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COVID-19 Anosmia: High Prevalence, Plural Neuropathogenic Mechanisms, and Scarce Neurotropism of SARS-CoV-2? Viruses 2021; 13:v13112225. [PMID: 34835030 PMCID: PMC8625547 DOI: 10.3390/v13112225] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative pathogen of coronavirus disease 2019 (COVID-19). It is known as a respiratory virus, but SARS-CoV-2 appears equally, or even more, infectious for the olfactory epithelium (OE) than for the respiratory epithelium in the nasal cavity. In light of the small area of the OE relative to the respiratory epithelium, the high prevalence of olfactory dysfunctions (ODs) in COVID-19 has been bewildering and has attracted much attention. This review aims to first examine the cytological and molecular biological characteristics of the OE, especially the microvillous apical surfaces of sustentacular cells and the abundant SARS-CoV-2 receptor molecules thereof, that may underlie the high susceptibility of this neuroepithelium to SARS-CoV-2 infection and damages. The possibility of SARS-CoV-2 neurotropism, or the lack of it, is then analyzed with regard to the expression of the receptor (angiotensin-converting enzyme 2) or priming protease (transmembrane serine protease 2), and cellular targets of infection. Neuropathology of COVID-19 in the OE, olfactory bulb, and other related neural structures are also reviewed. Toward the end, we present our perspectives regarding possible mechanisms of SARS-CoV-2 neuropathogenesis and ODs, in the absence of substantial viral infection of neurons. Plausible causes for persistent ODs in some COVID-19 convalescents are also examined.
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152
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Hoang MP, Staibano P, McHugh T, Sommer DD, Snidvongs K. Self-reported olfactory and gustatory dysfunction and psychophysical testing in screening for Covid-19: A systematic review and meta-analysis. Int Forum Allergy Rhinol 2021; 12:744-756. [PMID: 34725952 PMCID: PMC8652821 DOI: 10.1002/alr.22923] [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: 10/02/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/01/2022]
Abstract
Background A substantial proportion of coronavirus disease‐2019 (COVID‐19) patients demonstrate olfactory and gustatory dysfunction (OGD). Self‐reporting for OGD is widely used as a predictor of COVID‐19. Although psychophysical assessment is currently under investigation in this role, the sensitivity of these screening tests for COVID‐19 remains unclear. In this systematic review we assess the sensitivity of self‐reporting and psychophysical tests for OGD. Methods A systematic search was performed on PubMed, EMBASE, and ClinicalTrials.gov from inception until February 16, 2021. Studies of suspected COVID‐19 patients with reported smell or taste alterations were included. Data were pooled for meta‐analysis. Sensitivity, specificity, and diagnostic odds ratio (DOR) were reported in the outcomes. Results In the 50 included studies (42,902 patients), self‐reported olfactory dysfunction showed a sensitivity of 43.9% (95% confidence interval [CI], 37.8%‐50.2%), a specificity of 91.8% (95% CI, 89.0%‐93.9%), and a DOR of 8.74 (95% CI, 6.67‐11.46) for predicting COVID‐19 infection. Self‐reported gustatory dysfunction yielded a sensitivity of 44.9% (95% CI, 36.4%‐53.8%), a specificity of 91.5% (95% CI, 87.7%‐94.3%), and a DOR of 8.83 (95% CI, 6.48‐12.01). Olfactory psychophysical tests analysis revealed a sensitivity of 52.8% (95% CI, 25.5%‐78.6%), a specificity of 88.0% (95% CI, 53.7%‐97.9%), and a DOR of 8.18 (95% CI, 3.65‐18.36). One study used an identification test for gustatory sensations assessment. Conclusion Although demonstrating high specificity and DOR values, neither self‐reported OGD nor unvalidated and limited psychophysical tests were sufficiently sensitive in screening for COVID‐19. They were not suitable adjuncts in ruling out the disease.
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Affiliation(s)
- Minh P Hoang
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Department of Otolaryngology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Phillip Staibano
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Tobial McHugh
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Doron D Sommer
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Kornkiat Snidvongs
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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153
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Brandini DA, Takamiya AS, Thakkar P, Schaller S, Rahat R, Naqvi AR. Covid-19 and oral diseases: Crosstalk, synergy or association? Rev Med Virol 2021; 31:e2226. [PMID: 33646645 PMCID: PMC8014590 DOI: 10.1002/rmv.2226] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
The coronavirus disease 2019 (Covid-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that clinically affects multiple organs of the human body. Cells in the oral cavity express viral entry receptor angiotensin-converting enzyme 2 that allows viral replication and may cause tissue inflammation and destruction. Recent studies have reported that Covid-19 patients present oral manifestations with multiple clinical aspects. In this review, we aim to summarise main signs and symptoms of Covid-19 in the oral cavity, its possible association with oral diseases, and the plausible underlying mechanisms of hyperinflammation reflecting crosstalk between Covid-19 and oral diseases. Ulcers, blisters, necrotising gingivitis, opportunistic coinfections, salivary gland alterations, white and erythematous plaques and gustatory dysfunction were the most reported clinical oral manifestations in patients with Covid-19. In general, the lesions appear concomitant with the loss of smell and taste. Multiple reports show evidences of necrotic/ulcerative gingiva, oral blisters and hypergrowth of opportunistic oral pathogens. SARS-CoV-2 exhibits tropism for endothelial cells and Covid-19-mediated endotheliitis can not only promote inflammation in oral tissues but can also facilitate virus spread. In addition, elevated levels of proinflammatory mediators in patients with Covid-19 and oral infectious disease can impair tissue homeostasis and cause delayed disease resolution. This suggests potential crosstalk of immune-mediated pathways underlying pathogenesis. Interestingly, few reports suggest recurrent herpetic lesions and higher bacterial growth in Covid-19 subjects, indicating SARS-CoV-2 and oral virus/bacteria interaction. Larger cohort studies comparing SARS-CoV-2 negative and positive subjects will reveal oral manifestation of the virus on oral health and its role in exacerbating oral infection.
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Affiliation(s)
- Daniela A. Brandini
- Department of Diagnosis and SurgerySchool of DentistrySão Paulo State University (UNESP)AraçatubaSão PauloBrazil
| | - Aline S. Takamiya
- Department of Diagnosis and SurgerySchool of DentistrySão Paulo State University (UNESP)AraçatubaSão PauloBrazil
| | - Pari Thakkar
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Samantha Schaller
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Rani Rahat
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Afsar R. Naqvi
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
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154
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Birtay T, Bahadir S, Kabacaoglu E, Yetiz O, Demirci MF, Genctoy G. Prognosis of patients hospitalized with a diagnosis of COVID-19 pneumonia in a tertiary hospital in Turkey. Ann Saudi Med 2021; 41:327-335. [PMID: 34873938 PMCID: PMC8650597 DOI: 10.5144/0256-4947.2021.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV2/COVID-19 emerged in China and caused a global pandemic in 2020. The mortality rate has been reported to be between 0% and 14.6% in all patients. In this study, we determined the clinical and laboratory parameters of COVID-19 related morbidity and mortality in our hospital. OBJECTIVES Investigate the relationship between demographic, clinical, and laboratory parameters on COVID-19-related morbidity and mortality. DESIGN Retrospective observational study. SETTINGS Tertiary care hospital. PATIENTS AND METHODS Patients diagnosed with COVID-19 pneumonia from March until the end of December were included in the study. MAIN OUTCOME MEASURES The relationship between demographic, clinical, and laboratory parameters and the morbidity and mortality rates of patients diagnosed with COVID-19. SAMPLE SIZE 124 patients RESULTS: The mortality rate was 9.6% (12/124). Coronary artery disease (P<.0001) diabetes mellitus (P=.04) fever (>38.3°C) at presentation (P=.04) hypertension (P<.0001), and positive smoking history (P<.0001) were significantly associated with mortality. Patients who died were older, had a higher comorbid disease index, pneumonia severity index, fasting blood glucose, baseline serum creatinine, D-dimer, and had lower baseline haemoglobin, SaO2, percentage of lymphocyte counts and diastolic blood pressure. Patients admitted to the ICU were older, had a higher comorbidity disease index, pneumonia severity index, C-reactive protein, WBC, D-dimer, creatinine, number of antibiotics used, longer O2 support duration, lower hemoglobin, lymphocyte (%), and baseline SaO2 (%). CONCLUSIONS Our results were consistent with much of the reported data. We suggest that the frequency, dosage, and duration of steroid treatment should be limited. LIMITATIONS Low patient number, uncertain reason of mortality, no standard treatment regimen, limited treatment options, like ECMO. CONFLICT OF INTEREST None.
