ABSTRACT
OBJECTIVE: To determine the prevalence of COVID-19 in a cohort of children undergoing tonsillectomy through assessment of B cell immune responses to SARS-CoV-2 in both peripheral blood and tonsil tissue. METHODS: In this cohort study at a tertiary pediatric hospital (Children's National Hospital) in Washington, DC, we recruited 100 children undergoing tonsillectomy from late September 2020 to January 2021. Serum, peripheral blood cells, and tonsil tissue were collected and examined for immune reactivity to SARS-CoV-2. Parent-reported clinical histories were compared to antibody and B-cell responses. RESULTS: Among 100 children undergoing tonsillectomy, 19% had evidence of immune responses to SARS-CoV-2 (CoV2+), indicating prior COVID-19. In all seropositive participants, we detected SARS-CoV-2 specific B cells in both peripheral blood mononuclear cells and tonsils, providing evidence for tissue-specific immunity in these children. Of the 19, 63% reported no known history of COVID-19, and an additional 3 were asymptomatic or unaware of an acute infection when detected on pre-surgery screen. Hispanic children represented 74% of CoV2+ subjects compared to 37% of the full cohort. 100% of CoV2+ children lived in a zip code with poverty level >10%. CONCLUSIONS: Nearly one-fifth of children undergoing tonsillectomy at an urban U.S. hospital had evidence of prior COVID-19 during the early pandemic, with the majority unaware of prior infection. Our results underscore the ethnic and socio-economic disparities of COVID-19. We found concordant evidence of humoral immune responses in children in both blood and tonsil tissue, providing evidence of local immune responses in the upper respiratory tract. LEVEL OF EVIDENCE: 3 Laryngoscope, 2022.
ABSTRACT
The novel coronavirus disease 2019 (COVID-19) is highly contagious and rapidly spreading all over the world. COVID-19 patients might present with higher susceptibility to fungal co-infection. Mucormycosis is a life-threatening fungal disease characterized by vascular invasion by hyphae, leading to thrombosis and necrosis. Currently, COVID-19-associated mucormycosis (CAM) is creating a threat to patient's life in the community and is considered a fatal clinical entity in the Indian subcontinent. Mucormycosis is emerging as a matter of concern in COVID-19 patients with poorly controlled diabetes mellitus and other comorbidities as risk factors. Here, a 48-year-old man previously admitted to the COVID hospital due to severe acute respiratory syndrome coronavirus 2 infection presented with foreign body sensation and was later diagnosed with primary mucormycosis at the palatine tonsils. Early diagnosis and prompt treatment with surgery followed by liposomal amphotericin B are essential for the successful management of the CAM. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.
Subject(s)
Time-to-Treatment , Tonsillectomy/methods , Tonsillitis/surgery , Waiting Lists , Adolescent , Adult , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Young AdultABSTRACT
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.