Digital forehead infrared thermometer may not be able to identify the silent spreaders. @Shutterstock
Fever was considered as the most common symptom of COVID-19, encouraging wide use of digital forehead infrared thermometer at airports, offices, hospitals, shopping centres and other public and commercial establishments, to identify the suspected patients. But over-estimating fever as a predominant symptom of COVID-19 can affect the pandemic response efforts, suggested a new study.
Fever is not actually a predominant symptom of the disease caused by the novel coronavirus stated the study published in the Indian Council of Medical Research's researcher arm Indian Journal of Medical Research. The researchers came to the conclusion after observing the symptoms of 144 COVID-19 patients admitted at the All India Institute of Medical Sciences (AIIMS) Trauma Centre, Delhi, and AIIMS in Jhajjar, Haryana between March and April. They found that only 17 per cent of the patients had a fever and more than 44 per cent of them were asymptomatic at the time of hospital admission and remained so throughout.
Based on the findings, the researchers noted that overemphasis on fever as a predominant symptom may lead to several cases being missed and may be a cause of concern as asymptomatic patients are potential transmitters of infection in the community.
Titled 'Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India', the study paper has been co-authored by Dr Randeep Guleria, director of AIIMS Delhi, with 28 others.
Did we miss the silent spreaders?
A previous study published in the journal Annals of Internal Medicine revealed that asymptomatic patients may account for as much as 45 per cent of all COVID-19 cases. The patients with no symptoms play a significant role in the early and ongoing spread of the novel coronavirus, the study noted, adding that the silent spread of the virus makes it more challenging to control the pandemic. To identify the silent spreaders and mitigate the pandemic, the report highlighted the need for expansive testing and contact tracing.
But we probably missed many asymptomatic COVID-19 patients in the early days of the pandemic as per the AIIMS study. It showed that as early as March-April, there were many silent spreaders. Out of the 144 patients observed in the study, 44.4 per cent had no symptoms. Those who had symptoms experienced cough as the most common symptom (34.7 per cent), while only 17.4 per cent complained of having fever. Nasal symptoms were also found to be present in only 2% patients.
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Uncommon symptoms of COVID-19
Speaking to a news channel, Dr Randeep Guleria said that COVID-19 infection is much more systemic than what was believed earlier and stressed the need for a wider lens to study the symptoms of COVID-19. According to him, people infected with the novel coronavirus also reported some uncommon symptoms like - stroke, heart attack, diarrhoea, conjunctivitis.
Initially, fever, cough, sore throat, breathlessness and fatigue were listed as the common symptoms of Covid-19. In June, the Union Ministry of Health added loss of smell and taste, diarrhoea, and muscle pain as also symptoms of the viral disease.
Interestingly, the researchers did not find a link between age, gender or even smoking habit to those who caught the Covid-19 infection. The study also found no significant association between the severity of the disease with age, sex, and smoking status.
However, a recent systematic review and meta-analysis, had suggested smoking as a risk factor for Covid-19 progression citing higher prevalence of smoking among COVID-19 patients with severe, progressive disease or intensive care admission.
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