ABSTRACT
OBJECTIVE: This study investigated how the coronavirus disease 2019 pandemic has impacted on presentations to ENT first-on-call services. METHODS: All appointments to a rapid access triage clinic from 1 June to 31 August in 2019 and 2020 were reviewed retrospectively and their reasons for consultation classified. A binomial proportion test was used to determine whether the proportions of consultations per presentation differed significantly between years. This analysis was repeated with the number of unique patients per presenting complaint. RESULTS: The proportions of nine reasons for consultation differed significantly between 2019 and 2020, including an increase in otitis media and nasal trauma presentations, and a decrease in otitis externa and tonsillitis presentations. Reattendances caused some variation in the frequency of certain diagnoses. CONCLUSION: Our data suggest a shift in the presentations to first-on-call services, which may be a result of changes in patient behaviour and access to healthcare services.
Subject(s)
Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , Otorhinolaryngologic Diseases/epidemiology , Ear/injuries , Foreign Bodies/epidemiology , Foreign Bodies/therapy , Humans , Otitis Externa/epidemiology , Otitis Externa/therapy , Otitis Media/epidemiology , Otitis Media/therapy , Otorhinolaryngologic Diseases/diagnosis , Otorhinolaryngologic Diseases/therapy , Retrospective Studies , Tonsillitis/epidemiology , Tonsillitis/therapy , United Kingdom/epidemiologyABSTRACT
OBJECTIVES: To present the otologic findings of a patient with COVID-19 and complicated acute otitis media, evaluate for the presence of SARS-CoV-2 in middle ear fluid, and assess whether suctioning of middle ear fluid may be aerosol- generating. METHODS: The case of a man with SARS-CoV-2 infection and complicated acute otitis media with facial paralysis is presented to illustrate unique clinical decisions made in context of the COVID-19 pandemic. A cadaveric temporal bone was used to simulate droplet spread during suctioning of fluorescein-labelled middle ear fluid and visualized with a blue-light filter. RESULTS: A 23-year-old male who presented with complicated acute otitis media with facial paralysis was found to have an acute infection with SARS-CoV-2, with positive viral PCR of nasopharyngeal swab, and a negative PCR of the middle ear fluid. He was placed on isolation precautions and treated with myringotomy, topical and systemic antibiotics, and antivirals. Consistent with observations during endonasal suctioning, suctioning of middle ear fluid was not found to be aerosol or droplet generating. CONCLUSION: The case of a patient with active COVID-19 presenting with complicated acute otitis media in whom middle ear fluid was sampled to evaluate the etiology of the infection and the potential middle ear predilection of SARS-CoV-2 is described. This study has implications for the clinical management of patients with both known and unknown SARS-CoV-2 infection who present with ear disease. While middle ear suctioning may not be aerosol-generating, the risk of coughing or prolonged close contact requires heightened precautions during otologic procedures in patients with suspected or confirmed COVID-19.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Antiviral Agents/administration & dosage , COVID-19 Testing/methods , COVID-19 , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Middle Ear Ventilation , Otitis Media , SARS-CoV-2/isolation & purification , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/therapy , Facial Paralysis/etiology , Facial Paralysis/therapy , Humans , Infection Control/methods , Male , Middle Ear Ventilation/methods , Middle Ear Ventilation/standards , Occupational Exposure/prevention & control , Otitis Media/complications , Otitis Media/etiology , Otitis Media/physiopathology , Otitis Media/therapy , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/microbiology , Treatment Outcome , Young AdultABSTRACT
Since late December 2019, a new type of coronavirus (CIVID-19) causing a cluster of respiratory infections was first identified in Wuhan-China. And it disseminated to all countries. Generally, COVID-19 cases have fever, cough, respiratory distress findings (dyspnoea, intercostal retraction, cyanosis etc.). In this paper, we have presented an adult otitis media case whom infected with COVID-19, but she have not any classical COVID-19 symptoms.