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1.
Laryngo- Rhino- Otologie ; 101:S335, 2022.
Article in English | EMBASE | ID: covidwho-1967688

ABSTRACT

Purpose We investigated the prevalence of smell and/or taste loss and the clinical characteristics and recovery in a cohort of consecutive patients treated by two COVID-19 reference hospitals and evaluated the late persistence of hyposmia. Material and Methods 53 consecutive RT-PCR diagnosed patients (23 males, 30 females, 42,54 ± 10, 95 years) who had been hospitalized between January- June 2021 in the COVID-19 care wards were contacted, excluding patients with cognitive disorders and severe deconditioning. These patients (Group A) have been examined twice, once direct after leaving the hospital, and once again 4-6 weeks later. The patients- nasal and oral mucosa (Fungiform Papillae on tongue-s tip-fPap) were examined with a contact endoscope. Their olfaction was also examined with Sniffin' Sticks. As control-group we have examined 53 healthy subjects (Group B). Results Significant alterations in form and vascularization of fPap have been detect, specially by the first examination. Patients EGM-Thresholds of both measurements are higher than those of healthy subjects, although those of the second one are clearly lower. The same results have been found using Schniffin- Sticks. Discussion Our findings suggest that COVID-19 can produce a mild to profound neuropathy of multiple cranial nerves, which are responsible for the regeneration of fPap and the transmission of the chemical stimuli.

2.
Laryngo- Rhino- Otologie ; 101:S324, 2022.
Article in English | EMBASE | ID: covidwho-1967684

ABSTRACT

Introduction As a result of the SARS-CoV-2 pandemic, a concept had to be devised in all clinics in order to ensure patient safety and staff protection. This included measures such as reducing patient numbers, introducing double triage and temporarily deploying treatment teams. The objective was to shorten the exposure time in order to protect against infection. The objective of this study was to examine the effects of these measures. Materials and Methods For the period July 2019 to July 2021, the numbers and treatment durations of all outpatient contacts during regular service from the hospital information system were analysed. Here, distinctions were made according to various treatment categories. Results Up to February 2020, the average number of patient contacts per month was 1669 ± 98. Following a reduced number of patient contacts from March 2020 due to the onset of the Coronavirus (1st lockdown), a highly significantly lower number of patients were treated as outpatients from May 2020 (1096 ± 141, p < 0.01). Prior to the pandemic, the mean treatment duration was 2.1 ± 0.1 hours, but later during the pandemic, only 1.5 ± 0.1 hours. The difference between both treatment durations was highly significant (p < 0.01). According to a comparison of treatment categories, only emergency patients appeared to have significantly longer maximum treatment durations than all other patient groups. Discussion:Even though compliance with all hygiene measures complicates the course of treatment, the main objective of shortening the duration of treatment was achieved. Mean and standard deviation represent 84 % of all patients. This parameter was incorporated into the clinic-s quality management system as a key figure that must be collected monthly.

3.
Laryngo- Rhino- Otologie ; 101:S319-S320, 2022.
Article in English | EMBASE | ID: covidwho-1967681

ABSTRACT

Purpose In the CoViD-19 pandemy there is a need for voice examination techniques that minimize the risk of infection for both patient and examiner. To investigate whether the measurement of the Acoustic Voice Quality Index (AVQI) is valid and comparable to previous unmasked measurements if the speaker wears a surgical mask or a FFP-2 mask in order to reduce the risk of transmitting air-borne viruses such as SARS-CoV-2. Methods A convenience sample of 31 supposedly healthy participants was subjected to AVQI voice examination four times: Twice wearing no mask, once with a surgical mask and once with a FFP-2 mask as used regularly in our hospital. The order of the four mask conditions was randomized. The spread in the results between the two recordings without mask was then compared to the spread in the recordings with each mask and the recording without masks. Results The mean absolute difference in AVQI was 0.45 between the measurements without masks, 0.48 between no mask and surgical mask and 0.51 be-tween no mask and FFP-2 mask . The results were neither clinically nor statistically significant (in a signed rank test). Conclusion Based on a convenience sample of healthy or only mildly impaired voices wearing CoViD-19 protective masks does not substantially impair the results of AVQI measurements.

