Dear editor,
There is a great interest to make a rapid differential clinical
diagnosis of COVID-19 among respiratory disease patients and determining
the prevalence rate of these diseases among the COVID-19 population.
Symptom screening became a prevalent tool in the attempt to control
local dissemination of COVID-19, starting from affected cities to
quarantines [1]. This can be
attributed to that the coronavirus family may cause varied symptoms such
as fever, pneumonia, lung infection, and breathing difficulty
[2]. All this has pushed several
studies to review the characteristics and symptoms of adults infected
with COVID-19 [3]. In our
retrospective study, approximately 522 patients with allergic rhinitis,
asthma, COPD, and COVID-19 were collected from Beni-Suef University
hospital and Hospital of Chest Diseases in Beni-Suef, Egypt, and
analyzed for demographic and clinical features. Radiological features
were analyzed for all COVID-19 patients. About 312 (59.8%) females and
210 (40.2%) males were included in the study. They were of different
age groups, 146 (28%) patients were between the ages of 18 and 30
years, 253 (48.5%) patients were between the ages of 30 and 45 years,
and 123 (23.5%) patients were between the ages of 45 and 60 years.
The patients were grouped into 5 groups: (1) allergic rhinitis patients,
(2) asthmatic patients, (3) asthmatic patients with allergic rhinitis,
(4) COPD patients, (5) COVID-19 patients. COVID-19 patients were
subdivided into 3 groups: (5a) COVID-19 patients only, (5b) COVID-19
patients with COPD, (5c) COVID-19 patients with asthma (table 1).
Approximately, the prevalence of allergic rhinitis, asthma, and COPD
among the 228 participated COVID-19 patients was 0%, 30.7%, and 35.1%
respectively (figure 1). There was a significant difference in the
prevalence of the 3 respiratory diseases among COVID-19 patients. The
numbers of COVID-19 patients, having asthma or COPD, were significantly
higher compared to the number of COVID-19 patients with allergic
rhinitis at p<0.05. There was no significant difference
between the number of COPD (n=80) or asthmatic patients (n=70) among
COVID-19 patients. All chest CT scans of COVID-19 patients (228
patients, 100%) showed bilateral ground-glass opacity with abnormal
findings on chest CT. Comparing categorical variables between patients
groups using the chi-square test showed that symptoms of all COVID-19
patients were significantly different compared to allergic rhinitis,
COPD, and asthmatic patients who didn’t have COVID-19 infection at
p<0.05. Fever, dry cough, diarrhea, loss of smell and taste
senses, shortness of breath, and blue lips were significantly higher in
all COVID-19 patients at p<0.05 compared to other groups.
We concluded that clinical diagnosis is a very important tool in
differentiation between SARS-CoV-2 and other respiratory diseases
especially allergic rhinitis, asthma, and COPD. Fever, dry cough,
diarrhea, loss of sense of smell and taste, shortness of breath, and
blue lips, are the most distinguishing symptoms for COVID-19. After
that, COVID-19 diagnosis should be confirmed by ground-glass opacity and
abnormal findings on chest CT without the need for a nasopharyngeal swab
especially in epidemic countries. Also, COPD and asthmatic patients are
more susceptible to COVID-19 infection than allergic rhinitis patients.