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Affiliation(s)
- Tayfun Birtay
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | - Suzan Bahadir
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | - Ebru Kabacaoglu
- From the Department of Chest Diseases, Baskent University, Antalya, Turkey
| | - Ozgur Yetiz
- From the Department of Anesthesia, Baskent University, Antalya, Turkey
| | | | - Gultekin Genctoy
- From the Department of Nephrology, Baskent University, Antalya, Turkey
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155
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Raad RA, Ganti A, Goshtasbi K, Lehrich BM, Papagiannopoulos P, LoSavio P, Mahdavinia M, Kuan EC, Batra PS, Tajudeen BA. Temporal patterns of nasal symptoms in patients with mild severity SARS-CoV-2 infection. Am J Otolaryngol 2021; 42:103076. [PMID: 33915513 PMCID: PMC8064817 DOI: 10.1016/j.amjoto.2021.103076] [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: 01/07/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023]
Abstract
Background No study to date has analyzed the progression of sinonasal symptoms over time in COVID-19 patients. The purpose of this study is to analyze the progression of sinonasal symptoms and risk factors for olfactory dysfunction in the mild severity COVID-19 patient. Methods An internet survey was used to assess sinonasal symptoms in patients with COVID-19. Changes in rhinologic domain and symptom-specific Sinonasal Outcome Test (SNOT-22) scores were compared at five time points: two weeks before diagnosis, at diagnosis, two weeks after diagnosis, four weeks after diagnosis, and six months after diagnosis. Results 521 responses were collected. Rhinologic domain SNOT-22 scores increased significantly (p < 0.001) to 8.94 at the time of diagnosis, remained elevated two weeks post-diagnosis (5.14, p = 0.004), and decreased significantly four weeks post-diagnosis (3.14, p = 0.004). Smell-specific SNOT-22 scores peaked at the time of diagnosis (2.05, p < 0.001), remained elevated two weeks after diagnosis (1.19, p < 0.001), and returned to baseline four weeks post-diagnosis (0.64, p > 0.999). Taste-specific SNOT-22 scores also peaked at diagnosis (2.06, p < 0.001), remained elevated two weeks after diagnosis (1.19, p < 0.001), and returned to baseline four weeks after diagnosis (0.71, p > 0.999). There were no significant differences in sense of smell or taste between 1-month and 6-month timepoints. Conclusion Sinonasal symptoms, particularly loss of smell and taste, may be important presenting symptoms in the mild severity COVID-19 patient. Our findings support incorporating these symptoms into screening protocols. Level of evidence: 4
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156
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Peramo-Álvarez FP, López-Zúñiga MÁ, López-Ruz MÁ. Medical sequels of COVID-19. ACTA ACUST UNITED AC 2021; 157:388-394. [PMID: 34632064 PMCID: PMC8491931 DOI: 10.1016/j.medcle.2021.04.008] [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: 02/28/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022]
Abstract
COVID-19 pandemic has impacted the world population, with a high rate of morbidity and mortality. While the evidence to date has attempted to describe clinical feature of acute illness, recent reports have also begun to describe persistent symptoms that extend beyond the initial period of illness. Adverse outcomes, in addition to respiratory, have been found to occur at different levels: cardiovascular, neurological, or immunological; skin, gastrointestinal or renal manifestations. The detrimental effect on mental health has also been described, not only in COVID-19 patients. The burden of disease secondary to this pandemic is likely to be enormous and not limited to acute disease alone, thus epidemiological studies are needed to further investigate the long-term impact of this disease. This review summarizes the current evidence on short-term effects and describes the possible long-term sequelae of COVID-19.
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157
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Peramo-Álvarez FP, López-Zúñiga MÁ, López-Ruz MÁ. Medical sequels of COVID-19. Med Clin (Barc) 2021; 157:388-394. [PMID: 34140166 PMCID: PMC8157124 DOI: 10.1016/j.medcli.2021.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
COVID-19 pandemic has impacted the world population, with a high rate of morbidity and mortality. While the evidence to date has attempted to describe clinical feature of acute illness, recent reports have also begun to describe persistent symptoms that extend beyond the initial period of illness. Adverse outcomes, in addition to respiratory, have been found to occur at different levels: cardiovascular, neurological, or immunological; skin, gastrointestinal or renal manifestations. The detrimental effect on mental health has also been described, not only in COVID-19 patients. The burden of disease secondary to this pandemic is likely to be enormous and not limited to acute disease alone, thus epidemiological studies are needed to further investigate the long-term impact of this disease. This review summarizes the current evidence on short-term effects and describes the possible long-term sequelae of COVID-19.
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Affiliation(s)
| | - Miguel Ángel López-Zúñiga
- Infectious Diseases Unit, Hospital Universitario Virgen de las Nieves, Granada, España,Autor para correspondencia
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158
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Najafloo R, Majidi J, Asghari A, Aleemardani M, Kamrava SK, Simorgh S, Seifalian A, Bagher Z, Seifalian AM. Mechanism of Anosmia Caused by Symptoms of COVID-19 and Emerging Treatments. ACS Chem Neurosci 2021; 12:3795-3805. [PMID: 34609841 PMCID: PMC8507153 DOI: 10.1021/acschemneuro.1c00477] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023] Open
Abstract
The occurrence of anosmia, the loss or change in sense of smell, is one of the most common symptoms of COVID-19 experienced by almost 53% of those affected. Several hypotheses explain the mechanism of anosmia in patients suffering from COVID-19. This study aims to review the related mechanisms and answer the questions regarding COVID-19-related anosmia as well as propose a new strategy for treatment of long-term anosmia as a result of COVID-19 infection. This paper covers all of the studies investigating olfactory disorders following COVID-19 infection and explains the possible reasons for the correlated anosmia, including olfactory cleft syndrome, local inflammation in the nasal epithelium, early apoptosis of olfactory cells, changes in olfactory cilia and odor transmission, damage to microglial cells, effect on olfactory bulbs, epithelial olfactory injury, and impairment of olfactory neurons and stem cells. The key questions that arise in this field have been discussed, such as why prevalent anosmia is varied among the age categories and among sexes and the correlation of anosmia with mild or severe COVID-19 infection. The angiotensin-converting enzyme 2 receptor is a significant player in the mechanism of anosmia in COVID-19 patients. Based on current studies, a novel approach to treat long-COVID-19 with ongoing anosmia has been proposed. The fields of smart drug delivery, tissue engineering, and cell therapy provide a hypothesized strategy that can minimize the side effects of current treatments and support efficient recovery of the olfactory system.
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Affiliation(s)
- Raziyeh Najafloo
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Jila Majidi
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Alimohamad Asghari
- Skull
Base Research Center, Hazrat Rasoul Akram Hospital, The Five Senses
Health Institute, Iran University of Medical
Sciences (IUMS), Tehran 1445613131, Iran
| | - Mina Aleemardani
- Biomaterials
and Tissue Engineering Group, Department of Materials Science and
Engineering, Kroto Research Institute, The
University of Sheffield, Sheffield S3 7HQ, United Kingdom
| | - Seyed Kamran Kamrava
- ENT
and Head and Neck Research Center and Department, Hazrat Rasoul Akram
Hospital, The Five Senses Health Institute, Iran University of Medical Sciences (IUMS), Tehran 1445613131, Iran
| | - Sara Simorgh
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
| | - Amelia Seifalian
- University
College London Medical School (UCL), London WC1E 6BT, United
Kingdom
- Watford
General Hospital, Watford WD18 0HB, United Kingdom
| | - Zohreh Bagher
- Department
of Tissue Engineering & Regenerative Medicine, Faculty of Advanced
Technologies in Medicine, Iran University
of Medical Sciences (IUMS), Tehran 1449614535, Iran
- ENT
and Head and Neck Research Center and Department, Hazrat Rasoul Akram
Hospital, The Five Senses Health Institute, Iran University of Medical Sciences (IUMS), Tehran 1445613131, Iran
| | - Alexander M. Seifalian
- Nanotechnology
and Regenerative Medicine Commercialisation Centre (NanoRegMed Ltd.), London BioScience Innovation Centre, London NW1 0NH, United Kingdom
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159
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Khan I, Gupta V, Shukla SK. Objective Evaluation of Olfactory and Taste Dysfunction Among COVID-19 Patients: A Cross Sectional Study from Tribal India. Indian J Otolaryngol Head Neck Surg 2021; 74:3193-3201. [PMID: 34692451 PMCID: PMC8524209 DOI: 10.1007/s12070-021-02907-z] [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: 07/29/2021] [Accepted: 10/02/2021] [Indexed: 11/01/2022] Open
Abstract
There is a varying prevalence of olfactory and taste dysfunction (OTD) in COVID-19 patients, with a higher prevalence reported in the European population as compared to the Asian population. Psychophysical tests are crucial to determine the exact frequency, extent and clinical characteristics of these OTDs. The present study objectively evaluated the OTD for patients treated in the Dedicated COVID-19 Hospital (DCH) in Shahdol. This prospective cross-sectional study was conducted after IEC approval in DCH Shahdol for a period of four months among RT-PCR positive patients, and they were evaluated using validated chemosensitive psychophysical test during ENT consultation to identify OTD. The sample size was calculated as 92 considering prevalence (p) of OTD as 41.3% by applying formula: n = (Z1-a/2)2 × p (1-p) / d 2. The information pertaining to the subjects was kept anonymous and confidential. During data analysis, an association was significant for p value < 0.05. It was observed that 45.5% of subjects reported either loss of taste or smell. During objective evaluation, olfactory and taste dysfunction was observed among 42.4% of subjects (95/224). The Chi-square analysis reflected statistically significant difference (p < 0.05) between subjects with OTD and without OTD for the variables such as days from onset of symptoms to admission, and symptoms (fever, sore throat and shortness of breath). Taste and smell are among the important senses and in India they are mostly subjectively evaluated for COVID-19 induced OTD which results in underreporting of these symptoms. So, a gold standard objective evaluation should be taken into consideration to evaluate OTD.
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Affiliation(s)
- Izhar Khan
- Department of Otorhinolaryngology, Government Medical College, Shahdol, Madhya Pradesh India
| | - Vikas Gupta
- Department of Community Medicine, Government Medical College, Shahdol, Madhya Pradesh India
| | - Sanjay Kumar Shukla
- Department of Otorhinolaryngology, Government Medical College, Shahdol, Madhya Pradesh India
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160
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.09.21264771. [PMID: 34671775 PMCID: PMC8528083 DOI: 10.1101/2021.10.09.21264771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 35.34-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
- Department of Public Health, University of California Merced, Merced, CA 95348
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
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161
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Soares LES, Guirado MMG, Berlingieri G, Ramires MCCH, Lyra LADOP, Teixeira IS, Oliveira PC, Tateno RY, Palma LF, Campos L. Intranasal photobiomodulation therapy for COVID-19-related olfactory dysfunction: A Brazilian multicenter case series. Photodiagnosis Photodyn Ther 2021; 36:102574. [PMID: 34628071 PMCID: PMC8496972 DOI: 10.1016/j.pdpdt.2021.102574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022]
Abstract
Olfactory dysfunction is commonly seen in COVID-19 patients; however, little is known about the pathophysiology and management. The present study aimed to report a series of cases in which three protocols of intranasal photobiomodulation therapy (PBMT) were used for COVID-19-related olfactory dysfunction. Irrespective of the PBMT protocol, olfaction recovery was noted in all cases but with varying degrees of improvement. Although intranasal PBMT seems to be a promising therapeutic modality, more research is needed to better define effectiveness.
