Coronavirus disease 2019 (COVID-19) usually presents with respiratory symptoms, including cough, sputum, and dyspnea, at the time of disease onset. But, there has been a large proportion of patients who initially presented with non-respiratory symptoms, like fever, diarrhea, myalgia, etc.¹

A previous report from China, published in 2020, reported that fatigue and expectoration signaled severe COVID-19 infection. The authors also stated that shortness of breath, chest distress, muscle or joint pain, and dry cough were common in severe patients.²

If we can identify the symptoms that can predict the prognosis of COVID-19, it would help us provide adequate care to the patients, well in time, and play a vital role in resource allocation.

So, a recent study by Zhou et al compared the characteristics and outcomes of patients with respiratory symptoms and non-respiratory symptoms at the onset of COVID-19 illness.¹ The study included patients admitted to eight hospitals in Hunan and Guangxi Province. Investigators gathered information on demographics, clinical manifestations, laboratory findings, radiological findings, treatment regimens, and outcomes data, and evaluated the same. 

A total of 541 subjects with a mean age of 43 years were included in this study. Four hundred and four (74.5%) subjects had initial respiratory symptoms, and 137 (25.5%) had non-respiratory symptoms.

Investigators made the following observations:

ARDS: Acute respiratory distress syndrome

The study revealed that relatively young COVID-19 patients who have non-respiratory symptoms at disease onset have better outcomes. Those who have dyspnea at COVID-19 onset are more likely to have worse outcomes.

References

1. Zhou A, Song Q, Peng Y, et al. Symptoms at disease onset predict prognosis in COVID-19 disease. Libyan J Med. 2022; 17(1): 2010338.
2. Li J, Chen Z, Nie Y, et al. Identification of Symptoms Prognostic of COVID-19 Severity: Multivariate Data Analysis of a Case Series in Henan Province. J Med Internet Res. 2020 Jun; 22(6): e19636.