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Tag: Symptoms

Covid-19: Researchers Identify Six Distinct Symptom ‘types’ of COVID-19

Analysis of data from the COVID Symptom Study app, led by researchers from King’s College London, reveals that there are six distinct ‘types’ of COVID-19, each distinguished by a particular cluster of symptoms.

Moreover, the team found that these types differed in the severity of the disease and the need for respiratory support during hospitalisation.

The findings have major implications for clinical management of COVID-19, and could help doctors predict who is most at risk and likely to need hospital care in a second wave of coronavirus infections.

Although continuous cough, fever and loss of smell (anosmia) are usually highlighted as the three key symptoms of COVID-19, data gathered from app users shows that people can experience a wide range of different symptoms including headaches, muscle pains, fatigue, diarrhea, confusion, loss of appetite, shortness of breath and more. The progression and outcomes also vary significantly between people, ranging from mild flu-like symptoms or a simple rash to severe or fatal disease.

To find out whether particular symptoms tend to appear together and how this related to the progression of the disease, the research team used a machine learning algorithm to analyse data from a subset of around 1,600 users in the UK and US with confirmed COVID-19 who had regularly logged their symptoms using the app in March and April.

The analysis revealed six specific groupings of symptoms emerging at characteristic timepoints in the progression of the illness, representing six distinct ‘types’ of COVID-19. The algorithm was then tested by running it on a second independent dataset of 1,000 users in the UK, US and Sweden, who had logged their symptoms during May.

All people reporting symptoms experienced headache and loss of smell, with varying combinations of additional symptoms at various times. Some of these, such as confusion, abdominal pain and shortness of breath, are not widely known as COVID-19 symptoms, yet are hallmarks of the most severe forms of the disease.

The six clusters are as follows:

1– (‘flu-like’ with no fever): Headache, loss of smell, muscle pains, cough, sore throat, chest pain, no fever.

2- (‘flu-like’ with fever): Headache, loss of smell, cough, sore throat, hoarseness, fever, loss of appetite.

3- (gastrointestinal): Headache, loss of smell, loss of appetite, diarrhea, sore throat, chest pain, no cough.

4- (severe level one, fatigue): Headache, loss of smell, cough, fever, hoarseness, chest pain, fatigue.

5- (severe level two, confusion): Headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain.

6- (severe level three, abdominal and respiratory): Headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain, shortness of breath, diarrhea, abdominal pain.

Next, the team investigated whether people experiencing particular symptom clusters were more likely to require breathing support in the form of ventilation or additional oxygen.

They discovered that only 1.5% of people with cluster 1, 4.4% of people with cluster 2 and 3.3% of people with cluster 3 COVID-19 required breathing support. These figures were 8.6%, 9.9% and 19.8% for clusters 4,5 and 6 respectively. Furthermore, nearly half of the patients in cluster 6 ended up in hospital, compared with just 16% of those in cluster 1.

Broadly, people with cluster 4,5 or 6 COVID-19 symptoms tended to be older and frailer, and were more likely to be overweight and have pre-existing conditions such as diabetes or lung disease than those with type 1,2 or 3.

The researchers then developed a model combining information about age, sex, BMI and pre-existing conditions together with symptoms gathered over just five days from the onset of the illness.

This was able to predict which cluster a patient falls into and their risk of requiring hospitalisation and breathing support with a higher likelihood of being correct than an existing risk model based purely on age, sex, BMI and pre-existing conditions alone.

Given that most people who require breathing support come to hospital around 13 days after their first symptoms, this extra eight days represents a significant ‘early warning’ as to who is most likely to need more intensive care.

“These findings have important implications for care and monitoring of people who are most vulnerable to severe COVID-19,” said Dr Claire Steves from King’s College London. “If you can predict who these people are at day five, you have time to give them support and early interventions such as monitoring blood oxygen and sugar levels, and ensuring they are properly hydrated – simple care that could be given at home, preventing hospitalisations and saving lives.”

Lead researcher Dr Carole Sudre from King’s College London said: ”Our study illustrates the importance of monitoring symptoms over time to make our predictions about individual risk and outcomes more sophisticated and accurate. This approach is helping us to understand the unfolding story of this disease in each patient so they can get the best care.”

*Researchers have now identified skin rash as a key symptom of COVID-19 in up to one in ten cases. However, it was not recognised as a symptom during the time when the data was gathered for this analysis so it is currently unknown how skin rashes map on to these six clusters.

