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Coelho DH, Reiter ER, Budd SG, Shin Y, Kons ZA, Costanzo RM. Predictors of smell recovery in a nationwide prospective cohort of patients with COVID-19. Am J Otolaryngol 2022; 43:103239. [PMID: 34547716 PMCID: PMC8443532 DOI: 10.1016/j.amjoto.2021.103239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine which factors (demographic, symptoms, comorbidities, and treatments) are associated with recovery of smell in patients with COVID-19 associated olfactory loss. STUDY DESIGN Prospective, longitudinal questionnaires. SETTING National survey. METHODS A longitudinal web-based nationwide survey of adults with COVID-19 associated smell and taste loss was launched April 10, 2020. After completing an initial entry survey, participants received detailed follow-up questionnaires 14 days, and 1, 3 and 6 months later. RESULTS As of June 25, 2021, 798 participants met study inclusion criteria and completed 6-month questionnaires. Of demographic characteristics only age <40 years was positively associated with smell recovery (p < .003). Of symptoms, difficulty breathing was negatively associated with smell recovery (p < .004), and nasal congestion positively associated with smell recovery (p < .03). Of pre-existing comorbidities only previous head injury (p < .017) was negatively associated with smell recovery. None of the queried medications used to treat COVID were associated with better rates of smell recovery. CONCLUSIONS Age <40 and presence of nasal congestion at time of COVID-19 infection were predictive of improved rates of smell recovery, while difficulty breathing at time of COVID-19 infection, and prior head trauma predicted worsened rates of recovery. Further study will be required to identify potential mechanisms for the other observed associations. Such information can be used by clinicians to counsel patients suffering COVID-19 associated smell loss as to prognosis for recovery.
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Affiliation(s)
- Daniel H Coelho
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - Evan R Reiter
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Serenity G Budd
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Yongyun Shin
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Zachary A Kons
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Richard M Costanzo
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Sa-nguanmoo N, Namdee K, Khongkow M, Ruktanonchai U, Zhao Y, Liang XJ. Review: Development of SARS-CoV-2 immuno-enhanced COVID-19 vaccines with nano-platform. NANO RESEARCH 2022; 15:2196-2225. [PMID: 34659650 PMCID: PMC8501370 DOI: 10.1007/s12274-021-3832-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 05/04/2023]
Abstract
Vaccination is the most effective way to prevent coronavirus disease 2019 (COVID-19). Vaccine development approaches consist of viral vector vaccines, DNA vaccine, RNA vaccine, live attenuated virus, and recombinant proteins, which elicit a specific immune response. The use of nanoparticles displaying antigen is one of the alternative approaches to conventional vaccines. This is due to the fact that nano-based vaccines are stable, able to target, form images, and offer an opportunity to enhance the immune responses. The diameters of ultrafine nanoparticles are in the range of 1-100 nm. The application of nanotechnology on vaccine design provides precise fabrication of nanomaterials with desirable properties and ability to eliminate undesirable features. To be successful, nanomaterials must be uptaken into the cell, especially into the target and able to modulate cellular functions at the subcellular levels. The advantages of nano-based vaccines are the ability to protect a cargo such as RNA, DNA, protein, or synthesis substance and have enhanced stability in a broad range of pH, ambient temperatures, and humidity for long-term storage. Moreover, nano-based vaccines can be engineered to overcome biological barriers such as nonspecific distribution in order to elicit functions in antigen presenting cells. In this review, we will summarize on the developing COVID-19 vaccine strategies and how the nanotechnology can enhance antigen presentation and strong immunogenicity using advanced technology in nanocarrier to deliver antigens. The discussion about their safe, effective, and affordable vaccines to immunize against COVID-19 will be highlighted.
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Affiliation(s)
- Nawamin Sa-nguanmoo
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing, 100190 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Katawut Namdee
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency, Pathum Thani, 12120 Thailand
| | - Mattaka Khongkow
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency, Pathum Thani, 12120 Thailand
| | - Uracha Ruktanonchai
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency, Pathum Thani, 12120 Thailand
| | - YongXiang Zhao
- National Center for International Research of Biotargeting Theranostics, Guangxi Key Laboratory of Biotargeting Theranostics, Collaborative Innovation Center for Targeting Tumour Theranostics and Therapy, Guangxi Medical University, Nanning, 530021 China
| | - Xing-Jie Liang
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing, 100190 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
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McDonald DJ, Bien J, Green A, Hu AJ, DeFries N, Hyun S, Oliveira NL, Sharpnack J, Tang J, Tibshirani R, Ventura V, Wasserman L, Tibshirani RJ. Can auxiliary indicators improve COVID-19 forecasting and hotspot prediction? Proc Natl Acad Sci U S A 2021; 118:e2111453118. [PMID: 34903655 PMCID: PMC8713796 DOI: 10.1073/pnas.2111453118] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 02/07/2023] Open
Abstract
Short-term forecasts of traditional streams from public health reporting (such as cases, hospitalizations, and deaths) are a key input to public health decision-making during a pandemic. Since early 2020, our research group has worked with data partners to collect, curate, and make publicly available numerous real-time COVID-19 indicators, providing multiple views of pandemic activity in the United States. This paper studies the utility of five such indicators-derived from deidentified medical insurance claims, self-reported symptoms from online surveys, and COVID-related Google search activity-from a forecasting perspective. For each indicator, we ask whether its inclusion in an autoregressive (AR) model leads to improved predictive accuracy relative to the same model excluding it. Such an AR model, without external features, is already competitive with many top COVID-19 forecasting models in use today. Our analysis reveals that 1) inclusion of each of these five indicators improves on the overall predictive accuracy of the AR model; 2) predictive gains are in general most pronounced during times in which COVID cases are trending in "flat" or "down" directions; and 3) one indicator, based on Google searches, seems to be particularly helpful during "up" trends.
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Affiliation(s)
- Daniel J McDonald
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada V6T 1Z4;
| | - Jacob Bien
- Department of Data Sciences and Operations, University of Southern California, Los Angeles, CA 90089
| | - Alden Green
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Addison J Hu
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Nat DeFries
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Sangwon Hyun
- Department of Data Sciences and Operations, University of Southern California, Los Angeles, CA 90089
| | - Natalia L Oliveira
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - James Sharpnack
- Department of Statistics, University of California, Davis, CA 95616
| | - Jingjing Tang
- Computational Biology Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Robert Tibshirani
- Department of Statistics, Stanford University, Stanford, CA 94305
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305
| | - Valérie Ventura
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Larry Wasserman
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Ryan J Tibshirani
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA 15213
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA 15213
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Khodeir MM, Shabana HA, Rasheed Z, Alkhamiss AS, Khodeir M, Alkhowailed MS, Alharbi S, Alsoghair M, Alsagaby SA, Al Abdulmonem W. COVID-19: Post-recovery long-term symptoms among patients in Saudi Arabia. PLoS One 2021; 16:e0260259. [PMID: 34879074 PMCID: PMC8654233 DOI: 10.1371/journal.pone.0260259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND After recovery from acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients experience long-term symptoms in different body systems. The aim of the present study was to identify these symptoms, their severity, and their duration as a first step in building a system to classify post-recovery long-term symptoms of coronavirus disease 2019 (COVID-19). METHODS An online-based cross-sectional survey was administered between September and October 2020. Data regarding the severity of post-recovery symptoms and their duration were collected using an Arabic questionnaire divided into six categories encompassing the 20 most prevalent symptoms. RESULTS A total of 979 patients recovered from COVID-19 in Saudi Arabia in the study period, of whom 53% were male and 47% were female. The most common symptoms included general fatigue and weakness (73% each), with moderate severity of neurological symptoms including mood changes (41%) and insomnia (39%). Among the special senses, loss of smell and taste of marked severity were reported by 64% and 55% among respiratory symptoms, cough of mild severity (47%), and dyspnea of moderate severity (43%). Loss of appetite of moderate severity was reported in 42%, and diarrhea, abdominal pain, and nausea of mild severity were reported by 53%, 50%, and 44% of respondents, respectively. CONCLUSIONS Long-term symptoms after recovery from COVID-19 warrant patient follow-up. The authors propose a classification system as a starting point to guide the identification and follow-up of long-term symptoms post-recovery, and recommend larger-scale studies to broaden the definition of recovery from COVID-19, which appears to have two phases, acute and chronic.
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Affiliation(s)
- Mostafa M. Khodeir
- Faculty of Medicine, Department of Pathology, Cairo University, Cairo, Egypt
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Hassan A. Shabana
- Faculty of Medicine, Chest Diseases Department, Cairo University, Cairo, Egypt
| | - Zafar Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Abdullah S. Alkhamiss
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Mohamed Khodeir
- Psychiatric Department, Brook Hospital, Louisville, Kentucky, United States of America
| | - Mohammad S. Alkhowailed
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Sami Alharbi
- Pulmonary Department, King Fahad Specialist Hospital, Ministry of Health, Buraidah, Saudi Arabia
| | - Mansour Alsoghair
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Suliman A. Alsagaby
- Department of Medical Laboratories, Central Biosciences Research Laboratories, College of Science in Al Zulfi, Majmaah University, Al Majma’ah, Saudi Arabia
| | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
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Lerner DK, Garvey KL, Arrighi-Allisan AE, Filimonov A, Filip P, Shah J, Tweel B, Del Signore A, Schaberg M, Colley P, Govindaraj S, Iloreta AM. Clinical Features of Parosmia Associated With COVID-19 Infection. Laryngoscope 2021; 132:633-639. [PMID: 34870334 PMCID: PMC9015517 DOI: 10.1002/lary.29982] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
Objective To characterize the clinical features, risk factors, symptom time‐course, and quality of life implications for parosmia among coronavirus disease (COVID)‐related olfactory dysfunction patients. Methods Individuals with olfactory dysfunction associated with laboratory‐confirmed or clinically suspected COVID‐19 infection were recruited from otolaryngology and primary care practices over a period from August 2020 to March 2021. Participants completed olfactory dysfunction and quality of life surveys. Results A total of 148 (64.1%) of 231 respondents reported parosmia at some point. Parosmia developed within 1 week of any COVID‐19 symptom onset in 25.4% of respondents, but more than 1 month after symptom onset in 43.4% of respondents. Parosmia was associated with significantly better quantitative olfactory scores on Brief Smell Identification Test (8.7 vs. 7.5, P = .006), but demonstrated worse quality of life scores, including modified brief Questionnaire of Olfactory Dysfunction—Negative Statements and Sino‐Nasal Outcome Test‐22 scores (12.1 vs. 8.5, P < .001; 26.2 vs. 23.2, P = .113). Participants who developed parosmia at any point were significantly younger and less likely to have history of chronic sinusitis than those who did not develop parosmia (40.2 vs. 44.9 years, P = .007; 7.2% vs. 0.7%, P = .006). Conclusion COVID‐19‐associated olfactory dysfunction is frequently linked with development of parosmia, which often presents either at onset of smell loss or in a delayed fashion. Despite better quantitative olfactory scores, respondents with parosmia report decreased quality of life. A majority of respondents with persistent parosmia have sought treatment. Level of Evidence 3 Laryngoscope, 132:633–639, 2022
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Affiliation(s)
- David K Lerner
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katherine L Garvey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Annie E Arrighi-Allisan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrey Filimonov
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter Filip
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janki Shah
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Tweel
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony Del Signore
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madeleine Schaberg
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Patrick Colley
- Department of Otolaryngology, Albert Einstein College of Medicine, New York, New York, USA
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alfred Marc Iloreta
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Sheen F, Tan V, Lim AJ, Haldar S, Sengupta S, Allen D, Somani J, Chen HY, Tambyah P, Forde CG. The COVOSMIA-19 trial: Preliminary application of the Singapore smell and taste test to objectively measure smell and taste function with COVID-19. Food Qual Prefer 2021; 97:104482. [PMID: 34848929 PMCID: PMC8612753 DOI: 10.1016/j.foodqual.2021.104482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 11/21/2021] [Indexed: 12/05/2022]
Abstract
Sudden loss of smell and/or taste has been identified as an early symptom of SARS-CoV-2 2019 (COVID-19) infection, and presents an effective target for prompt self-isolation and reducing community spread. The current study sought to develop and test a novel, rapid, self-administered test to objectively measure smell and taste losses associated with COVID-19, and administered self-report questionnaires to characterise symptoms associated with COVID-19 in Singapore. Participants (N = 99) completed questionnaires to record recent changes in smell and taste ability. This was followed by the ‘Singapore Smell and Taste Test’ (SSTT), a personal, objective testing kit for daily self-assessment of smell and taste function at their place of residence. Seventy-two recruited participants were confirmed as COVID-19 positive at baseline, of which 58 completed the SSTT at home. Of these, 36.2% had objectively measured smell and/or taste loss. The SSTT measures of smell and taste function were positively associated with participants’ self-reported smell and taste acuity, and rated smell intensity of 6 common household items. This study presents the first application of the SSTT as a rapid, cost-effective, objective tool to self-monitor smell and taste function in a residential setting, and ensures comparability across individuals through the use of standardised stimuli. The SSTT has potential for future application in populations with limited access to formal COVID-19 testing as a self-administered objective method to monitor sudden changes in smell and taste, and to prompt early self-isolation, in order to reduce community transmission of COVID-19.
