Clinical Characteristics and main presentation of the COVID19 among Iraqi people

The COVId19 pandemic is a newly emerging infectious disease that needs to be understood thoroughly in order to be controlled. This study aimed to study the clinical and laboratory characteristics of the COVID19 patient . Patient and methods: A cross-sectional study was done in Iraq, at Salahadeen general hospital from the period 1st March to the end of May 2020 on patients diagnosed with COVID 19. A total of 75 COVID19 patients enrolled in the study. a full history was taken, a full physical examination was done, computerized tomography, and laboratory tests. Results: The age distribution of the COVID19 patient were commonly aged (30-50 years) 37(49.3%), and those aged <30 years represented about 6(8%) of the sample. The dominant gender was male 43(57.3%). About 58 (77.3%) of the patient had comorbid disease, coronary vascular disease was 49(65.3%), hypertension was found among 47(62.7%), DM was found among 40(53.3%). Smoking found among 35(46.7%) of the patients . The commonest symptoms were dyspnea 63(84%), fever 51(68%), Myalgia 46(61.3%), loss of smell 8(10.7%), vomiting 8(10.7%), sputum 8(10.7%), loss of taste 6(8%), diarrhea 6(8%), dry mouth found among


Introduction
The causes of a cluster of cases of pneumonia were established as a novel coronavirus in Wuhan, China. [1] The outbreak was quickly spread across China, followed by an explosion of cases in most countries worldwide. As of July 12, 2020 over 12 million confirmed diseases (including more than 0.5 million deaths) have been recorded around the world. The World

Health Organization (WHO) identified 2019 (COVID-19) as a pandemic [.2]
COVID-19 has several different characteristics, such as high infectiousness during incubation, the time delay from real exposure to the virus to the symptom appearance, the number of persons will be infected and the effects of different management protocols and preventive measures to be taken to control the disease . [3] The rang of incubation period was 3-14 days, but some studies reported that the median incubation period 5.1 days, and within 11.5 days 97.5% will be symptomatic. Some people their incubation period may be longer than 14 days (1%). [4] The majority of COVID-19 patients presented with fever, cough and dyspnea, [5,6]but also in few reports there was reporting of digestive symptoms as presenting signs and symptoms in some patients [7,8].
It's important to understand the clinical history of the disease in any community in order to control its spread and identify the patient as early as possible. As the researcher

Patients & Methods
This cross sectional study done in Salahadeen governorate in Iraq, at Salahadeen general hospital from the period 1st March to end of May 2020 on patient diagnosed with COVID 19. A total of 75 patient infected with COVID19 was enrolled in the study. All patient were confirmed as COVID 19 patient by nasal swab, full history was taken from them.
Full physical examination was done, computerized tomography, and laboratory tests e.g.
blood count CRP and SPO2% were measured. Ethical approval was taken from the research committee of Salahadeen directorate, as well as verbal approval from the patient was taken .
Data was analyzed using SPSS version 23 for data entry and analysis. P value < 0.05 was considered as significant .

Discussion
The age distribution of the COVID19 patient were commonly aged (30-50 years) (49.3%), and those aged <30 years represented about (8%) of the sample. This figure goes with what reported in Basra south of Iraq by Habib OS et al [9] found that commonly affected age was 30-50 years (42%), and found that those aged < 30 years was (18%). Venkatesan P [10] reported that there were warning signs of changing in COVID19 demography as the infection Males (57.3%) were more affected than females (42.7%). , this goes with Habib OS et al [9] found that (50.7%) of COVID 19 patients were male and (49.3%) were females. Pan L et al [8] found male (52.6%) were more than female (47.4%), and Zheng Y, et al [11] found the same think (54.8%), (45.2%) respectively . loss of taste 6(8%), cough 6(8%), fatigue 5(6.7%) and arthralgia 4(5.3%) found among the patients This is critical because if clinicians track only the symptoms of the respiratory system for identifying cases for COVID-19, cases with extra pulmonary symptoms can be missed or had delayed diagnosis until the respiratory symptoms manifested. Therefore those patients didn't receive prompt treatment and preventive measures will be delayed also .
The mean C -reactive protein rate was (49.8±41.2). The Lymphopenia was reported among 34(45.3%) of the patient, this supported by the findings of Wan S et al [12] reported lymphocytopenia among 51%.
Lymphopenia and increased C-reactive protein may be associated with the cytokine storm induced by the invasion of the changes in peripheral white blood cells and immune cells such as lymphocytes as a result of virus invasion [15,16].

Conclusions
The commonest presentation of the patient was dyspnea, followed by fever. Digestive symptoms, and myalgia were common, therefore a good attention should be paid to the patient with these symptoms. COVID19 may be became a stigma in our community therefore