Clinical Features of COVID-19 among Bangladeshi patients
Though the incubation period of SARS-CoV-2 was reported to be 2-10 days according to WHO,[37] it demonstrated to infect people with a median incubation period of 3 days [38]. The maximum latency was observed up to 24 days which is longer compared to MERS (5 days) and seasonal flu (2 days). This implies the necessity for longer periods of quarantine or effective monitoring of persons potentially exposed to the pathogen [39]. The disease caused by the SARS-CoV-2 manifests with diverse clinical characteristics ranging from asymptomatic patients to acute pneumonia with multiorgan failure. After analyzing various symptoms, the disease is now classified into four levels of severity [40]. Mild patients only exhibit symptoms of viral infection in the upper respiratory tract while moderate patients manifested with fever, respiratory symptoms of cough and shortness of breath. Patients with severe cases manifest with dyspnea, acute respiratory distress syndrome (ARDS) and septic shock. Finally, patients who need ICU support are considered as critical and show features such as respiratory arrest, septic shock, and multiple organ impairment [41].
A study of 103 RT-PCR confirmed COVID-19 Bangladeshi patients demonstrated that 74.76% were mild, 9.71% were moderate and 15.53% were severely ill patients. The most predominant clinical features include fever (78.6%), fatigue (68%) and cough, (44.7%) loss of appetite (37.9%), shortness of breath (37.9%) and anosmia (35.0%) [42]. Another study of 100 COVID-19 patients demonstrated symptoms like rhinitis (13.0%), body ache (13%), headache (12.0%), sputum (7.0%) abdominal pain (4.0%) hemoptysis (3.0%) [43]. A cohort study of 201 patients showed that very few patients were manifested with rare symptoms like burning body (1%), toothache (1%), itchiness (0.5%), red-eye (0.5%), oral ulcer (0.5%), constipation (0.5%) and 4.5% were asymptomatic [44]. Hypertension (34.0%) was the most prevalent comorbidities associated with the patients followed by diabetes mellitus (21.4%). Ischemic heart disease (9.7%), chronic kidney disease (7.8%) renal disease (8.0%), asthma/COPD (6.0%) were also manifested in the patients [42].