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Affiliation(s)
- Florence Sheen
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Vicki Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Amanda JiaYing Lim
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Sumanto Haldar
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Sharmila Sengupta
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - David Allen
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Jyoti Somani
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Hui Yee Chen
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - Paul Tambyah
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Ciarán G Forde
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore.,Wageningen University, Sensory Science and Eating Behaviour, Division of Human Nutrition, the Netherlands
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107
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Harit A, Kumar P, Jha RP. Olfactory dysfunction as a screening tool for mild and moderate cases of COVID-19: a single-center prevalence study of 646 patients in flu clinic. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2021. [PMCID: PMC8685820 DOI: 10.1186/s43163-021-00186-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background To evaluate the prevalence of olfactory dysfunction (OD) in the Indian population and to establish olfactory dysfunction as a screening tool in COVID-19-positive patients. Data was collected using a questionnaire from laboratory-confirmed COVID-19 patients. The patient’s demographic and clinical details were analyzed to calculate the prevalence of olfactory dysfunction, general symptoms like fever, cough, malaise, diarrhea, along with the sinonasal symptoms. All the symptoms were self-reported, and no objective tests were carried out. Results Out of 646 laboratory-confirmed cases of COVID-19 infection, olfactory dysfunction was self-reported by 465 (72%) patients and gustatory dysfunction (GD) was seen in 406 (62.8%) patients. The affected males (416) were proportionately more than females (230), with the mean age of our study population being 39.47 ± 13.85 (range 18–85 years). The most common symptoms were myalgia (n = 494, 76.5%), cough (n = 471, 72.9%), and fever (n = 444, 68.7%). Out of 465 patients with olfactory dysfunction, only 108 (23.2%) reported nasal obstruction. Five hundred thirty-three (82.5%) RT-PCR-positive patients did not give a history of smoking; however, co-morbidity was reported by 163 patients, of which 117 were found to have olfactory dysfunction. One hundred seventy (26.3%) patients gave a positive contact history. 13.6% reported olfactory dysfunction as their first symptom. A positive association was seen between olfactory dysfunction and gustatory dysfunction Conclusions Our study demonstrates a high prevalence of 72% in the Indian population. We recommend that anosmia be used as a screening tool to identify mild to moderate cases of COVID-19.
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Spinato G, Fabbris C, Conte F, Menegaldo A, Franz L, Gaudioso P, Cinetto F, Agostini C, Costantini G, Boscolo‐Rizzo P. COVID-Q: Validation of the first COVID-19 questionnaire based on patient-rated symptom gravity. Int J Clin Pract 2021; 75:e14829. [PMID: 34510668 PMCID: PMC8646717 DOI: 10.1111/ijcp.14829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/11/2021] [Accepted: 09/03/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of the present study was to develop and validate the CoronaVirus-Disease-2019 (COVID-19) Questionnaire (COVID-Q), a novel symptom questionnaire specific for COVID-19 patients, to provide a comprehensive evaluation that may be helpful for physicians, and evaluate the questionnaire's performance in identifying subjects at higher risk of testing positive. MATERIALS AND METHODS Consecutive non-hospitalised adults who underwent nasopharyngeal-throat swab for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) detection at Treviso Hospital in March 2020, were enrolled. Subjects were divided into positive (cases) and negative (controls). All subjects answered the COVID-Q. Patients not able to answer COVID-Q because of clinical conditions were excluded. Parallel Analysis and Principal Component Analysis identified items measuring the same dimension. The Item Response Theory (IRT)-based analyses evaluated the functioning of item categories, the presence of clusters of local dependence among items, item fit within the model and model fit to the data. RESULTS Answers obtained from 230 cases (113 males; mean age 55 years, range 20-99) and 230 controls (61 males; mean age 46 years, range 21-89) were analysed. Six components were extracted with parallel analysis: asthenia, influenza-like symptoms, ear and nose symptoms, breathing issues, throat symptoms, and anosmia/ageusia. The final IRT models retained 27 items as significant for symptom assessment. The total questionnaire's score was significantly associated with positivity to the molecular test: subjects with multiple symptoms were more likely to be affected (P < .001). Older age, male gender presence of breathing issues and anosmia/ageusia were significantly related to positivity (P < .001). Comorbidities had not a significant association with the COVID-19 diagnosis. CONCLUSION COVID-Q could be validated since the evaluated aspects were overall significantly related to infection. The application of the questionnaire to clinical practice may help to identify subjects who are likely to be affected by COVID-19 and address them to a nasopharyngeal swab in order to achieve an early diagnosis.
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Affiliation(s)
- Giacomo Spinato
- Department of NeurosciencesSection of Otolaryngology and Regional Centre for Head and Neck CancerUniversity of PadovaTrevisoItaly
- Department of Surgery, Oncology and GastroenterologySection of Oncology and ImmunologyUniversity of PadovaPadovaItaly
| | - Cristoforo Fabbris
- Department of NeurosciencesSection of Otolaryngology and Regional Centre for Head and Neck CancerUniversity of PadovaTrevisoItaly
| | - Federica Conte
- Department of PsychologyUniversity of Milano BicoccaMilanItaly
| | - Anna Menegaldo
- Department of NeurosciencesSection of Otolaryngology and Regional Centre for Head and Neck CancerUniversity of PadovaTrevisoItaly
| | - Leonardo Franz
- Department of NeurosciencesSection of Otolaryngology and Regional Centre for Head and Neck CancerUniversity of PadovaTrevisoItaly
| | - Piergiorgio Gaudioso
- Department of NeurosciencesSection of Otolaryngology and Regional Centre for Head and Neck CancerUniversity of PadovaTrevisoItaly
| | - Francesco Cinetto
- Department of MedicineClinical Immunology and HematologyUniversity of PadovaTrevisoItaly
| | - Carlo Agostini
- Department of MedicineClinical Immunology and HematologyUniversity of PadovaTrevisoItaly
| | | | - Paolo Boscolo‐Rizzo
- Section of OtorhinolaryngologyAzienda Sanitaria Universitaria Integrata di TriesteTriesteItaly
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El-Anwar MW, Mohamed SM, Sweed AH. Smell disorders associated with COVID-19 infection. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2021. [PMCID: PMC8087888 DOI: 10.1186/s43163-021-00095-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, nose, anosmia, hyposmia, smell, olfactory, ORL, different ENT related symptoms. We reviewed published and peer-reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. Main text Within the included 2549 COVID-19 laboratory-confirmed positive patients, smell affection was reported in 1453 patients (57%). The other reported ENT manifestations were taste disorder (49.2%), headache (42.8%), nasal blockage (26.3%), sore throat (25.7%), runny nose or rhinorrhea (21.3%), upper respiratory tract infection (URTI) (7.9%), and frequent sneezing (3.6%). Conclusion Smell affection in COVID-19 is common and could be one of the red flag signs in COVID-19 infection. With a sensitivity of utilized questionnaire in smell identification, a homogenous universal well-defined COVID-19 questionnaire is needed to make the COVID-19 data collection more sensible.
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Machado AS, Castelo PM, Capela E Silva F, Lamy E. Covid-19: Signs and symptoms related to the feeding behavior. Physiol Behav 2021; 242:113605. [PMID: 34600920 PMCID: PMC8482655 DOI: 10.1016/j.physbeh.2021.113605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 08/03/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022]
Abstract
COVID-19 reached pandemic level in March 2020 and the number of confirmed cases continued to increase worldwide. The clinical course of the disease has not yet been fully characterized, and some specific symptoms related to smell, taste, and feeding behavior require further examination. The present study aimed to assess the presence of symptoms related to the feeding behavior occurred during and/or after COVID-19 in adults residing in Portugal and to link them to disease severity using a multivariate approach. Data were collected from May to September 2020, through a questionnaire answered online containing questions about general and specific symptoms before, during and after COVID-19. 362 participants were included: 201 were symptomatic, being 15 hospitalized and 186 non-hospitalized. Cluster analysis grouped the symptomatic non-hospitalized participants as mild and severe cases. For these patients, the most frequent symptoms related to the feeding process were smell disorders in 40% and 62%, taste disorders in 37% and 60%, and dry mouth, in 23% and 48% of the mild and severe cases, respectively. Dry mouth was significantly associated with difficulty to swallow, pain during swallow, choking when eating or drinking, and preference for mushy/pasty foods (p < 0.01; Chi-squared test). Among the severe cases, the incidence of coughing during the meal (31%), difficulty (19%) and pain during swallow (17%), preference for mushy/pasty foods (10%) and choking when eating or drinking (6%) were clinically relevant and may indicate the presence of swallowing disorders. This group also showed a higher frequency of general symptoms, such as fever, headache, abdominal pain, tiredness, diarrhea, nausea, and shortness of breath (p < 0.05; Chi-squared test). Smell disorders, taste disorders and dry mouth were the most frequent symptoms related to the feeding behavior for both mild and severe cases. Dry mouth was significantly associated with swallowing difficulties and future research should investigate it as a frequent symptom and as a predictive of the presence of eating and swallowing disorders in COVID-19 cases.
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Affiliation(s)
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, University Federal de São Paulo (UNIFESP), Brazil
| | - Fernando Capela E Silva
- MED - Mediterranean Institute for Agriculture, Environment and Development, IIFA - Instituto de Investigação e Formação Avançada, University of Évora, Portugal; Department of Medical and Health Sciences, School of Health and Human Development, University of Évora, Évora, Portugal
| | - Elsa Lamy
- MED - Mediterranean Institute for Agriculture, Environment and Development, IIFA - Instituto de Investigação e Formação Avançada, University of Évora, Portugal.
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Zahran M, Ghazy R, Ahmed O, Youssef A. Atypical otolaryngologic manifestations of COVID-19: a review. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2021. [PMCID: PMC7819626 DOI: 10.1186/s43163-021-00075-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract
Background
COVID-19 pandemic caused by SARS-CoV-2 started in China in late 2019. Clinical features include fever, cough, dyspnea, body aches, and gastrointestinal symptoms. Some COVID-19-positive patients presented with unusual manifestations such as olfactory dysfunction, parotitis, or cervical lymphadenopathy.
Main body
Since many patients are diagnosed with SARS-CoV-2, the need for an up to date review of the atypical ENT presentations of COVID-19 is mandatory. Articles from PubMed and Google searches were reviewed and the atypical presentations in otolaryngology were presented.
Conclusions
It is crucial for ENT physicians to have high index of suspicion to identify those COVID 19 patients with atypical presentations. This facilitates early case isolation to eliminate viral spread across the community.
