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1.
Aust J Gen Pract ; 512022 04 06.
Article in English | MEDLINE | ID: covidwho-1786590

ABSTRACT

On average, 47% of patients with COVID-19 self-report an olfactory disorder, although the inaccuracy of self-reporting means this figure may be higher.


Subject(s)
COVID-19 , Olfaction Disorders , Anosmia/etiology , COVID-19/complications , Humans , Olfaction Disorders/etiology , SARS-CoV-2
2.
Cells ; 11(5)2022 02 24.
Article in English | MEDLINE | ID: covidwho-1725524

ABSTRACT

Among the first clinical symptoms of the SARS-CoV-2 infection is olfactory-gustatory deficit; this continues for weeks and, in some cases, can be persistent. We prospectively evaluated 162 patients affected by COVID-19 using a visual analogue scale (VAS) for nasal and olfactory-gustatory symptoms. Patients were checked after 7, 14, 21, 28, 90, and 180 days. A total of 118 patients (72.8%) reported an olfactory VAS < 7 at baseline (group B), and 44 (27.2%) reported anosmia (VAS ≥ 7) (group A) and underwent the Brief Smell Identification Test (B-SIT) and Burghart Taste Strips (BTS) to quantify the deficit objectively and repeated the tests to confirm the sense recovery. Group A patients showed B-SIT anosmia and hyposmia in 44.2% and 55.8% of cases, respectively. A total of 88.6% of group A patients reported ageusia with VAS ≥ 7, and BTS confirmed 81.8% of ageusia and 18.2% of hypogeusia. VAS smell recovery was recorded starting from 14 days, with normalization at 28 days. The 28-day B-SIT score showed normosmia in 90.6% of group A patients. The mean time for full recovery (VAS = 0) was shorter in group B (22.9 days) than in group A (31.9 days). Chemosensory deficit is frequently the first symptom in patients with COVID-19, and, in most cases, recovery occurs after four weeks.


Subject(s)
Ageusia , COVID-19 , Olfaction Disorders , Anosmia/etiology , COVID-19/complications , Humans , Olfaction Disorders/diagnosis , SARS-CoV-2 , Smell , Taste
3.
Eur Rev Med Pharmacol Sci ; 26(3): 1042-1048, 2022 02.
Article in English | MEDLINE | ID: covidwho-1708605

ABSTRACT

OBJECTIVE: Alterations of the olfactory function in patients affected by COVID-19 often have an early onset and a variable duration ranging from a few weeks to months. The aim of this study was to evaluate olfactory dysfunction persistence after recovery from COVID-19, and potential related clinical-demographic conditions. PATIENTS AND METHODS: A total of 76 patients recovered from COVID-19 from at least 20 days with olfactory dysfunction during the infection were included in the study. For the subjective evaluation of olfactory function, a visual analogic scale (VAS) was used. The objective evaluation was performed with the use of the Sniffin' Sticks test. RESULTS: Objective assessment of olfactory function revealed that 48 (63.16%) patients were found to be normosmic (TDI ≥ 30.5), 26 (34.21%) were hyposmic (TDI from 30.5 to 16.5) and two (2.63%) were anosmic (TDI ≤ 16.5) at the time of the evaluation. These results did not show a significant difference between subjective and objective tests (p = 0.45). Most patients recovered their sense of smell within the first two months after recovery while a portion (22.2%) still experienced olfactory alterations 4-6 months after SARS-CoV-2 infection. Patients who had not recovered their sense of smell had a significantly longer period of SARS-CoV-2 positivity compared to patients that fully recovered (36.07 ± 7.78 days vs. 29 ± 7.89 days; p = 0.04). CONCLUSIONS: Our results suggest that the duration of the infection negatively correlates with the recovery of olfactory function.


