The olfactory bulb - gateway for SARS-Cov-2?

Introduction. Anosmia and ageusia are one of the most common and characteristic symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, with a frequency of almost 50% in patients in Western countries. Hypotheses proposing that the virus potentially affects the central nervous system (CNS) are on the rise. One hypothesis suggests that the virus enters via nasal mucosa and then enters the olfactory bulb via cribriform plate, with further dissemination to the CNS. Case report. A 34-year-old female patient experienced the loss of the sense of smell and taste about two months before testing positive for SARS-Cov-2. Coronavirus disease 2019 (COVID- 19) presented with minor pneumonia and worsening anosmia and ageusia. After treatment, the patient recovered well, but anosmia and ageusia appeared again, varying in intensity, and since February 2021, they have become persistent. The case was evaluated by an otorhinolaryngologist, pulmonologist, and finally, a neurologist. In the meantime, the patient tested negative for SARS-Cov-2 and received two doses of the Sputnik V vaccine. Brain magnetic resonance imaging (MRI) was performed, and it clearly showed severe bilateral olfactory bulb atrophy. The patient has had anosmia and ageusia up to this day, and future MRI follow- up is planned. Conclusion. Loss of sense of smell and taste may be a predictor of further CNS dissemination of the virus and possible neurological complications (which is still a subject of consideration). The olfactory bulb could be a gateway to COVID-19 intrusion into the CNS, and its atrophy could be an indicator of the process. Further investigation on this topic is required, including a wide application of MRI, in order to come to definite conclusions.

"Eyes don't say it all” - Communication challenges while wearing facemasks in class

Facemasks are personal protective equipment worn to reduce the risk of the transmission of Covid-19. University students and teachers/lecturers in Serbia are required to wear facemasks in class at all times. However, such practice may cause challenges in student-teacher communication. We present students' experiences regarding speech intelligibility in the educational setting. We distributed an anonymous online questionnaire among students from various universities. Speaking with a facemask in class creates communication challenges for teachers and students alike. Students claim that teachers often have difficulties understanding students who speak wearing masks;teachers often ask students to repeat the sentence, and teachers often ask students to speak louder. Similarly, when teachers talk with their facemasks, students often report not hearing or understanding teachers back. In turn, students would ask teachers to repeat the sentence and raise voices. Students pay more attention to teachers' facial expressions, hand gestures, body language, and tone of voice. Students tend to engage their non-verbal interaction skills more often to facilitate communication. We further discuss the differences regarding students' gender and the type of facemask typically worn. We express concern that the inability to communicate clearly may cause annoyance and frustration in the academic setting. © 2022 Internoise 2022 - 51st International Congress and Exposition on Noise Control Engineering. All rights reserved.

Do we understand online information given by healthcare providers during the COVID19 pandemic?

Introduction: The COVID19 pandemic has increased the need for timely and reliable health information to optimise citizens' self-protective engagement. Due to preventive measures, such as lock-down and physical distancing, people relied on the internet more than before. There is a large gap in pharmacy educators knowledge about health information-seeking pathways on the internet, especially with the appearance of the COVID19 infodemic. Results of the authors work may help healthcare professionals to better communicate and educate citizens in everyday practice. Objective(s): The aim of this study was to examine the impact of the COVID19 pandemic on searching for and understanding online health information, as well as reliance and confidence in the information gathered from various online sources. Method(s): An online survey was conducted using Google Forms on a sample of anonymous respondents in Serbia. The link for the questionnaire was posted on social media channels and was accessible from April to May 2020, during the epidemic outbreak. The survey included questions on socio-demographic characteristics and behaviour in seeking and evaluating online health information sources. The authors compared the responses collected at a one-time point in regard of period before and during the COVID19 pandemic. Healthcare professionals were excluded from the study. Data were managed using the IBM SPSS Statistics and included methods of descriptive and inferential statistics. Result(s): The age of participants was 37.82 +/-11.11 years in average. Out of 351 respondents, 66.7% were women, 47.9% were university graduates, and 76.6% were employed. At the beginning of the pandemic, the average time for health-related information searching on the internet and social media significantly increased (p < 0.01). The majority of participants found important the profession of the author of health information published on the internet (N = 305, 86.9%) and on social media (N = 272, 77.5%). Prior to COVID19, the respondents valued the most (on a five-point rating scale) the information obtained from physicians (4.33 +/- 0.75) and pharmacists (4.12 +/- 0.79), followed by health officials (3.73 +/- 1.02) and journalists (2.66 +/- 1.02). This trend continued during the pandemic. Understanding of health information published on the internet and/or social media decreased significantly (from 3.82 +/- 1.01 before to 3.67 +/- 1.14 during the pandemic, measured on a five-point rating scale, p < 0.01). This decrease in the understanding of health information was significantly influenced by gender (p < 0.05). The level of education and employment status significantly impacted the understanding of health information before the pandemic (p < 0.05 for both variables), while during the pandemic these factors did not prove to be statistically significant. Conclusion(s): Citizens' interest in health has grown significantly due to the COVID19 pandemic. However, their understanding of health information during this global crisis has decreased. This underlined the importance of clarity of the health information provided online. Physicians and pharmacists are marked as online health information providers with the highest level of confidence at the time of infodemic. They should be more involved in writing and disseminating accurate, precise, clear health information, adjusted to all categories of the population, to improve public health.

