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1.
Healthcare (Basel) ; 10(6)2022 May 31.
Article in English | MEDLINE | ID: covidwho-1869540

ABSTRACT

BACKGROUND: The intermittent abdominal pressure ventilation (IAPV) is a non-invasive ventilation (NIV) technique that avoids facial interfaces and is a diurnal ventilatory support alternative for neuromuscular patients during stable chronic phases of the disease. Coronavirus disease 2019 (COVID-19) is a novel infection possibly causing acute respiratory distress syndrome (ARDS). Neuromuscular diseases (NMD) and preexisting respiratory failure can be exacerbated by respiratory infection and progress to severe disease and ICU admission with a poor prognosis. AIM: To report on the versatility and feasibility of IAPV in acute restrictive respiratory failure exacerbated by COVID-19. PATIENT: We describe the case of a 33-year-old man with spastic tetraparesis, kyphoscoliosis, and impaired cough, eventually leading to a restrictive ventilation pattern. COVID-19 exacerbated respiratory failure and seizures. An NIV trial failed because of inadequate interface adhesion and intolerance. During NIV, dyspnea and seizures worsened. He underwent a high flow nasal cannula (HFNC) with a fluctuating benefit on gas exchange. IAPV was initiated and although there was a lack of cooperation and inability to sit; the compliance was good and a progressive improvement of gas exchange, respiratory rate, and dyspnea was observed. CONCLUSIONS: IAPV is a versatile type of NIV that can be adopted in complicated restrictive respiratory failure. COVID-19 exacerbates preexisting conditions and is destined to be a disease of frailty. COVID-19 is not a contraindication to IAPV and this kind of ventilation can be employed in selected cases in a specialistic setting. Moreover, this report suggests that IAPV is safe when used in combination with HFNC. This hybrid approach provides the opportunity to benefit from both therapies, and, in this particular case, prevented the intubation with all connected risks.

2.
Commun Med (Lond) ; 2: 34, 2022.
Article in English | MEDLINE | ID: covidwho-1860434

ABSTRACT

Background: Key to curtailing the COVID-19 pandemic are wide-scale screening strategies. An ideal screen is one that would not rely on transporting, distributing, and collecting physical specimens. Given the olfactory impairment associated with COVID-19, we developed a perceptual measure of olfaction that relies on smelling household odorants and rating them online. Methods: Each participant was instructed to select 5 household items, and rate their perceived odor pleasantness and intensity using an online visual analogue scale. We used this data to assign an olfactory perceptual fingerprint, a value that reflects the perceived difference between odorants. We tested the performance of this real-time tool in a total of 13,484 participants (462 COVID-19 positive) from 134 countries who provided 178,820 perceptual ratings of 60 different household odorants. Results: We observe that olfactory ratings are indicative of COVID-19 status in a country, significantly correlating with national infection rates over time. More importantly, we observe indicative power at the individual level (79% sensitivity and 87% specificity). Critically, this olfactory screen remains effective in participants with COVID-19 but without symptoms, and in participants with symptoms but without COVID-19. Conclusions: The current odorant-based olfactory screen adds a component to online symptom-checkers, to potentially provide an added first line of defense that can help fight disease progression at the population level. The data derived from this tool may allow better understanding of the link between COVID-19 and olfaction.

3.
Food Qual Prefer ; 96: 104437, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1466350

ABSTRACT

Restrictions adopted by many countries in 2020 due to Covid-19 pandemic had severe consequences on the management of sensory and consumer testing that strengthened the tendency to move data collection out of the laboratory. Remote sensory testing, organized at the assessor's home or workplace and carried out under the live online supervision of the panel leader, represents a trade-off between adequate control and the convenience of conducting testing out of the lab. The Italian Sensory Science Society developed the "Remote sensory testing" research project aimed at testing the effectiveness and validity of the sensory tests conducted remotely through a comparison with evaluations in a classical laboratory setting. Guidelines were developed to assist panel leaders in setting up and controlling the evaluation sessions in remote testing conditions. Different methods were considered: triangle and tetrad tests, Descriptive Analysis and Temporal Dominance of Sensations tests, all of which involved trained panels, and Check-All-That-Apply and hedonic tests with consumers. Remote sensory testing provided similar results to the lab testing in all the cases, with the exception of the tetrad test run at work. Findings suggest that remote sensory testing, if conducted in strict compliance with specifically developed sensory protocols, is a promising alternative to laboratory tests that can be applied with both trained assessors and consumers even beyond the global pandemic.

4.
Sci Rep ; 11(1): 17504, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1392890

ABSTRACT

Chemosensory impairments have been established as a specific indicator of COVID-19. They affect most patients and may persist long past the resolution of respiratory symptoms, representing an unprecedented medical challenge. Since the SARS-CoV-2 pandemic started, we now know much more about smell, taste, and chemesthesis loss associated with COVID-19. However, the temporal dynamics and characteristics of recovery are still unknown. Here, capitalizing on data from the Global Consortium for Chemosensory Research (GCCR) crowdsourced survey, we assessed chemosensory abilities after the resolution of respiratory symptoms in participants diagnosed with COVID-19 during the first wave of the pandemic in Italy. This analysis led to the identification of two patterns of chemosensory recovery, partial and substantial, which were found to be associated with differential age, degrees of chemosensory loss, and regional patterns. Uncovering the self-reported phenomenology of recovery from smell, taste, and chemesthetic disorders is the first, yet essential step, to provide healthcare professionals with the tools to take purposeful and targeted action to address chemosensory disorders and their severe discomfort.