4.
Laryngo- Rhino- Otologie ; 101:S314, 2022.
Article in English | EMBASE | ID: covidwho-1967680

ABSTRACT

Background To date, systematic studies on the cause and prevalence of childhood hyposmia are lacking. The causes of this olfactory dysfunction can vary from simple adenoid hyperplasia or a condition following covid-19 infection to the rare Kallmann syndrome. Regardless of the entity, olfactory disorders can not only severely limit children's quality of life but also present a diagnostic challenge. Methods In the period from March to October 2021, 66 children (33 female, 33 male) between 5 and 18 years of age were examined. 41 of these children showed hyperplasia of the lymphatic tissue (adenoid vegetations and/or tonsillar hyperplasia). 25 healthy children without lymphatic hyperplasia were included in the control group. By means of the 'U-Sniff Test', an olfactory test validated for children, the preoperative olfactory ability was assessed. In addition to the known 12 olfactory sticks, we added two additional odors (chewing gum and ethanol). Results 39 % of the children with lymphoid hyperplasia showed a result below 8 points in the 'U-Sniff Test', while the controle group had regular test results. Children with lymphoid tissue hyperplasia were significantly more likely to be diagnosed with hyposmia than are children from the control group (p < 0.01). Odors unpleasant for children, such as fish or coffee, were more reliably detected than fragrant smells. The odor chewing gum was recognized by 91 % of the children in the age group under 6 years of age. The childrens origin or eating habits showed no correlation with their performance in the 'U-sniff Test'. Conclusion Children with lymphoid hyperplasia suffer significantly more often from hyposmia than children without adenoid/tonsillar hyperplasia. There is an evidence gap in the literature regarding this correlation.

5.
Laryngo- Rhino- Otologie ; 101:S313, 2022.
Article in English | EMBASE | ID: covidwho-1967679

ABSTRACT

Introduction The COVID pandemia led to a change in patient structure in German ENT clinics. Material/Methods The 30-day readmission rate of children in the ENT clinic of the Jena University Hospital from 01/01/2015 to 12/31/2015 was compared with the period from 07/01/2020 to 06/30/2021. Results In 2015, a total of 459 patients under the age of 18 were treated. In contrast, within one year of the COVID-19 pandemia, only 56 children and adolescents received inpatient therapy. Both groups were similar in terms of age and gender (group 2015: age 5.5 ± 4.4 years (mean ± standard deviation), 56 % male;group COVID-19: age 5.1 ± 3.4 years;58.9 % male). In 2015, 57.7 % of the patients were hospitalized for adenoid and / or tonsillar hyperplasia. In 2020/21 it was only 44.6 %. The 30-day readmission in the context of the COVID-19 pandemic was 12.5 %, significantly higher than in 2015 with 4.4 %. While only 30 % of readmissions were planned in 2015, this was 71.4 % at the time of the COVID-19 pandemic. In 2015, secondary bleeding was the cause of readmission in 20 %. In the context of the COVID-19 pandemic, there was not a single case of readmission due to secondary bleeding. Summary A changed patient spectrum due to the COVID-19 pandemic has an impact on the 30-day readmission rate of children in the ENT clinic. This must be taken into account in future therapy.