The olfactory bulb – gateway for SARS-Cov-2?

Introduction. Anosmia and ageusia are one of the most common and characteristic symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, with a frequency of almost 50% in patients in Western countries. Hypotheses proposing that the virus potentially affects the central nervous system (CNS) are on the rise. One hypothesis suggests that the virus enters via nasal mucosa and then enters the olfactory bulb via cribriform plate, with further dissemination to the CNS. Case report. A 34-year-old female patient experienced the loss of the sense of smell and taste about two months before testing positive for SARS-Cov-2. Coronavirus disease 2019 (COVID-19) presented with minor pneumonia and worsening anosmia and ageusia. After treatment, the patient recovered well, but anosmia and ageusia appeared again, varying in intensity, and since February 2021, they have become persistent. The case was evaluated by an otorhinolaryngologist, pulmonologist, and finally, a neurologist. In the meantime, the patient tested negative for SARS-Cov-2 and received two doses of the Sputnik V vaccine. Brain magnetic resonance imaging (MRI) was performed, and it clearly showed severe bilateral olfactory bulb atrophy. The patient has had anosmia and ageusia up to this day, and future MRI follow-up is planned. Conclusion. Loss of sense of smell and taste may be a predictor of further CNS dissemination of the virus and possible neurological complications (which is still a subject of consideration). The olfactory bulb could be a gateway to COVID-19 intrusion into the CNS, and its atrophy could be an indicator of the process. Further investigation on this topic is required, including a wide application of MRI, in order to come to definite conclusions. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Assessing resilience of healthcare infrastructure exposed to COVID-19: emerging risks, resilience indicators, interdependencies and international standards.

In the moment of preparation of this paper, the world is still globally in grip of the Corona (COVID-19) crisis, and the need to understand the broader overall framework of the crisis increases. As in similar cases in the past, also with this one, the main interest is on the "first response". Fully appreciating the efforts of those risking their lives facing pandemics, this paper tries to identify the main elements of the larger, possibly global, framework, supported by international standards, needed to deal with new (emerging) risks resulting from threats like Corona and assess the resilience of systems affected. The paper proposes that future solutions should include a number of new elements, related to both risk and resilience. That should include broadening the scope of attention, currently focused onto preparation and response phases, to the phases of "understanding risks", including emerging risks, and transformation and adaptation. The paper suggests to use resilience indicators in this process. The proposed approach has been applied in different cases involving critical infrastructures in Europe (energy supply, water supply, transportation, etc., exposed to various threats), including the health system in Austria. The detailed, indicator-based, resilience analysis included mapping resilience, resilience stress-testing, visualization, etc., showing, already before the COVID-19, the resilience (stress-testing) limits of the infrastructures. A simpler (57 indicator based) analysis has, then been done for 11 countries (including Austria). The paper links these results with the options available in the area of policies, standards, guidelines and tools (such as the RiskRadar), with focus on interdependencies and global standards-especially the new ISO 31,050, linking emerging risks and resilience.