Knowledge and awareness of COVID 19 on the respiratory system-A survey

Shabbarish Chockalingam1, Gayatri Devi R*2, Yuvaraj Babu K3 1Saveetha dental college and hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India 2Department of Physiology, Saveetha Dental College & Hospitals, Saveetha institute of Medical and Technical Sciences, Saveetha University, Chennai Tamil Nadu, India 3Department of Anatomy, Saveetha Dental College & Hospitals, Saveetha institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India


INTRODUCTION
COVID-19 or coronavirus disease 19 is a viral disease (World Health Organization, 2020). It belongs to the subfamily of orthocoronovirinae World Health Organization (2020) and it is also called as the Severe Acute Respiratory Syndrome Coronavirus-2 by the International Committee on Taxonomy of Viruses (Swathy and Sethu, 2015;Abigail, 2019;David, 2019;Cascella, 2020). It is a respiratory illness which is compared to SARS, unlike asthma that can be managed, there is a possibility of a cure. Still, it is highly contagious and also has a high risk of being fatal. The reason for the virus being so effective is its environmental factor, just like ecological factors have its effect on sleeping patterns (Timothy et al., 2019;Ilankizhai and Devi, 2016;Iyer et al., 2019;Harsha, 2015), viruses to be ef icient have to be resistant to environmental factors and the coronavirus is very effective at that, it sustains pH from 3-10, able to sustain temperatures of up to 70C. Unlike Tuberculosis, which obstructs the airway and ultimately, the entire respiratory system (Dave and Preetha, 2016). COVID affects the upper respiratory tract, which can be measured by inding the forced expiratory time as it provides an understanding of pulmonary physiology (Devi and Sethu, 2018;Baheerati and Devi, 2018). Sleep apnea can be caused due to respiratory problems, among which snoring is              most common (Shruthi and Preetha, 2018). Thyroid gland swells upon a de iciency of iodine, which can affect the immune system and from ighting diseases like Tuberculosis which can cause acute myocardial infarction (Samuel and Devi, 2015;Renuka and Sethu, 2015;Fathima and P, 2016;Choudhari and Jothipriya, 2016).
Its out break began in the live animal markets of Wuhan, China and has affected several irst worlds as well as third world countries leading to a global shutdown, with the countries most severely affected by the virus being Italy, China, United States of America, India and Singapore among others. Due to the highly contagious nature of the virus, the patient begins shedding infected cells as early as within the irst day of the infection with the symptoms for the disease not showing up for a few days (Kim, 2020).    32.07% were females. Chi square test was done and the association was found not to be statistically signi icant. Pearson's chi square value: 1.747, DF: 1, p value: 0.651 (>0.05) hence non signi icant.
Figure 18 X-axis represents the Gender and Y-axis represents the number of participants. Of the 55.66% who were familiar with fever, 38.67% were males and 16.98% were females. Chi square test was done and the association was found not to be statistically signi icant. Pearson's Chi square value: 6.538, DF:5, p value: 0.257 (>0.05) hence non signi icant. Figure 19 The X -axis represents Gender and Y-axis represents the number of participants. Out of the 39.62% who knew the answer, 25.42% were males who knew the answer was Upper respiratory tract and 14.15% were females. Chi square test was done and the association was found not to be statistically signi icant.Pearson's Chi square value: 4.023, DF: 4, p value: 0.366 (>0.05) hence non signi icant. Figure 20 The X-axis represents gender and the Yaxis represents the participants. Chi square test was Common symptoms include fever, cough, shortness of breath and in extreme cases even pneumonia, persistent pain in the chest and even bluish lips and face. While the coronavirus that can affect humans is responsible for up to 30% of colds but lower respiratory tract infections are caused by the ones which affect livestock and poultry (Holmes, 2003). Out of the strain of the virus, only α and β strains affect mammals.
In contrast, δ and γ strains affect birds with several rumours prevalent about how it is spread and the widespread dilemma about its symptoms where everyone has been advised to be in lockdown because of its effect on society. The rate of its spread and the fact that its fatality rate calls for more interest into the matter, like in the past, pandemics, awareness was poor about the disease thus as a result of that several new cases have shown up. The fatality count has increased and to combat that awareness was spread, and only then were we able to overcome such endeavours.
The study aims to assess the awareness of the COVID-19 pandemic and its effect on the human body.

MATERIALS AND METHODS
A survey was conducted using a self-made questionnaire of 15 questions. The survey was conducted on Google Forms, and the link was sent to each of the subjects. The number of subjects undertaking the survey totalled up to 106, out of which 41 were females, and 65 were males. In this survey, questions covered a variety of topics which include questions covering the general awareness, incubation period, method of spread, symptoms and also tackles the issues regarding the possibility of the disease is asymptomatic. The questions presented had multiple options which would help get a result that's highly speci ic and in turn, helping us with our survey. To prevent any sampling bias taking place, we used software for randomly selecting participants. The validity of the resulting experiment was cleared internally by the random selection of the participants and externally by replicating said experiment. In this experiment, the independent variables that were taken into consideration are the height, weight and skin colour while the dependent variables were the age and sex of the subjects. After conducting the survey, the data was collected and was statically analysed using SPSS statistics 19 and descriptive analysis was used to create pie charts.

