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1.
Oral Maxillofac Surg ; 26(1): 105-111, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1680899

ABSTRACT

PURPOSE: Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. METHODS: This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients' registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant. RESULTS: Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. CONCLUSION: Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.


Subject(s)
COVID-19 , Olfaction Disorders , Anosmia , Cross-Sectional Studies , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Olfaction Disorders/epidemiology , Oral and Maxillofacial Surgeons , Pandemics , Retrospective Studies , SARS-CoV-2
2.
Nat Med ; 28(1): 20-23, 2022 01.
Article in English | MEDLINE | ID: covidwho-1636011
3.
Oral Maxillofac Surg ; 26(1): 105-111, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1217439

ABSTRACT

PURPOSE: Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. METHODS: This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients' registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant. RESULTS: Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. CONCLUSION: Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.


Subject(s)
COVID-19 , Olfaction Disorders , Anosmia , Cross-Sectional Studies , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Olfaction Disorders/epidemiology , Oral and Maxillofacial Surgeons , Pandemics , Retrospective Studies , SARS-CoV-2
4.
J Med Virol ; 93(4): 2499-2504, 2021 04.
Article in English | MEDLINE | ID: covidwho-1217398

ABSTRACT

Various new clinical signs and symptoms, such as dysfunction of smell (anosmia) and taste (dysgeusia) have emerged ever since the coronavirus disease 2019 (COVID-19) pandemic begun. The objective of this study was to identify the clinical presentation and factors associated with 'new loss/change of smell (anosmia) or taste (dysgeusia)' at admission in patients positive by real time polymerase chain reaction for SARS-CoV-2 infection. All adult COVID-19 patients with new onset anosmia or dysgeusia at admission were included in study group. Equal number of age and gender matched COVID-19 patients without anosmia or dysgeusia at admission were included in the control group. A total of 261 COVID-19 patients were admitted during the study period of which 55 (21%) had anosmia and or dysgeusia. The mean (SD) age was 36 (13) years and majority were males (58%, n = 32). Comorbidity was present in 38% of cases (n = 21). Anosmia and dysgeusia were noted in more than 1/5th of the cases. Anosmia (96%, n = 53) was more common than dysgeusia (75%, n = 41). Presence of both ansomia and dysgeusia was noted in 71% of patients (n = 39). On comparing the cases with the controls, on univariate analysis, fever (higher in cases), rhinitis (lower in cases), thrombocytopenia, elevated creatinine and bilirubin (all higher in cases) were significantly associated with anosmia or dysgeusia. On multivariate analysis, only rhinitis (odds ratio [OR]: 0.28; 95% confidence interval [CI]: 0.09-0.83; p = .02) thrombocytopenia (OR: 0.99; 95% CI: 0.99-0.99; p = .01) and elevated creatinine (OR: 7.6; 95% CI: 1.5-37.6; p = .01) remained significant. In this retrospective study of COVID-19 patients, we found anosmia and dysgeusia in more than 1/5th of the cases. Absence of rhinitis, low platelet counts and elevated creatinine were associated with anosmia or dysgeusia in these patients.


Subject(s)
Anosmia/epidemiology , COVID-19/epidemiology , Dysgeusia/epidemiology , Adult , Anosmia/blood , Anosmia/physiopathology , Anosmia/virology , COVID-19/blood , COVID-19/diagnosis , COVID-19/physiopathology , Case-Control Studies , Dysgeusia/blood , Dysgeusia/physiopathology , Dysgeusia/virology , Female , Humans , India/epidemiology , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Pandemics , Platelet Count , Real-Time Polymerase Chain Reaction , Retrospective Studies , Rhinitis/epidemiology , Rhinitis/etiology , SARS-CoV-2/isolation & purification , Thrombocytopenia/epidemiology , Thrombocytopenia/etiology
5.
J Med Virol ; 93(5): 2740-2768, 2021 05.
Article in English | MEDLINE | ID: covidwho-1196532

