Respiratory Disease Screening as an Adverse Effect and Associated Factors of COVID-19 Recovered Patients from Quiha Treatment Center in Mekelle, Tigray, Ethiopia, 2020: A Community Based Institutional Study

Research Article

Austin Intern Med. 2021; 5(1): 1054.

Respiratory Disease Screening as an Adverse Effect and Associated Factors of COVID-19 Recovered Patients from Quiha Treatment Center in Mekelle, Tigray, Ethiopia, 2020: A Community Based Institutional Study

Gebreselassie AT¹*, Mekonen W¹, Gebrehiwot B¹, Muluye G² and Gereziher G³

¹Department of Psychiatry, College of Health Sciences, Mekelle University, Tigray, Ethiopia

²Department of Midwifery, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia

³Department of Reproductive Health, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia

*Corresponding author: Abreha Tsegay, Department of Psychiatry, College of Health Sciences, Mekelle University, Tigray, Ethiopia

Received: May 20, 2021; Accepted: June 11, 2021; Published: June 18, 2021

Abstract

Background: Coronavirus (COVID-19) is an illness caused by a virus that can spread from person to person. The virus that causes COVID-19 is a new coronavirus that has spread throughout the world. COVID-19 symptoms can range from mild (or no symptoms) to severe illness. In late December 2019, investigation of a cluster of pneumonia cases of unknown origin in Wuhan, China resulted in identification of a novel coronavirus. The virus is distinct from both Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), although closely related.

Objective: To assess respiratory disease screening as an adverse effect and associated factors of COVID-19 recovered patients from a treatment center in Mekelle, Tigray, Ethiopia.

Methods: A community based quantitative study design was conducted among 600 samples in Mekelle town, Tigray, Ethiopia. Data were collected using a structured and semi-structured questionnaire. Associations between dependent and independent variables were tested using logistic regression with the assumptions of p-values < 0.05 and confidence interval 95% and considered to be statistically significant.

Results: The prevalence of respiratory disease after screening using CRQ was 24.3%. Variable like who read and wrote [AOR=2.859, 95% CI: 1.349-6.063, P=0.006]. COVID-19 symptoms such as those who had shortness of breathing [AOR=3.485, 95% CI: 1.776-6.838, P=0.001], sore throat [AOR=4.645, 95% CI: 2.107-10.242, P=0.001], and chest pain pressure was AOR=3.453, 95%CI: 1.484-8.037, P=0.04] were significant factor for respiratory disease.

Conclusion: The study found that the prevalence of respiratory disease after screening using CRQ was 24.3%. Variables such as read and write, shortness of breathing, sore throat, and pneumonia were significant factors for respiratory disease.

Keywords: Respiratory disease; COVID -19; Screening; CRQ; Treatment center; Ethiopia

Abbreviations

ANOVA: One-way Analysis of Variance; AOR: Adjusted Odds Ratio; ARDS: Acute Respiratory Distress Syndrome; CDC: Disease Control and Prevention; CI: Confidence Interval; COR: Crude Odds Ratio; COVID-19: Coronavirus Disease; CRQ: Chronic Respiratory Questionnaires; FDA: Food and Drug Administration; HRERC: Health Research Ethics Review Committee; SARS: Severe Acute Respiratory Syndrome; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SPSS: Statistical Package for Social Sciences; WHO: World Health Organization

Introduction

COVID-19 is a respiratory virus and disease. It is spread by small droplets from coughs and sneezes and from touching infected surfaces. At least 80% of people who are infected with the virus will have anywhere from no symptoms to mild to moderate flu-like symptoms, including a fever and cough and the remaining 20% may develop more severe cases of coronavirus that may develop pneumonia or severe acute respiratory syndrome.

The Centers for Disease Control and Prevention (CDC) estimate that 3-17 % of COVID-19 patients develop a complication known as Acute Respiratory Distress Syndrome (ARDS). ARDS patients lose the ability to breathe normally and this is known as a respiratory failure that results from severe inflammation in the lungs. Risk factors for developing pneumonia from COVID-19 include diabetes, hypertension, chronic heart, chronic lung disease, immunesuppressed conditions, being elderly (increasing age), and obesity.