World Allergy Week: COVID-19 and Allergies

The coronavirus pandemic is a time of anxiety for most people, particularly those with existing health concerns. Millions of South Africans live with long-term conditions, including coeliac disease and allergic disorders such as eczema (atopic dermatitis), hay fever (allergic rhinitis) and asthma, one of the most common chronic diseases affecting children.

This year’s World Allergy Week campaign, from 28 June to 4 July, focuses on COVID-19 and allergies.

According to Professor Michael Levin, Head of Allergy at Red Cross War Memorial Children’s Hospital and CEO of Allergy Foundation South Africa (AFSA) there is potentially harmful misinformation around coronavirus and allergies circulating.

Patients are unsure about symptoms and whether their allergies increase the risk of serious COVID-19 complications. We want to reassure people and enable them to manage their allergies as well as possible during this time. To do this, we’re providing factual, up-to-date resources and support for allergy patients and caregivers, thanks to the generous support of Sanofi.”

Professor Levin stresses that people with allergies and asthma should always take good care of themselves, whether or not there is a pandemic. “It is conservatively estimated that 80% of asthma deaths could be prevented with better treatment and access to medication. Not managing your condition does not only negatively impact your health, it can be fatal.”

Dr Royal agrees the most important message for allergy sufferers is to continue good care. “Allergic disorders are systemic diseases and should not be looked at in isolation. They can be well-managed with education, correct medication and ongoing support from your healthcare professional. Whilst people with uncontrolled asthma may be in a high-risk group for severe illness from COVID-19, recent studies have shown this is not the case in well-controlled asthmatics.”

Continue to take and seek treatment, safely: “Do not to stop taking prescribed allergy or asthma medications, including inhaled or oral corticosteroids. Find ways to access care and medication that limits potential exposure to the virus. For example, have medication delivered, or send someone to collect. A telephone appointment with your doctor may be an option than going to the clinic or surgery.”

Coughing for example, is common to asthma and coronavirus; yet fever, body aches and pains which are usually experienced during coronavirus, are rarely related to asthma.

“If you have asthma, continuing to control it could help you defend against the virus. Taking prescribed controller therapy daily, whether you have symptoms or not, helps repair swelling and inflammation in the lungs so that you’re better able to fight off viruses – including the coronavirus,” says Dr Royal.

“There is no evidence that the use of inhaled or nasal steroids increases one’s risk of contracting COVID-19, and using them regularly might even help prevent you from getting the infection or from suffering with more severe symptoms.”

Nebulisers are not recommended, as they can increase the risk to those around you. Professor Levin advises using an asthma pump with a spacer, rather than a nebulizer. “Spacers deliver medication to the airways more effectively than a pump on its own.”

For people with skin or eye allergies, itching may mean touching and potentially increased infection risk. To prevent this, experts recommend regular skincare and steroid use as needed whilst also maintaining excellent hygiene measures – washing hands regularly, always wearing a mask and maintaining social distance.

Allergy care may change for people who become infected with COVID-19. According to Dr Motohiro Ebisawa, President of the World Allergy Foundation, “Professional help is essential to understanding what is causing symptoms such as shortness of breath, chest tightness, or difficulty breathing. Patients should not assume these symptoms are either from their asthma or COVID-19 but consult their physicians immediately in case emergency care is needed.”

Source: allergy foundation

COVID-19: Social media ‘gossip’ drives Covid-positive Benoni teacher to set herself on fire

A school principal whose wife attempted to commit suicide because of depression over Covid-19 plans to embark on community education campaigns aimed at destigmatising people infected by the virus.

Speaking to The Sowetan from his Benoni home in Ekurhuleni on Tuesday, the 51-year-old whose name is being withheld to protect their children, battled to save his 48-year-old wife from the flames engulfing her isolation room at their house.

“It was day 11 (June 6)of her being in quarantine at home. After all the support and medication we had given her, we did not realise she was losing it.”

He said his wife woke up that morning around 4am and went to the kitchen while everybody in the house was still asleep. He and their 17-year-old son went to check if she was fine before they went back to bed.

“After a while we realised there was something burning. I ran to her isolation room. It was locked. I broke the door open and found her in flames.”

“I immediately took a blanket and tried to put out the fire until my brave eight-year-old child ran to fetch a bucket of water which she emptied on her mom in an attempt to rescue her.”

While waiting for paramedics, the principal said, he tried to calm his wife.

“She was painfully sobbing. She got up and took a heater and held it tight. I ran again and removed it from her. She was hallucinating, my heart broke and I felt so helpless. I held her and watched her till the paramedic arrived and rushed her to hospital.”

He said his wife tested positive for the virus two weeks ago after coming back from a meeting at a school in Daveyton where she is a teacher.

