Overemphasis On Fever As A Predominant Symptom Of Coronavirus May Lead To Missing Several Cases: AIIMS Study

Overemphasis On Fever As A Predominant Symptom Of Coronavirus May Lead To Missing Several Cases: AIIMS Study

The study titled ‘Clinico-demographic profile and hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India’ evaluated symptoms of 144 patients of Novel Coronavirus
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Overemphasis On Fever As A Predominant Symptom Of Coronavirus May Lead To Missing Several Cases: AIIMS StudyOut of the 144 COVID-19 patients surveyed, 134 were male
Highlights
  • 29 doctors from AIIMS have conducted the study on COVID-19 patients
  • 44.4 per cent of the patients surveyed were asymptomatic: Study
  • Among the symptomatic, cough (34.7%) was the most common symptom: Study

New Delhi: Since the start of the Coronavirus pandemic, fever has been seen as a predominant symptom of SARS-CoV-2 causing COVID-19 disease. This is the reason, at the start of the pandemic, temperature checks at entry points at airports, railway stations, offices and other public places was mandated. However, after seven months into dealing with the pandemic, various other symptoms like loss of taste or smell, diarrhoea, chills, have been reported. A study titled ‘Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India’ conducted by 29 doctors including Dr Randeep Guleria from All India Institute of Medical Sciences (AIIMS) has found that fever was not a prime symptom of Novel Coronavirus.

The study published in the Indian Journal of Medical Research (IJMR) focused at single-centre collection of data regarding epidemiological, demographic, clinical and laboratory parameters, management and outcome of COVID-19 patients admitted in a tertiary care facility in north India. Data of 144 patients with COVID-19 admitted at AIIMS, Delhi, from March 23 till April 15, 2020, were recorded and analysed.

Also Read: Is Skin Rash A New COVID-19 Symptom? Experts Explain

Analysis Of Coronavirus Symptoms And The Treatment

According to the findings, a significant proportion of patients (44.4 per cent) was asymptomatic at admission, and remained so throughout the hospital course. As per the report, this may be a cause of concern as these asymptomatic patients are potential carriers or transmitters of infection in the community.

Among the symptomatic, cough (34.7 per cent) was the most common symptom followed by nasal symptoms (21.5 per cent), throat irritation (21.5 per cent) and fever (17.4 per cent).

Explaining what does this mean, the study states,

Fever was present in only 17 per cent of our patients, which was far less compared to other reports across the globe, including the Chinese cohort in whom 44 per cent had fever at the time of presentation and 88 per cent developed fever during the hospital stay. Thus, overemphasis on fever as a predominant symptom may lead to several cases being missed.

The majority of the patients were treated with supportive care and required only symptomatic treatment that is antihistamines (a drug used to treat allergies), vitamin C and paracetamol.

Also Read: Coronavirus Outbreak Explained: What Are The Long-Term Impacts Of COVID-19 On Human Body And The Recovery Process?

Only five (3.5 per cent) patients required oxygen supplementation, four (2.8 per cent) patients had severe disease requiring intensive care, one required mechanical ventilation and mortality occurred in two (1.4 per cent) patients. The two deaths were among the severe group, amounting to the mortality to 50 per cent in that group. Elaborating on the two deaths, the study states,

One of these was a 35-year-old male with diabetic ketoacidosis, multilobar consolidation and septic shock, who required cardiopulmonary resuscitation immediately on arrival to the hospital and died within the next three hours. The second was an emaciated, malnourished patient with bicytopenia (reduction of any of the two cell lines of blood), bilateral lung infiltrates and right upper zone cavitation, who died on the fifth day of admission due to refractory acute respiratory distress syndrome.

Patients’ Demography

Out of 144 patients studied, 134 (93.1 per cent) were males. The research document states that this may be related to the fact that the majority of the patients were part of a public congregation mainly attended by males, which was identified as a COVID-19 hotspot, and patients were identified on active screening.

While 134 patients were Indian nationals, 10 (6.9 per cent) were foreign nationals – Fiji, Kyrgyzstan, Malaysia and Thailand.

