key: cord-0968140-w02ahu2w
authors: Pacca, Carolina Colombelli; Zini, Nathalia; Versiani, Alice F.; de O. Lobl, Edoardo E.; Milhim, Bruno H. G. A.; Campos, Guilherme R. F.; Moraes, Marília M.; dos Santos, Thayza M.I.L; Dourado, Fernanda S.; Marques, Beatriz C.; da Rocha, Leonardo C.; dos Santos, Andresa L; da Silva, Gislaine C.D.; Ruiz, Leonardo G. P.; Nicesio, Raphael; Queiroz, Flávia; Reis, Andreia F. N.; da Silva, Natal S.; Nogueira, Maurício L.; Estofolete, Cássia F.
title: Follow-up of a hospital cohort during the first 3,530 suspected cases of COVID-19 in Sao Jose do Rio Preto, Sao Paulo, Brazil
date: 2021-02-04
journal: bioRxiv
DOI: 10.1101/2021.02.04.429711
sha: c4c28bd839d72393b946e19c0fe5ec5cc37920cf
doc_id: 968140
cord_uid: w02ahu2w

Introduction In a global context, COVID-19 is the most significant health threat in the present days, evidenced by the fact that, in just over four months, SARS-CoV-2 has spread to 171 countries, reaching a Pandemic status. Most patients with COVID-19 have a mild course of the disease. However, approximately 20% develop severe illness with a high mortality rate which is associated with age, comorbidities, and immunosuppression. Epidemiological studies are used to reveal the extent of viral spread in homes, communities, and hospitals. Thus, preventive and control measures can be established by the authorities. Objective In this study, patients with suspect COVID-19 symptoms who search for hospital care at the city of Sao José do Rio Preto (Sao Paulo, Brazil) were monitored, in order to identify the first case of this new disease in the region. In the first two months (March and April), more than 3000 individuals looked for the public and private health system with suspected respiratory symptoms, but only 164 (8.4%) were COVID-19 confirmed. Results From those, males (56.1%) and patients of the age distribution of 16-59 (91.2%), with diarrhea (22.2%), runny nose (25%), altered taste (15.9%), and anosmia (11.6%) presented statistical significance, although none comorbidities were related with COVID-19 occurrence. The odds ratio analysis supports this finding. Days of onset of symptoms are positively associated with whit viral load, and the same happens with the occurrence of symptoms (dyspnea and low saturation).

In late 2019, Wuhan, in Hubei province, China, became the focus of the world owing to a pneumonia 46 outbreak with unknown etiology [1] . The pathogen has been identified as novel enveloped RNA betacoronavirus (SARS-CoV-2), which has a phylogenetic similarity to SARS-CoV and that was not been analyzed to date. Subsequently, based on PCR results, the positive COVID-19 samples were 75 analyzed for clinical symptoms. This study was approved by the Ethics Committee of Faculdade de Nasopharyngeal swabs specimens were collected from patients with suspect respiratory 78 symptomatology who search for the public and private health system. Viral RNA was extracted using 

In order to measure the total of days of the symptoms, it was used the difference between the day was used to analyze the data. Initial symptoms and comorbidities were also correlated to the viral 100 load. In this correlation, the median of the Ct values from both N1 and N2 primers was normalized 101 with the internal control primer (human RNase P gene) to exclude any bias driven by low sample 102 quality. In this case, an unpaired t-test assuming Gaussian distribution with Welch's correction was Independent variables were adopted for the final model using univariate analysis (score test). The (Table 1) .

Clinical symptoms and comorbidities have been observed since the beginning of the 

Some studies have found that the peak load of SARS-CoV-2 probably means that a higher 235 viral load means lower Ct value, which is related to more viruses present at the biological sample. In 

BHGAM is supported Versiani: Conceptualization, Data Curation, Edoardo E. de O. Lobl: Review & Editing

Milhim: Data Curation

Data Curation. Fernanda S. Dourado: Data Curation. Beatriz 274 C. Marques: Data Curation. Leonardo C. da Rocha: Data Curation. Andresa L dos

Data Curation. Flávia Queiroz : Data Curation. Andreia F. N. Reis: Data

Data Curation, formal analysis. Maurício L. Nogueira: Funding 278 acquisition, Supervision. Cássia F. Estofolete: Supervision, Writing -Review & Editing

Emerging coronaviruses: Genome structure, replication, and 282 pathogenesis

A Novel Coronavirus from Patients 284 with Pneumonia in China

Laboratory Diagnosis of COVID-19: Current 296 Issues and Challenges

Epidemiological and clinical features 298 of the 2019 novel coronavirus outbreak in China

Clinical Characteristics of 138 Hospitalized 300 Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

A new coronavirus associated with 303 human respiratory disease in China

Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease

Clinical characteristics of novel 308 coronavirus cases in tertiary hospitals in Hubei Province