6.
Laryngo- Rhino- Otologie ; 101:S292, 2022.
Article in English | EMBASE | ID: covidwho-1967675

ABSTRACT

The majority of firework-related injuries in Germany are found at the turn of the year. With regard to hearing, a distinction is made between blast (BT) and explosion trauma (ET). The study examines the prevalence and characteristics of firework-related injuries over the past 11 years on New Year's Eve and compares these with the effects of the pyro ban 2020/21 imposed due to the COVID-19 pandemic. A retrospective chart review of all patients who presented themselves with the diagnosis blast trauma (H 83.3) or explosion trauma (T 70.8) at the Charité emergency service in the last 11 years from December 28 to January 5 was performed. 267 patients were recorded (78 % male). 1/3 each were assigned to the age group 10-19 and 20-29 years. 21 % of the patients were admitted to the hospital. There was an isolated BT of the ear in 66 %, hand injuries in 12 %, head injuries in 8 % and eye injuries in 4 %. 87 % had ear involvement with hearing loss: 83 % with tinnitus, 5.6 % with ET. The tone audiograms of BT and ET show differences only at 6 kHz, but not at 4 kHz. 8.6 % of the patients underwent surgical interventions. The treatment of a tympanic membrane perforation was carried out by: 54 % splinting vs. 38 % tympanoplasty. Therapy with a glucocorticoid was administered i.v. in 48 % and initiated orally in 17 %. Overall, there was a decrease in injuries of almost 90 % in 2020/21 compared to 2017/18. The use of fireworks leads to increased utilization of health care resources. The ban on the sale of pyrotechnics as well as the introduction of pyro ban zones in 2020 led to a relevant decrease in injuries. 2020 was the only year in which there were no injuries in children / adolescents. The BT of the ear is the most common firework-related injury.

7.
Laryngo- Rhino- Otologie ; 101:S203, 2022.
Article in English | EMBASE | ID: covidwho-1967674

ABSTRACT

Introduction The imposed radical governmental restrictions to combat the pandemic and the overstrained medical resources affected greatly, not only those infected from the novel virus, but also miscellaneous patient groups. Aim of this study was the assessment of the efficacy of oncologic healthcare during Covid-19 pandemic on patients with head neck squamous cell carcinoma in a tertiary university hospital in Germany. Material and Methods This retrospective, cross-sectional, observational study included 94 patients with newly diagnosed head and neck squamous cell carcinoma during a two-year period. Patients were assigned to two date-dependent groups;referrals before (Group A) and during (Group B) the Covid-19 pandemic. Time intervals from symptom(s) onset to diagnosis, diagnosis to treatment and treatment initiation to completion were recorded. Furthermore, TNM-stages and application of reconstructive surgery with free tissue transfer were determined. Results Despite the challenges and burden of the pandemic, tumor upstaging and treatment delays could not be observed. Conclusion A timely diagnosis and treeatment initiation plays a major role in prognosis of patients withs head and neck squamous cell carcinoma.

8.
Laryngo- Rhino- Otologie ; 101:S197, 2022.
Article in English | EMBASE | ID: covidwho-1967672

ABSTRACT

The Covid-19 pandemic situation over the past two years has placed considerable stress on the medical treatment facilities. The therapy and prognosis of head and neck cancer (HNC) depends largely on the time of diagnosis. In the medical subjective perception, HNC were diagnosed later under pandemic conditions for various reasons, such as additional fear of visiting a doctor and postponed examinations by the medical staff. For some sub-areas of medicine, valid studies are already available. With the help of an evaluation of the UICC tumor stages at diagnosis, it is intended to retrospectively determine whether the most common HNC in 2020 and 2021 were diagnosed later than in 2018 and 2019. The UICC stages of all (n = 207) laryngeal, oropharyngeal, hypopharyngeal and oral cavity carcinomas primarily treated at the Halberstadt Otorhinolaryngology Clinic were evaluated for the diagnosis periods 2018/2019 and 2020/2021 (until November 2021). Overall, there was no evidence of an increase in tumor stages in 2020/21 compared to 2018/19. Even an evaluation of the subgroups with a view to the stages at the time of diagnosis does not reveal any evidence of a significant delay due to the pandemic situation. Despite temporary logistical restrictions, it has apparently been possible to prevent an extension of the diagnostic periods for the most common head and neck tumors.