Also Read: Coronavirus Explainer: 20 COVID-19 Related Terms And What These Mean

In the case of 119 (82.6 per cent) patients, close contact with COVID-19 patients in public congregations was documented as the reason for exposure to the virus. Another prominent exposure characteristic is domestic travel to and from affected states (77.1 per cent).

Two patients (1.4 per cent) were reported to be smokers whereas seven (4.9 per cent) were reformed smokers. All nine patients recovered with treatment.

None of them had severe disease, or worsening during the hospital course. Due to the low number of smokers and the low frequency of adverse events, we could not evaluate the correlation of smoking with the severity of disease or adverse outcome, states the report.

Comorbidities were present in 23 (15.9 per cent) patients, of which diabetes mellitus was the most common; found in 16 (11.1 per cent) patients.

Also Read: Top US Doctor Raises Alarm Over India Heading Towards Becoming A Global Coronavirus Hotspot

Coronavirus Symptoms Identified So Far

According to the government, there are a total of 10 symptoms of COVID-19 – fever; cough; fatigue; shortness of breath; expectoration; myalgia (muscle pain); rhinorrhea (runny nose); sore throat; diarrhoea; loss of smell (anosmia) or loss of taste (ageusia) preceding the onset of respiratory symptoms.

On June 13, the Ministry of Health and Family Welfare added a new symptom of COVID-19 – loss of smell (anosmia) or loss of taste (ageusia) – in its existing list of symptoms. However, on April 27, the Centers for Disease Control and Prevention (CDC), a leading national public health institute of the United States had added six new symptoms of COVID-19 including ‘new loss of taste or smell’.

According to the doctors, since it’s a Novel Coronavirus, medical experts across the globe are learning about it every day and the symptoms are evolving.

Right from the lung to the gastrointestinal tract to the vascular system to the central nervous system to the eyes to the skin, Coronavirus is showing its manifestation in every area, said Dr Ravindra Mehta, Chief of Pulmonary and Critical Care Medicine at Apollo Hospitals in Bengaluru.

Also Read: Airborne Transmission Of Novel Coronavirus Can Occur In Healthcare Settings: World Health Organisation

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

11,34,05,654Cases
4,69,42,202Active
6,39,46,277Recovered
25,17,175Deaths
Coronavirus has spread to 192 countries. The total confirmed cases worldwide are 11,34,05,654 and 25,17,175 have died; 4,69,42,202 are active cases and 6,39,46,277 have recovered as on February 27, 2021 at 4:03 am.

India

1,10,79,979 16488Cases
1,59,590 3604Active
1,07,63,451 12771Recovered
1,56,938 113Deaths
In India, there are 1,10,79,979 confirmed cases including 1,56,938 deaths. The number of active cases is 1,59,590 and 1,07,63,451 have recovered as on February 27, 2021 at 2:30 am.

State & District Details

State Cases Active Recovered Deaths
DistrictCases
Mumbai45,478
Thane13,660
Pune9,920
Mumbai Suburban5,363
Aurangabad1,974
Nashik1,575
Raigad1,462
Palghar1,421
Solapur1,291
Jalgaon1,039
Akola757
Nagpur692
Kolhapur646
Satara629
Ratnagiri350
Amravati291
Dhule228
Hingoli208
Jalna201
Ahmednagar190
Nanded176
Yavatmal150
Sangli145
Latur139
Osmanabad125
Sindhudurg114
Buldhana88
Parbhani78
gondia69
Beed54
Nandurbar42
Gadchiroli42
Bhandara41
Chandrapur32
Washim13
Wardha11

21,38,154 8,333

68,810 3,349

20,17,303 4,936

52,041 48

DistrictCases
Kannur357
Kasaragod333
Palakkad224
Malappuram119
Kollam118
Thrissur106
Thiruvananthapuram104
Pathanamthitta98
Kozhikode90
Alappuzha76
Kottayam73
Ernakulam60
Idukki40
Wayanad36

