J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Short Communication

Volume 14, Number 8, August 2022, pages 321-326

Outcomes of COVID-19 Among High-Risk Individuals: A Study Comparing Febrile and Afebrile Presentation

**Table 1.** Comparison of Symptoms and Severity of Illness Between Febrile and Afebrile Symptomatic Groups
Parameter	Febrile group (n = 1,240), mean ± SD or no. (%)	Afebrile symptomatic group (n = 2,512), mean ± SD or no. (%)	P value
SD: standard deviation.
Age, years	42.4 ± 38.6	52 ± 22.9	< 0.0001
Gender
Male	841 (67.8)	1,461 (58.1)	< 0.0001
Female	399 (32.1)	1,051 (41.8)	< 0.0001
Prior chronic medical illness
Diabetes mellitus	443 (35.7)	921 (36.6)	0.57
Hypertension	516 (41.2)	978 (38.9)	0.17
Chronic lung disease	158 (12.7)	374 (14.8)	0.08
Chronic kidney disease	150 (12)	393 (15.6)	0.003
Chronic liver disease	58 (4.6)	161 (6.4)	0.02
Obesity	263 (21.2)	528 (42.5)	< 0.0001
Neurological disorder	100 (8.0)	162 (6.4)	0.06
Coronary heart disease	222 (17.9)	402 (16.0)	0.14
Heart failure	78 (6.2)	154 (6.1)	0.90
Immunosuppressant treatment	52 (4.1)	130 (5.1)	0.17
HIV	37 (2.9)	72 (2.8)	0.86
Pregnancy	32 (2.5)	81 (3.2)	0.23
Duration of symptom before testing, days	5.8 ± 3.5	8.2 ± 5.2	< 0.0001
Symptoms, no. (%)
Fever	1,240 (100)	0 (0)
Nasal congestion	210 (16.9)	121 (4.8)	< 0.0001
Sore throat	421 (33.9)	214 (8.5)	< 0.0001
Malaise	721 (53.1)	1,480 (58.9)	0.0008
Myalgia	892 (71.9)	1,829 (72.8)	0.57
Cough	324 (26.1)	723 (28.7)	0.08
Dyspnea	118 (9.5)	321 (12.7)	0.003
Anosmia	215 (17.3)	278 (16.4)	0.47
Ageusia	321 (25.8)	542 (24.4)	0.33
Rash	22 (1.7)	39 (1.5)	0.61
Headache	680 (54.8)	1,345 (53.5)	0.45
Diarrhea	86 (6.9)	132 (5.2)	0.03
Dizziness	343 (27.6)	362 (14.4)	< 0.0001
Others	182 (14.6)	542 (21.5)	< 0.0001
Severity of illness
Non-hypoxic	933 (75.2)	1,854 (73.8)	0.35
Hypoxic	307 (24.8)	658 (26.2)	0.35
Mortality	35 (2.8)	82 (3.2)	0.50

Table 1. Comparison of Symptoms and Severity of Illness Between Febrile and Afebrile Symptomatic Groups

Parameter

Febrile group (n = 1,240), mean ± SD or no. (%)

Afebrile symptomatic group (n = 2,512), mean ± SD or no. (%)

P value

SD: standard deviation.

Age, years

42.4 ± 38.6

52 ± 22.9

< 0.0001

Gender

Male

841 (67.8)

1,461 (58.1)

< 0.0001

Female

399 (32.1)

1,051 (41.8)

< 0.0001

Prior chronic medical illness

Diabetes mellitus

443 (35.7)

921 (36.6)

0.57

Hypertension

516 (41.2)

978 (38.9)

0.17

Chronic lung disease

158 (12.7)

374 (14.8)

0.08

Chronic kidney disease

150 (12)

393 (15.6)

0.003

Chronic liver disease

58 (4.6)

161 (6.4)

0.02

Obesity

263 (21.2)

528 (42.5)

< 0.0001

Neurological disorder

100 (8.0)

162 (6.4)

0.06

Coronary heart disease

222 (17.9)

402 (16.0)

0.14

Heart failure

78 (6.2)

154 (6.1)

0.90

Immunosuppressant treatment

52 (4.1)

130 (5.1)

0.17

HIV

37 (2.9)

72 (2.8)

0.86

Pregnancy

32 (2.5)

81 (3.2)