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Affiliation(s)
- Luís Eduardo Silva Soares
- Graduate Program in Biomedical Engineering, University of Vale do Paraíba (UNIVAP), Research and Development Institute (IP&D). São José dos Campos, SP, Brazil; Study Group of Laser and Health Institute, São Paulo, SP, Brazil
| | - Milena Miranda Goulart Guirado
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Doutor José de Carvalho Florence Hospital, São José dos Campos, SP, Brazil
| | | | | | | | - Inessa Solek Teixeira
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Imperial Charity Hospital, Florianópolis, SC, Brazil
| | - Patrícia Costa Oliveira
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Instituto Federal do Paraná, Campus Londrina, PR, Brazil
| | - Ricardo Yudi Tateno
- Graduate Program in Implantology, University of Santo Amaro, School of Dentistry. São Paulo, SP, Brazil
| | - Luiz Felipe Palma
- Graduate Dentistry Program, Ibirapuera University. São Paulo, SP, Brazil
| | - Luana Campos
- Study Group of Laser and Health Institute, São Paulo, SP, Brazil; Graduate Program in Implantology, University of Santo Amaro, School of Dentistry. São Paulo, SP, Brazil.
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162
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Nowicka A, Jaszczak J, Szymanek Pasternak A, Simon K. Application of self-assessment triage tool in COVID-19 pandemic: descriptive study (Preprint). JMIR Hum Factors 2021; 9:e34134. [PMID: 35168192 PMCID: PMC8982648 DOI: 10.2196/34134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/30/2021] [Accepted: 02/13/2022] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 pandemic has sped up the implementation of telehealth solutions in medicine. A few symptom checkers dedicated for COVID-19 have been described, but it remains unclear whether and how they can affect patients and health systems. Objective This paper demonstrates our experiences with the COVID-19 risk assessment (CRA) tool. We tried to determine who the user of the web-based COVID-19 triage app is and compare this group with patients in the infectious diseases ward’s admission room to evaluate who could benefit from implementing the COVID-19 online symptom checker as a remote triage solution. Methods We analyzed the answers of 248,862 people interacting with an online World Health Organization–based triage tool for assessing the probability of SARS-CoV-2 infection. These users filled in an online questionnaire between April 7 and August 6, 2020. Based on the presented symptoms, risk factors, and demographics, the tool assessed whether the user’s answers were suggestive of COVID-19 and recommended appropriate action. Subsequently, we compared the sociodemographic and clinical characteristics of tool users with patients admitted to the Infectious Diseases Admission Room of J. Gromkowski Hospital in Wrocław. Results The CRA tool tended to be used by asymptomatic or oligosymptomatic individuals (171,226 [68.80%] of all users). Most users were young (162,432 [65.27%] were below 40 years of age) and without comorbidities. Only 77,645 (31.20%) of the self-assessment app users were suspected of COVID-19 based on their reported symptoms. On the contrary, most admission room patients were symptomatic—symptoms such as fever, cough, and dyspnea were prevalent in both COVID-19-positive and COVID-19-negative patients. COVID-19-suspected patients in the CRA tool group presented similar COVID-19 symptoms as those who presented to the admission room. These were cough (25,062/40,007 [62.64%] in the CRA tool group vs 138/232 [59.48%] in the admission room group), fever (23,123/40,007 [57.80%] in the CRA tool group vs 146/232 [62.93%] in the admission room group), and shortness of breath (15,157/40,007 [37.89%] in the CRA tool group vs 87/232 [37.50%] in the admission room group). Conclusions The comparison between the symptomatology of the users interacting with the CRA tool and those visiting the admission room revealed 2 major patient groups who could have benefited from the implementation of the self-assessment app in preclinical triage settings. The primary users of the CRA tool were young, oligosymptomatic individuals looking for screening for COVID-19 and reassurance early in the COVID-19 pandemic. The other group were users presenting the typical symptoms suggestive of COVID-19 at that time. The CRA tool recognized these individuals as potentially COVID-19 positive and directed them to the proper level of care. These use cases fulfil the idea of preclinical triage; however, the accuracy and influence on health care must be examined in the clinical setting.
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Affiliation(s)
- Anna Nowicka
- Provincial Specialist Hospital them. J. Gromkowski, Wrocław, Poland
- Infermedica, Wrocław, Poland
| | | | - Anna Szymanek Pasternak
- Provincial Specialist Hospital them. J. Gromkowski, Wrocław, Poland
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Simon
- Provincial Specialist Hospital them. J. Gromkowski, Wrocław, Poland
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wrocław, Poland
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von Bartheld CS, Hagen MM, Butowt R. The D614G Virus Mutation Enhances Anosmia in COVID-19 Patients: Evidence from a Systematic Review and Meta-analysis of Studies from South Asia. ACS Chem Neurosci 2021; 12:3535-3549. [PMID: 34533304 PMCID: PMC8482322 DOI: 10.1021/acschemneuro.1c00542] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 02/08/2023] Open
Abstract
The prevalence of chemosensory dysfunction in patients with COVID-19 varies greatly between populations. It is unclear whether such differences are due to factors at the level of the human host, or at the level of the coronavirus, or both. At the host level, the entry proteins which allow virus binding and entry have variants with distinct properties, and the frequency of such variants differs between ethnicities. At the level of the virus, the D614G mutation enhances virus entry to the host cell. Since the two virus strains (D614 and G614) coexisted in the first six months of the pandemic in most populations, it has been difficult to distinguish between contributions of the virus and contributions of the host for anosmia. To answer this question, we conducted a systematic review and meta-analysis of studies in South Asian populations when either the D614 or the G614 virus was dominant. We show that populations infected predominantly with the G614 virus had a much higher prevalence of anosmia (pooled prevalence of 31.8%) compared with the same ethnic populations infected mostly with the D614 virus strain (pooled anosmia prevalence of 5.3%). We conclude that the D614G mutation is a major contributing factor that increases the prevalence of anosmia in COVID-19, and that this enhanced effect on olfaction constitutes a previously unrecognized phenotype of the D614G mutation. The new virus strains that have additional mutations on the background of the D614G mutation can be expected to cause a similarly increased prevalence of chemosensory dysfunctions.
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Affiliation(s)
- Christopher S. von Bartheld
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada 89557, USA
| | - Molly M. Hagen
- School of Public Health, University of Nevada, Reno, Nevada 89557, USA
| | - Rafal Butowt
- L. Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
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Piotrowicz K, Gąsowski J, Michel JP, Veronese N. Post-COVID-19 acute sarcopenia: physiopathology and management. Aging Clin Exp Res 2021; 33:2887-2898. [PMID: 34328636 PMCID: PMC8323089 DOI: 10.1007/s40520-021-01942-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022]
Abstract
In this review, we discuss the pathophysiologic and management aspects of acute sarcopenia in relation to SARS-CoV-2 infection. COVID-19 is as a multi-organ infectious disease characterized by a severe inflammatory and highly catabolic status, influencing the deep changes in the body build, especially the amount, structure, and function of skeletal muscles which would amount to acutely developed sarcopenia. Acute sarcopenia may largely impact patients’ in-hospital prognosis as well as the vulnerability to the post-COVID-19 functional and physical deterioration. The individual outcome of the COVID-19 and the degree of muscle mass and functional loss may be influenced by multiple factors, including the patient’s general pre-infection medical and functional condition, especially in older adults. This paper gathers the information about how the SARS-CoV-2 hyper-inflammatory involvement exacerbates the immunosenescence process, enhances the endothelial damage, and due to mitochondrial dysfunction and autophagy, induces myofibrillar breakdown and muscle degradation. The aftermath of these acute and complex immunological SARS-CoV-2-related phenomena, augmented by anosmia, ageusia and altered microbiota may lead to decreased food intake and exacerbated catabolism. Moreover, the imposed physical inactivity, lock-down, quarantine or acute hospitalization with bedrest would intensify the acute sarcopenia process. All these deleterious mechanisms must be swiftly put to a check by a multidisciplinary approach including nutritional support, early physical as well cardio-pulmonary rehabilitation, and psychological support and cognitive training. The proposed holistic and early management of COVID-19 patients appears essential to minimize the disastrous functional outcomes of this disease and allow avoiding the long COVID-19 syndrome.
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Affiliation(s)
- Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, 2 Jakubowskiego St., building I, 5th floor, 30-688, Kraków, Poland.
| | | | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
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Manifestations cliniques et paracliniques de la COVID-19, diagnostic virologique. NPG NEUROLOGIE - PSYCHIATRIE - GÉRIATRIE 2021. [PMCID: PMC8188459 DOI: 10.1016/j.npg.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Des formes parfaitement asymptomatiques aux formes de COVID-19 sévères, nécessitant une prise en charge en Service de réanimation, la COVID-19 est aujourd’hui mieux décrite. Entre 30 et 50 % des patients resteront asymptomatiques et la majorité des malades symptomatiques développeront les signes d’une infection virale des voies respiratoires (fièvre, toux, asthénie). La particularité de la COVID-19 réside dans le large éventail de symptômes associés et de l’évolution, dans environ 5 % des cas, vers un syndrome de détresse respiratoire aiguë. Si l’âge demeure le facteur de risque principal de développer une forme sévère de COVID-19, il ne semble pas exister de tableau clinique spécifique au sujet âgé, pour qui l’expression de la maladie se rapproche de l’adulte jeune.
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Les facteurs pronostiques dans la Covid-19. NPG NEUROLOGIE - PSYCHIATRIE - GÉRIATRIE 2021. [PMCID: PMC8206591 DOI: 10.1016/j.npg.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Depuis la fin de l’année 2019, la France, de même que l’ensemble des pays du monde, est confrontée à une situation épidémiologique inédite : la Covid-19. Les personnes les plus vulnérables, et notamment les personnes âgées sont particulièrement touchées par cette épidémie. Bien que de nombreux patients se rétablissent complètement, plusieurs facteurs conduisent à un mauvais pronostic. Diverses études ont proposé comme objectif d’identifier les facteurs pronostiques de mortalité et d’évolution vers une maladie grave pour les patients diagnostiqués avec la Covid-19. Certains de ces facteurs pronostiques peuvent être utilisés dans la prise de décision relative à la prise en charge des patients infectés par la Covid-19.