Subject(s)
COVID-19/epidemiology , Olfaction Disorders/epidemiology , Adolescent , Adult , Aged , Anosmia/epidemiology , Anosmia/etiology , Anosmia/virology , COVID-19/complications , COVID-19/virology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Olfaction Disorders/etiology , Olfaction Disorders/virology , Prospective Studies , Recovery of Function , SARS-CoV-2 , Smell , Young Adult
5.
Hum Brain Mapp ; 43(5): 1548-1560, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1653231

ABSTRACT

To address the impact of COVID-19 olfactory loss on the brain, we analyzed the neural connectivity of the central olfactory system in recently SARS-CoV-2 infected subjects with persisting olfactory impairment (hyposmia). Twenty-seven previously SARS-CoV-2 infected subjects (10 males, mean age ± SD 40.0 ± 7.6 years) with clinically confirmed COVID-19 related hyposmia, and eighteen healthy, never SARS-CoV-2 infected, normosmic subjects (6 males, mean age ± SD 36.0 ± 7.1 years), were recruited in a 3 Tesla MRI study including high angular resolution diffusion and resting-state functional MRI acquisitions. Specialized metrics of structural and functional connectivity were derived from a standard parcellation of olfactory brain areas and a previously validated graph-theoretic model of the human olfactory functional network. These metrics were compared between groups and correlated to a clinical index of olfactory impairment. On the scanning day, all subjects were virus-free and cognitively unimpaired. Compared to control, both structural and functional connectivity metrics were found significantly increased in previously SARS-CoV-2 infected subjects. Greater residual olfactory impairment was associated with more segregated processing within regions more functionally connected to the anterior piriform cortex. An increased neural connectivity within the olfactory cortex was associated with a recent SARS-CoV-2 infection when the olfactory loss was a residual COVID-19 symptom. The functional connectivity of the anterior piriform cortex, the largest cortical recipient of afferent fibers from the olfactory bulb, accounted for the inter-individual variability in the sensory impairment. Albeit preliminary, these findings could feature a characteristic brain connectivity response in the presence of COVID-19 related residual hyposmia.


Subject(s)
Anosmia/diagnostic imaging , Brain/diagnostic imaging , COVID-19/diagnostic imaging , Nerve Net/diagnostic imaging , Smell/physiology , Adult , Anosmia/etiology , COVID-19/complications , Female , Humans , Magnetic Resonance Imaging , Male
6.
CMAJ Open ; 9(4): E1134-E1140, 2021.
Article in English | MEDLINE | ID: covidwho-1560179

ABSTRACT

BACKGROUND: Reports have suggested that anosmia is strongly associated with SARS-CoV-2 infection, but patients were often asked about this symptom after their diagnosis. This study assessed associations between prospectively reported anosmia and other symptoms related to SARS-CoV-2 infection, and SARS-CoV-2 positivity in community testing centres in Toronto, Ontario. METHODS: We conducted a retrospective cross-sectional study in which data were collected from 2 COVID-19 assessment centres affiliated with 2 hospitals in Toronto, Ontario, from Apr. 5 to Sept. 30, 2020. We included symptomatic profiles of all people who underwent a SARS-CoV-2 test at either clinic within the study period. We used generalized estimating equations to account for repeat visits and to assess associations between anosmia and other symptoms and SARS-CoV-2 positivity. RESULTS: A total of 83 443 SARS-CoV-2 tests were conducted across the 2 sites for 72 692 participants during the study period. Of all tests, 1640 (2.0%) were positive; 837 (51.0%) of people who tested positive were asymptomatic. The adjusted odds ratio for the association between anosmia and test positivity was 5.29 (95% confidence interval [CI] 4.50-6.22), with sensitivity of 0.138 (95% CI 0.121-0.154), specificity of 0.980 (95% CI 0.979-0.981), a positive predictive value of 0.120 (95% CI 0.106-0.135) and a negative predictive value of 0.983 (95% CI 0.982-0.984). INTERPRETATION: Anosmia had high specificity and a positive predictive value of 12% for SARS-CoV-2 infection in this community population with low prevalence of SARS-CoV-2 positivity. The presence of anosmia should increase clinical suspicion of SARS-CoV-2 infection, and our findings suggest that people presenting with this symptom should be tested.


