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Acta Otorhinolaryngol Ital ; 41(3): 197-205, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1222316


OBJECTIVE: Interactions between SARS-CoV-2 and pharyngeal associated lymphoid tissue are thought to influence the manifestations of COVID-19. We aimed to determine whether a previous history of tonsillectomy, as a surrogate indicator of a dysfunctional pharyngeal associated lymphoid tissue, could predict the presentation and course of COVID-19. METHODS: Multicentric cross-sectional observational study involving seven hospitals in Northern and Central Italy. Data on the clinical course and signs and symptoms of the infection were collected from 779 adults who tested positive for SARS-CoV-2, and analysed in relation to previous tonsillectomy, together with demographic and anamnestic data. RESULTS: Patients with previous tonsillectomy showed a greater risk of fever, temperature higher than 39°C, chills and malaise. No significant differences in hospital admissions were found. CONCLUSIONS: A previous history of tonsillectomy, as a surrogate indicator of immunological dysfunction of the pharyngeal associated lymphoid tissue, could predict a more intense systemic manifestation of COVID-19. These results could provide a simple clinical marker to discriminate suspected carriers and to delineate more precise prognostic models.

COVID-19 , Palatine Tonsil , Tonsillectomy/adverse effects , Adult , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Palatine Tonsil/surgery , Pandemics , SARS-CoV-2
Otolaryngol Head Neck Surg ; 164(1): 82-86, 2021 01.
Article in English | MEDLINE | ID: covidwho-646277


While olfactory dysfunction associated with coronavirus disease 2019 (COVID-19) has attracted considerable interest, few studies have tracked outcomes at serial time points or beyond 2 weeks. Furthermore, data are conflicting regarding whether COVID-19 severity correlates with degree of olfactory dysfunction. This prospective case-control study analyzed prevalence and severity of subjective loss of smell in outpatients (n = 23) and inpatients (n = 20) with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection vs healthy controls (n = 25). Olfactory dysfunction was reported more commonly in COVID-19 patients than in healthy controls (P < .001), and outpatients paradoxically reported loss of smell more commonly than inpatients (P = .02). Headaches were present in 52% of patients with olfactory dysfunction. Anosmia or hyposmia persisted beyond 5 days but most of the patients recovered by 30 days, suggesting favorable prognosis for olfaction. Differences between inpatients and outpatients are potentially reflective of timeline of olfactory symptoms and contextual factors, underscoring the importance of corroborative objective testing, coupled with careful tracking of temporal relationships.

COVID-19/complications , Olfaction Disorders/epidemiology , Recovery of Function , SARS-CoV-2 , Smell/physiology , Aged , COVID-19/epidemiology , Case-Control Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Prevalence , Prognosis , Prospective Studies , Retrospective Studies