2
|
Almubark RA, Memish ZA, Tamim H, Alenazi TH, Alabdulla M, Sanai FM, BinDhim NF, Alfaraj S, Alqahtani SA. Natural History and Clinical Course of Symptomatic and Asymptomatic COVID-19 Patients in the Kingdom of Saudi Arabia. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2021; 9:118-124. [PMID: 34084102 PMCID: PMC8152377 DOI: 10.4103/sjmms.sjmms_853_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/18/2021] [Accepted: 04/01/2021] [Indexed: 12/15/2022]
Abstract
Objectives: To analyze symptomatic and asymptomatic COVID-19 patients in Saudi Arabia in terms of initial presentation, risk factors, laboratory findings, clinical outcomes and healthcare utilization. Methods: All laboratory-confirmed reverse transcription–polymerase chain reaction positive COVID-19 patients who had been tested at three governmental hospitals in Saudi Arabia (two in Riyadh and one in Makkah) between March 8 and May 18, 2020 were included. Demographics, COVID-19 variables, clinical characteristics and healthcare utilization variables were extracted and combined, and a descriptive analysis was conducted. Symptomatic and asymptomatic (on presentation) patients' data were compared. Results: Eighty percent of the patients were males (81.4% of symptomatic and 73.2% of asymptomatic patients, P = 0.02). Moreover, 47.6% and 38.4% of symptomatic and asymptomatic patients were aged 40–64 years, respectively. Fever, cough and breathing difficulties were frequent presenting symptoms. Overall, diabetes (16.4%), hypertension (11.7%), chronic respiratory disease (7.1%) were the most frequent comorbidities, with no differences between the two groups. Symptomatic patients had higher C-reactive protein levels (3.55 vs. 0.30 mg/L; P < 0.0001) and lower total lymphocytes (1.41 vs. 1.70; P = 0.02). ICU admission and mortality were 12.1% and 4.1% in symptomatic, compared to 6.0% and 2.9% in asymptomatic patients, respectively. Conclusion: In the studied COVID-19 cohort, symptomatic patients tended to be older, had higher C-reactive protein and more lymphopenia with worse outcome than asymptomatic patients. This granular analysis of COVID-19 cohorts enables identification of at-risk cohorts in future waves, optimizing development of patient pathways and public health interventions.
Collapse
Affiliation(s)
- Rasha A Almubark
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.,College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Thamer H Alenazi
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Alabdulla
- Department of Transplant Infectious Disease, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Faisal M Sanai
- Department of Medicine, Gastroenterology Unit, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Nasser F BinDhim
- Scientific Affairs Department, Sharik Association for Health Research, Riyadh, Saudi Arabia.,College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.,CEO Office, Saudi Food and Drug Authority, Atlanta, GA, USA
| | - Sarah Alfaraj
- Infection Control and Corona Center, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| | - Saleh A Alqahtani
- Liver Transplantation Unit, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,Division of Gastroenterology and Hepatology, John Hopkins University, Baltimore, USA
| |
Collapse
|
3
|
Abbasinia M, Hormati A, Eshagh Hossaini SK, Foroghi Ghomi SY, Zamani F, Afifian M, Ahmadpour S. Clinical Manifestations of Gastrointestinal Symptoms in COVID-19 Patients: An Integrative Review. Gastroenterol Nurs 2021; 44:E1-E10. [PMID: 33538525 PMCID: PMC7853724 DOI: 10.1097/sga.0000000000000584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/16/2020] [Indexed: 01/08/2023] Open
Abstract
After the outbreak of novel coronavirus disease 2019 (COVID-19) in Wuhan, China, its spread to other countries is rapidly increasing. In this integrative review, we report the prevalence of gastrointestinal symptoms in patients with COVID-19. For this purpose, available articles on gastrointestinal manifestations in patients with COVID-19, which were reported from China, were reviewed. All reviewed articles were searched from December 11, 2019, to June 20, 2020, based on specific key words. Related findings in these articles show that the main target of COVID-19 is lung tissue, as after the virus enters the body, it mainly causes respiratory symptoms in affected patients. But in addition to respiratory symptoms, it is possible that, over time, these patients present with other symptoms, the most obvious of which are gastrointestinal symptoms. It is well documented that diarrhea and vomiting are the most common gastrointestinal symptoms in COVID-19 patients. As part of this report, we also look at the incidence and frequency of gastrointestinal symptoms in COVID-19 patients in Iran. The results can be used by providers as a guideline for better management of gastrointestinal symptoms in these patients.
Collapse
Affiliation(s)
- Mohammad Abbasinia
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Ahmad Hormati
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Seyed Kamal Eshagh Hossaini
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Seyed Yaser Foroghi Ghomi
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Farhad Zamani
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mahboubeh Afifian
- Mohammad Abbasinia, PhD, MSc, is Assistant Professor of Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Ahmad Hormati, PhD, MD, is Assistant Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; and Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
- Seyed Kamal Eshagh Hossaini, PhD, MD, is Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Hazrat-e Fateme Masoume Hospital, Qom University of Medical Sciences, Qom, Iran
- Seyed Yaser Foroghi Ghomi, PhD, MD, is Assistant Professor of Emergency Medicine, Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
- Farhad Zamani, PhD, MD, is Professor of Gastroenterology and Hepatology, Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
- Mahboubeh Afifian, MSc, Department of Health Information Technology, Tehran University of Medical Sciences, Tehran, Iran
- Sajjad Ahmadpour, PhD, MSc, is Assistant Professor of Nuclear Pharmacy, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Sajjad Ahmadpour
- Correspondence to: Sajjad Ahmadpour, PhD, MSc, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran ()
| |
Collapse
|