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Du Y, Zhao W, Du L, Liu J. Neuropsychiatric symptoms associated with the COVID-19 and its potential nervous system infection mechanism: the role of imaging in the study. PSYCHORADIOLOGY 2021; 1:199-211. [PMID: 38666221 PMCID: PMC10917188 DOI: 10.1093/psyrad/kkab019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/07/2021] [Accepted: 12/01/2021] [Indexed: 04/28/2024]
Abstract
The epidemic of coronavirus disease 2019 (COVID-19) has broken the normal spread mode of respiratory viruses, namely, mainly spread in winter, resulting in over 230 million confirmed cases of COVID-19. Many studies have shown that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the nervous system by varying degrees. In this review, we look at the acute neuropsychiatric impacts of COVID-19 patients, including acute ischemic stroke, encephalitis, acute necrotizing encephalopathy, dysosmia, and epilepsy, as well as the long-term neuropsychiatric sequelae of COVID-19 survivors: mental disorder and neurodegenerative diseases. In particular, this review discusses long-term changes in brain structure and function associated with COVID-19 infection. We believe that the traditional imaging sequences are important in the acute phase, while the nontraditional imaging sequences are more meaningful for the detection of long-term neuropsychiatric sequelae. These long-term follow-up changes in structure and function may also help us understand the causes of neuropsychiatric symptoms in COVID-19 survivors. Finally, we review previous studies and discuss some potential mechanisms of SARS-CoV-2 infection in the nervous system. Continuous focus on neuropsychiatric sequelae and a comprehensive understanding of the long-term impacts of the virus to the nervous system is significant for formulating effective sequelae prevention and management strategies, and may provide important clues for nervous system damage in future public health crises.
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Affiliation(s)
- Yanyao Du
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wei Zhao
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Clinical Research Center for Medical Imaging in Hunan Province, Changsha 410011, Hunan, China
| | - Lei Du
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati 45255, OH, USA
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
- Clinical Research Center for Medical Imaging in Hunan Province, Changsha 410011, Hunan, China
- Department of Radiology Quality Control Center, Hunan Province, Changsha 410011, Hunan, China
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113
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The Role of ACE2 Receptors of the Olfactory System in Anosmia in COVID-19: An Overview. Neurol Res Int 2021; 2021:5776801. [PMID: 34777862 PMCID: PMC8580692 DOI: 10.1155/2021/5776801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/17/2021] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019 (COVID-19). The latest data show that more than 211.7 million people were infected and more than 4.4 million deaths have been reported. The illness presents a wide range of symptoms, ranging from mild to severe. Mild symptoms include cough, fever, dyspnea, fatigue, myalgia and arthralgia, anosmia, and dysgeusia. Furthermore, this virus can affect the central nervous system (CNS) and present a range of mild to severe nervous symptoms, from headache and dysphoria to loss of consciousness, coma, paralysis, and acute cerebrovascular disease. The virus can enter nonneuronal cells of the olfactory epithelium and cause a complete loss of smell. Anosmia and hyposmia are commonly reported in clinics, and being asymptomatic or showing mild symptoms can be primary symptoms in early infected persons. Dysgeusia/hypogeusia is another symptom presented with anosmia/hyposmia. In this article, we reviewed the articles of anosmia and suggested a possible mechanism for this.
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Bagasra O, Pandey P, Sanamandra JR, Houston JM, McLean E, Albrecht H. Infectivity of Human Olfactory Neurons to SARS-CoV-2: A Link to Anosmia. Oman Med J 2021; 36:e307. [PMID: 34733553 PMCID: PMC8551687 DOI: 10.5001/omj.2021.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives We sought to determine whether SARS-CoV-2 infections are associated with anosmia and if this virus infects other neuronal cells. We utilized male and female olfactory neuronal cell lines and other olfactory cell lines to determine the viral targets. Methods We used four undifferentiated and two partially differentiated human developing neuronal cell lines. Infectivity was confirmed by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), immunofluorescence assay (IFA) probing with anti-SARS-CoV-2 antibody, evaluation of cytopathic effects, and neurite formation. We induced partial differentiation of all cell lines (since both olfactory cell lines were terminally differentiated) with retinoic acid (RA) to determine whether differentiation was a factor in viral permissiveness. The expression of serine protease, transmembrane serine protease 2 (TMPRSS2), and angiotensin-converting enzyme II (ACE2) receptors were examined by RT-qPCR and IFA to determine the mechanism of viral entry. Results Four to five days after exposure, both olfactory cell lines exhibited morphological evidence of infection; IFA analyses indicated that ~30% of the neurons were SARS-CoV-2 positive. At two weeks, 70–80% were positive for SARS-CoV-2 antigens. The partially differentiated (CRL-2266 and CRL-2267) and undifferentiated cell lines (CRL-2142, CRL-2149, CRL-127, and CDL-2271) were essentially non-permissive. After RA treatment, only CRL-127 exhibited slight permissiveness (RT-qPCR). The TMPRSS2 receptor showed high expression in olfactory neurons, but low expression in RA treated CRL-127. ACE2 exhibited high expression in olfactory neurons, whereas other cell lines showed low expression, including RA-treated cell lines. ACE2 expression slightly increased in CRL-127 post RA-treatment. Conclusions Our studies confirm neurotropism of SARS-CoV-2 to olfactory neurons with viral entry likely mediated by TMPRSS2/ACE2. Other neuronal cell lines were non-permissive. Our results established that the nerve cells were infected regardless of male or female origin and strengthened the reported association of COVID-19 with loss of smell in infected individuals.
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Affiliation(s)
- Omar Bagasra
- Claflin University, South Carolina Center for Biotechnology, SC, USA
| | - Pratima Pandey
- Claflin University, South Carolina Center for Biotechnology, SC, USA
| | | | | | | | - Helmut Albrecht
- Department of Internal Medicine, PRISMA Health Midlands, University of South Carolina, Columbia, SC, USA
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Poerbonegoro NL, Reksodiputro MH, Sari DP, Mufida T, Rahman MA, Reksodiputro LA, Audindra S, Yosia M. Cross-sectional study on the proportion of smell and taste disturbances in hospitalized COVID-19 patients. Ann Med Surg (Lond) 2021; 71:102909. [PMID: 34646554 PMCID: PMC8498779 DOI: 10.1016/j.amsu.2021.102909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The number of confirmed Coronavirus Disease-2019 (COVID-19) cases in Indonesia had reached 1.4 million cases from a total population of 270 million. Smell and/or taste disturbances are frequently found as early symptoms of COVID-19 patients. Our study aimed to investigate the proportion and characteristics of anosmia and/or ageusia in COVID-19. MATERIALS AND METHODS This cross-sectional study identifies the proportion and severity of smell and taste disturbances in COVID-19 patients. Subjects were recruited by consecutive sampling. All subjects were required to fill in the questionnaire modified from the American Academy of Otolaryngology-Head and Neck Surgery Anosmia Reporting Tool (AAO-HNS ART). Symptoms severity was measured with a numerical rating scale of 0-10; 0-3 is defined as mild, 4-6 as moderate, and 7-10 as severe. RESULTS Out of 51 subjects, 34 (66.7%) suffered from smell and/or taste disturbances. Twenty-nine of 34 subjects (85.3%) suffered from smell disturbance, and 24 of 34 subjects (70.5%) suffered from taste disturbance. Severe smell disturbance occurred in 68.9% of subjects, while severe taste disturbance occurred in 50%. The median onset was three days for smell disturbance and four days for taste disturbance after any symptoms of COVID-19. CONCLUSION Smell and/or taste disturbances were early symptoms of COVID-19. These symptoms commonly occurred within the first four days of clinical onset and frequently manifested in severe conditions.
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Affiliation(s)
- Niken Lestari Poerbonegoro
- Otorhinolaryngology-Head Neck Surgery Medical Staff Group, Universitas Indonesia Hospital, Depok, West Java, Indonesia
| | - Mirta Hediyati Reksodiputro
- Otorhinolaryngology-Head Neck Surgery Medical Staff Group, Universitas Indonesia Hospital, Depok, West Java, Indonesia
| | - Dewi Puspito Sari
- Otorhinolaryngology-Head Neck Surgery Medical Staff Group, Universitas Indonesia Hospital, Depok, West Java, Indonesia
| | - Thalia Mufida
- Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | - Sacha Audindra
- Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Mikhael Yosia
- Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Potential for Stem Cell-Based Therapy in the Road of Treatment for Neurological Disorders Secondary to COVID-19. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2021; 8:355-369. [PMID: 34746370 PMCID: PMC8555723 DOI: 10.1007/s40883-021-00234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/19/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
Abstract
The severe acute respiratory syndrome coronavirus 2 has led to the worldwide pandemic named coronavirus disease 2019 (COVID-19). It has caused a significant increase in the number of cases and mortalities since its first diagnosis in December 2019. Although COVID-19 primarily affects the respiratory system, neurological involvement of the central and peripheral nervous system has been also reported. Herein, the higher risk of neurodegenerative diseases in COVID-19 patients in future is also imaginable. Neurological complications of COVID-19 infection are more commonly seen in severely ill individuals; but, earlier diagnosis and treatment can lead to better long-lasting results. In this respect, stem cell biotechnologies with considerable self-renewal and differentiation capacities have experienced great progress in the field of neurological disorders whether in finding out their underlying processes or proving them promising therapeutic approaches. Herein, many neurological disorders have been found to benefit from stem cell medicine strategies. Accordingly, in the present review, the authors are trying to discuss stem cell-based biotechnologies as promising therapeutic options for neurological disorders secondary to COVID-19 infection through reviewing neurological manifestations of COVID-19 and current stem cell-based biotechnologies for neurological disorders. Lay Summary Due to the substantial burden of neurological disorders in the health, economic, and social system of society, the emergence of neurological manifestations following COVID-19 (as a life-threatening pandemic) creates the need to use efficient and modern methods of treatment. Since stem cell-based methods have been efficient for a large number of neurological diseases, it seems that the use of mentioned methods is also effective in the process of improving neurological disorders caused by COVID-19. Hereupon, the current review aims to address stem cell-based approaches as treatments showing promise to neurological disorders related to COVID-19.
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117
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Predictive usefulness of RT-PCR testing in different patterns of Covid-19 symptomatology: analysis of a French cohort of 12,810 outpatients. Sci Rep 2021; 11:21233. [PMID: 34707198 PMCID: PMC8551264 DOI: 10.1038/s41598-021-99991-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/24/2021] [Indexed: 01/05/2023] Open
Abstract
Reverse transcriptase polymerase chain reaction (RT-PCR) is a key tool to diagnose Covid-19. Yet it may not be the most efficient test in all patients. In this paper, we develop a clinical strategy for prescribing RT-PCR to patients based on data from COVIDOM, a French cohort of 54,000 patients with clinically suspected Covid-19, including 12,810 patients tested by RT-PCR. We use a machine-learning algorithm (decision tree) in order to predict RT-PCR results based on the clinical presentation. We show that symptoms alone are sufficient to predict RT-PCR outcome with a mean average precision of 86%. We identify combinations of symptoms that are predictive of RT-PCR positivity (90% for anosmia/ageusia) or negativity (only 30% of RT-PCR+ for a subgroup with cardiopulmonary symptoms): in both cases, RT-PCR provides little added diagnostic value. We propose a prescribing strategy based on clinical presentation that can improve the global efficiency of RT-PCR testing.
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118
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Machine Learning Refutes Loss of Smell as a Risk Indicator of Diabetes Mellitus. J Clin Med 2021; 10:jcm10214971. [PMID: 34768493 PMCID: PMC8584618 DOI: 10.3390/jcm10214971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/02/2022] Open
Abstract
Because it is associated with central nervous changes, and olfactory dysfunction has been reported with increased prevalence among persons with diabetes, this study addressed the question of whether the risk of developing diabetes in the next 10 years is reflected in olfactory symptoms. In a cross-sectional study, in 164 individuals seeking medical consulting for possible diabetes, olfactory function was evaluated using a standardized clinical test assessing olfactory threshold, odor discrimination, and odor identification. Metabolomics parameters were assessed via blood concentrations. The individual diabetes risk was quantified according to the validated German version of the “FINDRISK” diabetes risk score. Machine learning algorithms trained with metabolomics patterns predicted low or high diabetes risk with a balanced accuracy of 63–75%. Similarly, olfactory subtest results predicted the olfactory dysfunction category with a balanced accuracy of 85–94%, occasionally reaching 100%. However, olfactory subtest results failed to improve the prediction of diabetes risk based on metabolomics data, and metabolomics data did not improve the prediction of the olfactory dysfunction category based on olfactory subtest results. Results of the present study suggest that olfactory function is not a useful predictor of diabetes.
