The objective of this study was to predict disease severity with the help of initial symptoms in Covid-19 patients.

Ninety Nine coronavirus positive cases were recruited for the study. Their initial symptoms were recorded and correlated with parameters of disease severity like chest CT Severity Scores and laboratory parameters like C-reactive protein, serum Lactate dehydrogenase and serum ferritin. They were followed up over the period of 20 days and their initial symptoms were also correlated with mortality at 20th day.

Fever was found to be the most common initial symptom in 58(59%) of patients, followed by sore throat 11 (11%) and shortness of breath 8(8%). Fever was also the first symptom in individuals with greatest mortality at 20th day among all age groups. Similarly, older age, greater CT severity scores (OR 8.14, 95% CI 1.82-36.25), raised CRS markers and lower oxygen saturations at room air (RR 1.18, 95% CI 1.07-1.30) were independently related to severe disease and higher mortality.

Fever as the first symptom was the most sensitive indicator of severe covid-19 infection especially in older population. Dyspnea followed by fever is the second most common symptom related to acute respiratory distress syndrome and severe covid infection.