ABSTRACT
BACKGROUND: COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. Aims/Objectives. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. Material and Methods. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded. The Otolaryngology team was tested for COVID-19 before and after the procedures. RESULTS: Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Twenty-seven patients (29%) underwent a tracheostomy. After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days. In the nontracheostomized patients, the mortality was 42.4%. CONCLUSIONS: Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients.
ABSTRACT
PURPOSE: Severe acute respiratory syndrome caused by COVID-19 has spread globally for the last few months. Healthcare workers (HCW) are overexposed and infection rates are higher than in the rest of the population. Strict clinical assessment is paramount to detect suspicious cases. In this context, olfactory or taste dysfunction (OTD) appears as an early and frequent symptom. Evaluating its presence in early stages plays an important role nowadays. METHODS: We performed a descriptive observational single-center study among 256 HCW at Hospital Universitario de Fuenlabrada affected by COVID-19 and confirmed using RT-PCR. A telephonic interview was performed, after obtaining oral informed consent. RESULTS: OTD was present in up to 70% of the cases as an early symptom, including mild-to-severe cases. The extent of these sensory deficits lasted an average of 11 days. In 26% of the patients, these sensory alterations persisted for over a month. CONCLUSION: OTD is reported as an early symptom among HCW with SARS-CoV-2 infection. Its strong association with test positivity is useful in the management of the infection and should be enough to indicate preventive isolation. We consider that OTD needs to be included in clinical screening questionnaires in HCW.