Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia.
Infectious Disease and Immunology Research Center, Indonesia Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
PLoS One. 2022 Jun 10;17(6):e0269026. doi: 10.1371/journal.pone.0269026. eCollection 2022.
The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms.
This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy.
This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not.
A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.
新冠肺炎（COVID-19）患者的疾病谱和结局可能有所不同。本研究报告了印度尼西亚巴厘岛 COVID-19 患者的特征，并评估了其临床症状的诊断价值。
这是一项观察性研究，在八家医院进行。患者分为非重症 COVID-19、重症 COVID-19 和非 COVID-19。收集 COVID-19 患者的人口统计学、临床、实验室和影像学特征以及结局。使用卡方检验或方差分析评估与严重程度和结局相关的因素。我们还比较了非重症 COVID-19 和非 COVID-19 患者的临床特征，以评估诊断准确性。
本研究纳入 92 例患者：41 例非 COVID-19 和 51 例 COVID-19，包括 45 例非重症和 6 例重症病例。COVID-19 最常见的症状是咳嗽（47.1%）、发热（31.0%）和呼吸困难（25.3%）。咳嗽、疲劳和嗅觉丧失具有较高的准确性，将这些症状结合起来进行临床诊断，可提高预测 COVID-19 患者的准确性（60.1%）。我们发现重症 COVID-19 患者的淋巴细胞计数和白细胞介素-1R 水平较低，C 反应蛋白、白细胞介素-6 和白细胞介素-8 水平较高。乳酸脱氢酶与入住重症监护病房和使用呼吸机有关，而中性粒细胞-淋巴细胞比值、C 反应蛋白和白细胞介素-6 等其他标志物则与入住重症监护病房和使用呼吸机无关。
在巴厘岛，一系列症状（包括咳嗽、疲劳和嗅觉丧失）可能与 COVID-19 有关。临床医生应注意这些症状，以便及时进行 COVID-19 诊断检测，而不仅仅是其他急性发热性疾病。