RESULTS AND DISCUSSION
Upon analysing the data, we found the awareness and attitude of the subject towards COVID-19 and the effect that it had on the respiratory system to be high.
The awareness of COVID-19 pandemic was found to be 99.06%, while only 0.94% was not aware (Figure 1). Physical contact was found to be the most chosen option of the lot with 60.38% selecting the option, while 20.75% chose air for the question about the way the disease spreads (Figure 2). 49.06% thought the incubation period to be between 7-14 days, the incubation period of the disease is 14 days. It was thus making 7-14 days the favourable response ( Figure 3). With the social distancing norms in place, 90.57% agreed that they were isolating themselves and were practising social distancing (Figure 4). A good majority were aware of the possibility of the disease being presented while the person was asymptomatic with 85% saying they were aware of this possibility ( Figure 5). 55.66% were aware of the disease presenting itself with a fever, i.e., they were most aware with fever being a symptom, which is generally the irst symptom to present itself. 17.92% chose cough is a common symptom of the disease (Figure 6). With any problems that arise, messages instantly start circulating about the various remedies which can be made at home. 49.06% said that they would be willing to try said medications, while only 22.64% said that this should be stopped (Figure 7) The lockdown has made 48.11% prioritise their life and the important things in it. This lockdown has helped them bene it, 21.70% were not happy at the abrupt manner at which it was held and found it very unplanned, 17.92% kept living there the way did before the lockdown began. The remaining 12.26% followed the guidelines but found it hampering on their lifestyles (Figure 8). 61.32% of the people were aware that the disease could spread at once after contracting the disease (Figure 9). While 40.57% said that the upper respiratory tract is the site that is the most affected by the disease, 45.28% thought that lungs were primarily affected by the virus (Figure 10). The way it spreads is by binding itself to cells that release genetic material. This option was chosen by 41% lower awareness ( Figure 11). Only 8% of the participants were aware of pneumonia being the inal symptom (Figure 12). Immuno compromised people have no immune system, which is needed to ight off infections, an option chosen by only 34.96% (Figure 13). Majority of the subjects who gave the survey agree that people with lung disorders are highly susceptible to migraine, with 84.91% agreeing ( Figure 14). 87.74% agreed that smoking makes one more susceptible ( Figure 15). Forty-one females took this study, and 65 males, comparing the results on the awareness of COVID-19 presenting itself without any symptoms was depicted with a P-value of 0.651, making it statistically not signi icant ( Figure 16) and in (Figure 17). We depict the association between gender and the knowledge of how the virus spreads in the body. It has a p-value of 0.200, making it statistically not signi icant. The last three graphs depict the awareness related to the path of action of COVID-19, (Figure 18) which depicts the association of gender and the common symptoms of COVID-19, had a p-value of 0.257, (Figure 19) compares gender with the site of the respiratory system that gets affected the most by COVID-19 it had a p-value of 0.366 and inally, (Figure 20 )depicting the awareness of duration before which the disease could be spread a pvalue of 0.237, making all three of them statistically not signi icant.
The awareness of COVID-19 pandemic was at 99.04%, which is similar to the inding of (Kobayashi, 2014), who had a high 96%. When asked about the awareness of the incubation period, which in the case of COVID-19, is 14 days, 49.06% chose the option 7-14days which was the most favourable option, the percentage of answers of the favourable response was not similar to the indings of Neha Gupta et al. 2015 which had a favourable reaction of a mere 28%. (Mehta, 2015). 90.57% agreed to be practising social distancing, similar to a study by Rajesh Singh 2020, who had a response rate of 87%. (Bhadoria, 2020). The awareness about how the virus spread in the body was asked with the indings that 40.57% knew the exact method of spread and this was not similar to indings of Okorie Nelson et al. 2017, who found at 71% awareness.

Limitations
Awareness of the subjects due to knowledge gained due to access to the internet. The small sample size can result in different results upon comparing to a more signi icant sample.

Future scope
This research will lay the building blocks for future research for inding the cure quicker should there be the next outbreak of a contagious and thus preventing such outbreaks in the future.

CONCLUSIONS
The research assessed the awareness of COVID-19 and its effect on the respiratory system among college students, and it was found to be high. With how rapidly the disease is spreading, high awareness is a good step forward towards the containment of the disease. However, even though the knowledge is high, more awareness must be raised about how the disease spreads to reach the masses who are yet not aware.

Con lict of Interest
Nil.

Funding Support
Nil.