Subject(s)
Anosmia/etiology , COVID-19/diagnosis , Outpatients/statistics & numerical data , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Child , Child, Preschool , Cross-Sectional Studies , Diagnostic Tests, Routine , Female , Health Services Accessibility , Humans , Infant , Infant, Newborn , Male , Middle Aged , Ontario , Predictive Value of Tests , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors , SARS-CoV-2/genetics , Young Adult
7.
Viruses ; 13(11)2021 11 04.
Article in English | MEDLINE | ID: covidwho-1502532

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative pathogen of coronavirus disease 2019 (COVID-19). It is known as a respiratory virus, but SARS-CoV-2 appears equally, or even more, infectious for the olfactory epithelium (OE) than for the respiratory epithelium in the nasal cavity. In light of the small area of the OE relative to the respiratory epithelium, the high prevalence of olfactory dysfunctions (ODs) in COVID-19 has been bewildering and has attracted much attention. This review aims to first examine the cytological and molecular biological characteristics of the OE, especially the microvillous apical surfaces of sustentacular cells and the abundant SARS-CoV-2 receptor molecules thereof, that may underlie the high susceptibility of this neuroepithelium to SARS-CoV-2 infection and damages. The possibility of SARS-CoV-2 neurotropism, or the lack of it, is then analyzed with regard to the expression of the receptor (angiotensin-converting enzyme 2) or priming protease (transmembrane serine protease 2), and cellular targets of infection. Neuropathology of COVID-19 in the OE, olfactory bulb, and other related neural structures are also reviewed. Toward the end, we present our perspectives regarding possible mechanisms of SARS-CoV-2 neuropathogenesis and ODs, in the absence of substantial viral infection of neurons. Plausible causes for persistent ODs in some COVID-19 convalescents are also examined.


Subject(s)
Anosmia/epidemiology , Anosmia/etiology , COVID-19/complications , Olfactory Mucosa/virology , SARS-CoV-2/physiology , Viral Tropism , Angiotensin-Converting Enzyme 2/metabolism , Anosmia/physiopathology , COVID-19/pathology , COVID-19/virology , Humans , Olfactory Bulb/pathology , Olfactory Bulb/virology , Olfactory Mucosa/metabolism , Olfactory Mucosa/ultrastructure , Prevalence , Receptors, Coronavirus/metabolism
8.
PLoS Med ; 18(9): e1003777, 2021 09.
Article in English | MEDLINE | ID: covidwho-1440982

ABSTRACT

BACKGROUND: Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. METHODS AND FINDINGS: We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. CONCLUSIONS: Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Models, Biological , Ageusia/diagnosis , Ageusia/etiology , Ageusia/virology , Anosmia/diagnosis , Anosmia/etiology , Anosmia/virology , Appetite , Area Under Curve , COVID-19/virology , Chills/diagnosis , Chills/etiology , Chills/virology , Communicable Disease Control , Cough/diagnosis , Cough/etiology , Cough/virology , England , False Positive Reactions , Female , Fever/diagnosis , Fever/etiology , Fever/virology , Humans , Male , Mass Screening , Myalgia/diagnosis , Myalgia/etiology , Myalgia/virology , Pharyngitis/diagnosis , Pharyngitis/etiology , Pharyngitis/virology , Polymerase Chain Reaction , SARS-CoV-2/genetics , State Medicine
9.
PLoS One ; 16(9): e0256998, 2021.
Article in English | MEDLINE | ID: covidwho-1438345

ABSTRACT

BACKGROUND: Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell. METHODS: We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020. RESULTS: Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others. CONCLUSIONS: Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people's sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.


Subject(s)
Anosmia , COVID-19 , Olfactory Perception , SARS-CoV-2 , Taste Disorders , Taste Perception , Adult , Anosmia/etiology , Anosmia/physiopathology , Anosmia/psychology , COVID-19/complications , COVID-19/physiopathology , COVID-19/psychology , Female , Humans , Male , Middle Aged , Taste Disorders/etiology , Taste Disorders/physiopathology , Taste Disorders/psychology , Time Factors
10.
J Laryngol Otol ; 135(9): 839-843, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1397806

