Epidemiology and Health

COVID-19: Original Article

Clinical symptom profile of hospitalized COVID-19 Brazilian patients according to SARS-CoV-2 variants: Natália Satchiko Hojo-Souza, Vander Luis de Souza Freitas, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza; Epidemiol Health. 2023;45:e2023079. Published online August 28, 2023; DOI: https://doi.org/10.4178/epih.e2023079

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Abstract

OBJECTIVES
The aim of this study was to investigate the prevalence of the main symptoms in Brazilian coronavirus disease 2019 (COVID-19) patients hospitalized during 4 distinct waves, based on their infection with different severe acute respiratory disease coronavirus 2 (SARS-CoV-2) variants.

METHODS

This study included hospitalized patients who tested positive for SARS-CoV-2 during 15 weeks around the peak of each of 4 waves: W1, ancestral strain/B.1 lineage (May 31 to September 12, 2020); W2, Gamma/P.1 variant (January 31 to May 15, 2021); W3, Omicron variant (December 5, 2021 to March 19, 2022); and W4, BA.4/BA.5 subvariants (May 22 to September 3, 2022). Symptom data were extracted from the Brazilian Severe Acute Respiratory Syndrome Database. Relative risks were calculated, and an analysis of symptom networks was performed.

RESULTS

Patients who were hospitalized during the prevalence of the Gamma/P.1 variant demonstrated a higher risk, primarily for symptoms such as fatigue, abdominal pain, low oxygen saturation, and sore throat, than patients hospitalized during the first wave. Conversely, patients who were hospitalized during the predominance of the Omicron variant exhibited a lower relative risk, particularly for symptoms such as loss of smell, loss of taste, diarrhea, fever, respiratory distress, and dyspnea. Similar results were observed in COVID-19 patients who were hospitalized during the wave of the Omicron subvariants BA.4/BA.5. A symptom network analysis, conducted to explore co-occurrence patterns among different variants, revealed significant differential profiles across the 4 waves, with the most notable difference observed between the W2 and W4 networks.

CONCLUSIONS

Overall, the relative risks and patterns of symptom co-occurrence associated with different SARS-CoV-2 variants may reflect disease severity.

Summary

Key Message
The study highlights the varying prevalence and distinct symptom profiles among Brazilian COVID-19 patients hospitalized during different waves linked to specific SARS-CoV-2 variants. It suggests that the manifestation of symptoms differs significantly across variant-driven waves, signifying potential shifts in disease severity. Specifically, patients during the Gamma/P.1 variant wave showed higher risks for symptoms like fatigue, abdominal pain, and respiratory impairment, while those during the Omicron wave exhibited lower risks for certain symptoms like loss of smell and taste, indicating changing symptomatology and potentially evolving disease impact linked to different variants.

Citations

Citations to this article as recorded by

Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study
Yuta Matsubara, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Ho Namkoong, Shotaro Chubachi, Hiromu Tanaka, Shuhei Azekawa, Shinya Sugimoto, Yusuke Yoshimatsu, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Toshiro Sato, Makoto Ishii, Naoki Hasegawa, Yuk
Journal of Gastroenterology.2024; 59(3): 195. CrossRef
Prevalence and Factors Associated with Olfactory Dysfunction in Individuals with COVID-19 in Brazil: A Study of 20,669 Cases from 2020 to 2021
Carlos Dornels Freire de Souza, Amanda Júlia de Arruda Magalhães, Yasmin Vitória Silva Nobre, Carlos Alberto Souza, André Luis Oliveira do Nascimento, Luísa Robalinho de Faria, Márcio Bezerra-Santos, Anderson da Costa Armstrong, Jandir Mendonça Nicácio, O
Medical Principles and Practice.2024; : 1. CrossRef
Risks of Adverse Outcomes for Hospitalized COVID-19 Patients during the Four Waves in Brazil According to SARS-CoV-2 Variants, Age Group, and Vaccine Status
Natália Satchiko Hojo-Souza, Waasila Jassat, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza
Viruses.2023; 15(10): 1997. CrossRef