10,52,357 3,671

51,679 485

9,96,514 4,142

4,164 14

DistrictCases
Udupi1,176
Kalaburagi669
Yadgir538
Bengaluru Urban529
Raichur369
Mandya346
Belagavi337
Bidar219
Hassan205
Davangere204
Vijayapura201
Dakshina Kannada179
Chikkaballapura149
Mysuru107
Bagalkote103
Uttara Kannada95
Shivamogga67
Dharwad61
Ballari60
Gadag45
Bengaluru Rural40
Tumakuru36
Kolar29
Haveri24
Chikkamagaluru19
Chitradurga14
Koppal5
Kodagu4
Ramanagara3
Chamarajanagara0

9,50,207 571

5,520 75

9,32,367 642

12,320 4

DistrictCases
Kurnool795
Krishna557
Guntur511
Anantapur428
East Godavari356
Chittoor319
Sri Potti Sriramulu Nell*296
Y.S.R.205
West Godavari199
Srikakulam183
Prakasam104
Visakhapatnam103
Vizianagaram23

8,89,681 96

635 24

8,81,877 71

7,169 1

DistrictCases
Chennai23,324
Chengalpattu1,314
Thiruvallur774
Villupuram509
Kanchipuram503
Tiruvannamalai496
Cuddalore477
Ariyalur444
Tirunelveli433
Tuticorin333
Kallakurichi324
Madurai322
Salem258
Coimbatore188
Virudhunagar185
Dindigul175
Perambalur133
Ranipet133
Thanjavur130
Theni129
Tiruchirappalli119
Ramanathapuram119
Tiruppur116
Kanniyakumari110
Tenkasi103
Nagapattinam99
Karur88
Namakkal83
Erode75
Vellore71
Thiruvarur67
Pudukkottai53
Sivaganga46
Tirupathur45
Krishnagiri43
The Nilgiris17
Dharmapuri15

8,50,577 481

4,046 7

8,34,043 483

12,488 5

DistrictCases
North West5,463
Central4,817
West4,768
New Delhi3,405
North3,059
East2,472
South East2,446
South West2,391
South2,329
North East1,914
Shahdara1,580

6,38,849 256

1,231 62

6,26,712 193

10,906 1

DistrictCases
Gautam Buddha Nagar1,119
Agra933
Ghaziabad794
Meerut504
Lucknow386
Saharanpur298
Kanpur Nagar286
Moradabad252
Varanasi243
Hapur225
Aligarh215
Basti214
Amethi206
Rampur203
Jaunpur194
Firozabad190
Barabanki168
Gorakhpur166
Bulandshahr166
Siddharth Nagar159
Ghazipur159
Bijnor157
Deoria143
Azamgarh138
Sant Kabeer Nagar132
Mathura129
Ayodhya120
Muzaffarnagar117
Sambhal116
Sultanpur97
Ambedkar Nagar92
Maharajganj85
Amroha80
Rae Bareli78
Bahraich73
Kheri72
Kannauj69
Baghpat68
Kushi Nagar67
Bhadohi60
Ballia60
Gonda59
Etah52
Hardoi49
Balrampur49
Mau48
Mainpuri46
Etawah46
Hathras43
Unnao42
Jalaun41
Jhansi41
Shamli40
Chandauli38
Auraiya37
Farrukhabad36
Sitapur32
Prayagraj30
Banda27
Shahjahanpur25
Shravasti23
Budaun23
Mirzapur22
Bareilly17
Kasganj16
Pratapgarh15
Pilibhit15
Sonbhadra10
Kaushambi6
Kanpur Dehat4
Chitrakoot4
Lalitpur3
Hamirpur3
Mahoba3
Fatehpur3