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119
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A review of ischemic stroke in COVID-19: currently known pathophysiological mechanisms. Neurol Sci 2021; 43:67-79. [PMID: 34671854 PMCID: PMC8528653 DOI: 10.1007/s10072-021-05679-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/15/2021] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19), the third type of coronavirus pneumonia after severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), is spreading widely worldwide now. This pneumonia causes not only respiratory symptoms but also multiple organ dysfunction, including thrombotic diseases such as ischemic stroke. The purpose of this review is to explore whether COVID-19 is a risk factor for ischemic stroke and its related pathophysiological mechanisms. Based on the high thrombosis rate and frequent strokes of COVID-19 patients, combined with related laboratory indicators and pathological results, the discussion is mainly from two aspects: nerve invasion and endothelial dysfunction. SARS-CoV-2 can directly invade the CNS through blood-borne and neuronal retrograde pathways, causing cerebrovascular diseases. In addition, the endothelial dysfunction in COVID-19 is almost certain. Cytokine storm causes thromboinflammation, and downregulation of ACE2 leads to RAS imbalance, which eventually lead to ischemic stroke.
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120
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Kohler P, Güsewell S, Seneghini M, Egger T, Leal O, Brucher A, Lemmenmeier E, Möller JC, Rieder P, Ruetti M, Stocker R, Vuichard-Gysin D, Wiggli B, Besold U, Kuster SP, McGeer A, Risch L, Friedl A, Schlegel M, Vernazza P, Kahlert CR. Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19-a prospective multicenter cohort study. BMC Med 2021; 19:270. [PMID: 34649585 PMCID: PMC8514323 DOI: 10.1186/s12916-021-02144-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In a prospective healthcare worker (HCW) cohort, we assessed the risk of SARS-CoV-2 infection according to baseline serostatus. METHODS Baseline serologies were performed among HCW from 23 Swiss healthcare institutions between June and September 2020, before the second COVID-19 wave. Participants answered weekly electronic questionnaires covering information about nasopharyngeal swabs (PCR/rapid antigen tests) and symptoms compatible with coronavirus disease 2019 (COVID-19). Screening of symptomatic staff by nasopharyngeal swabs was routinely performed in participating facilities. We compared numbers of positive nasopharyngeal tests and occurrence of COVID-19 symptoms between HCW with and without anti-nucleocapsid antibodies. RESULTS A total of 4812 HCW participated, wherein 144 (3%) were seropositive at baseline. We analyzed 107,807 questionnaires with a median follow-up of 7.9 months. Median number of answered questionnaires was similar (24 vs. 23 per person, P = 0.83) between those with and without positive baseline serology. Among 2712 HCW with ≥ 1 SARS-CoV-2 test during follow-up, 3/67 (4.5%) seropositive individuals reported a positive result (one of whom asymptomatic), compared to 547/2645 (20.7%) seronegative participants, 12 of whom asymptomatic (risk ratio [RR] 0.22; 95% confidence interval [CI] 0.07 to 0.66). Seropositive HCWs less frequently reported impaired olfaction/taste (6/144, 4.2% vs. 588/4674, 12.6%, RR 0.33, 95% CI 0.15-0.73), chills (19/144, 13.2% vs. 1040/4674, 22.3%, RR 0.59, 95% CI 0.39-0.90), and limb/muscle pain (28/144, 19.4% vs. 1335/4674, 28.6%, RR 0.68 95% CI 0.49-0.95). Impaired olfaction/taste and limb/muscle pain also discriminated best between positive and negative SARS-CoV-2 results. CONCLUSIONS Having SARS-CoV-2 anti-nucleocapsid antibodies provides almost 80% protection against SARS-CoV-2 re-infection for a period of at least 8 months.
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Affiliation(s)
- Philipp Kohler
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
| | - Sabine Güsewell
- Cantonal Hospital St. Gallen, Clinical Trials Unit, St. Gallen, Switzerland
| | - Marco Seneghini
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Thomas Egger
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Onicio Leal
- Epitrack, Recife, Brazil.,Department of Economics, University of Zurich, Zurich, Switzerland
| | - Angela Brucher
- Psychiatry Services of the Canton of St. Gallen (South), St. Gallen, Switzerland
| | - Eva Lemmenmeier
- Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland
| | - J Carsten Möller
- Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | | | - Markus Ruetti
- Fuerstenland Toggenburg Hospital Group, Wil, Switzerland
| | | | - Danielle Vuichard-Gysin
- Thurgau Hospital Group, Division of Infectious Diseases and Hospital Epidemiology, Münsterlingen, Switzerland
| | - Benedikt Wiggli
- Cantonal Hospital Baden, Division of Infectious Diseases and Hospital Epidemiology, Baden, Switzerland
| | - Ulrike Besold
- Geriatric Clinic St. Gallen, St. Gallen, Switzerland
| | | | | | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch, Schaan, Liechtenstein.,Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Littenheid, Switzerland.,Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern, Switzerland
| | - Andrée Friedl
- Cantonal Hospital Baden, Division of Infectious Diseases and Hospital Epidemiology, Baden, Switzerland
| | - Matthias Schlegel
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Pietro Vernazza
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Christian R Kahlert
- Cantonal Hospital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland. .,Children's Hospital of Eastern Switzerland, Division of Infectious Diseases and Hospital Epidemiology, St. Gallen, Switzerland.
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Valletta RC, Camargo LAD, Rodrigues SO, Silva SVD, Gonçalves MC, Queiroz NR, Galvão Filho AR, Avelino MAG. Olfactory dysfunction in the scenario of COVID-19 pandemic in patients screened by the telemonitoring. EINSTEIN-SAO PAULO 2021; 19:eAO6204. [PMID: 34644743 PMCID: PMC8483635 DOI: 10.31744/einstein_journal/2021ao6204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/01/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the clinical and epidemiological profile of patients with olfactory dysfunction in the scenario of COVID-19 pandemic. METHODS The study selected patients with loss of smell, previously screened by telemonitoring system of the Municipal Health Department of Goiânia (GO), Brazil, who agreed to answer a questionnaire about COVID-19 symptoms and findings of exams. The interviews were conducted by six otolaryngologists, who applied the specific questionnaire, over the phone. RESULTS A total of 13,910 patients underwent telemonitoring, and 627 (4.51%) had olfactory loss complaints. Out of them, 330 were included in the survey. We observed a higher prevalence of altered smell in women (67%), and in patients aged under 50 years (86%). In most cases the manifestations had a sudden onset (70%), and in the first 5 days of illness (80%). The most prevalent associated symptom was a change in taste (89%), and only 2.7% of interviewed patients required hospitalization. CONCLUSION Anosmia in COVID-19 is more prevalent in females and individuals aged under 50 years. It is a relevant initial symptom predictive of the disease, together with dysgeusia.
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Olfactory and Taste Dysfunction in Coronavirus Disease 2019 Pandemic. Indian J Otolaryngol Head Neck Surg 2021; 74:3159-3166. [PMID: 34631493 PMCID: PMC8487225 DOI: 10.1007/s12070-021-02871-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/14/2021] [Indexed: 12/13/2022] Open
Abstract
This study is done to raise awareness of olfactory and taste dysfunction association in coronavirus disease, urging early detection and isolation of coronavirus positive patients thus breaking the chain of transmission of disease. This is a retrospective observational study done in outpatient department of tertiary care hospital in Mumbai, west India from 1st May 2020 to 1st August 2020 on patients who were confirmed positive for COVID-19 by real-time reverse transcription polymerase chain reaction (rRT-PCR) and having olfactory dysfunction and/or taste disorders. In study population, anosmia and ageusia occurred in 88% and 83.33% respectively. In control population, anosmia and ageusia occurred in 93% and 85.71% respectively. The mean duration of anosmia was around 2 weeks and 3 weeks for study and control group respectively. In study population 94.6% recovered from anosmia, whereas in control population 64.3% recovered from anosmia. Anosmia gradually improved to hyposmia. In the study population 94.3% hyposmia patients showed recovery, while in control population 85.2% showed recovery. Ageusia collaborated with the duration of anosmia. Recovery from taste dysfunction was 88.6% and 63.9% in study and control population respectively. Olfactory and taste dysfunction are very important clinical features of coronavirus positive patients with anosmia being the most prominent symptom. All patients presenting with smell and or taste dysfunction should be screened for coronavirus disease, helping in early detection in asymptomatic patients.
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Simple Disposable Odor Identification Tests for Predicting SARS-CoV-2 Positivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910185. [PMID: 34639486 PMCID: PMC8507979 DOI: 10.3390/ijerph181910185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized laboratory settings. We aimed to develop a quick, simple, affordable, and reliable test to objectively assess the prevalence and diagnostic accuracy of OD in COVID-19. The olfactory function of 64 COVID-19 inpatients and 34 controls was evaluated using a questionnaire and a simple disposable odor identification test (SDOIT) developed for this study. Four SDOIT models were assessed: 10-SDOIT, 9-SDOIT, 8-SDOIT, and 4-SDOIT, with 10, 9, 8 and 4 samples, respectively. We found a high frequency of self-reported OD in COVID-19 patients, with 32.8% and 42.2% reporting current and recent OD, respectively. Different SDOIT models revealed smell impairment in 54.7-64.1% of COVID-19 patients. The combination of either 10-SDOIT results and self-reported OD, or 8-SDOIT results and self-reported OD, were the best predictors of COVID-19, both with an AUC value of 0.87 (0.85 and 0.86 for the age-matched subjects). OD is a common symptom of COVID-19. A combination of self-reported smell deterioration and OD psychophysically evaluated using SDOIT appears to be a good predictor of COVID-19.
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124
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Altunisik E, Baykan AH, Sahin S, Aydin E, Erturk SM. Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study. AJNR Am J Neuroradiol 2021; 42:2207-2214. [PMID: 34556477 DOI: 10.3174/ajnr.a7278] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Anosmia or hyposmia, often accompanied by changes in taste, is recognized as a common symptom that can assist in the diagnosis of coronavirus disease 2019 (COVID-19). The pathogenesis of olfactory dysfunction in COVID-19 is not yet fully understood. MR imaging represents a useful anatomic imaging method for the evaluation of olfactory dysfunction associated with varying etiologies, including viral infection, trauma, and neurodegenerative processes. This case-control study was conducted to compare quantitative measurements of olfactory anatomic structures between patients diagnosed with COVID-19 associated with persistent olfactory dysfunction and healthy controls. MATERIALS AND METHODS This study has a retrospective design. Cranial MR imaging was performed on all participants in both the patient and control groups. The bilateral olfactory bulb volume, olfactory tract length, and olfactory sulcus depth were measured in all patients. RESULTS A total of 116 people aged 18-60 years, including 36 patients diagnosed with COVID-19 and 80 controls, were included in the study. All measured values were compared between the patient and control groups. The right, left, and total olfactory bulb volume values were significantly lower in the patient group than in the control group. The patient group also had significantly lower right and left olfactory sulcus depth and olfactory tract length values compared with those in the control group. CONCLUSIONS MR imaging findings can be used to demonstrate olfactory injury in patients with COVID-19. The olfactory pathway may represent an alternative route for virus entry into the central nervous system.
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Affiliation(s)
- E Altunisik
- From the Department of Neurology (E. Altunisik)
| | - A H Baykan
- Radiology (A.H.B.), Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - S Sahin
- Department of Radiology (S.S.), Adiyaman Training and Research Hospital, Adiyaman, Turkey
| | - E Aydin
- Department of Radiology (E. Aydin), Baskent University Faculty of Medicine, Izmir, Turkey
| | - S M Erturk
- Department of Radiology (S.M.E), Istanbul University Faculty of Medicine, Istanbul, Turkey
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125
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Lashkari A, Ranjbar R. A case-based systematic review on the SARS-COVID-2-associated cerebrovascular diseases and the possible virus routes of entry. J Neurovirol 2021; 27:691-701. [PMID: 34546547 PMCID: PMC8454012 DOI: 10.1007/s13365-021-01013-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sparked a global pandemic that continues to affect various facets of human existence. Many sources reported virus-induced acute cerebrovascular disorders. Systematically, this paper reviews the case studies of COVID-19-related acute cerebrovascular diseases such as ischaemic stroke, intracerebral hemorrhage, and cerebral sinus thrombosis. We also spoke about how SARS-CoV-2 can infect the brain and trigger the aforementioned disorders. We stated that SARS-CoV-2 neuroinvasion and BBB dysfunction could cause the observed disorders; however, further research is required to specify the mechanisms and pathogenesis of the virus.
