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2.
J Surg Oncol ; 124(4): 476-482, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1263111

ABSTRACT

BACKGROUND: Considering the pandemic's mode of transmission, the impact on quality of life (QOL) is likely to be exaggerated among healthcare workers (HCWs) who treat head and neck diseases (hHCWs). METHODS: A cross-sectional self-reported QOL assessment was undertaken between July and September 2020 using the World Health Organization Quality of Life instrument sent out to hHCWs. Factors that predicted a poorer QOL were identified using regression models and mediation analysis. RESULTS: Responses from 979 individuals across 53 countries were analyzed with 62.4% participation from low- and middle-income countries. The physical domain had the highest mean scores of 15 ± 2.51, while the environmental domain was the lowest (14.17 ± 2.42). Participants from low- and middle-income countries had a significantly worse physical (p < 0.001) and environmental (p < 0.001) domains, while a low coronavirus disease 2019-related mortality significantly impacted the environmental domain (p-0.034). CONCLUSION: QOL-related issues among hHCWs are a vexing problem and need intervention at an individual and systems level in all parts of the world.


Subject(s)
COVID-19/epidemiology , Head and Neck Neoplasms/therapy , Health Personnel/psychology , Internationality , Quality of Life , Surgical Oncology , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Self Report , Young Adult
4.
BMC Infect Dis ; 21(1): 232, 2021 Feb 27.
Article in English | MEDLINE | ID: covidwho-1105699

ABSTRACT

BACKGROUND: Although there are reports of otolaryngological symptoms and manifestations of CoronaVirus Disease 19 (COVID-19), there have been no documented cases of sudden neck swelling with rash in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection described in literature. CASE PRESENTATION: We report a case of a sudden neck swelling and rash likely due to late SARS-CoV-2 in a 64-year-old woman. The patient reported COVID-19 symptoms over the previous three weeks. Computed Tomography (CT) revealed a diffuse soft-tissue swelling and edema of subcutaneous tissue, hypodermis, and muscular and deep fascial planes. All the differential diagnoses were ruled out. Both the anamnestic history of the patient's husband who had died of COVID-19 with and the collateral findings of pneumonia and esophageal wall edema suggested the association with COVID-19. This was confirmed by nasopharyngeal swab polymerase chain reaction. The patient was treated with lopinavir/ritonavir, hydroxychloroquine and piperacillin/tazobactam for 7 days. The neck swelling resolved in less than 24 h, while the erythema was still present up to two days later. The patient was discharged after seven days in good clinical condition and with a negative swab. CONCLUSION: Sudden neck swelling with rash may be a coincidental presentation, but, in the pandemic context, it is most likely a direct or indirect complication of COVID-19.


Subject(s)
COVID-19/complications , Exanthema/etiology , SARS-CoV-2 , COVID-19/diagnostic imaging , COVID-19/drug therapy , Edema/etiology , Female , Humans , Middle Aged , Neck/pathology , Tomography, X-Ray Computed
6.
JAMA Otolaryngol Head Neck Surg ; 146(8): 723-728, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-603689

ABSTRACT

Importance: Early diagnosis of coronavirus disease 2019 (COVID-19) may help control the diffusion of the disease into the population. Objective: To investigate the presence of sinonasal manifestations at the onset of COVID-19 to achieve an earlier diagnosis. Design, Setting, and Participants: This retrospective telephone survey study investigated patients diagnosed with COVID-19 from March 5 to March 23, 2020, who were hospitalized or discharged from a single referral center. Patients who were unable to answer (intubated, receiving noninvasive ventilation, or deceased) or unreachable by telephone were excluded. Of 359 consecutive patients, 204 fulfilled the inclusion criteria; 76 were unable to answer, 76 were unreachable by telephone, and 3 refused. Exposures: Sinonasal manifestations reported before COVID-19 diagnosis were studied with a validated questionnaire: Italian Sino-Nasal Outcome Test 22 (I-SNOT-22). If reduction of taste and/or smell was documented by item 5 of the I-SNOT-22, further inquiries were made to score them separately on a scale from 0 to 5, with 0 indicating no problem and 5 indicating problem as bad as it can be. Main Outcomes and Measures: The prevalence of sinonasal manifestations preceding COVID-19 diagnosis. Results: Among the 204 patients enrolled (110 [53.9%] male; mean [SD] age, 52.6 [14.4] years), the median I-SNOT-22 total score was 21 (range, 0-73). I-SNOT-22 identified 116 patients (56.9%) with reduction of taste and/or smell, 113 (55.4%) with taste reduction (median score, 5; range, 2-5), and 85 (41.7%) with smell reduction (median score, 5; range, 1-5). Eighty-two patients (40.2%) reported both. Severe reduction of taste was present in 81 patients (39.7%), and severe reduction of smell was present in 72 patients (35.3%). Only 12 patients (14.8%) with severe taste reduction and 12 patients (16.7%) with severe smell reduction reported severe nasal obstruction. Severe reduction of taste and smell was more prevalent in female vs male patients (odds ratios, 3.16 [95% CI, 1.76-5.67] vs 2.58 [95% CI, 1.43-4.65]) and middle-aged vs younger patients (effect sizes, 0.50 [95% CI, 0.21-0.78] vs 0.85 [95% CI, 0.55-1.15]). No significant association was observed between smoking habits and severe reduction of taste (odds ratio, 0.95; 95% CI, 0.53-1.71) and/or smell (odds ratio, 0.65; 95% CI, 0.35-1.21). Conclusions and Relevance: The findings of this telephone survey study suggest that reduction of taste and/or smell may be a frequent and early symptom of COVID-19. Nasal obstruction was not commonly present at the onset of the disease in this study. The general practitioner may play a pivotal role in identifying potential COVID-19 in patients at an early stage if taste and/or smell alterations manifest and in suggesting quarantine before confirmation or exclusion of the diagnosis.