6,03,350 118

2,184 2

5,92,441 114

8,725 2

DistrictCases
Kolkata2,777
Howrah1,435
24 Paraganas North1,031
Hooghly604
24 Paraganas South281
Maldah235
Dinajpur Uttar216
Coochbehar210
Birbhum206
Medinipur West159
Medinipur East153
Nadia139
Purba Bardhaman130
Murshidabad125
Bankura116
Darjeeling97
Jalpaiguri88
Paschim Bardhaman70
Purulia66
Dinajpur Dakshin50
Alipurduar39
Kalimpong18
Jhargram9

5,74,716 216

3,343 10

5,61,110 223

10,263 3

DistrictCases
Ganjam581
Jajapur322
Khordha238
Baleshwar190
Kendrapara164
Cuttack155
Bhadrak137
Balangir129
Puri103
Sundargarh102
Jagatsinghapur91
Nayagarh86
Mayurbhanj73
Nuapada69
Gajapati61
Dhenkanal36
Boudh34
Kendujhar34
Deogarh33
Kalahandi33
Sonepur29
Kandhamal28
Anugul26
Malkangiri20
Bargarh16
Koraput16
Sambalpur16
Jharsuguda8
Nabarangpur2
Rayagada2

3,37,018 94

640 31

3,34,463 63

1,915

DistrictCases
Jaipur2,177
Jodhpur1,748
Udaipur724
Bharatpur563
Kota503
Nagaur500
Ajmer379
Dungarpur374
Pali352
Jhalawar329
Bhilwara250
Sikar231
Chittorgarh188
Tonk171
Jalore164
Rajsamand140
Sirohi130
Bikaner112
Banswara91
Alwar90
Churu81
Jhunjhunu64
Dausa61
Dholpur60
Baran59
Jaisalmer53
Barmer34
Hanumangarh31
SawaiMadhopur26
Karauli17
Pratapgarh14
Ganganagar8
Bundi5

3,20,078 149

1,231 23

3,16,061 125

2,786 1

DistrictCases
Bilaspur100
Korba100
Mungeli87
Baloda Bazar85
Jashpur77
Janjgir-Champa56
Mahasamund54
Rajnandgaon52
Kabirdham52
Raigarh47
Raipur46
Balod41
Korea39
Durg31
Bemetara21
Kanker19
Balrampur17
Surguja14
Gariyaband10
Surajpur9
Dhamtari6
Bijapur2
Bastar2
Dantewada0
Kondagaon0
Narayanpur0
Sukma0

3,12,179 279

2,827 38

3,05,524 310

3,828 7

DistrictCases
Hyderabad2,475
Ranga Reddy183
Suryapet87
Jagitial77
Nizamabad76
MedchalMalkajgiri75
Mancherial43
YadadriBhuvanagiri40
Jogulamba Gadwal40
Vikarabad40
Nalgonda33
Warangal Urban32
Mahabubnagar30
Sangareddy26
Khammam26
Adilabad22
Nirmal21
Karimnagar17
RajannaSircilla16
Medak11
Kamareddy11
Mahabubabad10
Jayashankar Bhupalapally9
Nagarkurnool8
Kumuram Bheem Asifabad8
Jangoan8
Siddipet7
Peddapalli5
Bhadradri Kothagudem5
Warangal Rural4
Mulugu3
Narayanpet3
Wanaparthy1

2,98,631 178

1,939 29

2,95,059 148

1,633 1

DistrictCases
Gurugram2,950
Faridabad867
Sonipat404
Rohtak145
Palwal120
Jhajjar114
Karnal104
Hisar98
Ambala93
Panipat78
Nuh68
Bhiwani60
Rewari56
Kurukshetra55
Sirsa50
Kaithal48
Mahendragarh47
CharkiDadri43
Panchkula39
Fatehabad38
Jind38
Yamunanagar19

2,70,411 148

1,103 49

2,66,264 98

3,044 1

DistrictCases
Ahmadabad17,125
Surat2,311
Vadodara1,555
Gandhinagar410
Mahesana159
Banas Kantha147
Bhavnagar146
Rajkot135
Arvalli134
Mahisagar125
Anand107
PanchMahals107
Patan105
SabarKantha101
Kachchh99
Kheda98
Jamnagar63
Bharuch56
Botad55
Surendranagar55
Valsad47
GirSomnath45
Dohad43
Chhotaudepur37
Naysari35
Junagadh31
Narmada25
DevbhumiDwarka22
Amreli16
Porbandar11
Tapi6
Dang5
Morbi4

