الفهرس 
History of Covid-19Only 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
A cluster of cases of pneumonia with unknown etiology were reported and confirmed as 2019-nCoV in 2019. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has since spread globally. Reverse transcription polymerase chain reaction (RT-PCR), which is performed to detect viral nucleic acids, is currently considered as the diagnostic gold standard for early diagnosis in patients with suspected SARS-CoV-2 infection. The whole world faced new waves of COVID-19, forcing laboratories to the maximum of their testing capacity despite limited reagent supplies. Therefore, there is an increasing need for more rapid assays, such as lateral flow assays. Several reports have described the performance of rapid antigen test kits, most of which were derived from COVID-19 symptomatic subjects. The aim of the work was to determine the Diagnostic accuracy of COVID 19 antigen swab in pulmonary and extrapulmonary COVID 19, Clarify extrapulmonary symptoms of COVID 19. This was a cross sectional study performed on 447 patients diagnosed with COVID-19 at the Chest out-patient clinic or Chest Department and Intensive Care Unit in Menoufia University hospital during the period from July 2021 to March 2022. Patients consent and approval of medical ethics committe of Menoufia University were obtained. (8/2021 CHST 26) Patients were diagnosed to have COVID 19 by one of these: Contact to COVID 19 patient with new symptoms after the contact, Specific symptoms to COVID 19 (loss of taste and smell), Positive
Summary
102
laboratory findings positive radiological findings specific to COVID 19, Positive rapid COVID 19 antigen tests or PCR positive for COVID-19.
Data about the patient history, clinical picture and physical examination were obtained.
The patients’ laboratory investigation included (CBC), (CRP), serum ferritin levels, lactate dehydrogenase, D-dimer, procalcitonin, blood glucose, serum albumin, liver function tests, kidney function tests, electrolytes.
Nasopharyngeal rapid antigen swab for COVID 19 (ROCHE rapid antigen detection kit for COVID-19)
In this study patients were subdivided into 2 groups, 105 patients with pulmonary symptoms of COVID 19 and 342 patients with extra-pulmonary symptoms of COVID 19 in presence or in absence of pulmonary symptoms.
This current work revealed a slight male predominance among patients with COVID-19 compared to females.
Pulmonary symptoms included cough (37.4%) as the most common symptom followed by sore throat (28%) and dyspnea (34.7%). Extra-pulmonary symptoms included, muscle ache, loss of smell and taste, and headache and GIT, cardiac, ocular, hematological, cutaneous, renal, neurological, and hepatic symptoms. The most frequent extra-pulmonary symptom was muscle ache (52%) followed by loss of taste and smell (39.8%).
Test results of the rapid antigen swabs of COVID-19 were presented as 396 patients out of 447 patients (88.6%) that clinically diagnosed with COVID-19 showed positive test results, and the
Summary
103
remaining 51 patients (11.4%) showed negative In the subdivided group of pulmonary symptoms, 85 patients out of 105 COVID patients (81%) showed positive results and 20 patients (19%) showed negative results. In extra-pulmonary symptoms group, percentage of positive test results was increased to be 90.4% presented in 311 patients out of 342 patients and the remaining 31 patients (9.6) had negative test results in this group.
179 patients out of 447 COVID-19 patients (40%) showed positive CT findings while the remaining 268 patients (60%) showed negative findings.
Our study showed wide variety in CBC changes in COVID-19 patients and included lymphopenia, leukocytosis, thrombocytopenia, leukopenia, pancytopenia, and thrombocytosis with lymphopenia as the most common hematological symptom presented in 63 patients (18.4%). On biochemical evaluation, specific parameters such as altered liver function test, renal function test seen in extrapulmonary group more than the pulmonary group. Inflammatory markers such as D-dimer, serum ferritin, serum lactate dehydrogenase and C-reactive protein were seen in both pulmonary and extrapulmonary manifestations of COVID-19.