0.23

Duration of symptom before testing, days

5.8 ± 3.5

8.2 ± 5.2

< 0.0001

Symptoms, no. (%)

Fever

1,240 (100)

0 (0)

Nasal congestion

210 (16.9)

121 (4.8)

< 0.0001

Sore throat

421 (33.9)

214 (8.5)

< 0.0001

Malaise

721 (53.1)

1,480 (58.9)

0.0008

Myalgia

892 (71.9)

1,829 (72.8)

0.57

Cough

324 (26.1)

723 (28.7)

0.08

Dyspnea

118 (9.5)

321 (12.7)

0.003

Anosmia

215 (17.3)

278 (16.4)

0.47

Ageusia

321 (25.8)

542 (24.4)

0.33

Rash

22 (1.7)

39 (1.5)

0.61

Headache

680 (54.8)

1,345 (53.5)

0.45

Diarrhea

86 (6.9)

132 (5.2)

0.03

Dizziness

343 (27.6)

362 (14.4)

< 0.0001

Others

182 (14.6)

542 (21.5)

< 0.0001

Severity of illness

Non-hypoxic

933 (75.2)

1,854 (73.8)

0.35

Hypoxic

307 (24.8)

658 (26.2)

0.35

Mortality

35 (2.8)

82 (3.2)

0.50

**Table 2.** Comparison Between Symptoms and Outcomes Among Participants in Six Study Sub-Groups
Parameter	Diabetes mellitus ± additional illness (n = 1,364)	P	Hypertension ± additional non-diabetic chronic illness (n = 545)	P	Chronic lung disease (n = 428)	P	Chronic kidney disease ± HT (n = 339)	P	Chronic liver disease (n = 165)	P	Others (n = 911)	P
FG: febrile group; AFG: afebrile group; HT: hypertension.
Fever	443 (100)	0		223 (100)	0(0)		118 (100)	0 (0)		96 (100)	0 (0)		42 (100)	0(0)		318 (100)	0 (0)
Nasal congestion	96 (21.6)	32 (3.4)	< 0.001	9 (4.0)	12 (3.7)	0.85	13 (11.0)	8 (2.5)	0.0003	22 (22.9)	9 (3.7)	< 0.001	8 (19.0)	12 (9.7)	0.11	62 (19.4)	48 (8.0)	< 0.0001
Sore throat	182 (41.0)	62 (6.7)	< 0.001	42 (18.8)	21 (6.5)	< 0.001	32 (27.1)	18 (5.8)	< 0.001	18 (18.7)	8 (3.2)	< 0.001	12 (28.5)	12 (9.7)	0.003	135 (42.4)	93 (15.6)	< 0.0001
Malaise	391 (88.2)	621 (67.4)	< 0.001	102 (45.7)	204 (63.3)	< 0.001	60 (50.8)	260 (83.8)	< 0.001	30 (31.2)	42 (17.2)	0.004	20 (47.6)	18 (14.6)	< 0.0001	118 (37.1)	335 (56.4)	< 0.0001
Myalgia	416 (93.9)	718 (77.9)	< 0.001	118 (52.9)	206 (63.9)	0.009	72 (61.0)	120 (38.7)	< 0.001	32 (33.3)	118 (48.5)	0.01	24 (57.1)	123 (100)	< 0.0001	230 (72.3)	543 (91.5)	< 0.0001
Cough	112 (25.2)	224 (24.3)	0.70	51 (22.8)	112 (34.7)	0.002	26 (22.0)	176 (56.7)	< 0.001	12 (12.5)	114 (46.9)	< 0.001	8 (19.0)	54 (43.9)	0.004	115 (36.1)	43 (7.2)	< 0.0001
Dyspnea	24 (5.4)	64 (6.9)	0.28	11 (4.9)	40 (12.4)	0.003	24 (20.3)	92 (29.6)	0.052	12 (12.5)	70 (28.8)	0.001	16 (38.0)	51 (41.4)	0.701	31 (9.7)	4 (0.6)	< 0.0001
Anosmia	62 (13.9)	12 (1.3)	< 0.001	12 (5.3)	12 (3.7)	0.35	16 (13.5)	18 (5.8)	0.008	18 (18.7)	42 (17.2)	0.75	10 (23.8)	12 (9.7)	0.02	97 (30.5)	182 (30.6)	0.97
Ageusia	96 (21.6)	146 (15.8)	0.007	54 (24.2)	146 (45.3)	< 0.001	38(32.2)	41 (32.2)	0.99	36 (37.5)	68 (27.9)	0.08	31 (73.8)	48 (39.0)	0.0001	66 (20.7)	93 (15.6)	0.05
Rash	0	0		0 (0)	0 (0)	-	0 (0)	0 (0)		0 (0)	2 (0.8)		2 (4.7)	5 (4.0)	0.83	20 (6.2)	32 (5.3)	0.58
Headache	371 (83.7)	436 (47.3)	< 0.001	114 (51.1)	181 (56.2)	0.24	72 (61.0)	118 (38.0)	< 0.001	32 (33.3)	122 (50.2)	0.004	22 (52.3)	62 (50.4)	0.83	69 (21.6)	426 (71.8)	< 0.0001
Diarrhea	25 (5.6)	22 (2.3)	0.002	11 (4.9)	8 (2.4)	0.12	20 (16.9)	12 (3.8)	< 0.0001	3 (3.1)	34 (3.9)	0.70	4 (9.5)	14 (11.3)	0.74	23 (7.2)	42 (7.0)	0.93
Dizziness	114 (25,7)	62 (6.7)	< 0.001	72 (32.2)	38 (11.8)	< 0.001	32 (27.1)	112 (36.1)	0.07	14 (14.5)	42 (17.2)	0.54	22 (52.3)	32 (26.0)	0.001	89 (27.9)	76 (12.8)	< 0.0001
Others	60 (13.5)	182 (19.7)	0.004	18 (8.0)	46 (14.2)	0.026	20 (16.9)	56 (18.6)	0.68	16 (16.6)	62 (25.5)	0.07	9 (21.4)	22 (17.8)	0.60	59 (18.5)	174 (29.3)	0.0004
Non-hypoxic	341 (76.9)	741 (80.4)	0.13	196 (87.8)	284 (88.1)	0.91	72 (61)	222 (71.6	0.03	51 (53.1)	142 (58.4)	0.37	22 (52.4)	61 (49.5)	0.74	251 (78.9)	404 (68.1)	0.0006
Hypoxic	102 (23)	180 (19.5)	0.13	27 (12.2)	38 (11.8)	0.88	46 (38.9)	88 (28.3)	0.03	45 (46.9)	101 (41.6)	0.37	20 (47.6)	62 (50.4)	0.75	67 (21)	189 (31.8)	0.0005
Mortality	9 (2)	16 (1.7)	0.69	2 (0.8)	4 (1.2)	0.65	8 (6.7)	22 (7)	0.91	8 (8.3)	21 (8.6)	0.92	3 (7.1)	7 (5.6)	0.72	5 (1.5)	12 (2)	0.59