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Quantitative but not qualitative flavor recognition impairments in COVID-19 patients. Ir J Med Sci 2021; 191:1759-1766. [PMID: 34562193 PMCID: PMC8475319 DOI: 10.1007/s11845-021-02786-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: 07/19/2021] [Accepted: 09/12/2021] [Indexed: 11/24/2022]
Abstract
Background Smell and taste dysfunctions (STDs) are symptoms associated with COVID-19 syndrome, even if their incidence is still uncertain and variable. Aims In this study, the effects of SARS-CoV-2 infection on chemosensory function have been investigated using both a self-reporting questionnaire on smell and flavor perception, and a simplified flavor test. Methods A total of 111 subjects (19 hospitalized [HOS] and 37 home-isolated [HI] COVID-19 patients, and 55 healthy controls [CTRL]) were enrolled in the study. They received a self-evaluation questionnaire and a self-administered flavor test kit. The flavor test used consists in the self-administration of four solutions with a pure olfactory stimulus (coffee), a mixed olfactory-trigeminal stimulus (peppermint), and a complex chemical mixture (banana). Results After SARS-CoV-2 infection, HOS and HI patients reported similar prevalence of STDs, with a significant reduction of both smell and flavor self-estimated perception. The aromas of the flavor test were recognized by HI and HOS COVID-19 patients similarly to CTRL; however, the intensity of the perceived aromas was significantly lower in patients compared to controls. Conclusion Data reported here suggests that a chemosensory impairment is present after SARS-CoV-2 infection, and the modified “flavor test” could be a novel self-administering objective screening test to assess STDs in COVID-19 patients. Clinical trial registration no. NCT04840966; April 12, 2021, retrospectively registered Supplementary Information The online version contains supplementary material available at 10.1007/s11845-021-02786-x.
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Fistera D, Härtl A, Pabst D, Manegold R, Holzner C, Taube C, Dolff S, Schaarschmidt BM, Umutlu L, Kill C, Risse J. What about the others: differential diagnosis of COVID-19 in a German emergency department. BMC Infect Dis 2021; 21:969. [PMID: 34535095 PMCID: PMC8446739 DOI: 10.1186/s12879-021-06663-x] [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: 11/13/2020] [Accepted: 09/07/2021] [Indexed: 12/18/2022] Open
Abstract
Background The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections. Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.
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Affiliation(s)
- David Fistera
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,Department of Pulmonary Medicine, University Medicine Essen - Ruhrlandklinik, Essen, Germany.
| | - Annalena Härtl
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Dirk Pabst
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Randi Manegold
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Carola Holzner
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Medicine Essen - Ruhrlandklinik, Essen, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, West German Center of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Clemens Kill
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Joachim Risse
- Center of Emergency Medicine, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany
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SARS-CoV-2 rapid antigen testing in the healthcare sector: A clinical prediction model for identifying false negative results. Int J Infect Dis 2021; 112:117-123. [PMID: 34517045 PMCID: PMC8431843 DOI: 10.1016/j.ijid.2021.09.008] [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: 07/19/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives SARS-CoV-2 rapid antigen tests (RAT) provide fast identification of infectious patients when RT-PCR results are not immediately available. We aimed to develop a prediction model for identification of false negative (FN) RAT results. Methods In this multicenter trial, patients with documented paired results of RAT and RT-PCR between October 1st 2020 and January 31st 2021 were retrospectively analyzed regarding clinical findings. Variables included demographics, laboratory values and specific symptoms. Three different models were evaluated using Bayesian logistic regression. Results The initial dataset contained 4,076 patients. Overall sensitivity and specificity of RAT was 62.3% and 97.6%. 2,997 cases with negative RAT results (FN: 120; true negative: 2,877; reference: RT-PCR) underwent further evaluation after removal of cases with missing data. The best-performing model for predicting FN RAT results containing 10 variables yielded an area under the curve of 0.971. Sensitivity, specificity, PPV and NPV for 0.09 as cut-off value (probability for FN RAT) were 0.85, 0.99, 0.7 and 0.99. Conclusion FN RAT results can be accurately identified through ten routinely available variables. Implementation of a prediction model in addition to RAT testing in clinical care can provide decision guidance for initiating appropriate hygiene measures and therefore helps avoiding nosocomial infections.
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170
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Montero-Moraga JM, Buron A, Sala M, Santia P, Lupia M, Beltrán A, Villar R, Horcajada JP, Castells X, Gil OD, León EP, Serra C. Impact and Management of COVID-19 Among Healthcare Workers in Two Acute Care Hospitals and Two Associated Long-term Care Centres in Barcelona, Spain. J Occup Environ Med 2021; 63:e586-e591. [PMID: 34491967 DOI: 10.1097/jom.0000000000002290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To describe the characteristics of COVID-19-related episodes in healthcare workers (HCW) of two hospitals. METHODS Prospective study of HCW with COVID-like symptoms and/or who were close contacts of confirmed COVID-19. The percentage of positive PCRs among those with symptoms was calculated, and symptom's positive predictive value and negative predictive value. The characteristics of contacts were described, as well as the secondary clinical attack rate. RESULTS We registered 1222 episodes of HCW with COVID-like symptoms; 340 (27.8%) had a positive PCR. In 885 episodes, a HCW was a close contact of a confirmed case. In 45.5% of these, the HCW had contact with another HCW. The secondary clinical attack rate of contacts of HCW was 14.5%. CONCLUSION We found a high prevalence of disease and transmission between HCW during the first wave of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Jose Maria Montero-Moraga
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim 25-29, Barcelona 08003, Spain (Dr Montero-Moraga, Dr Buron, Dr Sala, Santia, and Dr Castells); Preventive Medicine and Public Health Training Unit PSMar-ASPB-UPF, Passeig Marítim 25-29, Barcelona 08003, Spain (Dr Montero-Moraga and Santia); Research Network on Health Services in Chronic Diseases (REDISSEC), Barcelona, Spain (Dr Buron, Dr Sala, and Dr Castells); Occupational Health Service, Parc de Salut Mar, Passeig Marítim 25-29, Barcelona 08003, Spain (Lupia, Beltrán, Villar, and Serra); Centre for Research in Occupational Health (CiSAL), IMIM-Hospital del Mar Medical Research Institute/Pompeu Fabra University, Barcelona, Spain (Lupia, Beltrán, Villar, and Serra); CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain (Villar and Serra); Department of Infectious Diseases, Hospital del Mar, Barcelona, Spain (Horcajada); Department of Microbiology, Laboratorio de Referencia de Catalunya, Hospital del Mar, Barcelona, Spain (Gil and León)
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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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172
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Goyal R, Kapoor A, Goyal MK, Singh R. Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India. Indian J Otolaryngol Head Neck Surg 2021; 73:371-377. [PMID: 34123736 PMCID: PMC8185497 DOI: 10.1007/s12070-021-02670-1] [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: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September-November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.
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Affiliation(s)
- Rashmi Goyal
- Department of ENT, Jaipuria Hospital, RUHS-CMS, Jaipur, Rajasthan India
| | - Anju Kapoor
- Department of Paediatrics, Peoples College of Medical Sciences, Bhopal, MP India
| | | | - Rekha Singh
- RDBP Jaipuria Hospital, Jaipur, Rajasthan India
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Parente-Arias P, Barreira-Fernandez P, Quintana-Sanjuas A, Patiño-Castiñeira B. Recovery rate and factors associated with smell and taste disruption in patients with coronavirus disease 2019. Am J Otolaryngol 2021; 42:102648. [PMID: 33799139 PMCID: PMC7358151 DOI: 10.1016/j.amjoto.2020.102648] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 01/05/2023]
Abstract
Purpose To determine the occurrence of olfactory and gustatory disruptions in COVID-19 patients, their association with demographic and clinical features and prognosis. Material and methods This observational cohort study involved consecutively diagnosed COVID-19 patients tested between March the 3rd 2020 and March the 24th 2020, in a geographically defined cohort area. All COVID-19 patients were evaluated in a University Hospital. The primary outcome of interest is the prevalence of smell and taste alterations, factors associated and recovery rate. Univariate and multivariate analysis by logistic regression was performed to detect factors associated to these symptoms. Results 151 patients were included and 99 (65.6%) reported olfactory or gustatory symptoms. Olfactory dysfunction was reported by 75 patients (49.7%). Isolated anosmia was found in 2 patients (1.3%). Gustatory dysfunction was reported by 91 patients (60.3%). Factors associated with higher prevalence of smell dysfunction included age, sex, and comorbidities. The time to smell disruption development was significantly shorter in mild to moderate patients than in severe patients (p = 0.043). In 85.3% of patients with smell disruption, the symptom had been resolved in the first 2 months. 14.7% of patients remained symptomatic after 3 months of follow-up. Conclusions Olfactory and gustatory dysfunction was common in COVID-19 patients. Smell disruption has high recovery rate and was associated with age, sex, and clinical severity. It may be beneficial to investigate the appearance of taste and/or smell disruptions in individual patients, with respect to diagnosis and prognosis.
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174
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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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Jiang DH, Roy DJ, Gu BJ, Hassett LC, McCoy RG. Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A State-of-the-Art Review. JACC Basic Transl Sci 2021; 6:796-811. [PMID: 34541421 PMCID: PMC8442719 DOI: 10.1016/j.jacbts.2021.07.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/22/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023]
Abstract
The vast majority of patients (>99%) with severe acute respiratory syndrome coronavirus 2 survive immediate infection but remain at risk for persistent and/or delayed multisystem. This review of published reports through May 31, 2021, found that manifestations of postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) affect between 33% and 98% of coronavirus disease 2019 survivors and comprise a wide range of symptoms and complications in the pulmonary, cardiovascular, neurologic, psychiatric, gastrointestinal, renal, endocrine, and musculoskeletal systems in both adult and pediatric populations. Additional complications are likely to emerge and be identified over time. Although data on PASC risk factors and vulnerable populations are scarce, evidence points to a disproportionate impact on racial/ethnic minorities, older patients, patients with preexisting conditions, and rural residents. Concerted efforts by researchers, health systems, public health agencies, payers, and governments are urgently needed to better understand and mitigate the long-term effects of PASC on individual and population health.
