Multicentre study on the course of non-sinunasal olfactory disorders

The COVID-19 pandemic continues to keep the world on tenterhooks with increasing numbers of infections and at the same time increasing cases of post-viral olfactory dysfunction. In 5 to 20 % of those affected, loss of smell persists after 1 to 2 months. In a multicentre study (n= 652, of which 404 were women), non-sinunasal, acquired olfactory disorders of different entities were considered: postviral 584 of which 490 after COVID-19 infection, idiopathic 28, traumatic 40. There was an overall olfactory improvement over 3.5 (± 1.2) months for threshold, discrimination and identification (t > 3.65;p < 0.001) for all olfactory disorders studied. When analyzed separately for COVID-19 infection, other postviral olfactory disorders showed initially poorer olfactiory function (M = 23.6 vs. 26.5;t = 2.9;p = 0.01), but showed comparable improvement over time (F = 0.05;p = 0.83). Patients with parosmia showed better olfaction (M = 23.2 vs. 25.1;t = 2.5;p = 0.02), but not in the subgroup analysis after COVID-19 infection. At the first visit after 4.1 ( ± 3.3) months after acute COVID 21% patients were normosmotic;at the second visit after a further 3.6 ( ± 1.5) months, 34% of patients had normosmia after COVID-19 infection. During the course, an improvement in the ability to smell was demonstrable. For many patients with COVID-19-associated olfactory loss, an improvement that is experienced as complete may only occur over the course of months and possibly years.

Increased risk of acute stroke in patients with severe course of COVID-19: A multicenter study and meta-analysis

Introduction: Recent studies linked coronavirus disease 2019 (COVID-19) to thromboembolic complications likely mediated by increased blood coagulability and inflammatory endothelial impairment. Objective: We aimed to assess the risk of acute stroke in patients with COVID-19 related to clinical severity of the disease. Methods: We conducted an observational multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we performed a systematic review using PubMed/MEDLINE, EMBASE, Cochrane Library and bibliographies of identified articles following PRISMA guidelines including data from observational studies of acute stroke in COVID-19 patients. Data was extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RR) and 95% confidence intervals (95%CIs) for acute stroke related to COVID- 19 severity using random effects model. Between-study heterogeneity was assessed using Cochran's Q and I -statistics. PROSPERO identifier: CRD42020187194. Results: Of 165 patients hospitalized for COVID-19 (49.1% males, median age 67 [57-79], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95%CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were StrokeJournal of the American Heart Association (JAHA)eligible for meta-analysis. Among 741 pooled COVID-19 patients overall stroke rate was 2.9%(95%CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR 4.12, 95%CI 1.7-10.25;p=0.002) with no evidence of heterogeneity (I=0%,p=0.82). Conclusions: Synthesized analysis of data from our multicenter study and previously publishedcohorts demonstrate that severity of COVID-19 is associated with an increased risk of acute stroke, underscoring the necessity of neurological monitoring in patients infected with SARS-CoV-2.

Corona outpatient clinic at dresden university hospital: Clinical characteristics of SARS-CoV-2 tested patients

Background On 9 March 2020, the Corona Outpatient Clinic was opened at the Carl Gustav Carus University Hospital in Dresden, where 2.871 persons presented themselves until March 31, 2020, of which 2.257 patients were tested for SARS-CoV-2. The aim of this work is to analyse the clinical characteristics of these pa-tients. Methods Based on a questionnaire filled out by each patient, the indi-cation for SARS-CoV-2 testing was given by a physician. The data of the patient’s characteristics and the test results were evaluated in aggregated form without individual-related in-formation. Results In the study period from March 9 to March 31, 2020 2.257 patients were tested for SARS-CoV-2. 163 tests were positive. The most frequent symptom was cough. Headache, muscle pain and fever were significantly associated with SARS-CoV-2 infection (p 0.05). 79 % of the patients presented within six days of the onset of symptoms. 78 of those who were tested positive (49 %) said they had been abroad in the 14 days before the start of illness. 82 (52 %) had prior contact with a person who was tested positive for SARS-CoV-2. Conclusions Main symptoms of SARS-CoV-2 infected patients are cough and headache. Muscle pain, headache and fever were significantly more common in people infected with SARS-CoV-2. Patients often present just before or during the critical phase of the disease. © Deutscher Ärzteverlag ;ZFA ;Zeitschrift für Allgemeinmedizin ;2020.

Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis.

BACKGROUND AND PURPOSE: Recent observations linked coronavirus disease 2019 (COVID-19) to thromboembolic complications possibly mediated by increased blood coagulability and inflammatory endothelial impairment. We aimed to define the risk of acute stroke in patients with severe and non-severe COVID-19. METHODS: We performed an observational, multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we conducted a systematic review using PubMed/MEDLINE, Embase, Cochrane Library and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including data from observational studies of acute stroke in COVID-19 patients. Data were extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RRs) and 95% confidence intervals (95% CIs) for acute stroke related to COVID-19 severity using a random-effects model. Between-study heterogeneity was assessed using Cochran's Q and I2 statistics. International Prospective Register of Systematic Reviews registration number: CRD42020187194. RESULTS: Of 165 patients hospitalized for COVID-19 (49.1% males, median age = 67 years [57-79 years], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95% CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were eligible for meta-analysis. Amongst 741 pooled COVID-19 patients, overall stroke rate was 2.9% (95% CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR = 4.18, 95% CI: 1.7-10.25; P = 0.002) with no evidence of heterogeneity (I2  = 0%, P = 0.82). CONCLUSIONS: Synthesized analysis of data from our multicenter study and previously published cohorts indicates that severity of COVID-19 is associated with an increased risk of acute stroke.