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Lee SH, Yeoh ZX, Sachlin IS, Gazali N, Soelar SA, Foo CY, Low LL, Syed Alwi SB, Tengku Kamalden TMI, Shanmuganathan J, Zaid M, Wong CY, Chua HH, Yusuf S, Muhamad D, Devesahayam PR, Ker HB, Salahuddin Z, Mustafa M, Sawali H, Lee HG, Din S, Misnan NA, Mohamad A, Ismail MN, Periasamy C, Chow TS, Krishnan EK, Leong CL, Lim LPF, Zaidan NZ, Ibrahim MZ, Abd Wahab S, Mohd Hashim SS. Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia. Sci Rep 2022; 12:2111. [PMID: 35136124 PMCID: PMC8826975 DOI: 10.1038/s41598-022-06029-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/21/2022] [Indexed: 01/08/2023] Open
Abstract
Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.
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Affiliation(s)
- Shen-Han Lee
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia.
| | - Zhi Xiang Yeoh
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Ida Sadja'ah Sachlin
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Norzi Gazali
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | | | - Chee Yoong Foo
- Real World Insights, IQVIA Asia Pacific, Petaling Jaya, Malaysia
| | - Lee Lee Low
- Department of Medicine, Hospital Sultanah Bahiyah, Kedah, Malaysia
| | | | | | | | - Masliza Zaid
- Department of Medicine, Hospital Sultanah Aminah, Johor, Malaysia
| | - Chun Yiing Wong
- Department of Otorhinolaryngology, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Hock Hin Chua
- Department of Medicine, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Suhaimi Yusuf
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | - Dzawani Muhamad
- Department of Medicine, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | | | - Hong Bee Ker
- Department of Medicine, Hospital Raja Permaisuri Bainun, Perak, Malaysia
| | - Zulkiflee Salahuddin
- Department of Otorhinolaryngology, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Mahiran Mustafa
- Department of Medicine, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Halimuddin Sawali
- Department of Otorhinolaryngology, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Heng Gee Lee
- Department of Medicine, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Sobani Din
- Department of Otorhinolaryngology, Hospital Sungai Buloh, Selangor, Malaysia
| | | | - Amran Mohamad
- Department of Otorhinolaryngology, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | - Mohd Noor Ismail
- Department of Medicine, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | | | - Ting Soo Chow
- Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia
| | | | - Chee Loon Leong
- Department of Medicine, Hospital Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | | | - Mohd Zambri Ibrahim
- Department of Otorhinolaryngology, Hospital Tuanku Fauziah, Perlis, Malaysia
| | | | - Siti Sabzah Mohd Hashim
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
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Abstract
Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted. The infant was extubated 48 hours postsurgery and was discharged home well after completion of 1 week of intravenous antibiotics. The child was discharged well from our follow-up at 1 month review. We discuss the pathophysiology of deep neck space abscesses, its incidence in the paediatric population and the various management options.
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Affiliation(s)
- Anusha Balasubramanian
- Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.,Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - J Redzwan Shah
- Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | - Norzi Gazali
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Philip Rajan
- Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
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