9.
Laryngo- Rhino- Otologie ; 101:S193-S194, 2022.
Article in English | EMBASE | ID: covidwho-1967671

ABSTRACT

Introduction According to international publications the COVID-19 pandemic led to a delay in the medical treatment of different diseases. The purpose of our investigation was to evaluate the incidence and the stage of head and neck cancer in the period from 01/2020-12/2021. These data were compared to that before the pandemic in the time period from 01/2018-12/2019. Method Using our oncological documentation system, a monocentric analysis of the number of tumor diagnosis and tumor stages at initial diagnosis was carried out looking at the 2-year pandemic period from 2020-2021. The purpose of the investigation was to determine whether there was a pandemic-related delay in treatment of oncological patients in our clinic. Results The analysis showed no decrease in the number of new tumor cases in the pandemic years 2020-2021 compared to the years 2018-2019. Furthermore, no shift towards more advanced tumor stages during the COVID-19 pandemic could be determined. Conclusion Occasionally the COVID-19 pandemic led to delayed tumor diagnosis and treatment, which resulted in a worse outcome for many patients. This effect could be turned around by accurate appointment planning taking tumor suspected cases under consideration. Furthermore, special office hours particularly for tumor cases even in times of a lockdown including video consultations when appropriate and patient awareness campaigns led to a favorable patient care.

10.
Laryngo- Rhino- Otologie ; 101:S354, 2022.
Article in English | EMBASE | ID: covidwho-1967669

ABSTRACT

Introduction In medical school, capacity building is a central goal. During the COVID pandemic, in-classroom teaching was temporarily suspended and online teaching was used even to teach psychomotor ability skills such as specific examination skills, e.g. of the head and neck. Our study aimed to measure performance and capacity of self-evaluation in students who had only received online teaching. Methods After completing a new extensive online ENT examination course, we conducted a standardized clinical skills exam for nine different ENT examination items with 30 students. Using Likert-scales, self-evaluation was measured based on questionnaires right before the clinical skills exam and objective evaluation during the exam was assessed following a standardized regime. Self-evaluation and objective evaluation were correlated. We compared this cohort to a cohort that had completed a traditional in-classroom ENT skills course. Results Compared to in-classroom teaching, students of the online cohort self-assessed their examination skills similar whereas objective evaluation showed slightly decreased skill levels. In easier psychomotor examination techniques, students overestimated their skills more often. In more difficult examination techniques such as endoscopy, both over- and underestimation were more often observed. The highest level of misjudgment was found in techniques with intermediate difficulty. Conclusion Online courses can add additional value to in-classroom teaching in a timely and reasonable way and can help to gain ENT examination skills. Nevertheless, online-only teaching cannot replace in-classroom teaching to acquire the sophisticated psychomotor skills needed for a thorough clinical ENT examination. Virtuelle Hochschule Bayern.

11.
Laryngo- Rhino- Otologie ; 101:S354, 2022.
Article in English | EMBASE | ID: covidwho-1967668

ABSTRACT

Background The COVID-19 pandemic has considerably catalyzed digitization processes in medical education. This opens up fields of innovative research, which must also show evidence in terms of student learning success. In particular, this applies to the acquisition of practical skills. Objective It was exmined to what extent students can acquire practical skills within a purely digitally implemented ENT mirror examination and how sustainable the learning success is when students return after one semester. By referring to the study 'Learning curve of the ENT mirror examination' by Polk et al. 2020, a comparison of online and face-to-face teaching can be drawn as well. Materials and methods Within a five-day ENT internship, 146 students were taught 6 ENT mirror examinations via a videoconferencing system. Student performance was assessed daily in a testing group (PG, n = 48) and also in a control group (KG, n = 98) on day 5 using a standardized checklist. After one semester, the examination was retaken for PG (n = 29) and KG (n = 17). Results Within the five days, PG showed a significant increase in performance on all partial examinations. For most partial examinations, PG's and KG's performance differed significantly, but these differences were largely undetectable after one semester. The results of online and face-to-face teaching showed great similarities. Conclusion Even during the COVID-19 pandemic, students were able to acquire practical skills in the ENT mirror examination at a level of performance comparable to that of face-to-face teaching. The PG's daily formative examinations seemed to ensure a better examination routine at the end of the internship, but the PG students' results became more similar to those of the KG over time.