Table 2. Comparison Between Symptoms and Outcomes Among Participants in Six Study Sub-Groups

Parameter

Diabetes mellitus ± additional illness (n = 1,364)

Hypertension ± additional non-diabetic chronic illness (n = 545)

Chronic lung disease (n = 428)

Chronic kidney disease ± HT (n = 339)

Chronic liver disease (n = 165)

Others (n = 911)

FG (n = 443)

AFG (n = 921)

FG (n = 223)

AFG (n = 322)

FG (n = 118)

AFG (n = 310)

FG (n = 96)

AFG (n = 243)

FG (n = 42)

AFG (n = 123)

FG (n = 318)

AFG (n = 593)

FG: febrile group; AFG: afebrile group; HT: hypertension.

Fever

443 (100)

223 (100)

0(0)

118 (100)

0 (0)

96 (100)

0 (0)

42 (100)

0(0)

318 (100)

0 (0)

Nasal congestion

96 (21.6)

32 (3.4)

< 0.001

9 (4.0)

12 (3.7)

0.85

13 (11.0)

8 (2.5)

0.0003

22 (22.9)

9 (3.7)

< 0.001

8 (19.0)

12 (9.7)

0.11

62 (19.4)

48 (8.0)

< 0.0001

Sore throat

182 (41.0)

62 (6.7)

< 0.001

42 (18.8)

21 (6.5)

< 0.001

32 (27.1)

18 (5.8)

< 0.001

18 (18.7)

8 (3.2)

< 0.001

12 (28.5)

12 (9.7)

0.003

135 (42.4)

93 (15.6)

< 0.0001

Malaise

391 (88.2)