2,69,031 460

2,136 145

2,62,487 315

4,408

DistrictCases
Patna279
Bhagalpur266
Rohtas256
Khagaria253
Begusarai243
Madhubani199
Munger188
Jehanabad178
Katihar175
Darbhanga143
Samastipur139
Siwan139
PurbiChamparan138
Purnia135
Banka134
Buxar134
Nalanda123
Gopalganj123
Nawada122
Sheikhpura118
Gaya115
Kaimur (bhabua)105
Bhojpur103
Saran101
Muzaffarpur96
Saharsa88
Supaul87
Vaishali87
Madhepura82
Kishanganj75
Aurangabad75
Sitamarhi73
Lakhisarai72
Araria68
Pashchim Champaran57
Arwal52
Jamui47
Sheohar20

2,62,464 46

431 47

2,60,493 92

1,540 1

DistrictCases
Indore3,839
Bhopal1,880
Ujjain799
Burhanpur351
Neemuch319
Jabalpur276
East Nimar266
Sagar228
Gwalior211
Khargone196
Dewas140
Dhar132
Mandsaur112
Morena109
Bhind87
Raisen71
Barwani60
Ratlam51
Rewa39
Shajapur39
Hoshangabad37
Vidisha37
Chhatarpur35
Betul35
Rajgarh31
Dindori29
Sheopur26
Damoh26
Satna24
Anuppur22
Panna20
Tikamgarh18
Sidhi17
Narsinghpur17
Chhindwara16
Agar Malwa15
Mandla15
Shivpuri15
Jhabua14
Shandol14
Singrauli13
Ashoknagar13
Datia12
Sehore12
Umaria10
Balaghat9
Guna8
Harda4
Alirajpur3
Katni3
Seoni2
Niwari0

2,61,013 332

2,518 83

2,54,633 246

3,862 3

DistrictCases
Kamrup Metro276
Golaghat203
Nagaon143
Hojai89
Dima Hasao86
Karimganj85
Tinsukia84
Cachar80
Dibrugarh61
Hailakandi57
Lakhimpur57
Marigaon50
Dhemaji47
Kamrup42
Kokrajhar37
Dhubri30
Charaideo29
Barpeta28
Udalguri28
Sonitpur27
Jorhat24
Nalbari23
Darrang20
Sivasagar20
Goalpara19
Biswanath16
Baksa14
KarbiAnglong13
Bongaigaon12
Chirang6
West KarbiAnglong5
South SalmaraMancachar4
Majuli2

2,17,518 34

1,634 11

2,14,792 22

1,092 1

DistrictCases
Amritsar485
Jalandhar297
Ludhiana293
Tarn Taran163
Gurdaspur154
Hoshiarpur140
S.A.S Nagar137
Patiala132
Sangrur107
Shahid Bhagat Singh Nagar (Nawanshahr)99
Pathankot86
Rupnagar (Ropar)74
Faridkot74
Sri Muktsar Sahib71
Moga65
Bathinda60
Fatehgarh Sahib57
Fazilka53
Firozepur50
Kapurthala44
Mansa31
Barnala25

1,81,004 622

4,222 352

1,70,968 255

5,814 15

DistrictCases
Anantnag395
Srinagar300
Kulgam295
Baramulla271
Shopian255
Kupwara231
Bandipora175
Udhampur155
Ramban151
Jammu138
Budgam110
Pulwama108
Kathua53
Rajouri39
Ganderbal37
Poonch35
Doda27
Reasi26
Samba25
Kishtwar10
Mirpur0
Muzaffarabad0