COVID-19 is a viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that primarily targets the respiratory system, with initial symptoms often including shortness of breath and fever [1]. Emerging infectious diseases, such as Severe Acute Respiratory Syndrome (SARS) and Zika virus disease, present a major threat to public health [2]. In late December 2019, a cluster of patients was admitted to hospitals with an initial diagnosis of pneumonia of an unknown etiology. These patients were epidemiologically linked to the seafood and wet animal wholesale market in Wuhan, Hubei Province, China [3].

According to world meters info reported that globally, 41,169,789 cases and 1,131,329 deaths were encountered within 213 countries since last December 2019 due to COVID-19 until now there is no treatment or vaccination found.

The clinical manifestations of COVID-19 are protean, which include an asymptomatic carrier, ARD, and pneumonia of varying degrees of severity. First, asymptomatic cases were diagnosed based on positive viral nucleic acid test results, but without any COVID-19 symptoms, such as fever, gastrointestinal, or respiratory symptoms, and no significant abnormalities on chest radiograph [4].

There are currently no appropriate scientifically approved vaccines/drugs for COVID-19. Nonetheless, few broad-spectrum antiviral drugs, azithromycin were tested against COVID-19 in clinical trials, and finally, Food and Drug Administration (FDA) approved emergency use of remdesivir in hospitalized COVID-19 patients [5].

Convalescent plasma therapy is effective and specific for COVID-19 and this intervention has a special significance for eliminating SARS-CoV-2 and is believed to be a promising state-ofthe- art therapy during the COVID-19 pandemic crisis [6].

Levels of potassium, albumin, and lymphocytes were increased persistently after treatment from sustained lopinavir use. Increasing eosinophils may be an indicator of COVID-19 improvement. Viral load of SARS-CoV-2, radiography, and eosinophil improved continuously not more than 9 days [7].

A study done in China reported that urea nitrogen concentration at admission was associated with the presence of CT abnormalities (P=0.046, AOR=7.149, 95% CI: 1.038 - 49.216). Lung function abnormalities were detected in 14 patients and the measurement of D-dimer levels at admission may be useful for prediction of impaired diffusion defect (P=0.031, AOR=1.06, 95% CI: 1.006- 1.129). Radiological and physiological abnormalities were still found in a considerable proportion of COVID-19 survivors without critical cases 3 months after discharge. A higher level of D-dimer on admission could effectively predict impaired DLCO after 3 months of discharge [8].

Post-mortem studies have noted diffuse alveolar damage, leading some to postulate that long-term pulmonary sequelae are possible from COVID-19, such as interstitial pulmonary fibrosis [9]. Besides, based on the literature from other viral infections, reduced or abnormal pulmonary function may be expected in people with COVID-19 in the months after recovery, although there are limited studies to date evaluating pulmonary function [10].

The long-term effect of COVID-19 is still largely unknown. However, based on previous experiences with other viral pulmonary infections, long-term pulmonary consequences are indeed expected in some patients. A significant number of patients recovering from the acute viral illness may have significant impairment in overall functional capacity and specifically their pulmonary function in the first few months [11].

The predominant pattern of lung lesions in patients with COVID-19 patients is diffuse alveolar damage, as described in patients infected with severe acute respiratory syndrome and Middle East respiratory syndrome coronaviruses. Hyaline membrane formation and pneumocyte atypical hyperplasia are frequent. Importantly, the presence of platelet–fibrin thrombi in small arterial vessels is consistent with coagulopathy, which appears to be common in patients with COVID-19 and should be one of the main targets of therapy [12].

The pooled analysis revealed that common complications up to 6 months after discharge were: impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15–45 %); and reduced exercise capacity (mean 6-min walking distance 461 m, CI:450–473 m). Low scores on Short-Form 36 were identified beyond 6 months after discharge [13].

The study reported that 11.4% presented with at least one GI symptom (nausea, vomiting, or diarrhea), and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) had severe/critical types. Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%), and 16 (21.62%) had significantly higher rates of fever >38.5°C, fatigue, shortness of breath, and headache, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/ critical type [14].

A study was done revealed the prevalence of smell and taste of COVID-19 clients was 68% and 71% respectively. Smell and taste impairment [AOR=10.9, 95% CI: 5.08-23.15] was significant with COVID-19 [15]. The conceptual framework of the adopted literature review can see in (Figure 1).