621 (67.4)

< 0.001

102 (45.7)

204 (63.3)

< 0.001

60 (50.8)

260 (83.8)

< 0.001

30 (31.2)

42 (17.2)

0.004

20 (47.6)

18 (14.6)

< 0.0001

118 (37.1)

335 (56.4)

< 0.0001

Myalgia

416 (93.9)

718 (77.9)

< 0.001

118 (52.9)

206 (63.9)

0.009

72 (61.0)

120 (38.7)

< 0.001

32 (33.3)

118 (48.5)

0.01

24 (57.1)

123 (100)

< 0.0001

230 (72.3)

543 (91.5)

< 0.0001

Cough

112 (25.2)

224 (24.3)

0.70

51 (22.8)

112 (34.7)

0.002

26 (22.0)

176 (56.7)

< 0.001

12 (12.5)

114 (46.9)

< 0.001

8 (19.0)

54 (43.9)

0.004

115 (36.1)

43 (7.2)

< 0.0001

Dyspnea

24 (5.4)

64 (6.9)

0.28

11 (4.9)

40 (12.4)

0.003

24 (20.3)

92 (29.6)

0.052

12 (12.5)

70 (28.8)

0.001

16 (38.0)

51 (41.4)

0.701

31 (9.7)

4 (0.6)

< 0.0001

Anosmia

62 (13.9)

12 (1.3)

< 0.001

12 (5.3)

12 (3.7)

0.35

16 (13.5)

18 (5.8)

0.008

18 (18.7)

42 (17.2)

0.75

10 (23.8)

12 (9.7)

0.02

97 (30.5)

182 (30.6)

0.97

Ageusia

96 (21.6)

146 (15.8)

0.007

54 (24.2)

146 (45.3)

< 0.001

38(32.2)

41 (32.2)

0.99

36 (37.5)

68 (27.9)

0.08

31 (73.8)

48 (39.0)

0.0001

66 (20.7)

93 (15.6)

0.05

Rash

0 (0)

2 (0.8)

2 (4.7)

5 (4.0)

0.83

20 (6.2)

32 (5.3)

0.58

Headache

371 (83.7)

436 (47.3)

< 0.001

114 (51.1)

181 (56.2)

0.24

72 (61.0)

118 (38.0)

< 0.001

32 (33.3)

122 (50.2)

0.004

22 (52.3)

62 (50.4)

0.83

69 (21.6)

426 (71.8)

< 0.0001

Diarrhea

25 (5.6)

22 (2.3)

0.002

11 (4.9)

8 (2.4)

0.12

20 (16.9)

12 (3.8)

< 0.0001

3 (3.1)

34 (3.9)

0.70

4 (9.5)

14 (11.3)

0.74

23 (7.2)

42 (7.0)

0.93

Dizziness

114 (25,7)

62 (6.7)

< 0.001

72 (32.2)

38 (11.8)

< 0.001

32 (27.1)

112 (36.1)

0.07

14 (14.5)

42 (17.2)

0.54

22 (52.3)

32 (26.0)

0.001

89 (27.9)

76 (12.8)

< 0.0001

Others

60 (13.5)

182 (19.7)

0.004

18 (8.0)

46 (14.2)

0.026

20 (16.9)

56 (18.6)

0.68

16 (16.6)

62 (25.5)

0.07

9 (21.4)

22 (17.8)

0.60

59 (18.5)

174 (29.3)

0.0004

Non-hypoxic

341 (76.9)

741 (80.4)

0.13

196 (87.8)

284 (88.1)

0.91

72 (61)

222 (71.6

0.03

51 (53.1)

142 (58.4)

0.37

22 (52.4)

61 (49.5)

0.74

251 (78.9)

404 (68.1)

0.0006

Hypoxic

102 (23)

180 (19.5)

0.13

27 (12.2)

38 (11.8)

0.88

46 (38.9)

88 (28.3)

0.03

45 (46.9)

101 (41.6)

0.37

20 (47.6)

62 (50.4)

0.75

67 (21)

189 (31.8)

0.0005

Mortality

9 (2)

16 (1.7)

0.69

2 (0.8)

4 (1.2)

0.65

8 (6.7)

22 (7)

0.91

8 (8.3)

21 (8.6)

0.92

3 (7.1)

7 (5.6)

0.72

5 (1.5)

12 (2)

0.59