Lewek Pawel, Banaś Izabela, Witkowski Konrad, Lewek Joanna, Kardas Przemyslaw
Department of Family Medicine, Medical University of Lodz, Łódź, Poland.
Department of Preventive Cardiology and Lipidology, Chair of Nephrology and Hypertension, Medical University of Lodz, Łódź, Poland.
Front Med (Lausanne). 2023 Apr 5;10:1121558. doi: 10.3389/fmed.2023.1121558. eCollection 2023.
The understanding and treatment of COVID-19 has improved rapidly since December 2019 when SARS-CoV-2 was sequenced. However most papers on its symptomatology focus on hospitalized patients and address only a limited number of major presentations. Although differences depending on sex of COVID-19 patients have been previously confirmed (higher ICU admission and higher death rate for men), no publication has focused on sex-related differences in COVID-19 symptomatology.
The aim of the study was to present a reliable list of COVID-19 symptoms and identify any differences in symptom prevalence depending on sex.
A sample of Polish patients suffering from COVID-19 were surveyed using a cross-sectional anonymous online survey in Polish available on a web-based surveying platform (Survey Monkey). The survey included 20 questions asking about COVID-19 symptoms, days of occurrence (from day 1 until day 14 and "15 days or more") and patient characteristics including sex, age, height, weight, place of residence and type of therapy received during COVID-19. The survey was made available during the third COVID-19 wave in Poland. The link to the survey was distributed across social networks. Participation was open to anyone willing, without any incentives. The data was analyzed statistically.
Survey responses were collected from 2,408 participants (56.9% women) aged 18-90 (42 ± 12), 84.7% living in cities, who took part in the study between December 2020 and February 2021. Out of 54 predefined symptoms, the three most prevalent were fatigue (reported by 87.61% respondents), anosmia (73.74%) and headache (69.89%). Women were found to be more symptomatic than men, 31 symptoms occurred more often in women (including anosmia, headache and myalgias, < 0.05). Subfebrility, fever and hemoptysis were more prevalent in men. Twelve symptoms (incl. hypothermia, sneezing and nausea) lasted longer in women than men ( < 0.05). Fatigue, cough, nasal dryness, xerostomia and polydipsia were the longest lasting symptoms of COVID-19 (lasted over 14 days).
Our study presents a wide range of symptoms, which may enable better recognition of COVID-19, especially in an outpatient setting. Understanding these differences in the symptomatology of community and hospitalized patients may help diagnose and treat patients faster and more accurately. Our findings also confirmed differences in symptomatology of COVID-19 between men and women, which may lay the foundation for a better understanding of the different courses of this disease in the sexes. Further studies are necessary to understand whether a different presentation correlates with a different outcome.
自2019年12月严重急性呼吸综合征冠状病毒2（SARS-CoV-2）测序以来，对新型冠状病毒肺炎（COVID-19）的认识和治疗迅速改善。然而，大多数关于其症状学的论文都集中在住院患者身上，且仅涉及有限数量的主要症状表现。尽管先前已证实COVID-19患者存在性别差异（男性入住重症监护病房的比例更高，死亡率也更高），但尚无出版物关注COVID-19症状学中的性别相关差异。
本研究旨在列出一份可靠的COVID-19症状清单，并确定症状发生率在性别上的差异。
通过基于网络的调查平台（Survey Monkey）上提供的一份波兰语横断面匿名在线调查问卷，对波兰的COVID-19患者样本进行了调查。该调查包括20个问题，询问COVID-19症状、出现症状的天数（从第1天到第14天以及“15天或更长时间”）以及患者特征，包括性别、年龄、身高、体重、居住地点和COVID-19期间接受的治疗类型。该调查在波兰第三波COVID-19疫情期间提供。调查问卷的链接在社交网络上分发。任何愿意参与的人都可参与，无需任何激励措施。对数据进行了统计分析。
在2020年12月至2021年2月期间，共收集了2408名参与者（56.9%为女性）的调查回复，年龄在18 - 90岁（42±12岁），84.7%居住在城市。在54种预先定义的症状中，最常见的三种症状是疲劳（87.61%的受访者报告有此症状）、嗅觉丧失（73.74%）和头痛（69.89%）。发现女性比男性症状更多，31种症状在女性中出现的频率更高（包括嗅觉丧失、头痛和肌痛，P<0.05）。低热、发热和咯血在男性中更常见。12种症状（包括体温过低、打喷嚏和恶心）在女性中持续的时间比男性更长（P<0.05）。疲劳、咳嗽、鼻干、口干和烦渴是COVID-19持续时间最长的症状（持续超过14天）。
我们的研究列出了广泛的症状，这可能有助于更好地识别COVID-19，尤其是在门诊环境中。了解社区患者和住院患者症状学的这些差异可能有助于更快、更准确地诊断和治疗患者。我们的研究结果还证实了COVID-19在男性和女性症状学上的差异，这可能为更好地理解该疾病在不同性别中的不同病程奠定基础。有必要进行进一步研究，以了解不同的症状表现是否与不同的结果相关。