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Affiliation(s)
- Ali Lashkari
- Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, Iran
| | - Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Majolo F, da Silva GL, Vieira L, Anli C, Timmers LFSM, Laufer S, Goettert MI. Neuropsychiatric Disorders and COVID-19: What We Know So Far. Pharmaceuticals (Basel) 2021; 14:ph14090933. [PMID: 34577633 PMCID: PMC8465079 DOI: 10.3390/ph14090933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 01/09/2023] Open
Abstract
SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) affects the central nervous system (CNS), which is shown in a significant number of patients with neurological events. In this study, an updated literature review was carried out regarding neurological disorders in COVID-19. Neurological symptoms are more common in patients with severe infection according to their respiratory status and divided into three categories: (1) CNS manifestations; (2) cranial and peripheral nervous system manifestations; and (3) skeletal muscle injury manifestations. Patients with pre-existing cerebrovascular disease are at a higher risk of admission to the intensive care unit (ICU) and mortality. The neurological manifestations associated with COVID-19 are of great importance, but when life-threatening abnormal vital signs occur in severely ill COVID-19 patients, neurological problems are usually not considered. It is crucial to search for new treatments for brain damage, as well as for alternative therapies that recover the damaged brain and reduce the inflammatory response and its consequences for other organs. In addition, there is a need to diagnose these manifestations as early as possible to limit long-term consequences. Therefore, much research is needed to explain the involvement of SARS-CoV-2 causing these neurological symptoms because scientists know zero about it.
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Affiliation(s)
- Fernanda Majolo
- Post-Graduate Program in Biotechnology, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (F.M.); (C.A.); (L.F.S.M.T.)
- Postgraduate Program in Medical Sciences Center, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (G.L.d.S.); (L.V.)
| | - Guilherme Liberato da Silva
- Postgraduate Program in Medical Sciences Center, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (G.L.d.S.); (L.V.)
| | - Lucas Vieira
- Postgraduate Program in Medical Sciences Center, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (G.L.d.S.); (L.V.)
| | - Cetin Anli
- Post-Graduate Program in Biotechnology, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (F.M.); (C.A.); (L.F.S.M.T.)
| | - Luís Fernando Saraiva Macedo Timmers
- Post-Graduate Program in Biotechnology, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (F.M.); (C.A.); (L.F.S.M.T.)
- Postgraduate Program in Medical Sciences Center, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (G.L.d.S.); (L.V.)
| | - Stefan Laufer
- Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmacy, Eberhard Karls Universität Tübingen, 72076 Tübingen, Germany;
- Tübingen Center for Academic Drug Discovery (TüCAD2), 72076 Tübingen, Germany
| | - Márcia Inês Goettert
- Post-Graduate Program in Biotechnology, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (F.M.); (C.A.); (L.F.S.M.T.)
- Postgraduate Program in Medical Sciences Center, Universidade do Vale do Taquari-Univates, Lajeado 95914-014, Rio Grande do Sul, Brazil; (G.L.d.S.); (L.V.)
- Correspondence: ; Tel.: +55-5137147000
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127
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Olfactory dysfunction and coronavirus disease 2019 severity: a prospective cohort study. The Journal of Laryngology & Otology 2021; 135:1010-1018. [PMID: 34496986 PMCID: PMC8458848 DOI: 10.1017/s0022215121002425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective The primary goal of this study was to evaluate the association between olfactory dysfunction or taste impairment and disease severity and radiological findings in coronavirus disease-2019. The secondary goal was to assess the prevalence, severity and course of olfactory dysfunction or taste impairment in patients with coronavirus disease 2019. Method This prospective observational cohort study evaluated patients hospitalised with coronavirus disease 2019 between April 1 and 1 May 2020. Olfactory dysfunction and taste impairment were evaluated by two questionnaires. Chest computed tomography findings and coronavirus disease-2019 severity were assessed. Results Among 133 patients, 23.3 per cent and 30.8 per cent experienced olfactory dysfunction and taste impairment, respectively, and 17.2 per cent experienced both. The mean age was 56.03 years, and 64.7 per cent were male and 35.3 per cent were female. No statistically significant association was found between olfactory dysfunction (p = 0.706) and taste impairment (p = 0.35) with either disease severity or chest computed tomography grading. Conclusion Olfactory dysfunction or taste impairment does not have prognostic importance in patients with coronavirus disease 2019.
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128
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Rashid RA, Zgair A, Al-Ani RM. Effect of nasal corticosteroid in the treatment of anosmia due to COVID-19: A randomised double-blind placebo-controlled study. Am J Otolaryngol 2021. [DOI: https://doi.org/10.1016/j.amjoto.2021.103033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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129
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Rebholz H, Pfaffeneder-Mantai F, Knoll W, Hassel AW, Frank W, Kleber C. Olfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence. Am J Otolaryngol 2021; 42:103014. [PMID: 33873048 PMCID: PMC8041855 DOI: 10.1016/j.amjoto.2021.103014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/28/2021] [Indexed: 01/11/2023]
Abstract
Background Smell dysfunction has been recognized as an early symptom of SARS-CoV-2 infection, often occurring before the onset of core symptoms of the respiratory tract, fever or muscle pain. In most cases, olfactory dysfunction is accompanied by reduced sense of taste, is partial (microsmia) and seems to normalize after several weeks, however, especially in cases of virus-induced complete smell loss (anosmia), there are indications of persisting deficits even 2 months after recovery from the acute disease, pointing towards the possibility of chronic or even permanent smell reduction for a significant part of the patient population. To date, we have no knowledge on the specificity of anosmia towards specific odorants or chemicals and about the longer-term timeline of its persistence or reversal. Methods In this longitudinal study, 70 participants from a community in Lower Austria that had been tested positive for either IgG or IgM SARS-CoV-2 titers in June 2020 and a healthy control cohort (N = 348) underwent smell testing with a 12-item Cross-Cultural Smell Identification Test (CC-SIT), based upon items from the University of Pennsylvania Smell Identification Test (UPSIT). The test was performed in October 2020, i.e. 4 months after initial diagnosis via antibody testing. Results were analyzed using statistical tests for contingency for each smell individually in order to detect whether reacquisition of smell is dependent on specific odorant types. Results For all odorants tested, except the odor “smoke”, even 4 months or more after acute SARS-CoV-2 infection, participants with a positive antibody titer had a reduced sense of smell when compared to the control group. On average, while the control cohort detected a set of 12 different smells with 88.0% accuracy, the antibody-positive group detected 80.0% of tested odorants. A reduction of accuracy of detection by 9.1% in the antibody-positive cohort was detected. Recovery of the ability to smell was particularly delayed for three odorants: strawberry (encoded by the aldehyde ethylmethylphenylglycidate), lemon (encoded by citronellal, a monoterpenoid aldehyde), and soap (alkali metal salts of the fatty acids plus odorous additives) exhibit a sensitivity of detection of an infection with SARS-CoV-2 of 31.0%, 41.0% and 40.0%, respectively. Conclusion Four months or more after acute infection, smell performance of SARS-CoV-2 positive patients with mild or no symptoms is not fully recovered, whereby the ability to detect certain odors (strawberry, lemon and soap) is particularly affected, suggesting the possibility that these sensitivity to these smells may not only be lagging behind but may be more permanently affected.
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Affiliation(s)
- H Rebholz
- Center of Neurodegeneration, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, Paris, France; GHU Psychiatrie et Neurosciences, Paris, France
| | - F Pfaffeneder-Mantai
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria.
| | - W Knoll
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; AIT Austrian Institute of Technology GmbH, Biosensor Technologies, 3430 Tulln, Austria
| | - A W Hassel
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institute of Chemical Technology of Inorganic Materials, Johannes Kepler University Linz, Linz, Austria
| | - W Frank
- Center of Health Systems Research, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria
| | - C Kleber
- Department of Physics and Chemistry of Materials, Faculty of Medicine/Dental Medicine, Danube Private University, Krems, Austria; Institute of Chemical Technology of Inorganic Materials, Johannes Kepler University Linz, Linz, Austria
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130
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Singhavi H, Pai A, Mair M, Singhavi J, Gandhi P, Baker A, Das S, Kumar S, Conboy P. SARS-Cov2: a meta-analysis of symptom distribution by continent in 7310 adult COVID-19 infected patients. Virusdisease 2021. [PMID: 34124318 DOI: 10.1007/s13337-021-00699-y/figures/5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
UNLABELLED There is recent evidence that suggests that there are multiple strains of coronavirus in different parts of the world. Moreover, scientist have noted multiple mutations and postulated that these changes might increase the infective rate of the virus. However literature on varying severity of disease based on these strains is absent. In this meta-analysis, we have made an attempt to correlate the symptoms in different continents with respect to various studied strains of virus. We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting symptoms of COVID-19. All articles published between December 2019 and May 2020 was included in this meta-analysis. A total of 56 studies consisted of 7310 patients were included in the meta-analysis. Mean age of patients varied from 22 to 69.8 years. The pooled proportion of male patients was 52%. Highest incidence of fever (76%) and cough (56%) was noted in Chinese population. Sore throat (29%) was most common in Asian population. Upper respiratory tract symptom like Rhinorrhoea, Anosmia and dysgeusia (32%, 47% and 39%) were well documented in European population as compared to the other continents. Nausea and diarrhoea were more common in European (17%, 19%) and Australian (12%, 16%) population. Dyspnoea and fatigue were consistently similar in all the continents. We postulate that different mutations in COVID-19 virus may vary its pathogenicity and screening symptoms across all the continents should be not be generalised but continent-specific. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13337-021-00699-y.
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Affiliation(s)
| | - Ameya Pai
- Tata Memorial Hospital, Mumbai, India
| | - Manish Mair
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | | | - Prachi Gandhi
- Department of Neonatology, University Hospital of Leicester, Leicester, UK
| | - Andrew Baker
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sudip Das
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sanjeev Kumar
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Peter Conboy
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
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131
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Singhavi H, Pai A, Mair M, Singhavi J, Gandhi P, Baker A, Das S, Kumar S, Conboy P. SARS-Cov2: a meta-analysis of symptom distribution by continent in 7310 adult COVID-19 infected patients. Virusdisease 2021; 32:400-409. [PMID: 34124318 PMCID: PMC8187893 DOI: 10.1007/s13337-021-00699-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 05/20/2021] [Indexed: 01/19/2023] Open
Abstract
There is recent evidence that suggests that there are multiple strains of coronavirus in different parts of the world. Moreover, scientist have noted multiple mutations and postulated that these changes might increase the infective rate of the virus. However literature on varying severity of disease based on these strains is absent. In this meta-analysis, we have made an attempt to correlate the symptoms in different continents with respect to various studied strains of virus. We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting symptoms of COVID-19. All articles published between December 2019 and May 2020 was included in this meta-analysis. A total of 56 studies consisted of 7310 patients were included in the meta-analysis. Mean age of patients varied from 22 to 69.8 years. The pooled proportion of male patients was 52%. Highest incidence of fever (76%) and cough (56%) was noted in Chinese population. Sore throat (29%) was most common in Asian population. Upper respiratory tract symptom like Rhinorrhoea, Anosmia and dysgeusia (32%, 47% and 39%) were well documented in European population as compared to the other continents. Nausea and diarrhoea were more common in European (17%, 19%) and Australian (12%, 16%) population. Dyspnoea and fatigue were consistently similar in all the continents. We postulate that different mutations in COVID-19 virus may vary its pathogenicity and screening symptoms across all the continents should be not be generalised but continent-specific. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13337-021-00699-y.