1,26,286 85

803 17

1,23,527 101

1,956 1

DistrictCases
East Singhbum170
Ranchi148
Hazaribagh110
Garhwa80
Ramgarh75
Koderma58
Simdega48
Dhanbad32
Gumla28
Palamu27
West Singhbhum21
SaraikelaKharsawan20
Giridih19
Bokaro16
Latehar14
Khunti10
Lohardaga8
Deoghar5
Dumka5
Pakur4
Jamtara2
Godda2
Chatra1
Sahebganj0

1,19,863 68

492 25

1,18,284 43

1,087

DistrictCases
Dehradun370
Nainital323
Tehri Garhwal110
Haridwar94
Udam Singh Nagar83
Almora71
Champawat45
Pithoragarh43
Chamoli36
PauriGarhwal36
Bageshwar31
Rudraprayag30
Uttar Kashi24

97,031

490 1

94,850

1,691 1

DistrictCases
Hamirpur117
Kangra105
Una41
Solan32
Chamba29
Bilaspur21
Mandi21
Sirmaur11
Shimla10
Kullu4
Kinnaur2
Lahaul And Spiti0

58,543 44

261 17

57,287 27

995

DistrictCases
South Goa69
North Goa57

54,871 100

587 56

53,490 41

794 3

DistrictCases
Pondicherry111
Mahe4
Karaikal2
Yanam0

39,697 20

194 2

38,836 22

667

DistrictCases
Dhalai196
Sepahijala174
Gomati74
South Tripura53
Unakoti49
West Tripura45
Khowai24
North Tripura14

33,407

32 0

32,984

391

DistrictCases
Churachandpur32
Kangpokpi26
Imphal West21
Thoubal18
Imphal East10
Tengnoupal9
Bishnupur7
Senapati6
Chandel5
Kamjong5
Ukhrul4
Jiribam3
Pherzawl3
Kakching2
Tamenglong2
Noney1

29,260 7

37 3

28,850 10

373

DistrictCases
Chandigarh313

21,659 69

322 43

20,986 26

351

DistrictCases
Changlang31
Papum Pare8
Lohit3
Namsai2
West Siang1
East Siang1
Upper Siang1
Tawang1
PakkeKessang1
West Kameng0
Upper Subansiri0
Tirap0
Siang0
Shi Yomi0
Anjaw0
Lower Subansiri0
Lower Dibang Valley0
Longding0
Leparada0
KurungKumey0
KraDaadi0
Kamle0
East Kameng0
Dibang Valley0
Lower Siang0

16,836

3 0

16,777

56

DistrictCases
East Khasi Hills22
West Garo Hills5
South West Garo Hills4
North Garo Hills1
West Jaintia Hills1
West Khasi Hills1
East Garo Hills0
East Jaintia Hills0
Ribhoi0
South Garo Hills0
South West Khasi Hills0

13,961

19 1

13,794 1

148

DistrictCases
Dimapur20
Mon8
Kohima7
Kiphire3
Tuensang3
Peren2
Phek1
Longleng0
Mokokchung0
Wokha0
Zunheboto0

12,198

9 4

12,098 4

91

DistrictCases
Kargil77
LehLadakh43

9,816 2

54 2

9,632 4

130

DistrictCases
East District3
South District3
North District0
West District0

6,135 2

45 2

5,955

135

DistrictCases
South Andamans33
Nicobars1
North And Middle Andaman1

5,017 1

3 1

4,952

62

DistrictCases
Kolasib11
Aizawl10
Mamit8
Lawngtlai2
Lunglei2
Saitual1
Champhai0
Hnahthial0
Khawzawl0
Saiha0
Serchhip0

4,422 3

26 1

4,386 4

10

DistrictCases
Dadra And Nagar Haveli20

3,406 1

4 1

3,400 2

2

DistrictCases
Lakshadweep District0

333 2

80 6

252 8

1

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Ministry Of Home Affairs Extends Existing COVID-19 Guidelines Till March 31

In a statement, the Ministry of Home Affairs (MHA) said while there has been a substantial decline in the active and new COVID-19 cases, there is need to maintain surveillance, containment and caution so as to fully overcome the pandemic