ABSTRACT

OBJECTIVE: This study aimed to assess olfactory dysfunction in patients at six months after confirmed coronavirus disease 2019 infection. METHODS: Coronavirus disease 2019 positive patients were assessed six months following diagnosis. Patient data were recoded as part of the adapted International Severe Acute Respiratory and Emerging Infection Consortium Protocol. Olfactory dysfunction was assessed using the University of Pennsylvania Smell Identification Test. RESULTS: Fifty-six patients were included. At six months after coronavirus disease 2019 diagnosis, 64.3 per cent of patients (n = 36) were normosmic, 28.6 per cent (n = 16) had mild to moderate microsmia and 7 per cent (n = 4) had severe microsmia or anosmia. There was a statistically significant association between older age and olfactory dysfunction. Hospital or intensive care unit admission did not lead to worse olfactory outcomes compared to those managed in the out-patient setting. CONCLUSION: At six months after coronavirus disease 2019 diagnosis, approximately two-thirds of patients will be normosmic. This study is the first to describe six-month outcomes for post-coronavirus disease 2019 patients in terms of olfactory dysfunction.


Subject(s)
COVID-19/complications , Olfaction Disorders/etiology , Anosmia/diagnosis , Anosmia/etiology , Female , Hospitalization , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Smell , Time Factors
11.
Eur Ann Otorhinolaryngol Head Neck Dis ; 139(2): 115-116, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1372882
12.
Lancet Digit Health ; 3(9): e577-e586, 2021 09.
Article in English | MEDLINE | ID: covidwho-1322425

ABSTRACT

BACKGROUND: Multiple voluntary surveillance platforms were developed across the world in response to the COVID-19 pandemic, providing a real-time understanding of population-based COVID-19 epidemiology. During this time, testing criteria broadened and health-care policies matured. We aimed to test whether there were consistent associations of symptoms with SARS-CoV-2 test status across three surveillance platforms in three countries (two platforms per country), during periods of testing and policy changes. METHODS: For this observational study, we used data of observations from three volunteer COVID-19 digital surveillance platforms (Carnegie Mellon University and University of Maryland Facebook COVID-19 Symptom Survey, ZOE COVID Symptom Study app, and the Corona Israel study) targeting communities in three countries (Israel, the UK, and the USA; two platforms per country). The study population included adult respondents (age 18-100 years at baseline) who were not health-care workers. We did logistic regression of self-reported symptoms on self-reported SARS-CoV-2 test status (positive or negative), adjusted for age and sex, in each of the study cohorts. We compared odds ratios (ORs) across platforms and countries, and we did meta-analyses assuming a random effects model. We also evaluated testing policy changes, COVID-19 incidence, and time scales of duration of symptoms and symptom-to-test time. FINDINGS: Between April 1 and July 31, 2020, 514 459 tests from over 10 million respondents were recorded in the six surveillance platform datasets. Anosmia-ageusia was the strongest, most consistent symptom associated with a positive COVID-19 test (robust aggregated rank one, meta-analysed random effects OR 16·96, 95% CI 13·13-21·92). Fever (rank two, 6·45, 4·25-9·81), shortness of breath (rank three, 4·69, 3·14-7·01), and cough (rank four, 4·29, 3·13-5·88) were also highly associated with test positivity. The association of symptoms with test status varied by duration of illness, timing of the test, and broader test criteria, as well as over time, by country, and by platform. INTERPRETATION: The strong association of anosmia-ageusia with self-reported positive SARS-CoV-2 test was consistently observed, supporting its validity as a reliable COVID-19 signal, regardless of the participatory surveillance platform, country, phase of illness, or testing policy. These findings show that associations between COVID-19 symptoms and test positivity ranked similarly in a wide range of scenarios. Anosmia, fever, and respiratory symptoms consistently had the strongest effect estimates and were the most appropriate empirical signals for symptom-based public health surveillance in areas with insufficient testing or benchmarking capacity. Collaborative syndromic surveillance could enhance real-time epidemiological investigations and public health utility globally. FUNDING: National Institutes of Health, National Institute for Health Research, Alzheimer's Society, Wellcome Trust, and Massachusetts Consortium on Pathogen Readiness.