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Affiliation(s)
| | - Ameya Pai
- Tata Memorial Hospital, Mumbai, India
| | - Manish Mair
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | | | - Prachi Gandhi
- Department of Neonatology, University Hospital of Leicester, Leicester, UK
| | - Andrew Baker
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sudip Das
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Sanjeev Kumar
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
| | - Peter Conboy
- Department of Otorhinolaryngology, Infirmary Square, University Hospital of Leicester, Leicester, UK
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Seth S, Rashid F, Khera K. An overview of the COVID-19 complications in paediatric population: A pandemic dilemma. Int J Clin Pract 2021; 75:e14494. [PMID: 34115913 PMCID: PMC8420266 DOI: 10.1111/ijcp.14494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/11/2021] [Indexed: 12/24/2022] Open
Abstract
AIM The primary objective of this article is to understand the various complications caused by the coronavirus in the paediatric population. METHOD An electronic search was conducted using PubMed and incorporated forward and backward research methods on clinical trials, case reports, case series, guidelines and reports from the centre for disease control and prevention (CDC), and the keywords included COVID-19, paediatrics, multisystem inflammatory syndrome in children (MIS-C), complications, acute kidney injury and heart failure. Secondary resources included one study from preprint servers (www.preprints.org), last search 8 May 2021, with notion of nonpeer review status. Data were collected and analysed to stay current with the most recent alerts and guidelines for the best care for children during the COVID-19 pandemic. RESULTS Evaluation and analysis of literature revealed MIS-C to be the most prevalent followed by neurological complications. Whereas the least prevalent were septic shock and ophthalmic complications. CONCLUSION Even though COVID-19 is known to be a less severe in the paediatric population, the complications of the virus have caused a great deal of stress to the paediatric patients' parents and paediatricians worldwide, and hence, emphasis should be given to the management of coronavirus complications in paediatrics.
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Affiliation(s)
- Shrey Seth
- Department of Pharmacy PracticeManipal College of Pharmaceutical Sciences, Manipal Academy of Higher EducationManipalIndia
| | - Femida Rashid
- Department of Pharmacy PracticeManipal College of Pharmaceutical Sciences, Manipal Academy of Higher EducationManipalIndia
| | - Kanav Khera
- Department of Pharmacy PracticeManipal College of Pharmaceutical Sciences, Manipal Academy of Higher EducationManipalIndia
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133
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Pan SY, Ding M, Huang J, Cai Y, Huang YZ. Airway resistance variation correlates with prognosis of critically ill COVID-19 patients: A computational fluid dynamics study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 208:106257. [PMID: 34245951 PMCID: PMC8231702 DOI: 10.1016/j.cmpb.2021.106257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the quantitative changes of respiratory functions for critically ill COVID-19 patients with mechanical ventilation, computational fluid dynamics (CFD) analysis was performed based on patient-specific three-dimensional airway geometry. METHODS 37 cases of critically ill patients with COVID-19 admitted to the ICU of Huangshi Traditional Chinese Medicine Hospital from February 1st to March 20th, 2020 were retrospectively analyzed. 5 patients whose clinical data met the specific criteria were finally cataloged into death group (2 patients) and survival group (3 patients). The patient-specific three-dimensional airways were reconstructed from the central airways down to the 4th-5th bifurcation of the tracheobronchial tree. The volume changes of bronchi were calculated during the disease progression according to the comparison of two CT scans. Additionally, the changes of air flow resistance were analyzed using numerical simulation of CFD. RESULTS Pearson correlation analysis demonstrated that there was negative correlation between the change of volume (ΔV) and the change of resistance (ΔR) for all COVID-19 patients (r=-0.7025). For total airway volume, an average decrease of -11.41±15.71% was observed in death group compared to an average increase of 1.86±10.80% in survival group (p=0.0232). For air flow through airways in lower lobe, the resistance increases for death group by 10.97±77.66% and decreases for survival group by -45.49±42.04% (p=0.0246). CONCLUSION The variation of flow resistance in the airway could be used as a non-invasive functional evaluation for the prognosis and outcome of critically ill patients with COVID-19. The 'virtual' pulmonary function test by integrating follow-up CT scans with patient-derived CFD analysis could be a potentially powerful way in improving the efficiency of treatment for critically ill patients with COVID-19.
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Affiliation(s)
- Shi-Yu Pan
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, Jiangsu, China
| | - Ming Ding
- Department of Respiratory Medicine, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
| | - Jing Huang
- Department of Respiratory Medicine, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China
| | - Yan Cai
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, Jiangsu, China.
| | - Ying-Zi Huang
- Department of Critical Care Medicine, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China.
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134
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Verma RR, Gupta N, Singh M. Letter to the editor regarding "The outcome of fluticasone nasal spray on anosmia and triamcinolone oral paste in dysgeusia in COVID-19 patients". Am J Otolaryngol 2021; 42:103103. [PMID: 34116850 PMCID: PMC8178533 DOI: 10.1016/j.amjoto.2021.103103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Ravneet Ravinder Verma
- Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, India.
| | - Nitin Gupta
- Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - Mugdha Singh
- Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, India
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135
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Rashid RA, Zgair A, Al-Ani RM. Effect of nasal corticosteroid in the treatment of anosmia due to COVID-19: A randomised double-blind placebo-controlled study. Am J Otolaryngol 2021; 42:103033. [PMID: 33839489 PMCID: PMC8024226 DOI: 10.1016/j.amjoto.2021.103033] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/04/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Anosmia is a common debilitating symptom of the novel coronavirus disease 2019 (COVID-19). Currently, there is no satisfactory treatment of anosmia. Therefore, this study was conducted to evaluate the therapeutic effect of nasal betamethasone drops in the recovery of olfaction in COVID-19-associated anosmia. METHODS The study was designed as a randomised, double-blind, placebo-controlled clinical trial. In total, 276 PCR-confirmed COVID-19 patients who were presented to the outpatient clinic with anosmia were enrolled in the study. In the betamethasone group, 138 participants received nasal drops of betamethasone 3 times daily until recovery for a maximum of one month. Similar dose of 9% NaCl drops was administered to 138 participants in the placebo group. RESULTS The median age of participants was 29 years (IQR 23-37). Among them, 198 (71.7%) were females. Ageusia was co-presented with anosmia in 234 (84.8%) of participants. In this study, 83% of participants had recovered from anosmia within 30 days, with a median recovery time of 13 days (IQR 8-18). Compared to placebo, nasal application of betamethasone drops has no significant effect on the recovery time of anosmia (hazard ratio 0.88; 95% CI 0.68-1.14; P = 0.31). CONCLUSION The use of nasal betamethasone to facilitate the recovery time of acute anosmia is not advised. In addition, age, smoking status, the duration of anosmia at presentation, and the co-presentation of ageusia with anosmia are important determinant covariates for the recovery time of anosmia. Further clinical trials, which take these covariates into account, will need to be undertaken. The trail has been registered at ClinicalTrails.gov, NCT04569825.
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Affiliation(s)
- Rasheed Ali Rashid
- Department of Surgery, College of Medicine, Tikrit University, Tikrit, 34001, Iraq
| | - Atheer Zgair
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Anbar, Ramadi, 31001, Iraq.
| | - Raid M Al-Ani
- Department of Surgery, College of Medicine, University of Anbar, Ramadi, 31001, Iraq
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136
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Kolethekkat AA, Al Abri R, Al Washahi M, Al Badaai Y, Balkhair AA. Clinical Characteristics of COVID-19 from the Otorhinolaryngologist's Perspective: First Report from Oman, Middle East. Indian J Otolaryngol Head Neck Surg 2021; 74:3104-3110. [PMID: 34458130 PMCID: PMC8385262 DOI: 10.1007/s12070-021-02829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/14/2021] [Indexed: 12/15/2022] Open
Abstract
To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms such as nasal congestion, rhinorrhoea, sneezing, facial pain, etc. were present with less frequency. In more than half of the patients (61.5%), all the symptoms recovered within 5 days, in 12 (18.5%) between 5 and 8 days, and in 9 (13.8%), between 9 and14 days. However, in four patients, symptoms lasted for 28–30 days. In seven patients (10.7%), symptoms recurred after the period of isolation, however, the retest was negative. Fever, cough and or shortness of breath are the commonly reported prominent symptoms of COVID-19, however, there is a changing trend of clinical presentation towards variable otorhinolaryngologic manifestations. Pharyngodynia, taste and smell dysfunctions are common in patients with COVID-19, and could represent potential characters.
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Affiliation(s)
- Arif Ali Kolethekkat
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Rashid Al Abri
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Mohammed Al Washahi
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Yahya Al Badaai
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Abdullah A Balkhair
- Infectious Disease Unit, Department of Medicine, Sultan Qaboos University Hospital, Seeb, Oman
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137
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He Y, Bai X, Zhu T, Huang J, Zhang H. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med 2021; 19:363. [PMID: 34425827 PMCID: PMC8381866 DOI: 10.1186/s12967-021-03039-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. Results A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.
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Affiliation(s)
- Yuanyuan He
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Xiaojie Bai
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Tiantian Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Jialin Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Hong Zhang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China.
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138
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Herz RS, Herzog ED, Merrow M, Noya SB. The Circadian Clock, the Brain, and COVID-19: The Cases of Olfaction and the Timing of Sleep. J Biol Rhythms 2021; 36:423-431. [PMID: 34396817 PMCID: PMC8442129 DOI: 10.1177/07487304211031206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Daily rhythms of behavior and neurophysiology are integral to the
circadian clocks of all animals. Examples of circadian clock
regulation in the human brain include daily rhythms in sleep-wake,
cognitive function, olfactory sensitivity, and risk for ischemic
stroke, all of which overlap with symptoms displayed by many COVID-19
patients. Motivated by the relatively unexplored, yet pervasive,
overlap between circadian functions and COVID-19 neurological
symptoms, this perspective piece uses daily variations in the sense of
smell and the timing of sleep and wakefulness as illustrative
examples. We propose that time-stamping clinical data and testing may
expand and refine diagnosis and treatment of COVID-19.
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Affiliation(s)
- Rachel S Herz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Psychology and Neuroscience, Boston College, Chestnut Hill, Massachusetts, USA
| | - Erik D Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Martha Merrow
- Institute of Medical Psychology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sara B Noya
- Institute of Pharmacology and Toxicology, University of Zürich, Zürich, Switzerland.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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139
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Post-COVID-19 Syndrome: Nine Months after SARS-CoV-2 Infection in a Cohort of 354 Patients: Data from the First Wave of COVID-19 in Nord Franche-Comté Hospital, France. Microorganisms 2021; 9:microorganisms9081719. [PMID: 34442798 PMCID: PMC8401026 DOI: 10.3390/microorganisms9081719] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/10/2021] [Indexed: 01/05/2023] Open
Abstract
(1) Background. Post-COVID-19 syndrome is defined as the persistence of symptoms after confirmed SARS-CoV-2 infection. (2) Methods. ANOSVID is an observational retrospective study in Nord Franche-Comté Hospital in France that included adult COVID-19 patients confirmed by RT-PCR from 1 March 2020 to 31 May 2020. The aim was to describe patients with post-COVID-19 syndrome with persistent symptoms (PS group) and to compare them with the patients without persistent symptoms (no-PS group). (3) Results. Of the 354 COVID-19 patients, 35.9% (n = 127) reported persistence of at least one symptom after a mean of 289.1 ± 24.5 days after symptom onset. Moreover, 115 patients reported a recurrence of symptoms after recovery, and only 12 patients reported continuous symptoms. The mean age of patients was 48.6 years (19–93) ± 19.4, and 81 patients (63.8%) were female. Patients in the PS group had a longer duration of symptoms of initial acute SARS-CoV-2 infection than patients in the no-PS group (respectively, 57.1 ± 82.1 days versus 29.7 ± 42.1 days, p < 0.001). A majority of patients (n = 104, 81.9%) reported three or more symptoms. The most prevalent persistent symptoms were loss of smell (74.0%, n = 94), fatigue (53.5%, n = 68), loss of taste (31.5%, n = 40), and dyspnea (30.7%, n = 39). These were followed by pain symptoms (26.8% (n = 34), 26.0% (n = 33), 24.4% (n = 31); headache, arthralgia, and myalgia, respectively). More than half of patients reporting persistent symptoms (58%, n = 73) were healthcare workers (HCWs). Among outpatients, this population was more present in the PS group than the no-PS group ((86.6%) n = 71/82 versus (72.2%) n = 109/151, p = 0.012). Post-COVID-19 syndrome was more frequent in patients with a past history of chronic rhinosinusitis (8.7% (n = 11%) versus 1.3% (n = 3), p < 0.001). No significant difference was found regarding clinical characteristics and outcome, laboratory, imaging findings, and treatment received in the two groups. (4) Conclusions. More than a third of our COVID-19 patients presented persistent symptoms after SARS-CoV-2 infection, particularly through loss of smell, loss of taste, fatigue, and dyspnea, with a high prevalence in HCWs among COVID-19 outpatients.