ABSTRACT

A meta-analysis was performed to identify patients with coronavirus disease 2019 (COVID-19) presenting with gastrointestinal (GI) symptoms during the first and second pandemic waves and investigate their association with the disease outcomes. A systematic search in PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE was performed up to July 25, 2020. The pooled prevalence of the GI presentations was estimated using the random-effects model. Pairwise comparison for the outcomes was performed according to the GI manifestations' presentation and the pandemic wave of infection. Data were reported as relative risk (RR), or odds ratio and 95% confidence interval. Of 125 articles with 25,252 patients, 20.3% presented with GI manifestations. Anorexia (19.9%), dysgeusia/ageusia (15.4%), diarrhea (13.2%), nausea (10.3%), and hematemesis (9.1%) were the most common. About 26.7% had confirmed positive fecal RNA, with persistent viral shedding for an average time of 19.2 days before being negative. Patients presenting with GI symptoms on admission showed a higher risk of complications, including acute respiratory distress syndrome (RR = 8.16), acute cardiac injury (RR = 5.36), and acute kidney injury (RR = 5.52), intensive care unit (ICU) admission (RR = 2.56), and mortality (RR = 2.01). Although not reach significant levels, subgroup-analysis revealed that affected cohorts in the first wave had a higher risk of being hospitalized, ventilated, ICU admitted, and expired. This meta-analysis suggests an association between GI symptoms in COVID-19 patients and unfavorable outcomes. The analysis also showed improved overall outcomes for COVID-19 patients during the second wave compared to the first wave of the outbreak.


Subject(s)
COVID-19/drug therapy , COVID-19/physiopathology , Gastroenterology/methods , Ageusia/epidemiology , Anorexia/epidemiology , Databases, Factual , Diarrhea/epidemiology , Dysgeusia/epidemiology , Feces/virology , Hematemesis/epidemiology , Hospitalization , Humans , Nausea/epidemiology , Pandemics , Prevalence , SARS-CoV-2 , Virus Shedding
6.
Neuroepidemiology ; 55(2): 154-161, 2021.
Article in English | MEDLINE | ID: covidwho-1166623

ABSTRACT

INTRODUCTION: Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. METHODS: We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. RESULTS: The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16-36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05-3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02-5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19-0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06-0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03-4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06-0.76). CONCLUSION: Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.


Subject(s)
Anosmia/epidemiology , COVID-19/physiopathology , Dysgeusia/epidemiology , Respiratory Hypersensitivity/epidemiology , Smoking/epidemiology , Age Factors , Aged , Anosmia/physiopathology , Dysgeusia/physiopathology , Emergency Service, Hospital , Female , Hospitalization , Humans , Hypersensitivity/epidemiology , Logistic Models , Male , Middle Aged , Multivariate Analysis , Olfaction Disorders/epidemiology , Olfaction Disorders/physiopathology , Prevalence , Retrospective Studies , Risk Factors , SARS-CoV-2 , Taste Disorders/epidemiology , Taste Disorders/physiopathology
7.
Rev Neurosci ; 32(3): 351-361, 2021 04 27.
Article in English | MEDLINE | ID: covidwho-1067453

ABSTRACT

The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95% CI was 50.68% (6.68-93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20% (14.99-60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83% (2.17-12.25) and 2.39% (10.75-14.22). The pooled prevalence of depression and anxiety was 3.52% (2.62-4.54) and 13.92% (9.44-19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms.


Subject(s)
Anosmia/epidemiology , Anxiety/epidemiology , COVID-19/physiopathology , Depression/epidemiology , Anosmia/physiopathology , Anxiety/psychology , COVID-19/psychology , Depression/psychology , Dysgeusia/epidemiology , Dysgeusia/physiopathology , Dysphonia/epidemiology , Dysphonia/physiopathology , Fatigue/epidemiology , Fatigue/physiopathology , Headache/epidemiology , Headache/physiopathology , Humans , Hypesthesia/epidemiology , Hypesthesia/physiopathology , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Paresthesia/epidemiology , Paresthesia/physiopathology , Prevalence , SARS-CoV-2
8.
Int J Pediatr Otorhinolaryngol ; 142: 110626, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065193

