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Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation

BACKGROUND: Fever is one of the most frequent symptoms of coronavirus disease 2019 (COVID-19) and clinicians are faced with a practice question on whether fever is a risk for progression of disease especially in persons with risk factors for severe illness. We studied if a difference exists in the c...

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Autores principales: Vasanthan, Krishnan, Sundar, Varun, Bhaskar, Emmanuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451553/
https://www.ncbi.nlm.nih.gov/pubmed/36128007
http://dx.doi.org/10.14740/jocmr4791
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author Vasanthan, Krishnan
Sundar, Varun
Bhaskar, Emmanuel
author_facet Vasanthan, Krishnan
Sundar, Varun
Bhaskar, Emmanuel
author_sort Vasanthan, Krishnan
collection PubMed
description BACKGROUND: Fever is one of the most frequent symptoms of coronavirus disease 2019 (COVID-19) and clinicians are faced with a practice question on whether fever is a risk for progression of disease especially in persons with risk factors for severe illness. We studied if a difference exists in the clinical course and outcome between febrile and afebrile (symptomatic) presentation. METHODS: Patients aged > 18 years with confirmed COVID-19 with at least one risk factor for severe illness were studied. Enrolment was done from a home COVID-19 care cohort between May 2020 and March 2022. Participants were divided into febrile and afebrile groups and further divided into six sub-groups based on their comorbidities (diabetes mellitus, hypertension, chronic lung disease, chronic kidney disease, liver disease and others) using a pre-specified inclusion method. Severity of illness was classified as non-hypoxic or hypoxic and clinical course was monitored. RESULTS: A total of 3,752 patients were studied, of whom 965 (25.7%) had severe illness and 117 (3.1%) died. Persons with obesity (P < 0.001), chronic kidney disease (P = 0.003) and chronic liver disease (P = 0.02) more frequently had presentation without fever. No significant difference in hypoxia (P = 0.35) or mortality (P = 0.50) was observed between febrile (n = 1,240) and afebrile (n = 2,512) presentation. CONCLUSION: Fever in COVID-19 was not associated with severe illness or mortality. The overall and risk factor specific mortality observed in our study is substantially low, probably due to lesser bias in selection of study participants or due to ethnicity of study population.
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spelling pubmed-94515532022-09-19 Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation Vasanthan, Krishnan Sundar, Varun Bhaskar, Emmanuel J Clin Med Res Short Communication BACKGROUND: Fever is one of the most frequent symptoms of coronavirus disease 2019 (COVID-19) and clinicians are faced with a practice question on whether fever is a risk for progression of disease especially in persons with risk factors for severe illness. We studied if a difference exists in the clinical course and outcome between febrile and afebrile (symptomatic) presentation. METHODS: Patients aged > 18 years with confirmed COVID-19 with at least one risk factor for severe illness were studied. Enrolment was done from a home COVID-19 care cohort between May 2020 and March 2022. Participants were divided into febrile and afebrile groups and further divided into six sub-groups based on their comorbidities (diabetes mellitus, hypertension, chronic lung disease, chronic kidney disease, liver disease and others) using a pre-specified inclusion method. Severity of illness was classified as non-hypoxic or hypoxic and clinical course was monitored. RESULTS: A total of 3,752 patients were studied, of whom 965 (25.7%) had severe illness and 117 (3.1%) died. Persons with obesity (P < 0.001), chronic kidney disease (P = 0.003) and chronic liver disease (P = 0.02) more frequently had presentation without fever. No significant difference in hypoxia (P = 0.35) or mortality (P = 0.50) was observed between febrile (n = 1,240) and afebrile (n = 2,512) presentation. CONCLUSION: Fever in COVID-19 was not associated with severe illness or mortality. The overall and risk factor specific mortality observed in our study is substantially low, probably due to lesser bias in selection of study participants or due to ethnicity of study population. Elmer Press 2022-08 2022-08-27 /pmc/articles/PMC9451553/ /pubmed/36128007 http://dx.doi.org/10.14740/jocmr4791 Text en Copyright 2022, Vasanthan et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communication
Vasanthan, Krishnan
Sundar, Varun
Bhaskar, Emmanuel
Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title_full Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title_fullStr Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title_full_unstemmed Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title_short Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation
title_sort outcomes of covid-19 among high-risk individuals: a study comparing febrile and afebrile presentation
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451553/
https://www.ncbi.nlm.nih.gov/pubmed/36128007
http://dx.doi.org/10.14740/jocmr4791
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