Subject(s)
Ageusia , Anosmia , COVID-19 , Cough , Dyspnea , Fever , Population Surveillance/methods , Adolescent , Adult , Aged , Aged, 80 and over , Ageusia/epidemiology , Ageusia/etiology , Anosmia/epidemiology , Anosmia/etiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Cough/epidemiology , Cough/etiology , Digital Technology , Dyspnea/epidemiology , Dyspnea/etiology , Female , Fever/epidemiology , Fever/etiology , Humans , Israel/epidemiology , Male , Middle Aged , Odds Ratio , Pandemics , SARS-CoV-2 , United Kingdom/epidemiology , United States/epidemiology , Young Adult
13.
Arch Pharm Res ; 44(7): 725-740, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1321878

ABSTRACT

Anecdotal evidence suggests that the severity of coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is likely to be distinguished by variations in loss of smell (LOS). Thus, we conducted a meta-analysis of 45 articles that include a total of 42,120 COVID-19 patients from 17 different countries to demonstrate that severely ill or hospitalized COVID-19 patients have a lesser chance of experiencing LOS than non-severely ill or non-hospitalized COVID-19 patients (odds ratio = 0.527 [95% CI 0.373-0.744; p < 0.001] and 0.283 [95% CI 0.173-0.462; p < 0.001], respectively). We also proposed a possible mechanism underlying the association of COVID-19 severity with anosmia, which may explain why patients without sense of smell develop severe COVID-19. Variations in LOS according to the severity of COVID-19 is a global phenomenon, with few exceptions. Since severely ill patients have a lower rate of anosmia, patients without anosmia should be monitored more closely in the early stages of COVID-19, for early diagnosis of severity of illness. An understanding of how the severity of COVID-19 infection and LOS are associated has profound implications for the clinical management and mitigation strategies for the disease.


Subject(s)
Anosmia/etiology , COVID-19/complications , Odorants , Olfactory Perception , Smell , Anosmia/diagnosis , Anosmia/physiopathology , Anosmia/psychology , COVID-19/diagnosis , COVID-19/therapy , Early Diagnosis , Female , Hospitalization , Humans , Male , Predictive Value of Tests , Prognosis , Risk Assessment , Risk Factors , Severity of Illness Index
14.
Neurol Res ; 44(1): 1-6, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1313683

ABSTRACT

OBJECTIVE: We sought to evaluate neurologic symptoms and findings in patients with COVID-19 infection hospitalized in a ward and intensive care unit (ICU). METHODS: This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. RESULTS: A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. DISCUSSION: This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.


Subject(s)
Anosmia/etiology , COVID-19/complications , Dysgeusia/etiology , Headache/etiology , Myalgia/etiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged
15.
Int Dent J ; 72(2): 249-256, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1300785

ABSTRACT

OBJECTIVE: The aim of this research was to determine the relationship and prevalence of taste and smell dysfunction in patients with COVID-19 in the United Arab Emirates (UAE) population. METHODS: Enrolled participants were interviewed online via a phone call after obtaining their informed consent. Quantification of smell, taste, and other sensations before, during, and after COVID-19 infection was correlated with the severity of COVID-19 symptoms. RESULTS: A total of 500 patients with (mild-severe) COVID-19 completed the survey. A total of 26.4% were asymptomatic, and 21.4% were classified as paucisymptomatic with less severe symptoms. Almost equal proportions of the studied population experienced extreme taste sensation reductions (43%) and loss of smell sensation (44%). Statistically significant drastic decreases in smell and taste senses were seen among younger individuals. The magnitude of reduction in both sense changes increased steeply from the asymptomatic group to the paucisymptomatic group to the symptomatic group. CONCLUSIONS: Sudden anosmia or ageusia need to be recognised for early detection of COVID-19 infection to identify otherwise hidden carriers, thus favoring an early isolation strategy that will restrict the spread of the disease.