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Affiliation(s)
- David H. Jiang
- Division of Health Care Delivery and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Darius J. Roy
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Brett J. Gu
- School of Medicine, Yale University; New Haven, Connecticut, USA
| | | | - Rozalina G. McCoy
- Division of Health Care Delivery and Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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176
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Shams Vahdati S, Ala A, Rahmanpour D, Sadeghi-Hokmabadi E, Tahmasbi F. Neurological manifestations of COVID-19 infection: an umbrella review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021; 57:113. [PMID: 34483649 PMCID: PMC8401342 DOI: 10.1186/s41983-021-00366-5] [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: 06/09/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Neurological involvements of COVID-19 are one of the most reported manifestations of this infection. This study aims to systematically review the previous systematic reviews which addressed the neurological manifestations of the COVID-19 infection. METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science databases and Google Scholar from December 2019 to December 2020. Articles were critically screened by two independent reviewers and if met the inclusion criteria, entered the study. Assessment of methodological quality was conducted by Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. Statistical analysis was not applicable. From a total of 1302 studies, 308 studies were removed due to their irrelevant title and abstract. After screening the full texts, a total of 66 found to be eligible. Twenty-one studies reported general manifestations of the COVID-19, 13 studies reported cerebrovascular events, 19 olfactory and oral dysfunctions, 5 systematic reviews on Guillen-Barré syndrome (GBS) and 8 articles on the sporadic manifestations like ocular signs and symptoms. The majority of the studies were classified as critically low or low in terms of quality. CONCLUSION Despite great heterogeneity in the current literature, neurological involvements are an important extra-pulmonary aspect of the COVID-19; most commonly in the form of general manifestations like headache and olfactory disturbances. Long-term effects of this virus on the nervous system must be a research priority for future references. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s41983-021-00366-5.
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Affiliation(s)
- Samad Shams Vahdati
- Emergency Medicine Research Team, Emergency Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ala
- Emergency Medicine Research Team, Emergency Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dara Rahmanpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elyar Sadeghi-Hokmabadi
- Neurosciences Research Center, Neurology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fateme Tahmasbi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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177
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Chu CF, Sabath F, Fibi-Smetana S, Sun S, Öllinger R, Noeßner E, Chao YY, Rinke L, Winheim E, Rad R, Krug AB, Taher L, Zielinski CE. Convalescent COVID-19 Patients Without Comorbidities Display Similar Immunophenotypes Over Time Despite Divergent Disease Severities. Front Immunol 2021; 12:601080. [PMID: 34867933 PMCID: PMC8634761 DOI: 10.3389/fimmu.2021.601080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 07/23/2021] [Indexed: 01/12/2023] Open
Abstract
COVID-19, the disease caused by SARS-CoV-2 infection, can assume a highly variable disease course, ranging from asymptomatic infection, which constitutes the majority of cases, to severe respiratory failure. This implies a diverse host immune response to SARS-CoV-2. However, the immunological underpinnings underlying these divergent disease courses remain elusive. We therefore set out to longitudinally characterize immune signatures of convalescent COVID-19 patients stratified according to their disease severity. Our unique convalescent COVID-19 cohort consists of 74 patients not confounded by comorbidities. This is the first study of which we are aware that excludes immune abrogations associated with non-SARS-CoV-2 related risk factors of disease severity. Patients were followed up and analyzed longitudinally (2, 4 and 6 weeks after infection) by high-dimensional flow cytometric profiling of peripheral blood mononuclear cells (PBMCs), in-depth serum analytics, and transcriptomics. Immune phenotypes were correlated to disease severity. Convalescence was overall associated with uniform immune signatures, but distinct immune signatures for mildly versus severely affected patients were detectable within a 2-week time window after infection.
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Affiliation(s)
- Chang-Feng Chu
- Institute of Virology, Technical University of Munich, Munich, Germany
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
- Infection Immunology, Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll-Institute, Friedrich Schiller University, Jena, Germany
| | - Florian Sabath
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Silvia Fibi-Smetana
- Institute of Biomedical Informatics, Graz University of Technology, Graz, Austria
| | - Shan Sun
- Institute of Virology, Technical University of Munich, Munich, Germany
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Rupert Öllinger
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Elfriede Noeßner
- Immunoanalytics-Tissue Control of Immunocytes, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Ying-Yin Chao
- Institute of Virology, Technical University of Munich, Munich, Germany
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Linus Rinke
- Institute for Immunology, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians-University Munich, Planegg-Martinsried, Germany
| | - Elena Winheim
- Institute for Immunology, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians-University Munich, Planegg-Martinsried, Germany
| | - Roland Rad
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Anne B. Krug
- Institute for Immunology, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians-University Munich, Planegg-Martinsried, Germany
| | - Leila Taher
- Institute of Biomedical Informatics, Graz University of Technology, Graz, Austria
| | - Christina E. Zielinski
- Institute of Virology, Technical University of Munich, Munich, Germany
- Central Institute for Translational Cancer Research (TranslaTUM), Technical University of Munich, Munich, Germany
- Infection Immunology, Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll-Institute, Friedrich Schiller University, Jena, Germany
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178
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Yan Q, Qiu D, Liu X, Guo X, Hu Y. Prevalence of Smell or Taste Dysfunction Among Children With COVID-19 Infection: A Systematic Review and Meta-Analysis. Front Pediatr 2021; 9:686600. [PMID: 34414141 PMCID: PMC8369032 DOI: 10.3389/fped.2021.686600] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Smell and taste dysfunctions are common and have been reported as an early indicator of COVID-19. The prevalence of smell and taste dysfunctions among children with COVID-19 varies greatly across studies, which remains to be summarized quantitatively. This review aimed at examining the pooled prevalence of smell or taste dysfunctions among children with COVID-19, summarizing possible causes of the inconsistencies in the current estimates. Methods: Systematic searches of databases were conducted for literature published until 12 January 2021. Statistical analyses were performed using R software, the pooled prevalence was combined using random effects model. The Loney criteria were used for quality assessment. Results: A total of 18 eligible studies were included. The results showed that the pooled prevalence of smell dysfunction among children with COVID-19 was 15.97% (95% CI: 8.18-23.77%), the pooled prevalence of taste dysfunction among children with COVID-19 was 9.20% (95% CI: 4.25-14.16%), the pooled prevalence of smell or taste dysfunction among children with COVID-19 was 15.50% (95% CI: 10.30-20.70%) and the pooled prevalence of smell and taste dysfunction among children with COVID-19 was 20.21% (95% CI: 14.14-26.28%). Higher smell or taste dysfunction rates were associated with being female, younger age, smaller sample size, patients in Asia, and with comorbidities. Conclusions: Evidence suggests that smell or taste dysfunctions were common among children with COVID-19. Further research is needed to identify effective strategies for preventing and treating smell and taste dysfunctions among children with COVID-19.
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Affiliation(s)
- Qingzi Yan
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiang Liu
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Xiaolan Guo
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Yixiang Hu
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
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179
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Das S, Sarkar S, Das A, Das S, Chakraborty P, Sarkar J. A comprehensive review of various categories of face masks resistant to Covid-19. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100835. [PMID: 34368502 PMCID: PMC8326209 DOI: 10.1016/j.cegh.2021.100835] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/28/2021] [Accepted: 07/21/2021] [Indexed: 12/26/2022] Open
Abstract
The science about the usage of face masks by the common public to avert COVID-19 transmission is proceeding swiftly. A primary route of transmission of COVID-19 is probably through small respiratory droplets, and it is transmissible from asymptomatic and pre-symptomatic individuals. According to the World Health Organization, wearing a mask in public can help reduce the transmission of the COVID-19 virus. Different categories and types of masks and their usage are reviewed in this work. In a nutshell, this review work elucidates the aspects of utilizing the various face masks along with all possibilities to fight against the ongoing pandemic of COVID-19.
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Affiliation(s)
- Sonali Das
- Department of Botany, Dinabandhu Andrews College, 54, Raja S.C. Mallick Road, Garia, Kolkata, West Bengal, 700084, India
| | - Sagarika Sarkar
- Department of Botany, Sarojini Naidu College for Women, 30, Jessore Rd, K.B.Sarani, Golpark, Kolkata, West Bengal, 700028, India
| | - Anusree Das
- Department of Botany, Dinabandhu Andrews College, 54, Raja S.C. Mallick Road, Garia, Kolkata, West Bengal, 700084, India
| | - Shreyosree Das
- Department of Botany, Dinabandhu Andrews College, 54, Raja S.C. Mallick Road, Garia, Kolkata, West Bengal, 700084, India
| | - Pallab Chakraborty
- Department of Botany, Acharya Prafulla Chandra College, New Barrakpur, Kolkata, West Bengal, 700131, India
| | - Joy Sarkar
- Department of Botany, Dinabandhu Andrews College, 54, Raja S.C. Mallick Road, Garia, Kolkata, West Bengal, 700084, India
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180
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Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [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: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
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Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
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181
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Zhou Q, Rao Q, Li H, Zhang M, Zhao X, Shi L, Ye C, Zhou X. Evaluation of injuries caused by coronavirus disease 2019 using multi-nuclei magnetic resonance imaging. MAGNETIC RESONANCE LETTERS 2021; 1:2-10. [PMID: 35673615 PMCID: PMC8349427 DOI: 10.1016/j.mrl.2021.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/06/2021] [Accepted: 07/19/2021] [Indexed: 01/08/2023]
Abstract
The ongoing pandemic of coronavirus disease 2019 (COVID-19) has been a great burden for the healthcare system in many countries because of its high transmissibility, severity, and fatality. Chest radiography and computed tomography (CT) play a vital role in the diagnosis, detection of complications, and prognostication of COVID-19. Additionally, magnetic resonance imaging (MRI), especially multi-nuclei MRI, is another important imaging technique for disease diagnosis because of its good soft tissue contrast and the ability to conduct structural and functional imaging, which has also been used to evaluate COVID-19-related organ injuries in previous studies. Herein, we briefly reviewed the recent research on multi-nuclei MRI for evaluating injuries caused by COVID-19 and the clinical 1H MRI techniques and their applications for assessing injuries in lungs, brain, and heart. Moreover, the emerging hyperpolarized 129Xe gas MRI and its applications in the evaluation of pulmonary structures and functional abnormalities caused by COVID-19 were also reviewed.
