Wallop of Symptoms and Co-morbidities on COVID-19 Outcome

Heba H. Abo ElNaga1, Hesham A. AbdelHalim2, *, Mohamed Abdellatif1, Haroun BG1, Basem Elnagdy1, Taghreed Ashraf1, Bahaa ElNaggar1, Passant S. Eldin1, Ismail TA1, Beshoy Mosaad1, Tasbeeha Ismail1, Rasmy Boules1, Shawky Methuselah1, Paula Rafaat1
1 Pulmonary Medicine Department, Faculty of Medicine, October 6 University, Giza, Egypt
2 Pulmonary Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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© 2021 Abo ElNaga et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Pulmonary medicine department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;
Tel: +202 38515201; E-mail:



Fever, cough, fatigue, and myalgia are usually the original clinical picture of the COVID-19 pandemic, which appears non-specific and not exclusive.


To illustrate the clinical picture pattern and assess the prevalence of underlying co-morbidities and their correlation with the severity of COVID-19 infected patients.


A cross-sectional online survey included 580 participants who were either suspected or confirmed with COVID-19 infection.


The severity of the disease significantly correlates with both age (p=.01) and the time lag of the diagnosis of COVID-19 (p=.03). Hypertension (p=.015) and diabetes mellitus (p<.01) were significantly associated with the duration of symptoms. A wide range of ages (21-60 years) seemed to be the only risk factor for the severity. When symptoms were tested, dyspnea appeared to be the most prevalent symptom, predicting a more severe disease (OR= .066, 95% CI: .022- .200), followed by diarrhea (OR= .285, 95% CI: .122-.663), then fever (OR= .339, 95% CI: .139-.824). During the examination of co-morbidities influences on the severity, the only major co-morbidity that predicted a more severe disease was IHD (OR= .218, 95% CI: .073- .648), p= .006.


Special consideration is required for patients with COVID-19 with an associated longer gap between symptoms and diagnosis and associated co-morbidities including hypertension, diabetes, and established chronic kidney disease (CKD), for which this study proved its profound influence on the severity of the illness and duration of symptoms.

Keywords: COVID 19, Symptoms, Co-morbidities, Outcome, Wallop, Questionnaire.