Subject(s)
Ageusia , COVID-19 , Ageusia/epidemiology , Ageusia/etiology , Anosmia/epidemiology , Anosmia/etiology , COVID-19/epidemiology , Humans , Prevalence , United Arab Emirates/epidemiology
17.
Sci Rep ; 11(1): 12775, 2021 06 17.
Article in English | MEDLINE | ID: covidwho-1275948

ABSTRACT

With increasing numbers of patients recovering from COVID-19, there is increasing evidence for persistent symptoms and the need for follow-up studies. This retrospective study included patients without comorbidities, who recovered from COVID-19 and attended an outpatient clinic at a university hospital for follow-up care and potential convalescent plasma donation. Network analysis was applied to visualize symptom combinations and persistent symptoms. Comprehensive lab-testing was ascertained at each follow-up to analyze differences regarding patients with vs without persistent symptoms. 116 patients were included, age range was 18-69 years (median: 41) with follow-ups ranging from 22 to 102 days. The three most frequent persistent symptoms were Fatigue (54%), Dyspnea (29%) and Anosmia (25%). Lymphopenia was present in 13 of 112 (12%) cases. Five of 35 cases (14%) had Lymphopenia in the later follow-up range of 80-102 days. Serum IgA concentration was the only lab parameter with significant difference between patients with vs without persistent symptoms with reduced serum IgA concentrations in the patient cohort of persistent symptoms (p = 0.0219). Moreover, subgroup analyses showed that patients with lymphopenia experienced more frequently persistent symptoms. In conclusion, lymphopenia persisted in a noticeable percentage of recovered patients. Patients with persistent symptoms had significantly lower serum IgA levels. Furthermore, our data provides evidence that lymphopenia is associated with persistence of COVID-19 symptoms.


Subject(s)
Anosmia/etiology , COVID-19/complications , Dyspnea/etiology , Fatigue/etiology , Immunoglobulin A/blood , Lymphopenia/etiology , SARS-CoV-2 , Adolescent , Adult , Aftercare , Aged , COVID-19/epidemiology , COVID-19/virology , Female , Follow-Up Studies , Germany/epidemiology , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
18.
Medicine (Baltimore) ; 100(24): e26371, 2021 Jun 18.
Article in English | MEDLINE | ID: covidwho-1269625

ABSTRACT

ABSTRACT: Most patients with coronavirus disease 2019 (COVID-19) have mild to moderate illness not requiring hospitalization. However, no study has detailed the evolution of symptoms in the first month of illness.At our institution, we conducted remote (telephone and video) visits for all adult outpatients diagnosed with COVID-19 within 24 h of a positive nasopharyngeal polymerase chain test for SARS-CoV-2. We repeated regular video visits at 7, 14, and 28 days after the positive test, retrospectively reviewed the prospective data collected in the remote visits, and constructed a week by week profile of clinical illness, through week 4 of illness.We reviewed the courses of 458 symptomatic patients diagnosed between March 12, 2020, and June 22, 2020, and characterized their weekly courses. Common initial symptoms included fever, headache, cough, and chest pain, which frequently persisted through week 3 or longer. Upper respiratory or gastrointestinal symptoms were much shorter lived, present primarily in week 1. Anosmia/ageusia peaked in weeks 2 to 3. Emergency department visits were frequent, with 128 visits in the 423 patients who were not hospitalized and 48 visits among the 35 outpatients (7.6%) who were eventually hospitalized (2 subsequently died). By the fourth week, 28.9% said their illness had completely resolved. After the 4-week follow up, 20 (4.7%) of the 423 nonhospitalized patients had further medical evaluation and management for subacute or chronic COVID-19 symptoms.Mild to moderate outpatient COVID-19 is a prolonged illness, with evolving symptoms commonly lasting into the fourth week of illness.