“It was on May 26 when she came back sick from work and we thought it was flu. She went to the doctors before she tested positive the next day.”

The principal said his wife did not display any further symptoms of the virus while in isolation.

“She would go for walks in the morning with her mask on around the yard while we cleaned and disinfected her room and sanitised everything in it. She appeared very well although she was panicking about her status.

“I assured her but I was not aware that she was being depressed from receiving messages on social media from friends and colleagues.”

He said she complained about being sent messages that made her feel like she was dying. She also complained about gossip that came from colleagues and friends. 

“I am a school principal. I felt the pain seeing the lack of education in our people on the pandemic. It made me realise that there was a great need to address the stigma in our society and for people to understand that words have power to destroy a person,” he said.

He also said he took his wife’s phone and blocked all her social media applications.

“I have a strong character and I can stay positive when faced with difficulties but after looking at her cry, I had to ask myself, ‘how would I react if I tested positive for the virus?

He said his wife did not take the news well.

On Monday, doctors confirmed his wife was now negative. “Now we focus on her journey to recovery on her burn wounds,” he said.

A family friend said the principal also went into quarantine and has, together with his children, twice tested negative.

Sources: TimesLive, Sowetan

Photo Credit: Unsplash

Dr Adri Kok from Alberton explains new Covid-19 symptoms

According to the People’s Post, as medical understanding of Covid-19 develops globally, studies are increasingly indicating that the condition can present in widely diverse ways.


Dr Adri Kok, a specialist physician and president of both the International Society for Internal Medicine and the Faculty of Consulting Physicians of South Africa, says in addition to asymptomatic (showing no symptoms) carriers of the virus, it has been observed that some patients do not exhibit the respiratory symptoms (cough, shortness of breath, and a sore throat) that are most typical of Covid-19, and yet they develop sudden and potentially life-threatening complications arising as a result of the viral infection.


Dr Kok, who practises at Netcare Union and Netcare Clinton hospitals in Alberton, says that internationally, cases have been documented where patients present for the first time in an emergency setting with stroke, heart attack or various types of organ failure, and testing then reveals these patients to be Covid-19 positive.


“There are reports of even young people suffering a stroke, which occurs when a part of the brain is deprived of oxygen due to a blood clot, as a first indication that they have Covid-19.


“Although this virus primarily affects the upper airway and then the lungs due to droplet spread, Covid-19 may set in motion a series of reactions in the body, which may attack the small blood vessels that are crucial to the functioning of other organs including the heart, kidneys, and brain,” she says.


Dr Kok explains that sometimes the body has an overzealous reaction to an infection, known as a “cytokine storm”, which can lead to serious complications in some cases where people have contracted Covid-19.


Cytokines are proteins that our bodies release to communicate with various cells to co-ordinate bodily responses, as is the case when our immune system stimulates inflammation to fight infection, or clotting to help repair damaged tissues.


“It has been suggested that in some Covid-19 patients who progress to a more advanced stage of the illness, a cytokine storm causes a physiological change in the pneumocytes of the lungs and this then has a pro-thrombotic or clot-causing effect, potentially leading to abnormal clotting in small blood vessels. This blood clotting is known as thrombosis,” she says.


Apart from stroke, Covid-19 positive patients can also present with cardiovascular damage such as acute ischaemic heart disease or pulmonary embolism, a medical emergency caused by a blood clot blocking an artery in the lung, or other organ dysfunction related to thrombosis, including acute kidney failure.


“In addition, it has been observed that Covid-19 can significantly deplete blood oxygen levels even though the patient may not initially feel symptoms of respiratory distress, which is known as ‘silent hypoxia’. By the time people seek medical assistance, their condition may already be serious, with a low oxygen concentration recorded.”


Dr Kok says that in addition to Covid-19 testing, which has become standard for all patients being admitted to Netcare hospitals, a D-dimer test, which indicates clotting, must be performed and the blood oxygen level of emergency patients must be monitored.


“Supplemental oxygen and blood thinning medication, as appropriate, can help to restore blood oxygen and counteract the abnormal clotting effect,” she says.


According to Dr Kok, people who already have any kind of heart or blood vessel disease may be at greater risk for not only contracting Covid-19, but also more severe illness.


“People with chronic illnesses or co-morbidities, especially those over the age of 55, should remain in close contact with their doctor.”


Dr Kok advises that people should report any new symptoms that may arise to their doctor, either their general practitioner or relevant treating specialist, promptly.


“From what we know of Covid-19 so far, better outcomes for many health conditions are usually achieved with early treatment,” she concludes.


Source: People’s Post, News24

Photo Credit: Unsplash


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