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Affiliation(s)
- Qian Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qiuchen Rao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
| | - Haidong Li
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ming Zhang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiuchao Zhao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lei Shi
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chaohui Ye
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xin Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
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182
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Cronkhite-Canada Syndrome: A Rare COVID-19 Mimicker. Am J Gastroenterol 2021; 116:1765. [PMID: 33811201 DOI: 10.14309/ajg.0000000000001254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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183
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Kim DH, Kim SW, Stybayeva G, Lim SY, Hwang SH. Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis. Clin Exp Otorhinolaryngol 2021; 14:312-320. [PMID: 33541033 PMCID: PMC8373831 DOI: 10.21053/ceo.2020.02369] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease. METHODS Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2). RESULTS Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43-12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47-0.66) but moderate negative (0.78; 95% CI, 0.69-0.85] and positive (0.78; 95% CI, 0.66-0.87) predictive values and a high specificity (0.91; 95% CI, 0.83-0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms. CONCLUSION Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - So Yun Lim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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184
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Purja S, Shin H, Lee JY, Kim E. Is loss of smell an early predictor of COVID-19 severity: a systematic review and meta-analysis. Arch Pharm Res 2021; 44:725-740. [PMID: 34302637 PMCID: PMC8302975 DOI: 10.1007/s12272-021-01344-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/17/2021] [Indexed: 12/13/2022]
Abstract
Anecdotal evidence suggests that the severity of coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is likely to be distinguished by variations in loss of smell (LOS). Thus, we conducted a meta-analysis of 45 articles that include a total of 42,120 COVID-19 patients from 17 different countries to demonstrate that severely ill or hospitalized COVID-19 patients have a lesser chance of experiencing LOS than non-severely ill or non-hospitalized COVID-19 patients (odds ratio = 0.527 [95% CI 0.373–0.744; p < 0.001] and 0.283 [95% CI 0.173–0.462; p < 0.001], respectively). We also proposed a possible mechanism underlying the association of COVID-19 severity with anosmia, which may explain why patients without sense of smell develop severe COVID-19. Variations in LOS according to the severity of COVID-19 is a global phenomenon, with few exceptions. Since severely ill patients have a lower rate of anosmia, patients without anosmia should be monitored more closely in the early stages of COVID-19, for early diagnosis of severity of illness. An understanding of how the severity of COVID-19 infection and LOS are associated has profound implications for the clinical management and mitigation strategies for the disease.
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Affiliation(s)
- Sujata Purja
- Evidence-Based Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Hocheol Shin
- Evidence-Based Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Ji-Yun Lee
- Pathophysiology Laboratory, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - EunYoung Kim
- Evidence-Based Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
- Clinical Research Laboratory College of Pharmacy, Division of Licensing of Medicines and Regulatory Science, The Graduate School of Pharmaceutical Management, Chung-Ang University, Seoul, Republic of Korea.
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Performance of Three SARS-CoV-2 Immunoassays, Three Rapid Lateral Flow Tests, and a Novel Bead-Based Affinity Surrogate Test for the Detection of SARS-CoV-2 Antibodies in Human Serum. J Clin Microbiol 2021; 59:e0031921. [PMID: 33962959 DOI: 10.1128/jcm.00319-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
For the control of immunity in COVID-19 survivors and vaccinated subjects, there is an urgent need for reliable and rapid serological assays. Based on samples from 63 COVID-19 survivors up to 7 months after symptom onset, and on 50 serum samples taken before the beginning of the pandemic, we compared the performances of three commercial immunoassays for the detection of SARS-CoV-2 IgA and IgG antibodies (Euroimmun SARS-COV-2 IgA/IgG, Mikrogen recomWell SARS-CoV-2 IgA/IgG, and Serion ELISA agile SARS-CoV-2 IgA/IgG) and three rapid lateral flow (immunochromatographic) tests (Abbott PanBio COVID-19 IgG/IgM, Nadal COVID-19 IgG/IgM, and Cleartest Corona 2019-nCOV IgG/IgM) with a 50% plaque-reduction neutralization test (PRNT50) representing the gold standard. Fifty-seven out of 63 PCR-confirmed COVID-19 patients (90%) showed neutralizing antibodies. The sensitivity of the seven assays ranged from 7.0% to 98.3%, and the specificity ranged from 86.0% to 100.0%. Only one commercial immunoassay showed a sensitivity and specificity of greater than 98%.
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186
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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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187
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Iftikhar A, Islam M, Shepherd S, Jones S, Ellis I. Is RAS the Link Between COVID-19 and Increased Stress in Head and Neck Cancer Patients? Front Cell Dev Biol 2021; 9:714999. [PMID: 34336866 PMCID: PMC8320172 DOI: 10.3389/fcell.2021.714999] [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: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
The COVID-19 pandemic emerged as a largely unexplained outbreak of pneumonia cases, in Wuhan City, China and rapidly spread across the world. By 11th March 2020, WHO declared it as a global pandemic. The resulting restrictions, to contain its spread, demanded a momentous change in the lifestyle of the general population as well as cancer patients. This augmented negative effects on the mental health of patients with head and neck cancer (HNC), who already battle with the stress of cancer diagnosis and treatment. The causative agent of COVID-19, SARS-CoV2, gains entry through the Angiotensin converting enzyme 2 (ACE2) receptor, which is a component of the Renin Angiotensin System (RAS). RAS has been shown to influence cancer and stress such that it can have progressive and suppressive effects on both. This review provides an overview of SARS-CoV2, looks at how the RAS provides a mechanistic link between stress, cancer and COVID-19 and the probable activation of the RAS axis that increase stress (anxiogenic) and tumor progression (tumorigenic), when ACE2 is hijacked by SARS-CoV2. The mental health crises brought about by this pandemic have been highlighted in many studies. The emerging links between cancer and stress make it more important than ever before to assess the stress burden of cancer patients and expand the strategies for its management.
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Affiliation(s)
| | | | | | | | - Ian Ellis
- Unit of Cell and Molecular Biology, The Dental School, University of Dundee, Dundee, United Kingdom
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Monárrez-Espino J, Zubía-Nevárez CI, Reyes-Silva L, Castillo-Palencia JP, Castañeda-Delgado JE, Herrera van-Oostdam AS, López-Hernández Y. Clinical Factors Associated with COVID-19 Severity in Mexican Patients: Cross-Sectional Analysis from a Multicentric Hospital Study. Healthcare (Basel) 2021; 9:healthcare9070895. [PMID: 34356272 PMCID: PMC8307927 DOI: 10.3390/healthcare9070895] [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: 06/02/2021] [Revised: 06/16/2021] [Accepted: 06/23/2021] [Indexed: 12/20/2022] Open
Abstract
(1) Background: Latin America has been harshly hit by SARS-CoV-2, but reporting from this region is still incomplete. This study aimed at identifying and comparing clinical characteristics of patients with COVID-19 at different stages of disease severity. (2) Methods: Cross-sectional multicentric study. Individuals with nasopharyngeal PCR were categorized into four groups: (1) negative, (2) positive, not hospitalized, (3) positive, hospitalized with/without supplementary oxygen, and (4) positive, intubated. Clinical and laboratory data were compared, using group 1 as the reference. Multivariate multinomial logistic regression was used to compare adjusted odds ratios. (3) Results: Nine variables remained in the model, explaining 76% of the variability. Men had increased odds, from 1.90 (95%CI 0.87–4.15) in the comparison of 2 vs. 1, to 3.66 (1.12–11.9) in 4 vs. 1. Diabetes and obesity were strong predictors. For diabetes, the odds for groups 2, 3, and 4 were 1.56 (0.29–8.16), 12.8 (2.50–65.8), and 16.1 (2.87–90.2); for obesity, these were 0.79 (0.31–2.05), 3.38 (1.04–10.9), and 4.10 (1.16–14.4), respectively. Fever, myalgia/arthralgia, cough, dyspnea, and neutrophilia were associated with the more severe COVID-19 group. Anosmia/dysgeusia were more likely to occur in group 2 (25.5; 2.51–259). (4) Conclusion: The results point to relevant differences in clinical and laboratory features of COVID-19 by level of severity that can be used in medical practice.
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Affiliation(s)
- Joel Monárrez-Espino
- Department of Health Research, Christus Muguerza del Parque Hospital, Chihuahua 31000, Mexico;
- Vice Presidency of Health Sciences, Medical Specialties Program, University of Monterrey, San Pedro Garza García 66238, Mexico;
- Correspondence: (J.M.-E.); (Y.L.-H.); Tel.: +52-614-4397-932 (J.M.-E.)
| | - Carolina Ivette Zubía-Nevárez
- Vice Presidency of Health Sciences, Medical Specialties Program, University of Monterrey, San Pedro Garza García 66238, Mexico;
| | - Lorena Reyes-Silva
- Department of Health Research, Christus Muguerza del Parque Hospital, Chihuahua 31000, Mexico;
| | - Juan Pablo Castillo-Palencia
- General Hospital of Soledad de Graciano Sánchez, San Luis Potosí Health Services, Soledad de Graciano Sánchez 78435, Mexico;
| | | | | | - Yamilé López-Hernández
- Metabolomics and Proteomics Laboratory, Mexican Council of Science and Technology, Zacatecas Autonomous University, Zacatecas 98000, Mexico
- Correspondence: (J.M.-E.); (Y.L.-H.); Tel.: +52-614-4397-932 (J.M.-E.)
