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Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019.
J Intern Med. 2020 09; 288(3):335-344.JI

Abstract

BACKGROUND

The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown.

OBJECTIVE

To study the clinical presentation of COVID-19 in Europe.

METHODS

Patients with positive diagnosis of COVID-19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes.

RESULTS

A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID-19 symptoms of mild-to-moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild-to-moderate COVID-19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients.

CONCLUSION

The clinical presentation of mild-to-moderate COVID-19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild-to-moderate COVID-19 that needs to be recognized as such by the WHO.

Authors+Show Affiliations

From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. Department of Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Internal Medicine, Infectiology, EpiCURA Hospital, Baudour, Belgium.Department of Internal Medicine, Infectiology, CHU Saint-Pierre, Brussels, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Medicine, Neurology, CHU de Charleroi, Charleroi, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Medicine, Neurology, CHU de Charleroi, Charleroi, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Statistics, Language Sciences, University of Mons, Mons, Belgium.Department of Otolaryngology - Head & Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Prague, Czech Republic. Confederation of European Otorhinolaryngology-Head & Neck Surgery, Vienna, Austria.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, Naples, Italy.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Otolaryngology-Head & Neck Surgery, Morgagni Pierantoni Hospital, Forli, Italy.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix Marseille University, La Conception University Hospital, Marseille, France.Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles, Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Faculté de Médecine et Pharmacie, Université de Mons (UMONS), Mons, Belgium.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Division of Otolaryngology-Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.From, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. BayesiaLab, Changé, France.Guy's and St Thomas NHS Foundation Trust, London, UK. British Rhinological Society (President), London, UK.Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. Department of Otolaryngology-Head & Neck Surgery, EpiCURA Hospital, Hornu, Belgium.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32352202

Citation

Lechien, Jerome R., et al. "Clinical and Epidemiological Characteristics of 1420 European Patients With Mild-to-moderate Coronavirus Disease 2019." Journal of Internal Medicine, vol. 288, no. 3, 2020, pp. 335-344.
Lechien JR, Chiesa-Estomba CM, Place S, et al. Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020;288(3):335-344.
Lechien, J. R., Chiesa-Estomba, C. M., Place, S., Van Laethem, Y., Cabaraux, P., Mat, Q., Huet, K., Plzak, J., Horoi, M., Hans, S., Rosaria Barillari, M., Cammaroto, G., Fakhry, N., Martiny, D., Ayad, T., Jouffe, L., Hopkins, C., & Saussez, S. (2020). Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. Journal of Internal Medicine, 288(3), 335-344. https://doi.org/10.1111/joim.13089
Lechien JR, et al. Clinical and Epidemiological Characteristics of 1420 European Patients With Mild-to-moderate Coronavirus Disease 2019. J Intern Med. 2020;288(3):335-344. PubMed PMID: 32352202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. AU - Lechien,Jerome R, AU - Chiesa-Estomba,Carlos M, AU - Place,Sammy, AU - Van Laethem,Yves, AU - Cabaraux,Pierre, AU - Mat,Quentin, AU - Huet,Kathy, AU - Plzak,Jan, AU - Horoi,Mihaela, AU - Hans,Stéphane, AU - Rosaria Barillari,Maria, AU - Cammaroto,Giovanni, AU - Fakhry,Nicolas, AU - Martiny,Delphine, AU - Ayad,Tareck, AU - Jouffe,Lionel, AU - Hopkins,Claire, AU - Saussez,Sven, AU - ,, Y1 - 2020/06/17/ PY - 2020/04/15/received PY - 2020/04/17/revised PY - 2020/04/17/accepted PY - 2020/5/1/pubmed PY - 2020/8/28/medline PY - 2020/5/1/entrez KW - COVID-19 KW - Europe KW - clinical KW - coronavirus KW - epidemiological KW - medicine KW - patients KW - symptoms SP - 335 EP - 344 JF - Journal of internal medicine JO - J Intern Med VL - 288 IS - 3 N2 - BACKGROUND: The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown. OBJECTIVE: To study the clinical presentation of COVID-19 in Europe. METHODS: Patients with positive diagnosis of COVID-19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes. RESULTS: A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID-19 symptoms of mild-to-moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild-to-moderate COVID-19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. CONCLUSION: The clinical presentation of mild-to-moderate COVID-19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild-to-moderate COVID-19 that needs to be recognized as such by the WHO. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/32352202/Clinical_and_epidemiological_characteristics_of_1420_European_patients_with_mild_to_moderate_coronavirus_disease_2019_ L2 - https://doi.org/10.1111/joim.13089 DB - PRIME DP - Unbound Medicine ER -