12.
Laryngo- Rhino- Otologie ; 101:S243, 2022.
Article in English | EMBASE | ID: covidwho-1967666

ABSTRACT

Aim The project aims to examine chemosensory dysfunction in long-COVID with a focus on olfactory function about 9 months after SARS-CoV-II-infection. Material and Methods In this population-based cross sectional study, PCR-confirmed SARS-CoV-2 outpatients were examined between November and June 2020 at Kiel university hospital. Data on medical history and chemosensory function were collected via questionnaires and a Visual Analogue Scale (VAS), olfactory performance was psychophysically objectified using the Sniffin' Sticks test. Results A total of 376 female and 290 male patients were included with a mean age of 48.2 years ranging from 19 to 87 years. The mean follow-up was 9.09 months (range 1.64-15.18) after initial positive PCR-testing. The prevalence for olfactory dysfunction (OD) during infection was 66,1 %. 33,7 % of the subjects reported persistent OD subjectively at the time of examination (female 28,8 %, male 42,3 %). T-test analysis showed a significant decline of reported olfactory evaluation from before COVID-19 to the time of examination based on VAS (p < 0.001). 34,6 % of the subjects were tested hyposmic or anosmic by Sniffin' Sticks. A significant correlation was shown between a subjective estimation of OD by the patients and an objectively tested OD (p < 0.001). The TDI-score correlated positively with the amount of time (in months) that passed since PCR-testing (p < 0.001). Discussion OD in SARS-CoV-II-infection is frequent and can be persistent long beyond the acute phase of ilness. We demonstrated that anamnestic OD is significantly related to psychophysically tested OD. Therefore one can conclude that a subjective OD is a likely predictor of an actual objective OD. Furthermore, OD shows a tendency to improve over time.

13.
Laryngo- Rhino- Otologie ; 101:S243, 2022.
Article in English | EMBASE | ID: covidwho-1967665

ABSTRACT

SARS-CoV-2 virus has evolved non structural proteins (NSLs) to avoid recogniton by innate immune receptors such as RIG-I which induces an antiviral type I IFN response. A proper type I IFN response is essential for an effective defense against SARS-CoV-2. The aim of this project is the evaluation of the effect of a prophylactic activation of RIG-I by a specific synthetic RNA ligand (5-triphosphate RNA, 3pRNA) to an antiviral state in cells that protects against SARSCoV- 2. We analysed the effect of activation of RIG-I by 3pRNA on SARS-CoV-2 infection in primary upper airway cells. Primary nasal epithelial cells (PNEC) and primary bronchial cells (NHBEC) were cultivated in air-liquid interface and differentiated to cilia bearing epithelial cells. Viral replication was analyzed by plaque assay and qPCR. Furthermore, interferon-stimulated genes and ACE2/TMPRSS2 were determined on the transcriptional level and IP-10 protein was quantified in supernatants by ELISA. Only PNEC in a fully differentiated state could be infected with SARS-CoV-2, while undifferentiated cells were not susceptible to infection with this virus. Upon stimulation with 3pRNA at 6h prior to infection, PNEC produced more than 10.000 pg/ml IP-10. Infection with SARS-CoV-2 significantly decreased the average of 3pRNA-induced IP-10 production. 3pRNA pretreatment of PNEC significantly reduced SARS-CoV-2 replication at 48 h by up to 99,7 % as evaluated by plaque assay and up to 90 % as measured by qPCR. These results demonstrate for the first time that RIG-I activation protects primary fully differentiated epithelial cells against SARS-CoV-2 replication. Our results support the concept that RIG-I-mediated prophylaxis is a promising strategy to mitigate SARS-CoV-2 infection.

14.
Laryngo- Rhino- Otologie ; 101:S242-S243, 2022.
Article in English | EMBASE | ID: covidwho-1967664

ABSTRACT

Introduction Olfactory dysfunction is a commonly described symptom in the setting of SARS-Cov-2 virus infection. The prevalence is reported to be 40-60 %. Spontaneous remission often occurs during the course, but many patients suffer from longer-term olfactory impairment. This study tests possible improvement of long-term impairment with intra-nasal reflex therapy (INRT). Methods Patients with > 6 weeks of persistent olfactory dysfunction after symptomatic covid-19 infection were included in the 28-day intervention study. INRT applications were performed on 6 dates over 14 days. Intranasal stimula- tion was performed endonasally bilaterally at 3 different sites. An ENT assessment was performed at the start and end points of the study. Quality of life was assessed bilaterally using SF36. An objective olfactory test (SniffinSticks) was performed trilaterally. Results A total of 15 patients, 9 women and 6 men (22-67 years) with disease onset between 03/2020 and 03/2021 were included. None of the study participants showed anatomical abnormalities, and the interventions (INRT) were well tolerated. Subjectively, there was a small to significant decrease in hyposmia in most patients in both groups, and objectively, some patients also showed improvement in their findings. Discussion The results suggest a promising approach as a complementary therapeutic option for hyposmia post covid-. To increase validity, an increase in the number of cases and the establishment of a control group is planned.