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140
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Ferdenzi C, Bousquet C, Aguera PE, Dantec M, Daudé C, Fornoni L, Fournel A, Kassan A, Mantel M, Moranges M, Moussy E, Richard Ortegón S, Rouby C, Bensafi M. Recovery From COVID-19-Related Olfactory Disorders and Quality of Life: Insights From an Observational Online Study. Chem Senses 2021; 46:6294641. [PMID: 34097726 DOI: 10.1093/chemse/bjab028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Although olfactory disorders (OD) are among the most significant symptoms of COVID-19, recovery time from COVID-19-related OD and their consequences on the quality of life remain poorly documented. We investigated the characteristics and behavioral consequences of COVID-19-related OD using a large-scale study involving 3111 French respondents (78% women) to an online questionnaire over a period of 9 months covering different epidemic waves (from 8 April 2020 to 13 January 2021). In the patients who subjectively recovered from COVID-19-related OD (N = 609), recovery occurred on average after 16 days and most of the time within 1 month ("normal" recovery range); 49 subjectively recovered in 1-2.5 months, and several cases took up to 6.5 months. Among the patients with ongoing OD (N = 2502), 974 were outside the "normal" recovery range (persistent OD) and reported OD for 1-10 months. Developing a persistent OD was more likely with increasing age and in women and was more often associated with parosmia and phantosmia. The deleterious impact of COVID-19-related OD on the quality of life was significantly aggravated by OD duration and was more pronounced in women. Because persistent OD is not infrequent after COVID-19, has deleterious consequences on the quality of life, and receives few solutions from the health practitioners, it would be beneficial to implement screening and treatment programs to minimize the long-term behavioral consequences of COVID-19-related OD.
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Affiliation(s)
- Camille Ferdenzi
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Christophe Bousquet
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Pierre-Emmanuel Aguera
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Morgane Dantec
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Christelle Daudé
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Lesly Fornoni
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Arnaud Fournel
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Aurélien Kassan
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Marylou Mantel
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Maëlle Moranges
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Erwan Moussy
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Stéphane Richard Ortegón
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Catherine Rouby
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
| | - Moustafa Bensafi
- Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, University Claude Bernard Lyon 1, CH Le Vinatier, Bât. 462 Neurocampus, 95 boulevard Pinel, 69675 Bron Cedex, France
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141
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D V, Sharma A, Kumar A, Flora SJS. Neurological Manifestations in COVID-19 Patients: A Meta-Analysis. ACS Chem Neurosci 2021; 12:2776-2797. [PMID: 34260855 PMCID: PMC8291134 DOI: 10.1021/acschemneuro.1c00353] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
Common symptoms such as dizziness, headache, olfactory dysfunction, nausea, vomiting, etc. in COVID-19 patients have indicated the involvement of the nervous system. However, the exact association of the nervous system with COVID-19 infection is still unclear. Thus, we have conducted a meta-analysis of clinical studies associated with neurological problems in COVID-19 patients. We have searched for electronic databases with MeSH terms, and the studies for analysis were selected based on inclusion and exclusion criteria and quality assessment. The Stats Direct (version 3) was used for the analysis. The pooled prevalence with 95% confidence interval of various neurological manifestations reported in the COVID-19 patients was found to be headache 14.6% (12.2-17.2), fatigue 33.6% (29.5-37.8), olfactory dysfunction 26.4% (21.8-31.3), gustatory dysfunction 27.2% (22.3-32.3), vomiting 6.7% (5.5-8.0), nausea 9.8% (8.1-11.7), dizziness 6.7% (4.7-9.1), myalgia 21.4% (18.8-24.1), seizure 4.05% (2.5-5.8), cerebrovascular diseases 9.9% (6.8-13.4), sleep disorders 14.9% (1.9-36.8), altered mental status 17.1% (12.3-22.5), neuralgia 2.4% (0.8-4.7), arthralgia 19.9% (15.3-25.0), encephalopathy 23.5% (14.3-34.1), encephalitis 0.6% (0.2-1.3), malaise 38.3% (24.7-52.9), confusion 14.2% (6.9-23.5), movement disorders 5.2% (1.7-10.4), and Guillain-Barre syndrome 6.9% (2.3-13.7). However, the heterogeneity among studies was found to be high. Various neurological manifestations related to the central nervous system (CNS) and peripheral nervous system (PNS) are associated with COVID-19 patients.
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Affiliation(s)
- Vitalakumar D
- Department of Pharmacology and Toxicology,
National Institute of Pharmaceutical Education and Research
(NIPER)-Raeberali, Lucknow 226002, India
| | - Ankita Sharma
- Department of Biotechnology, National
Institute of Pharmaceutical Education and Research (NIPER)-Raeberali,
Lucknow 226002, India
| | - Anoop Kumar
- Department of Pharmacology and Clinical Research, Delhi
Institute of Pharmaceutical Sciences and Research (DIPSAR), Delhi
Pharmaceutical Sciences & Research University (DPSRU), New Delhi
110017, India
| | - S. J. S. Flora
- Department of Pharmacology and Toxicology,
National Institute of Pharmaceutical Education and Research
(NIPER)-Raeberali, Lucknow 226002, India
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142
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Lechien JR, Chiesa-Estomba CM, Beckers E, Mustin V, Ducarme M, Journe F, Marchant A, Jouffe L, Barillari MR, Cammaroto G, Circiu MP, Hans S, Saussez S. Prevalence and 6-month recovery of olfactory dysfunction: a multicentre study of 1363 COVID-19 patients. J Intern Med 2021; 290:451-461. [PMID: 33403772 DOI: 10.1111/joim.13209] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate prevalence and recovery of olfactory dysfunction (OD) in COVID-19 patients according to the disease severity. METHODS From 22 March to 3 June 2020, 2581 COVID-19 patients were identified from 18 European hospitals. Epidemiological and clinical data were extracted at baseline and within the 2-month post-infection. RESULTS The prevalence of OD was significantly higher in mild form (85.9%) compared with moderate-to-critical forms (4.5-6.9%; P = 0.001). Of the 1916 patients with OD, 1363 completed the evaluations (71.1%). A total of 328 patients (24.1%) did not subjectively recover olfaction 60 days after the onset of the dysfunction. The mean duration of self-reported OD was 21.6 ± 17.9 days. Objective olfactory evaluations identified hyposmia/anosmia in 54.7% and 36.6% of mild and moderate-to-critical forms, respectively (P = 0.001). At 60 days and 6 months, 15.3% and 4.7% of anosmic/hyposmic patients did not objectively recover olfaction, respectively. The higher baseline severity of objective olfactory evaluations was strongly predictive of persistent OD (P < 0.001). CONCLUSION OD is more prevalent in mild COVID-19 forms than in moderate-to-critical forms. OD disappeared in 95% of patients regarding objective olfactory evaluations at 6 months.
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Affiliation(s)
- J R Lechien
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - C M Chiesa-Estomba
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - E Beckers
- Department of Otolaryngology-Head & Neck Surgery, Clinique de l'Europe, Brussels, Belgium
| | - V Mustin
- Department of Otolaryngology-Head & Neck Surgery, Clinique de l'Europe, Brussels, Belgium
| | - M Ducarme
- Department of Surgery, EpiCURA Hospital, Hornu, Belgium
| | - F Journe
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - A Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Brussels, Belgium
| | | | - M R Barillari
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - G Cammaroto
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck, Forli Hospital, Forli, Italy
| | - M P Circiu
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - S Hans
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - S Saussez
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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143
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Jung HJ, Lee HM. Contemporary Review of Olfactory Dysfunction in COVID-19. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2020.00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) is an extreme threat to international health care, resulting in more than two million deaths. Data reveal that olfactory disorder is a characteristic symptom of COVID-19 and has unique clinical manifestations. The olfactory dysfunction induced by COVID-19 has sudden onset, short duration, and rapid recovery, with anosmia often the only symptom. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) affects the human body by binding to angiotensin converting enzyme 2 (ACE2) of the olfactory epithelium. However, the etiology of COVID-19-induced olfactory dysfunction is unclear. In many countries, vaccines for COVID-19 in human are beginning to be administered. Conventional conservative treatments are common for olfactory disorders caused by COVID-19. Rhinologists should be aware of olfactory dysfunction to avoid delayed diagnosis of COVID-19. The article reviews the latest scientific evidence of anosmia in COVID-19.
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144
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Webster KE, O'Byrne L, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev 2021; 7:CD013877. [PMID: 34291812 PMCID: PMC8406518 DOI: 10.1002/14651858.cd013877.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Loss of olfactory function is well recognised as a cardinal symptom of COVID-19 infection, and the ongoing pandemic has resulted in a large number of affected individuals with abnormalities in their sense of smell. For many, the condition is temporary and resolves within two to four weeks. However, in a significant minority the symptoms persist. At present, it is not known whether early intervention with any form of treatment (such as medication or olfactory training) can promote recovery and prevent persisting olfactory disturbance. OBJECTIVES: To assess the effects (benefits and harms) of interventions that have been used, or proposed, to prevent persisting olfactory dysfunction due to COVID-19 infection. A secondary objective is to keep the evidence up-to-date, using a living systematic review approach. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane COVID-19 Study Register; Cochrane ENT Register; CENTRAL; Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished studies. The date of the search was 16 December 2020. SELECTION CRITERIA Randomised controlled trials including participants who had symptoms of olfactory disturbance following COVID-19 infection. Individuals who had symptoms for less than four weeks were included in this review. Studies compared any intervention with no treatment or placebo. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. Our primary outcomes were the presence of normal olfactory function, serious adverse effects and change in sense of smell. Secondary outcomes were the prevalence of parosmia, change in sense of taste, disease-related quality of life and other adverse effects (including nosebleeds/bloody discharge). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS: We included one study of 100 participants, which compared an intranasal steroid spray to no intervention. Participants in both groups were also advised to undertake olfactory training for the duration of the trial. Data were identified for only two of the prespecified outcomes for this review, and no data were available for the primary outcome of serious adverse effects. Intranasal corticosteroids compared to no intervention (all using olfactory training) Presence of normal olfactory function after three weeks of treatment was self-assessed by the participants, using a visual analogue scale (range 0 to 10, higher scores = better). A score of 10 represented "completely normal smell sensation". The evidence is very uncertain about the effect of intranasal corticosteroids on self-rated recovery of sense of smell (estimated absolute effect 619 per 1000 compared to 520 per 1000, risk ratio (RR) 1.19, 95% confidence interval (CI) 0.85 to 1.68; 1 study; 100 participants; very low-certainty evidence). Change in sense of smell was not reported, but the self-rated score for sense of smell was reported at the endpoint of the study with the same visual analogue scale (after three weeks of treatment). The median scores at endpoint were 10 (interquartile range (IQR) 9 to 10) for the group receiving intranasal corticosteroids, and 10 (IQR 5 to 10) for the group receiving no intervention (1 study; 100 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS There is very limited evidence regarding the efficacy of different interventions at preventing persistent olfactory dysfunction following COVID-19 infection. However, we have identified a small number of additional ongoing studies in this area. As this is a living systematic review, the evidence will be updated regularly to incorporate new data from these, and other relevant studies, as they become available. For this (first) version of the living review, we identified a single study of intranasal corticosteroids to include in this review, which provided data for only two of our prespecified outcomes. The evidence was of very low certainty, therefore we were unable to determine whether intranasal corticosteroids may have a beneficial or harmful effect.
