key: cord-1003529-kr6xhwwv
authors: Sarhan, Rania M; Mohammad, Mohammad F; Boshra, Marian S.
title: Differential clinical diagnosis and prevalence rate of allergic rhinitis, asthma and chronic obstructive pulmonary disease among COVID‐19 patients
date: 2021-06-29
journal: Int J Clin Pract
DOI: 10.1111/ijcp.14532
sha: 5bb3e1051fccae9aac5a3bde0c54ac025899a11e
doc_id: 1003529
cord_uid: kr6xhwwv

BACKGROUND: There is a great need 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. METHOD: Approximately 522 patients with allergic rhinitis, asthma, COPD, and COVID‐19 were analysed for demographic and clinical features. Radiological features were analysed only for COVID‐19 patients. RESULTS: COPD and asthma were more common among COVID‐19 patients than allergic rhinitis. All chest CT scans of COVID‐19 patients showed bilateral ground‐glass opacity. Fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips were significantly higher in all COVID‐19 patients compared to COPD, asthma, and allergic rhinitis patients. CONCLUSION: The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID‐19 patients, can be used for differential diagnosis between COVID‐19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID‐19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID‐19 infection among other respiratory disease patients.

breath, and blue lips were significantly higher in all COVID-19 patients compared to COPD, asthma, and allergic rhinitis patients.

The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID-19 patients, can be used for differential diagnosis between COVID-19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID-19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID-19 infection among other respiratory disease patients. patients was 0%, 30.7% and 35.1%, respectively ( Figure 1 ). There was a significant difference in the prevalence of the three respiratory diseases among COVID-19 patients. The numbers of COVID-19 patients, having asthma or COPD, were significantly higher compared with the number of COVID-19 patients with allergic rhinitis at P < .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 with allergic rhinitis, COPD, and asthmatic patients who did not have COVID-19 infection

• Differential diagnosis of COVID-19 between respiratory disease patients became complicated due to the symptom pattern overlap.

• Clinical diagnosis is a significant tool in differentiation between COVID-19 and other respiratory diseases.

• COPD and asthmatic patients are more susceptible to COVID-19 infection than allergic rhinitis patients. b Indicates significant difference in symptoms of fever, diarrhea, shortness of breath, blue color in the lips, and weakness in smell and taste senses, on comparing all COVID-19 groups to allergic rhinitis, asthma and COPD patients at P < .05. c Indicates significant difference in symptoms of hoarseness, runny nose, and pain in the ears or teeth on comparing allergic rhinitis patients, either having asthma or not, to other groups at P < .05. d Indicates significant difference in symptoms of headache, throat pain and increase in symptoms with exposure to cold air or dust, on comparing asthmatic patients, allergic rhinitis patients, and patients with both diseases to other groups at P < .05. 

The authors declared no conflict of interest.

Conception and design: All authors. Administrative support: All authors. Provision of study materials or patients: All authors. Collection and assembly of data: All authors. Data analysis and interpretation:

All authors. Manuscript writing: All authors. Final approval of manuscript: All authors.

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Rania M Sarhan https://orcid.org/0000-0002-0781-6454

Marian S. Boshra https://orcid.org/0000-0003-4916-4359

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Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a populationlevel observational study

F I G U R E 1 Prevalence rate of allergic rhinitis, asthma, and COPD in COVID-19 population. COPD = chronic obstructive pulmonary disease, COVID-19, coronavirus disease 2019.* A significant difference between the prevalence rate of asthma and allergic rhinitis in the COVID-19 population at P < .0. # A significant difference between the prevalence rate of COPD and allergic rhinitis in the COVID-19 population at P < .05