15.
Laryngo- Rhino- Otologie ; 101:S242, 2022.
Article in English | EMBASE | ID: covidwho-1967663

ABSTRACT

Background A loss of smell is often the first symptom of a COVID-19 infection. This study examined olfactory dysfunction (OD) of hospitalized COVID-19 patients in a single centre in a cross-sectional and longitudinal fashion. Methodology 27 hospitalized patients with PCR-confirmed, active COVID-19 disease were included. Olfactory history was taken using a questionnaire. Olfactory function was evaluated with Sniffin' Sticks tests (threshold-, discrimination- and identification test;TDI). Follow-up checks via identification testing were performed every two days during hospitalization, and 4 months after the first test. Results Looking at the TDI scores, 25 of 27 patients (93 %) showed an OD. Of those, 16 patients (64 %) reported a subjective normosmia. The assessment of the TDI score subcategories showed that the affected participants performed poor in the discrimination and the threshold tests, whereas the smell identification skills were impeded the least. When looking solely at the identification tests, only 17 of 27 individuals (63 %) showed pathologic scores. Conclusions Olfactory testing reveals a higher rate of affected individuals than subjective evaluation in COVID-19 patients. In addition, a mere testing of the identification abilities seems insufficient to diagnose ODs in these patients. A comprehensive test battery looking at threshold, discrimination and identification skills is recommendable.

16.
Laryngo- Rhino- Otologie ; 101:S242, 2022.
Article in English | EMBASE | ID: covidwho-1967662

ABSTRACT

Background This study aims to investigate the prevalence and long-term development of gustatory dysfunction (GD) after COVID-19. Methods In the population-based cross-sectional COVIDOM-study, 667 patients above the age of 18 years (mean 48.2) who tested positive for SARSCoV- 2 via PCR-testing on average 9.09 months ago were examined between November 2020 and June 2021. Extensive medical history taking was conducted via questionnaires. Participants were asked to rate their ability to taste before, during and after COVID-19 on a Visual Analogue Scale (VAS) ranging from 0 to 10. Whole mouth gustatory testing with Taste Strips for the qualities sweet, sour, salty, and bitter was performed. Results 60.9 % (406 of 667) participants reported gustatory impairment during their infection. Out of those, 56.9 % perceived this symptom as severe and 13.3 % noticed it as the earliest symptom. At the time of our examination, 36.2 % had a persistent subjective GD, defined as a lower score on the VAS than before COVID-19 (mean difference -0.9 points). This difference was significant (p < 0.001). In the testing, 7.3 % (47 of 667) participants had a GD, defined as the correct identification of less than three out of four Taste Strips. No signifi- cant correlation was found between subjectively persistent and tested GD (p = 0.250). Conclusions SARS-CoV-2 seems to frequently affect the gustatory function in the long term as well, what might have an influence on patients' everyday-life. However, Patients' own perception does not always correspond with psychophysiological testing which might be caused by the common difficulty to differentiate between the chemosensory senses of taste and smell.