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Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Lisa O'Byrne
- Department of Otolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin 4, Ireland
| | - Samuel MacKeith
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carl Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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O'Byrne L, Webster KE, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev 2021; 7:CD013876. [PMID: 34291813 PMCID: PMC8406942 DOI: 10.1002/14651858.cd013876.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Olfactory dysfunction is an early and sensitive marker of COVID-19 infection. Although self-limiting in the majority of cases, when hyposmia or anosmia persists it can have a profound effect on quality of life. Little guidance exists on the treatment of post-COVID-19 olfactory dysfunction, however several strategies have been proposed from the evidence relating to the treatment of post-viral anosmia (such as medication or olfactory training). OBJECTIVES To assess the effects (benefits and harms) of interventions that have been used, or proposed, to treat persisting olfactory dysfunction due to COVID-19 infection. A secondary objective is to keep the evidence up-to-date, using a living systematic review approach. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane COVID-19 Study Register; Cochrane ENT Register; CENTRAL; Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished studies. The date of the search was 16 December 2020. SELECTION CRITERIA Randomised controlled trials including participants who had symptoms of olfactory disturbance following COVID-19 infection. Only individuals who had symptoms for at least four weeks were included in this review. Studies compared any intervention with no treatment or placebo. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. Primary outcomes were the recovery of sense of smell, disease-related quality of life and serious adverse effects. Secondary outcomes were the change in sense of smell, general quality of life, prevalence of parosmia and other adverse effects (including nosebleeds/bloody discharge). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS We included one study with 18 participants, which compared the use of a 15-day course of oral steroids combined with nasal irrigation (consisting of an intranasal steroid/mucolytic/decongestant solution) with no intervention. Psychophysical testing was used to assess olfactory function at baseline, 20 and 40 days. Systemic corticosteroids plus intranasal steroid/mucolytic/decongestant compared to no intervention Recovery of sense of smell was assessed after 40 days (25 days after cessation of treatment) using the Connecticut Chemosensory Clinical Research Center (CCCRC) score. This tool has a range of 0 to 100, and a score of ≥ 90 represents normal olfactory function. The evidence is very uncertain about the effect of this intervention on recovery of the sense of smell at one to three months (5/9 participants in the intervention group scored ≥ 90 compared to 0/9 in the control group; risk ratio (RR) 11.00, 95% confidence interval (CI) 0.70 to 173.66; 1 study; 18 participants; very low-certainty evidence). Change in sense of smell was assessed using the CCCRC score at 40 days. This study reported an improvement in sense of smell in the intervention group from baseline (median improvement in CCCRC score 60, interquartile range (IQR) 40) compared to the control group (median improvement in CCCRC score 30, IQR 25) (1 study; 18 participants; very low-certainty evidence). Serious adverse events andother adverse events were not identified in any participants of this study; however, it is unclear how these outcomes were assessed and recorded (1 study; 18 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified other ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available. For this (first) version of the living review we identified only one study with a small sample size, which assessed systemic steroids and nasal irrigation (intranasal steroid/mucolytic/decongestant). However, the evidence regarding the benefits and harms from this intervention to treat persistent post-COVID-19 olfactory dysfunction is very uncertain.
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Affiliation(s)
- Lisa O'Byrne
- Department of Otolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin 4, Ireland
| | - Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Samuel MacKeith
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carl Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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146
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Wu D, Wang VY, Chen YH, Ku CH, Wang PC. The prevalence of olfactory and gustatory dysfunction in covid-19 - A systematic review. Auris Nasus Larynx 2021; 49:165-175. [PMID: 34332803 PMCID: PMC8279934 DOI: 10.1016/j.anl.2021.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Loss of smell or taste are early symptoms of COVID-19. Given the high asymptomatic rate of COVID-19, as well as unreliable temperature checking and contact history taking, it is important to understand the role of olfactory and gustatory dysfunction (OGD) in the diagnosis of COVID-19. The aim of this study is to determine how initial symptoms of OGD can be used to screen patients for COVID-19 laboratory testing. METHODS We followed recommendations from the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) statement to conduct this systematic review study. We used OGD-related key words to search for literature published between January 1, 2020 and September 30, 2020 on Pubmed, Ovid Medline databases. We estimated the prevalence of OGD and compared it with that of other OGD-related symptoms. The weighted summary proportion under the fixed and random effects model was assessed using MedCalc statistical software. Whenever there was heterogeneity, a random effects model was selected. Publication bias was assessed by funnel plot asymmetry and Egger's regression test. RESULTS A total of 25 articles (evidence level III:5; IV:20) were identified and reviewed. Data synthesis of 19 articles revealed that the pooled prevalence of olfactory dysfunction in COVID-19 is 53.56% (range 5.6-100%, 95% CI 40.25-66.61%). The pooled prevalence of gustatory dysfunction in COVID-19 is 43.93% (range 1.5-85.18%, 95% CI 28.72-59.74%), just behind fever (62.22%, range 18.18-95.83%, 95% CI 54.82-69.33%), cough (64.74%, range 38.89-87.5%, 95% CI 57.97-71.22%), and fatigue (56.74%, range 6.25-93.62%, 95% CI 32.53-79.35%). The prevalence of gustatory dysfunction in subgroup with objective evaluation is lower than those without (9.91% vs. 49.21%, relive risk 2.82, p<0.001). CONCLUSION Our updated systematic review attests that OGD is an important early symptom of COVID-19 infection. Screening for OGD should be further emphasized to prioritize patients for laboratory test.
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Affiliation(s)
- Daniel Wu
- Diamond Bar High School, Diamond Bar, California, USA
| | - Victoria Y Wang
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Ya-Hui Chen
- Department of Medical Research, Cathay General Hospital, Taipei, Taiwan
| | - Chih-Hung Ku
- Department of Health Industry Management, Kainan University, Taoyuan City, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Pa-Chun Wang
- Department of Medical Research, Cathay General Hospital, Taipei, Taiwan; Department of Otolaryngology Head & Neck Surgery, Cathay General Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
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147
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Johansson A, Mohamed MS, Moulin TC, Schiöth HB. Neurological manifestations of COVID-19: A comprehensive literature review and discussion of mechanisms. J Neuroimmunol 2021; 358:577658. [PMID: 34304141 PMCID: PMC8272134 DOI: 10.1016/j.jneuroim.2021.577658] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 01/08/2023]
Abstract
Several neurological symptoms and complications have been described in association with COVID-19, such as anosmia, ageusia, encephalitis and Guillain-Barré syndrome. Here, we review the literature describing SARS-CoV-2-induced neurological manifestations and provide a comprehensive discussion of proposed mechanisms underlying the neurological pathophysiology. First, we analyse the neuroinvasiveness potential of the coronavirus family based on previous SARS-CoV-1 studies. Then, we describe the current evidence on COVID-19-induced nervous tissue damage, including processes behind brain vasculopathy and cytokine storm. We also discuss in detail anosmia and Guillain-Barré syndrome. Finally, we provide a summarised timeline of the main findings in the field. Future perspectives are presented, and suggestions of further investigations to clarify how SARS-COV-2 can affect the CNS.
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Affiliation(s)
- Anton Johansson
- Functional Pharmacology Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mohamed S Mohamed
- Functional Pharmacology Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Thiago C Moulin
- Functional Pharmacology Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Functional Pharmacology Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden; Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia.
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148
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Hua-Huy T, Lorut C, Aubourg F, Morbieu C, Marey J, Texereau J, Fajac I, Mouthon L, Roche N, Dinh-Xuan AT. Persistent Nasal Inflammation 5 Months after Acute Anosmia in Patients with COVID-19. Am J Respir Crit Care Med 2021; 203:1319-1322. [PMID: 33684323 PMCID: PMC8456464 DOI: 10.1164/rccm.202011-4258le] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Thông Hua-Huy
- Cochin Hospital, APHP, Université de ParisParis, France
| | | | | | | | | | | | | | - Luc Mouthon
- Cochin Hospital, APHP, Université de ParisParis, France
| | - Nicolas Roche
- Cochin Hospital, APHP, Université de ParisParis, France
| | - Anh Tuan Dinh-Xuan
- Cochin Hospital, APHP, Université de ParisParis, France
- Corresponding author (e-mail: )
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Ye Q, Zhou J, He Q, Li RT, Yang G, Zhang Y, Wu SJ, Chen Q, Shi JH, Zhang RR, Zhu HM, Qiu HY, Zhang T, Deng YQ, Li XF, Liu JF, Xu P, Yang X, Qin CF. SARS-CoV-2 infection in the mouse olfactory system. Cell Discov 2021; 7:49. [PMID: 34230457 PMCID: PMC8260584 DOI: 10.1038/s41421-021-00290-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022] Open
Abstract
SARS-CoV-2 infection causes a wide spectrum of clinical manifestations in humans, and olfactory dysfunction is one of the most predictive and common symptoms in COVID-19 patients. However, the underlying mechanism by which SARS-CoV-2 infection leads to olfactory disorders remains elusive. Herein, we demonstrate that intranasal inoculation with SARS-CoV-2 induces robust viral replication in the olfactory epithelium (OE), not the olfactory bulb (OB), resulting in transient olfactory dysfunction in humanized ACE2 (hACE2) mice. The sustentacular cells and Bowman’s gland cells in the OE were identified as the major target cells of SARS-CoV-2 before invasion into olfactory sensory neurons (OSNs). Remarkably, SARS-CoV-2 infection triggers massive cell death and immune cell infiltration and directly impairs the uniformity of the OE structure. Combined transcriptomic and quantitative proteomic analyses revealed the induction of antiviral and inflammatory responses, as well as the downregulation of olfactory receptor (OR) genes in the OE from the infected animals. Overall, our mouse model recapitulates olfactory dysfunction in COVID-19 patients and provides critical clues for understanding the physiological basis for extrapulmonary manifestations of COVID-19.
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Affiliation(s)
- Qing Ye
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jia Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Qi He
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Rui-Ting Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Guan Yang
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Yao Zhang
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Shu-Jia Wu
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Qi Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jia-Hui Shi
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Rong-Rong Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Hui-Ming Zhu
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Hong-Ying Qiu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Tao Zhang
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China
| | - Yong-Qiang Deng
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xiao-Feng Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jian-Feng Liu
- Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing, China
| | - Ping Xu
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China.
| | - Xiao Yang
- State Key Laboratory of Proteomics, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing, China.
| | - Cheng-Feng Qin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China. .,Research Unit of Discovery and Tracing of Natural Focus Diseases, Chinese Academy of Medical Sciences, Beijing, China.
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Shiel E, Miyakis S, Tennant E, Fernando S, Kizny-Gordon A, Koh B, Findlay M, Garnham K, Pilli S, Segboer H, Tallon J, Kao J, Miller A, Shore T, Maher R, Telford M, Barclay K, Harris B, Newcombe J, Hudson B, Figtree M. Clinical Characteristics and Outcomes of COVID-19 in a low-prevalence, well-resourced setting, Sydney, Australia. Intern Med J 2021; 51:1605-1613. [PMID: 34228387 PMCID: PMC8447053 DOI: 10.1111/imj.15445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 12/15/2022]
Abstract
Background The Northern Sydney Local Health District was one of the first health regions to be affected by COVID‐19 in Australia. Aims To describe the clinical characteristics, risk factors and outcomes in our low‐prevalence Australian population. Methods This is a retrospective analysis of 517 laboratory‐confirmed COVID‐19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID‐19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission. Results The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID‐19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the ‘unknown’ source group (27.6%). The median incubation period was 5 days (interquartile range 3–8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X‐ray of >10 was independently associated with death. Conclusions In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID‐19 patients, and in surge capacity planning for hospitals.
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Affiliation(s)
- Emily Shiel
- Infectious Diseases Registrar, Royal North Shore Hospital
| | - Spiros Miyakis
- Infectious Diseases Consultant, Wollongong Hospital, Australia
| | - Elaine Tennant
- Staff Specialist Infectious Diseases, Northern Sydney Local Health District
| | - Shelanah Fernando
- Staff Specialist Infectious Diseases, Northern Sydney Local Health District
| | | | - Bryant Koh
- Microbiology Registrar, New South Wales Health Pathology
| | | | | | - Shravya Pilli
- Infectious Diseases Registrar, Royal North Shore Hospital
| | | | - Jo Tallon
- Director Infection Control, Royal North Shore Hospital
| | - Joanna Kao
- Radiology Fellow, Royal North Shore Hospital
| | | | - Tim Shore
- Radiologist, Royal North Shore Hospital
| | | | - Mark Telford
- Nurse Manager, Northern Sydney Local Health District
| | - Kate Barclay
- Staff Specialist Respiratory Medicine, Northern Beaches Hospital
| | - Ben Harris
- Staff Specialist Respiratory Medicine, Royal North Shore Hospital
| | - James Newcombe
- Staff Specialist Microbiology and Infectious Diseases , NSW Health Pathology, Northern Sydney Local Health District
| | - Bernie Hudson
- Staff Specialist Microbiology and Infectious Diseases , NSW Health Pathology, Northern Sydney Local Health District
| | - Mel Figtree
- Staff Specialist Microbiology and Infectious Diseases , NSW Health Pathology, Northern Sydney Local Health District
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