Subject(s)
COVID-19/complications , Olfaction Disorders/epidemiology , Taste Disorders/epidemiology , Adult , Aged , Clinical Decision-Making , Female , Humans , Italy/epidemiology , Male , Middle Aged , Olfaction Disorders/etiology , Self Report , Taste Disorders/etiology , Young Adult
5.
Chem Senses ; 2020 May 22.
Article in English | MEDLINE | ID: covidwho-1343675

ABSTRACT

In response to the COVID-19 pandemic, countries have implemented various strategies to reduce and slow the spread of the disease in the general population. For countries that have implemented restrictions on its population in a step-wise manner, monitoring of COVID-19 prevalence is of importance to guide decision on when to impose new, or when to abolish old, restrictions. We are here determining whether measures of odor intensity in a large sample can serve as one such measure. Online measures of how intense common household odors are perceived and symptoms of COVID-19 were collected from 2440 Swedes. Average odor intensity ratings were then compared to predicted COVID-19 population prevalence over time in the Swedish population and were found to closely track each other (r=-0.83). Moreover, we found that there was a large difference in rated intensity between individuals with and without COVID-19 symptoms and number of symptoms was related to odor intensity ratings. Finally, we found that individuals progressing from reporting no symptoms to subsequently reporting COVID-19 symptoms demonstrated a large drop in olfactory performance. These data suggest that measures of odor intensity, if obtained in a large and representative sample, can be used as an indicator of COVID-19 disease in the general population. Importantly, this simple measure could easily be implemented in countries without widespread access to COVID-19 testing or implemented as a fast early response before wide-spread testing can be facilitated.

6.
Front Pharmacol ; 12: 575402, 2021.
Article in English | MEDLINE | ID: covidwho-1211842

ABSTRACT

While available in only a few countries, home therapy is a possible strategy for the treatment of alpha-1 antitrypsin deficiency. We want to describe our experience in the management of human alpha-1 antitrypsin using home care intravenous augmentation therapy during this emergency period caused by SARS-CoV2 infection. We assessed the safety of the home treatment and the quality of life of patients enrolled in the program.

7.
Food Quality and Preference ; : 104220, 2021.
Article in English | ScienceDirect | ID: covidwho-1121089

ABSTRACT

Healthy and sustainable diets are necessary for global development goals, but people struggle to modify their eating behaviours which are often habitual and resistant to change. However, disruption can provide the impetus for change, and in the present research we view the Covid-19 pandemic as a potential catalytic disruption with the potential to induce positive behaviour change. Data were obtained from ∼900 USA adults, of which 44% self-reported to have made positive dietary change/s. Those who did so tended to be younger rather than older and with higher educational attainment. They also were less food neophobic than people who did not make positive change/s and placed greater importance on health as a motive of daily decisions about what to eat and drink. The contribution of psychographic variables in differentiating between groups of people who did / did not make positive changes once again show their importance in uncovering and explaining the complex factors that explain food-related consumer behaviour. It seems this holds also when daily lives are disrupted by unforeseen events.

8.
Chem Senses ; 462021 01 01.
Article in English | MEDLINE | ID: covidwho-990574

ABSTRACT

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19-; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: -82.5 ± 27.2 points; C19-: -59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.


Subject(s)
Anosmia/diagnosis , COVID-19/diagnosis , Adult , Anosmia/etiology , COVID-19/complications , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prognosis , SARS-CoV-2/isolation & purification , Self Report , Smell
10.
Nat Commun ; 11(1): 5152, 2020 10 14.
Article in English | MEDLINE | ID: covidwho-872697

ABSTRACT

In response to the COVID-19 pandemic, many governments have taken drastic measures to avoid an overflow of intensive care units. Accurate metrics of disease spread are critical for the reopening strategies. Here, we show that self-reports of smell/taste changes are more closely associated with hospital overload and are earlier markers of the spread of infection of SARS-CoV-2 than current governmental indicators. We also report a decrease in self-reports of new onset smell/taste changes as early as 5 days after lockdown enforcement. Cross-country comparisons demonstrate that countries that adopted the most stringent lockdown measures had faster declines in new reports of smell/taste changes following lockdown than a country that adopted less stringent lockdown measures. We propose that an increase in the incidence of sudden smell and taste change in the general population may be used as an indicator of COVID-19 spread in the population.


Subject(s)
Communicable Disease Control/legislation & jurisprudence , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Olfaction Disorders/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Taste Disorders/epidemiology , Betacoronavirus , COVID-19 , Communicable Disease Control/standards , Coronavirus Infections/transmission , Epidemiological Monitoring , France/epidemiology , Hospitalization , Humans , Italy/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Self Report , United Kingdom/epidemiology
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