17.
Laryngo- Rhino- Otologie ; 101:S233, 2022.
Article in English | EMBASE | ID: covidwho-1967661

ABSTRACT

Introduction Reprocessing of medical devices becomes increasingly complex, due to higher hygiene requirements. Former studies revealed satisfactory bactericidal properties of UV-C light disinfection in otorhinolaryngological endoscopes. Especially in the context of the current COVID-19 pandemic, virucidal properties are of high importance. In this study the virucidal efficacy of UV-C light disinfection was analyzed using a bacteriophage model. Materials and methods MS-2 bacteriophages were used as surrogate for stable viruses with high tenacity. The bacteriophage samples were irradiated for up to three cycles of 25 seconds by UV-C light (D25, UV-Smart Technologies B.V.). A dilution series of the irradiated test samples was mixed with 1x108 CFU of Escherichia coli. After incubation plaque formation of Escherichia coli were counted and hence the phage concentration was determined. Results The initial contamination of the test samples was 1.8x1012 plaque forming units (pfu). After 25 seconds of UV-C light irradiation, a non-significant Log reduction of 2.2 was found (p = 0,82). After 50 and 75 seconds of UV-exposure a significant Log reduction of 3.4 e.g. 5.1 (p = 0.05 e.g. p = 0.004) was found. The control sample showed a titer of 1.2 x 1010 pfu. Conclusion The tested UV system seems to provide a significant virucidal effect after a short time of exposure. In combination with the results of the bacteriological testing it appears suitable for clinical use as a substitute for current disinfection methods.

18.
Laryngo- Rhino- Otologie ; 101:S232, 2022.
Article in English | EMBASE | ID: covidwho-1967660

ABSTRACT

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.

19.
Laryngo- Rhino- Otologie ; 101:S352, 2022.
Article in English | EMBASE | ID: covidwho-1967658

ABSTRACT

Introduction The basic problem with teaching ENT is having to convey content in a very short period of time. Due to the Corona pandemic, content had to be digitised at short notice in order to continue teaching. Even hybrid teaching and learning formats were compromised. We therefore developed the innovative concept of a fully digital flipped classroom by combining digital teaching formats with live video conferencing and small group work (so-called breakout sessions). Material and methods From the beginning of the module, all learning materials were accessible for independent preparation via the Stud.IP and ILIAS learning platforms. The face-to-face classes were replaced by interactive video conferencing and the breakout session function was used as an innovative approach. The apparative diagnostics were integrated live with the help of capture cards from the gaming sector and an online survey was conducted at the end. Results The course was technically well implemented and meaningfully enriched with the help of live medical technology. Student satisfaction with the innovative concept was high overall and ensured high participation rates. The breakout session was rated positively overall. Discussion In the future our demonstrated concept will be one possible option to enlarge upon classroom teaching. In our opinion this will matter especially for underrepresented subjects like otorhino-laryngology. We had the experience that especially the contact point between theory and practice can be empowered by this method. The possibility to carry out a group work within a large digital event is a good option to personalize the education while saving time for the teachers.

20.
Diabetologie und Stoffwechsel ; 17:S54, 2022.
Article in English | EMBASE | ID: covidwho-1967654

ABSTRACT

Background and Aim Obesity and type 2 diabetes (T2D) show an increased risk for a severe COVID-19 disease. Treatment with DPP4 inhibitor (DPP4i) results in reduced mortality and better clinical outcome. Here, we aimed to identify potential mechanisms for the observed DPP4i effect in COVID-19. Methods We compared T2D subjects with (cases) and without (controls) DPP4i treatment (N=69), as well as patients hospitalised for severe COVID-19 and healthy controls (N=34) with regard to serum concentrations of soluble frizzle receptor protein 5 (sFRP5) using univariate statistics. Furthermore, we isolated pre-adipocytes, mature adipocytes and macrophages from adipose tissue biopsies (N=100) and performed western-blotting for sFRP5 and Wnt5a expression. Results In T2D patients, we identified a significant increase of the anti-inflammatory adipokine sFRP5 in relation to DPP4 inhibition. sFRP5 is a specific antagonist to Wnt5a, a glycopeptide secreted by adipose tissue macrophages acting proinflammatory in various diseases. We therefore examined sFRP5 levels in patients hospitalised for severe COVID-19 and found significant lower levels compared to healthy controls. Since sFRP5 might consequently be a molecular link for the beneficial effects of DPP4i in COVID-19, we further aimed to identify the exact source of sFRP5 in adipose tissue on cellular level. Results from western-blotting in adipose tissues showed a sFRP5 expression specifically in mature adipocytes of subcutaneous and omental adipose tissue. Conclusion In summary, our data suggest that DPP4i increase serum levels of anti-inflammatory sFRP5 which might be beneficial in COVID-19, reflecting a state of sFRP5 deficiency.

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