COVID-19: Brief Communication

Hydrogen peroxide as an auxiliary treatment for COVID-19 in Brazil: a randomized double-blind clinical trial: Marielle Bazzo Di Domênico, Kauê Collares, Renan Brandenburg dos Santos, Ulysses Lenz, Vinícius Picoli Antunes, Vinicius Webber Godinho, Henrique Cesca, Thales Henrique Jincziwski Ponciano, Pedro Henrique Corazza; Epidemiol Health. 2021;43:e2021051. Published online August 3, 2021; DOI: https://doi.org/10.4178/epih.e2021051

13,137 View
272 Download
6 Web of Science
4 Crossref

Abstract Summary PDF

Abstract

OBJECTIVES
This study evaluated the effectiveness of hydrogen peroxide (H2O2) as mouthwash and nasal spray on symptom relief in coronavirus disease 2019 (COVID-19) patients.

METHODS

Patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who were treated in a hospital or at home, and patients’ family members (not positive for SARS-CoV-2), were randomized into 2 groups: experimental (1% H2O2 for gargling, 0.5% H2O2 for nasal wash), and control. Patients gargled the solution 3 times a day, and applied the nasal spray twice a day, for a 7-day period. Family members received the same treatment as the treated COVID-19 patient. The researchers contacted patients every 2 days over an 8-day period. An average post-treatment interval of 8 days passed before testing family members.

RESULTS

The most frequent symptoms on day 0 were cough, loss of taste, and hyposmia; there were no significant differences between groups, independent of the period. The symptom of dyspnea presented a significant difference between days 2 and 4 (p<0.05). Among family members, 86.0% had no antibodies, 2.3% had antibodies, and 11.6% had active infections (4 in the experimental group and 6 in the control group). The most frequent adverse effects in the H2O2 group were a burning throat and nose.

CONCLUSIONS

H2O2 was not effective for the relief of COVID-19 symptoms and was associated with reports of transient adverse effects.

Summary

Key Message
The hydrogen peroxide (H2O2) at low concentrations disrupts the lipid membranes of some viruses through the action of oxygen free radicals. Nevertheless, the data obtained in the present study demonstrated that the use of the H2O2 as mouthwash and nasal spray was not effective on symptom relief in patients with COVID-19. Moreover, it was associated with transient adverse effects such as burning sensations in the nose and throat. Thus, the authors of this study advise against the use of H2O2 as a mouthwash and nasal spray to relieve COVID-19 symptoms and transmission.

Citations

Citations to this article as recorded by

Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial
Ludovic de Gabory, Sophie Vallet, Gaëlle Naelten, Chantal Raherison-Semjen
European Archives of Oto-Rhino-Laryngology.2024;[Epub] CrossRef
Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review
Miriam Ting, Alex Dahlkemper, Jeremy J. Schwartz, Manzel Woodfork, Jon B. Suzuki
Biomedicines.2023; 11(6): 1694. CrossRef
Efficacy of Mouth Rinses and Nasal Spray in the Inactivation of SARS-CoV-2: A Systematic Review and Meta-Analysis of In Vitro and In Vivo Studies
Majdy Idrees, Bridget McGowan, Amr Fawzy, Abdulwahab Ali Abuderman, Ramesh Balasubramaniam, Omar Kujan
International Journal of Environmental Research and Public Health.2022; 19(19): 12148. CrossRef
Enhanced Nasal Deposition and Anti-Coronavirus Effect of Favipiravir-Loaded Mucoadhesive Chitosan–Alginate Nanoparticles
Khent Primo Alcantara, Nonthaneth Nalinratana, Nopporn Chutiwitoonchai, Agnes L. Castillo, Wijit Banlunara, Opa Vajragupta, Pornchai Rojsitthisak, Pranee Rojsitthisak
Pharmaceutics.2022; 14(12): 2680. CrossRef

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