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Quilliot D, Gérard M, Bonsack O, Malgras A, Vaillant MF, Di Patrizio P, Jaussaud R, Ziegler O, Nguyen-Thi PL. Impact of severe SARS-CoV-2 infection on nutritional status and subjective functional loss in a prospective cohort of COVID-19 survivors. BMJ Open 2021; 11:e048948. [PMID: 34261689 PMCID: PMC8282420 DOI: 10.1136/bmjopen-2021-048948] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED The nutritional sequelae of COVID-19 have not been explored in a large cohort study. OBJECTIVES To identify factors associated with the change in nutritional status between discharge and 30 days post-discharge (D30). Secondary objectives were to determine the prevalence of subjective functional loss and severe disability at D30 and their associated factors. METHODS Collected data included symptoms, nutritional status, self-evaluation of food intake, Performance Status (PS) Scale, Asthenia Scale, self-evaluation of strength (SES) for arms and legs at discharge and at D30. An SES <7 was used to determine subjective functional loss. A composite criteria for severe disability was elaborated combining malnutrition, subjective functional loss and PS >2. Patients were classified into three groups according to change in nutritional status between discharge and D30 (persistent malnutrition, correction of malnutrition and the absence of malnutrition). RESULTS Of 549 consecutive patients hospitalised for COVID-19 between 1 March and 29 April 2020, 130 died including 17 after discharge (23.7%). At D30, 312 patients were at home, 288 (92.3%) of whom were interviewed. Of the latter, 33.3% were malnourished at discharge and still malnourished at D30, while 23.2% were malnourished at discharge but no longer malnourished at D30. The highest predictive factors of persistent malnutrition were intensive care unit (ICU) stay (OR=3.42, 95% CI: 2.04 to 5.75), subjective functional loss at discharge (OR=3.26, 95% CI: 1.75 to 6.08) and male sex (OR=2.39, 95% CI: 1.44 to 3.97). Subjective functional loss at discharge (76.8%) was the main predictive factor of subjective functional loss at D30 (26.3%) (OR=32.6, 95% CI: 4.36 to 244.0). Lastly, 8.3% had a severe disability, with a higher risk in patients requiring an ICU stay (OR=3.39, 95% CI: 1.43 to 8.06). CONCLUSION Patients who survived a severe form of COVID-19 had a high risk of persistent malnutrition, functional loss and severe disability at D30. We believe that nutritional support and rehabilitation should be strengthened, particularly for male patients who were admitted in ICU and had subjective functional loss at discharge. TRIAL REGISTRATION NUMBER NCT04451694.
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Affiliation(s)
- Didier Quilliot
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Marine Gérard
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Olivier Bonsack
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | - Aurélie Malgras
- Unité Transversale de Nutrition, CHRU de Nancy, Nancy, France
| | | | | | - Roland Jaussaud
- Internal Medicine and Clinical Immunology Department, CHRU de Nancy, Nancy, France
| | - Olivier Ziegler
- Endocrinology Diabetology and Nutrition Department, CHRU de Nancy, Nancy, France
| | - Phi-Linh Nguyen-Thi
- Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, CHRU de Nancy, Nancy, France
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Chee J, Loh WS, Liu Z, Mullol J, Wang DY. Clinical-Pathological Correlation of the Pathophysiology and Mechanism of Action of COVID-19 - a Primer for Clinicians. Curr Allergy Asthma Rep 2021; 21:38. [PMID: 34259961 PMCID: PMC8277568 DOI: 10.1007/s11882-021-01015-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Increasing knowledge of the pathogenesis of the SARS-CoV-2 infection and the complex interaction between host and viral factors have allowed clinicians to stratify the severity of COVID-19 infection. Epidemiological data has also helped to model viral carriage and infectivity. This review presents a comprehensive summary of the pathophysiology of COVID-19, the mechanisms of action of the SARS-CoV-2 virus, and the correlation with the clinical and biochemical characteristics of the disease. RECENT FINDINGS ACE2 and TMPRSS2 receptors have emerged as a key player in the mechanism of infection of SARS-CoV-2. Their distribution throughout the body has been shown to impact the organ-specific manifestations of COVID-19. The immune-evasive and subsequently immunoregulative properties of SARS-CoV-2 are also shown to be implicated in disease proliferation and progression. Information gleaned from the virological properties of SARS-CoV-2 is consistent with and reflects the clinical behavior of the COVID-19 infection. Further study of specific clinical phenotypes and severity classes of COVID-19 may assist in the development of targeted therapeutics to halt progression of disease from mild to moderate-severe. As the understanding of the pathophysiology and mechanism of action of SARS-CoV-2 continues to grow, it is our hope that better and more effective treatment options continue to emerge.
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Affiliation(s)
- Jeremy Chee
- Department of Otolaryngology, Head & Neck Surgery, National University Health System, Singapore, Singapore
| | - Woei Shyang Loh
- Department of Otolaryngology, Head & Neck Surgery, National University Health System, Singapore, Singapore
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Catalonia, Spain
| | - De Yun Wang
- Department of Otolaryngology, Head & Neck Surgery, National University Health System, Singapore, Singapore.
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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191
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Vitiello A, Ferrara F. Plausible Positive Effects of Statins in COVID-19 Patient. Cardiovasc Toxicol 2021; 21:781-789. [PMID: 34255300 PMCID: PMC8275916 DOI: 10.1007/s12012-021-09674-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023]
Abstract
Since the onset of the global COVID-19 pandemic, there has been much discussion about the advantages and disadvantages of ongoing chronic drug therapies in SARS-CoV-2-positive patients. These discussions include also statins treatment. The statins are among the most widely used drugs in the global population. Statins aim to lower cholesterol, which is essential for many biological processes but can lead to heart disease if levels are too high; however, also the pleiotropic effects of statins are well known. So could the anti-inflammatory or the potential antiviral effects of statins be helpful in avoiding extreme inflammation and severity in COVID-19? To date, there are conflicting opinions on the effects of statins in the course of COVID-19 infection. The aim of this article is to describe the molecular and pharmacological basis of the pleiotropic effects of statins that could be more involved in the fight against COVID-19 infection and to investigate the current epidemiological evidence in the literature on the current and important topic.
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Affiliation(s)
- Antonio Vitiello
- Clinical Pharmacologist, Pharmaceutical Department, Usl Umbria 1, A.Migliorati street, 06132, Perugia, Italy
| | - Francesco Ferrara
- Hospital Pharmacist Manager, Pharmaceutical Department, Usl Umbria 1, A.Migliorati street, 06132, Perugia, Italy.
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192
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Cirillo N. Taste alteration in COVID-19: Significant geographical differences exist in the prevalence of the symptom. J Infect Public Health 2021; 14:1099-1105. [PMID: 34274859 PMCID: PMC8266516 DOI: 10.1016/j.jiph.2021.07.002] [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: 01/25/2021] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 01/08/2023] Open
Abstract
Early detection of COVID-19 is important for reduction in the spread of the disease and gustatory disturbances (GD) are known to have a strong predictive value. In the present study, we aimed to map the geographical differences in the prevalence of GD in individuals infected with SARS-CoV-2 during the first wave of COVID-19 in order to improve case identification and to facilitate prioritization. We undertook a rapid scoping review of articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) and medRxiv from their inception until 3rd September, 2020. The minimum requirements for completing a restricted systematic review were fulfilled. Of the 431 articles retrieved, 61 studies (28,374 cases confirmed with COVID-19) from 20 countries were included in the analysis. GD were most prevalent in the Americas [66.78%, 95% CI 54.77–78.79%] compared to Europe [57.18%, 95% CI 52.35–62.01%], the Middle East [38.83%, 95% CI 27.47–50.19%] and East Asia [13.1%, 95% CI 0.14–26.06%]. No differences of GD prevalence were evident between February and August 2020. The data demonstrate that there is a marked geographical distribution of GD in COVID-19 patients which, possibly, might be explained by differences in diagnostic criteria for COVID-19 case definition during the early phase of the pandemic.
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Affiliation(s)
- Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, 720 Swanson Street, 3053 Carlton, Victoria, Australia.
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193
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Factors preventing SARS-CoV-2 transmission during unintentional exposure in a GP practice: a cohort study of patient contacts; Germany, 2020. Epidemiol Infect 2021; 149:e161. [PMID: 34210375 PMCID: PMC8296026 DOI: 10.1017/s0950268821001503] [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] [Indexed: 01/07/2023] Open
Abstract
Two general practitioners (GPs) with SARS-CoV-2 infection provided in-person patient care to patients of their joint medical practice before and after symptom onset, up until SARS-CoV-2 laboratory confirmation. Through active contact tracing, the local public health authorities recruited the cohort of patients that had contact with either GP in their putative infectious period. In this cohort of patient contacts, we assess the frequency and determinants of SARS-CoV-2-transmission from GPs to patients. We calculated incidence rate ratios (IRR) to explore the type of contact as an explanatory variable for COVID-19 cases. Among the cohort of 83 patient contacts, we identified 22 (27%) COVID-19 cases including 17 (21%) possible, three (4%) probable and two (2%) confirmed cases. All 22 cases had contact with a GP when the GP did not wear a mask, and/or when contact was ≥10 min. Importantly, patients who had contact <10 min with a GP wearing a facemask were at reduced risk (IRR 0.21; 95% CI 0.01–0.99) of COVID-19. This outbreak investigation adds to the body of evidence in supporting current guidelines on measures at preventing the transmission of SARS-CoV-2 in an outpatient setting.
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194
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Siddiqui M, Gültekingil A, Bakırcı O, Uslu N, Baskın E. Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study. Clin Exp Pediatr 2021; 64:364-369. [PMID: 34015895 PMCID: PMC8255514 DOI: 10.3345/cep.2021.00066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. PURPOSE This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. METHODS This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. RESULTS COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P= 0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). CONCLUSION In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.