Subject(s)
COVID-19/complications , Olfaction Disorders/epidemiology , Olfaction Disorders/virology , Taste Disorders/epidemiology , Taste Disorders/virology , Adult , Age Distribution , Aged , Aged, 80 and over , COVID-19/diagnosis , Early Diagnosis , Female , Humans , Male , Middle Aged , Nasal Obstruction/epidemiology , Olfaction Disorders/diagnosis , Prevalence , Retrospective Studies , SARS-CoV-2 , Sex Distribution , Taste Disorders/diagnosis
7.
Eur Arch Otorhinolaryngol ; 277(9): 2647-2648, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-526771

ABSTRACT

PURPOSE: To propose a way to safely perform endoscopic nasopharyngoscopy in ENT outpatient clinic during the COVID-19 pandemic. METHODS: This manuscript highlights the importance of endoscopy in daily ENT clinical practice, which is a pivotal procedure in the diagnosis of many head and neck pathologies. However, since the beginning of the COVID-19 outbreak, the authors have witnessed a drastic reduction (91%) in the use of endoscopic nasopharyngoscopy at their institutions. In fact, it is considered at risk of contamination for healthcare professionals, as any upper airway manipulation procedure. RESULTS: In the "Back approach to the patient" for endoscopic nasopharyngoscopy, the operator positions himself behind the patient and faces the monitor. The endoscopist, not being positioned in front of the patient, should, therefore, be less exposed to airborne transmission of SARS-CoV-2 virus. CONCLUSION: This simple variation of the physician's position during endoscopic nasopharyngoscopy could potentially reduce the risk of contagion since the operator is not in the trajectory of droplets and/or aerosols.


Subject(s)
Coronavirus Infections/prevention & control , Endoscopy , Nasopharynx/diagnostic imaging , Otolaryngologists , Otorhinolaryngologic Surgical Procedures , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aerosols , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Head , Humans , Neck , Occupational Health , Otolaryngology , Pneumonia, Viral/epidemiology , SARS-CoV-2
9.
Head Neck ; 42(6): 1303-1304, 2020 06.
Article in English | MEDLINE | ID: covidwho-143979

ABSTRACT

Performing a proper nasal and oropharyngeal swab procedure is essential in the screening of COVID-19 infection. The video illustration of nasal and oropharyngeal swab is presented (Video S1). To correctly perform the nasopharyngeal swab, the patient must be seated comfortably with the back of their head against the headrest. The swab is inserted in the nose horizontally, along an imaginary line between the nostril and the ear. Oropharyngeal sampling is easier to perform. The swab is directed toward the rear wall of the oropharynx and it is rotated a few times before removal. After taking the sample, it is necessary to insert both swabs in the same tube, breaking the rod with one swift and controlled movement. Finally, carefully reset the cap. It appears to be extremely important to properly collect nasopharyngeal and oropharyngeal swabs in order to minimize the false negative rate among COVID-19 positive patients.


Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Nasal Cavity/virology , Oropharynx/virology , Pneumonia, Viral/diagnosis , Specimen Handling/methods , COVID-19 , COVID-19 Testing , Humans , Pandemics , SARS-CoV-2
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