AIIMS Study Claims 'Over-Emphasis' On Fever As Predominant Covid-19 Symptom May Leave Many Cases Undetected

New AIIMS Study reports about 'over-emphasis' on fever as Covid-19 symptom and whether smoking affects the severity of the infection.

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New Delhi: A study published in the Indian Council of Medical Research's (ICMR) Indian Journal of Medical Research has revealed that fever as a symptom of Covid-19 may be getting over-emphasised.  The research observed 114 patients being treated in Delhi's All India Institute of Medical Sciences (AIIMS) Trauma Centre and AIIMS in Haryana's Jhajjar. Among 114, only 17 percent coronavirus patients had a fever. "Fever was present in only 17 percent of our patients, which was far less compared to other reports across the globe, including the Chinese cohort in whom 44 percent had a fever at the time of presentation and 88 per cent developed a fever during the hospital stay," The study stated. Additionally, "more than 44 per cent of the hospitalised patients were asymptomatic at the time of hospital admission and remained so throughout". "Thus, overemphasis on fever as a predominant symptom may lead to several cases being missed. This may be a cause of concern as these asymptomatic patients are potential transmitters of infection in the community," the study informed. It stated that a "significant proportion" of about 44.4 percent patients were asymptomatic and out of the ones with symptoms, 34.7 percent reported cough, followed by 17.4 percent talked about having fever, while only two percent had nasal issues. According to Covid-19 symptoms reported early on, patients were said to have fever, sore throat, cough, breathlessness and fatigue. However since March, several new symptoms have been informed about by the health ministry in its clinical protocol. In June, the Union Ministry of Health included a loss of smell and taste, diarrhoea, and muscle pain as Covid-19 symptoms. This study was conducted between March and April. The team of researchers includes AIIMS Delhi director Dr Randeep Guleria. Their published paper has been titled "Clinico-demographic profile & hospital outcomes of Covid-19 patients admitted at a tertiary care centre in north India". Association To Smoking As Coronavirus attacks a person's respiratory system with symptoms like breathlessness, there were parallels being drawn between the infection and smoking. There were widely believed links to how smoking makes one susceptible to Coronavirus infection. However, the researchers in this study have found no such association between age, gender or even the habit of smoking to those who contracted Covid-19. There was "no significant association" between the patient's condition to age, sex, smoking habit, TLC (total lung capacity) grading or lymphopenia. "However, a significant association was observed between severe disease at presentation and Neutrophil-to-Lymphocyte [N-L] Ratio," the study stated. The N-L Ratio ascertains inflammation in the body. Nine (6.3 percent) patients who were smokers, with a median smoking index of 200. "None of them had severe disease, or worsening during the hospital course." the study revealed. But further added as a caution that "However, according to a recent systematic review and meta-analysis, smoking appears to be a risk factor for Covid-19 progression with a higher prevalence of smoking among Covid-19 patients with severe, progressive disease or intensive care admission." WATCH | Delhi: Satyendar Jain inaugurates 450-bed Covid hospital in Burari, shares details | Ground Report