Subject(s)
Ambulatory Care , COVID-19/complications , COVID-19/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Anosmia/etiology , COVID-19/diagnosis , Chest Pain/etiology , Cough/etiology , Dyspnea/etiology , Emergency Service, Hospital , Fatigue/etiology , Female , Fever/etiology , Humans , Male , Middle Aged , Myalgia/etiology , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome , Young Adult
19.
Sci Rep ; 11(1): 12492, 2021 06 14.
Article in English | MEDLINE | ID: covidwho-1268000

ABSTRACT

The early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic. The objective of this study was to describe the clinical characteristics of primary care patients who tested positive for SARS-CoV-2. We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19. We examined the association between symptoms and a positive test using univariable and multivariable logistic regression, adjusted for clustering within laboratories, and calculated the diagnostic performance of these symptoms. Of the 1561 patients tested, 1543 patients (99%) agreed to participate. Among them, 253 were positive for SARS-CoV-2 (16%). The three most frequently reported 'ear-nose-throat' and non-'ear-nose-throat' symptoms in patients who tested positive were dry throat (42%), loss of smell (36%) and loss of taste (31%), respectively fever (58%), cough (52%) and headache (45%). In multivariable analyses, loss of taste (OR 3.8 [95% CI 3.3-4.4], p-value < 0.001), loss of smell (OR 3.0 [95% CI 1.9-4.8], p < 0.001), muscle pain (OR 1.6 [95% CI 1.2-2.0], p = 0.001) and dry nose (OR 1.3 [95% CI 1.1-1.6], p = 0.01) were significantly associated with a positive result. In contrast, sore throat (OR 0.6 [95% CI 0.4-0.8], p = 0.003), stuffy nose (OR 0.6 [95% CI 0.6-0.7], p < 0.001), diarrhea (OR 0.6 [95% CI 0.5-0.6], p < 0.001) and dyspnea (OR 0.5 [95% CI 0.3-0.7], p < 0.001) were inversely associated with a positive test. The combination of loss of taste or smell had the highest diagnostic performance (OR 6.7 [95% CI 5.9-7.5], sensitivity 44.7% [95% CI 38.4-51.0], specificity 90.8% [95% CI 89.1-92.3]). No other combination of symptoms had a higher performance. Our data could contribute to the triage and early identification of new clusters of cases.


Subject(s)
COVID-19/diagnosis , Primary Health Care , Adult , Aged , Anosmia/etiology , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Cough/etiology , Cross-Sectional Studies , Female , Fever/etiology , France/epidemiology , Headache/etiology , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , SARS-CoV-2/isolation & purification
20.
Int Immunopharmacol ; 98: 107871, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1267705

ABSTRACT

The aim of this study was to evaluate the usage of mometasone furoate nasal spray in the recovery of patients with severe microsmia or anosmia induced by COVID-19. This was a prospective clinical trial on non-hospitalized adult patients with COVID-19 (>18 years) who had severe microsmia or anosmia within two weeks. The subjects were randomly assigned to the mometasone furoate group (100 mcg twice daily) or sodium chloride group (0.9%); both groups also received olfactory training for 4 weeks. The primary outcome was the improvement of the olfactory score at the end of the study. Visual analog scale (VAS) and the University of Pennsylvania Smell Identification Test (UPSIT) were used to assess primary outcome. A total of 80 patients were recruited, 77 of them completed the study and were analyzed. There was no statistically significant difference in terms of demographics and baseline clinical characteristics. The olfactory scores (based on VAS) at weekly intervals showed a significant difference between the two groups (P:0.318, <0.001, <0.001, <0.001, respectively). The analyses also showed significant within-group differences from baseline. Nevertheless, the changes were not significant between the two groups (P: 0.444, 0.402, 0.267, 0.329). There was no significant difference between the two groups in terms of the UPSIT results (p > 0.239). However, a significant between-group difference was noted in the severity of loss of smell (P < 0.001). Compared to olfactory training, mometasone furoate nasal spray combination with olfactory training showed a higher improvement in severe chronic anosmia by COVID-19.


Subject(s)
Anosmia/drug therapy , COVID-19/complications , Mometasone Furoate/administration & dosage , Smell/drug effects , Administration, Intranasal , Adult , Anosmia/diagnosis , Anosmia/etiology , Anosmia/physiopathology , COVID-19/diagnosis , Double-Blind Method , Female , Humans , Iran , Male , Mometasone Furoate/adverse effects , Nasal Sprays , Prospective Studies , Recovery of Function , Time Factors , Treatment Outcome , Young Adult
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