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Affiliation(s)
- Meraj Siddiqui
- Department of Pediatrics, Baskent University, Ankara, Turkey
| | - Ayşe Gültekingil
- Department of Pediatric Emergency, Baskent University, Ankara, Turkey
| | - Oğuz Bakırcı
- Department of Pediatrics, Baskent University, Ankara, Turkey
| | - Nihal Uslu
- Department of Radiodiagnostics, Baskent University, Ankara, Turkey
| | - Esra Baskın
- Department of Pediatric Nephrology and Rheumatology, Baskent University, Ankara, Turkey
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195
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Galmiche S, Bruel T, Madec Y, Tondeur L, Grzelak L, Staropoli I, Cailleau I, Ungeheuer MN, Renaudat C, Fernandes Pellerin S, Hoen B, Schwartz O, Fontanet A. Characteristics Associated with Olfactory and Taste Disorders in COVID-19. Neuroepidemiology 2021; 55:381-386. [PMID: 34198303 PMCID: PMC8339025 DOI: 10.1159/000517066] [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: 01/30/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction Olfactory and taste disorders (OTDs) have been reported in COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the mechanisms of which remain unclear. We conducted a detailed analysis of OTDs as part of 2 seroepidemiological investigations of COVID-19 outbreaks. Methods Two retrospective cohort studies were conducted in a high school and primary schools of Northern France following a COVID-19 epidemic in February-March 2020. Students, their relatives, and school staff were included. Anti-SARS-CoV-2 antibodies were identified using a flow-cytometry-based assay detecting anti-S IgG. Results Among 2,004 participants (median [IQR] age: 31 [11–43] years), 303 (15.2%) tested positive for SARS-CoV-2 antibodies. OTDs were present in 91 (30.0%) and 92 (30.3%) of them, respectively, and had 85.1 and 78.0% positive predictive values for SARS-CoV-2 infection, respectively. In seropositive participants, OTDs were independently associated with an age above 18 years, female gender, fatigue, and headache. Conclusion This study confirms the higher frequency of OTDs in females than males and adults than children. Their high predictive value for the diagnosis of COVID-19 suggests that they should be systematically searched for in patients with respiratory symptoms, fever, or headache. The association of OTDs with headache, not previously reported, suggests that they share a common mechanism, which deserves further investigation.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France,
| | - Timothée Bruel
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Ludivine Grzelak
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France.,UMR 3569, Centre National de la Recherche Scientifique (CNRS), Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Isabelle Staropoli
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France
| | | | - Marie-Noëlle Ungeheuer
- ICAReB platform (Clinical Investigation & Access to Research Bioresources) of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | - Charlotte Renaudat
- ICAReB platform (Clinical Investigation & Access to Research Bioresources) of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | | | - Bruno Hoen
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,Direction de la recherche médicale, Institut Pasteur, Paris, France
| | - Olivier Schwartz
- Virus and Immunity Unit, Department of Virology, Institut Pasteur, Paris, France.,UMR 3569, Centre National de la Recherche Scientifique (CNRS), Paris, France.,Université de Paris, Sorbonne Paris Cité, Paris, France.,Vaccine Research Institute, Créteil, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
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Boymuradov S, Rustamova D, Bobamuratova D, Kurbanov Y, Karimberdiyev B, Yusupov S, Umarov R. Complications of COVID-19 in the maxillo-facial region: Clinical case and review of the literature. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [PMCID: PMC8129788 DOI: 10.1016/j.adoms.2021.100091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
COVID-19 is currently causing a pandemic around the world. With the increase in the number of patients, there was a slight increase in the incidence of various complications. In particular, infectious and inflammatory diseases of the face and jaw are observed in patients with COVID-19 in the early infectious stages of the disease, as well as in the late stages. In the previous literature, as a sign or complication of COVID-19 were mentioned cases of changes in the oral cavity - ulcers, rashes, and inflammation of salivary glands. The conditions presented in this article are a serious complication of COVID-19, radically different from the usual course of osteomyelitis, in which the patient has a course with a predominance of long-term, chronic-progressive, atrophic processes. Treatment was somewhat ineffective due to local chronic inflammation (pansinusitis), metabolic, microcirculatory, immune, and coagulation disorders in patients.
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Rahman MM, Ahmed M, Islam MT, Khan MR, Sultana S, Maeesa SK, Hasan S, Hossain MA, Ferdous KS, Mathew B, Rauf A, Uddin MS. Nanotechnology-Based Approaches and Investigational Therapeutics against COVID-19. Curr Pharm Des 2021; 28:948-968. [PMID: 34218774 DOI: 10.2174/1381612827666210701150315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/30/2021] [Indexed: 01/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus which is currently responsible for the global pandemic since December 2019. This class of coronavirus has affected 217 countries around the world. Most of the countries have taken some non-remedial preventive actions like country lockdown, work from home, travel bans, and the most significant one is social isolation. Pharmacists, doctors, nurses, technologists, and all other healthcare professionals are playing a pivotal role during this pandemic. Unluckily, there is no specific drug that can treat patients who are confirmed with COVID-19, though favipiravir and remdesivir have appeared as favorable antiviral drugs. Some vaccines have already developed, and vaccination has started worldwide. Different nanotechnologies are in the developing stage in many countries for preventing SARS-COV-2 and treating COVID-19 conditions. In this article, we review the COVID-19 pandemic situation as well as the nanotechnology-based approaches and investigational therapeutics against COVID-19.
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Affiliation(s)
- Md Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Muniruddin Ahmed
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Mohammad Touhidul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Md Robin Khan
- Bangladesh Reference Institute for Chemical Measurements, Dhaka. Bangladesh
| | - Sharifa Sultana
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Saila Kabir Maeesa
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Sakib Hasan
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Md Abid Hossain
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Kazi Sayma Ferdous
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Bijo Mathew
- Department of Pharmaceutical Chemistry, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi 682041, India
| | - Abdur Rauf
- Department of Chemistry, University of Swabi, Swabi, Anbar, Khyber Pakhtunkhwa. Bangladesh
| | - Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka. Bangladesh
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198
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COVID RADAR app: Description and validation of population surveillance of symptoms and behavior in relation to COVID-19. PLoS One 2021; 16:e0253566. [PMID: 34191828 PMCID: PMC8244909 DOI: 10.1371/journal.pone.0253566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background Monitoring of symptoms and behavior may enable prediction of emerging COVID-19 hotspots. The COVID Radar smartphone app, active in the Netherlands, allows users to self-report symptoms, social distancing behaviors, and COVID-19 status daily. The objective of this study is to describe the validation of the COVID Radar. Methods COVID Radar users are asked to complete a daily questionnaire consisting of 20 questions assessing their symptoms, social distancing behavior, and COVID-19 status. We describe the internal and external validation of symptoms, behavior, and both user-reported COVID-19 status and state-reported COVID-19 case numbers. Results Since April 2nd, 2020, over 6 million observations from over 250,000 users have been collected using the COVID Radar app. Almost 2,000 users reported having tested positive for SARS-CoV-2. Amongst users testing positive for SARS-CoV-2, the proportion of observations reporting symptoms was higher than that of the cohort as a whole in the week prior to a positive SARS-CoV-2 test. Likewise, users who tested positive for SARS-CoV-2 showed above average risk social-distancing behavior. Per-capita user-reported SARS-CoV-2 positive tests closely matched government-reported per-capita case counts in provinces with high user engagement. Discussion The COVID Radar app allows voluntarily self-reporting of COVID-19 related symptoms and social distancing behaviors. Symptoms and risk behavior increase prior to a positive SARS-CoV-2 test, and user-reported case counts match closely with nationally-reported case counts in regions with high user engagement. These results suggest the COVID Radar may be a valid instrument for future surveillance and potential predictive analytics to identify emerging hotspots.
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199
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Unique Imaging Findings of Neurologic Phantosmia Following Pfizer-BioNtech COVID-19 Vaccination: A Case Report. Top Magn Reson Imaging 2021; 30:133-137. [PMID: 34096896 DOI: 10.1097/rmr.0000000000000287] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
ABSTRACT Olfactory dysfunction related to SARS-CoV-2 infection and COVID-19 disease is now well established in the literature. In December 2020, the FDA approved the Pfizer-BioNTech and Moderna vaccines for use in preventing COVID-19 in the United States. To the best of our knowledge, this is the first report of a phantosmia post-Pfizer COVID-19 vaccination, with positive magnetic resonance imaging radiographic findings in a patient with documented absence of infection by SARS-CoV-2 virus or concomitant sinonasal disease.
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200
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Incidence of Anosmia among Covid 19 patients in India. Indian J Otolaryngol Head Neck Surg 2021; 74:3427-3436. [PMID: 34099977 PMCID: PMC8173102 DOI: 10.1007/s12070-021-02641-6] [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: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 01/08/2023] Open
Abstract
The pandemic COVID-19 has relentlessly caused havoc to human life since its outbreak in December 2019. The disease has been a challenge for all. The clinical manifestations of Covid-19 ranges from no symptoms at all to severe acute respiratory distress syndrome. Anosmia being one of the important clinical features of COVID-19 has always been overlooked by the Indian population. This formed the background for this study. Aim To identify the incidence of anosmia reported in COVID- 19 patients in India. Materials and Methods Literature search was carried out from January 2020 to March 2021 in databases like PUBMED and Google Scholar using the key words "ANOSMIA", "HYPOSMIA" and "OLFACTORY DYSFUNCTION" in conjunction with "COVID-19", "SARS-COV-2", and "CORONAVIRUS". Boolean operators were used to narrow and broaden the search. The search yielded sixteen eligible articles. Result The scrutiny of the 16 articles revealed an incidence range of anosmia from 9.2% to 82% and an average anosmia incidence rate of 30.19%. The cumulative incidence rate of anosmia in those studies where objective analysis was done is 52.2% and 16.4% for subjective analysis. Discussion The prevalence of anosmia in Indian population is found to be much lesser than that reported by European countries due to ethnicity or negligence. Objective evaluation of anosmia in COVID-19 patients increases the incidence of anosmia drastically. Hence objective evaluations such as UPIST, SNIFFING STICK test, etc. is to be promoted. This study also Emphasises the lack of common gold standard testing for olfaction like vision and hearing.
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