ABSTRACT
COVID-19 also known as severe acute respiratory syndrome coronavirus 2 is the result of a highly transmissible coronavirus which can result in severe infection of the respiratory tract. The global pandemic which began in early 2020 has created a number of challenges for the medical community to contain the rate of transmission, especially to health care workers. A minority of the infected population will progress toward severe respiratory distress ultimately requiring mechanical ventilator assistance. Although preliminary data suggest a poor prognosis for those requiring ventilation support, there is a subgroup who will eventually be weaned off. As the pandemic evolves, this cohort of infected, chronically intubated and ventilated individuals will become more prevalent and may require tracheostomy to aid in recovery. Unfortunately, tracheostomy is an aerosol-generating procedure which poses high risks to all members within the operating room, as described by previous authors. There is an urgent need to explore and develop methods to maximize the safety of tracheostomy and other aerosol-generating procedures in order to reduce intraoperative transmission. In the present article, we present a modified technique for negative pressure enclosure in patients with COVID-19 who underwent tracheostomy.
ABSTRACT
BACKGROUND: Olfactory dysfunction (OD) is common and has been reported as an early indicator of COVID-19. However, the reported prevalence of OD in the general population varies widely depending upon the metric used to assess olfaction.Methodology/Principal: To perform a systematic review and meta-analysis of the prevalence of OD in the healthy general population, review the various assessment metrics used, and compare pooled OD prevalence rates. RESULTS: A total of 175,073 subjects were identified (mean age 63.5 years, range 18 to 101) with an overall OD prevalence of 22.2% (95% CI 14.8-30.6). OD prevalence was significantly greater using objective olfactory assessments, compared to subjective measures (28.8%, CI 20.3-38.2 versus 9.5%, CI 6.1-13.5, p < 0.001). The prevalence of OD was greater using expanded identification tests (>8 items) compared to brief test with ≤8 items (30.3%, CI 16.2-46.5 versus 21.2%, CI 12.3-31.8). Prevalence was higher in studies with a mean age greater than 55 years compared to those with a mean age of 55 years or less (34.5%, CI 23.4-46.5 versus 7.5%, CI 2.6-14.5, p < 0.001). CONCLUSIONS: The reported prevalence of OD in the general population depends on the testing method and population age. OD prevalence was greater in studies using objective tests, expanded identification tests, and in those with older subjects.