COVID-19 as a turning point in the need for specialized units for the sense of smell

Background: The unprecedented prevalence of olfactory disfunction (OD) by SARS-CoV- 2 has revealed the lack of specialized units dealing with sense of smell. The main objective of the study is to know the number of newly created olfactory units (OU) since the COVID-19 pandemic, as well as to evaluate the diagnosis, management and treatment of patients with OD. Method(s): Prospective cross-sectional study. Carried out by means of a survey with 20 items: having or not having an OU, demographic data, smell test, evolution and management of OD, data on treatments. The variables of the survey were approved by the rhinology commission of the Spanish society of ENT. The digital survey was distributed to all members of Spanish ENT and Allergy Societies. Result(s): A total of 16 responses were missing data, and further 12 responses were duplicated. Finally, 136 surveys were included. From them 82.4% answers were from otolaryngologists and 17.7% from allergists. The cohort of allergists and otolaryngologists was compared to ensure comparability of both samples. There were significant differences in the instrumental assessment of the olfaction, VAS and smell test (p = 0.016) was more common in otolaryngologists. Also, the prescription of olfactory rehabilitation (OR) (p < 0.001) was more common in otolaryngologists. The 40.5% (+/- 7.6) of all the existent OU were created after COVID-19 pandemics. The 33.9% (+/- 4.5) of the respondent have an OU now, while 22.3% (+/- 3.9) already had it before COVID-19 pandemics. It means that 17% of hospitals who did not have an OU before COVID-19, now they have it, while 82.8% are still lacking it. OR was prescribed for 1-3 months by 38%;3-6 months by 48.1% and > 6 months by 13.9%. Those with an OU prescribe OR during more time (p = 0.002) being the most frequent answer 3-6 months (69.4%) when they have OU while 1-3 months (52.4%) for those who do not have it. Conclusion(s): This study revealed that COVID-19 pandemic has stimulated the creation of OU and has demonstrated the utility of OU to deal with patients with OD, as their daily practice is more adapted to up-to- date clinical evidence between allergist and otolaryngologists.

ENT practice during the COVID19 pandemic

Introduction: The SARS CoV-2 (COVID-19) disease has caused millions of cases since the pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual medical and surgical practices. Doctors and nurses represent a significant percentage of the general population infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons (ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during procedures. Objective: The objective of this article is to prepare a document on safe otorhinolaryngological practice during the COVID19 pandemic. Results: Compilation of the best evidence adapted to the risk of transmission, according to the combination of the results of the risk indicators established by the Ministry of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of the scientific commissions and the COVID-19 committee of the SEORLCCC.

Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study.

BACKGROUND AND OBJECTIVE: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers. METHODS: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms. RESULTS: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection. CONCLUSION: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.