequent in patients with a past history of chronic rhinosinusitis (8.7% (n = 11%) versus 1.3% (n = 3), p < 0.001). No significant difference was found regarding clinical characteristics and outcome, laboratory, imaging findings, and treatment received in the two groups. (4) Conclusions. More than a third of our COVID-19 patients presented persistent symptoms after SARS-CoV-2 infection, particularly through loss of smell, loss of taste, fatigue, and dyspnea, with a high prevalence in HCWs among COVID-19 outpatients.
Highlights No therapeutics have yet been proven effective for the treatment of severe illness caused by SARS-CoV-2. By neutralizing a key inflammatory factor in the cytokine release syndrome in COVID-19, tocilizumab (TCZ) can block the cytokine storm and reduce the severity of the disease. Our case-control study found that patients treated with TCZ had a lower index of mortality and/or invasive mechanical ventilation (IMV) requirement than patients without TCZ. This result strongly suggests that TCZ may reduce the number of IMV requirements and/or mortality in patients with severe SARS-CoV-2 pneumonia. This idea needs to be confirmed and spread in the medical community.
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