ABSTRACT

OBJECTIVES: To study the prevalence, clinical course and outcomes of olfactory and taste dysfunction in COVID-19 positive adolescents. METHODS: This prospective study was carried out from May to August 2020. The adolescents, aged 10-19 years, who were detected COVID-19 positive by RT-PCR with mild to moderate disease were included in the study. The following epidemiological and clinical outcomes were studied: age, sex, general symptoms, olfactory and taste dysfunction. RESULTS: Out of 141 patients included in the study, there were 83 males (58.9%) and 58 females (41.1%). The age varied from 10 to 19 years with an average of 15.2 years. Forty patients (28.4%) had olfactory or taste dysfunction. Out of these 40 patients, 28 patients (19.8%) had both olfactory and taste dysfunction. Of the 34 patients (24.1%) who complained of olfactory dysfunction, 16 patients complained of hyposmia and 18 patients complained of anosmia. Dysgeusia was reported by 34 patients (24.1%). The duration of OTD varied from 2 to 15 days with an average of 5.7 days. CONCLUSION: Loss of smell and taste are common symptoms in COVID-19 positive adolescents. It recovers spontaneously within a few weeks, along with the resolution of other symptoms.


Subject(s)
Anosmia/epidemiology , COVID-19/physiopathology , Dysgeusia/epidemiology , Adolescent , Anosmia/etiology , Anosmia/physiopathology , COVID-19/complications , Child , Disease Progression , Dysgeusia/etiology , Dysgeusia/physiopathology , Female , Humans , India/epidemiology , Male , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Prevalence , Prospective Studies , Recovery of Function , SARS-CoV-2 , Taste Disorders/epidemiology , Taste Disorders/etiology , Taste Disorders/physiopathology , Young Adult
9.
Brain Behav Immun ; 88: 11-16, 2020 08.
Article in English | MEDLINE | ID: covidwho-935435

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) represents a novel pneumonia leading to severe acute respiratory syndrome (SARS). Recent studies documented that SARS-Coronavirus2 (SARS-CoV2), responsible for COVID-19, can affect the nervous system. The aim of the present observational study was to prospectively assess subjective neurological symptoms (sNS) in patients with SARS-CoV2 infection. METHODS: We included patients hospitalized at the University Hospital of Rome "Tor Vergata", medical center dedicated to the treatment of patients with COVID-19 diagnosis, who underwent an anamnestic interview about sNS consisting of 13 items, each related to a specific symptom, requiring a dichotomized answer. RESULTS: We included 103 patients with SARS-CoV2 infection. Ninety-four patients (91.3%) reported at least one sNS. Sleep impairment was the most frequent symptom, followed by dysgeusia, headache, hyposmia, and depression. Women more frequently complained hyposmia, dysgeusia, dizziness, numbeness/paresthesias, daytime sleepiness, and muscle ache. Moreover, muscle ache and daytime sleepiness were more frequent in the first 2 days after admission. Conversely, sleep impairment was more frequent in patients with more than 7 days of hospitalization. In these patients we also documented higher white blood cells and lower C-reactive protein levels. These laboratory findings correlated with the occurrence of hyposmia, dysgeusia, headache, daytime sleepiness, and depression. CONCLUSIONS: Patients with SARS-CoV2 infection frequently present with sNS. These symptoms are present from the early phases of the disease. The possibly intrinsic neurotropic properties of SARS-CoV2 may justify the very high frequency of sNS. Further studies targeted at investigating the consequences of SARS-CoV2 infection on the CNS should be planned.


Subject(s)
Coronavirus Infections/physiopathology , Depression/physiopathology , Dysgeusia/physiopathology , Headache/physiopathology , Olfaction Disorders/physiopathology , Pneumonia, Viral/physiopathology , Sleepiness , Adult , Aged , Betacoronavirus , C-Reactive Protein/immunology , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Depression/epidemiology , Dizziness/epidemiology , Dizziness/physiopathology , Dysgeusia/epidemiology , Female , Headache/epidemiology , Hospitalization , Humans , Hypesthesia/epidemiology , Hypesthesia/physiopathology , Italy/epidemiology , Leukocyte Count , Male , Middle Aged , Myalgia/epidemiology , Myalgia/physiopathology , Olfaction Disorders/epidemiology , Pandemics , Paresthesia/epidemiology , Paresthesia/physiopathology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , SARS-CoV-2 , Sex Distribution , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/physiopathology
10.
Oral Dis ; 28 Suppl 1: 891-898, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-917755

ABSTRACT

OBJECTIVES: While chemosensory dysfunctions, dysgeusia and anosmia/hyposmia, are recognized as distinctive symptoms of COVID-19, their temporality of presentation and association with the patient age, gender, disease severity, and comorbidities has been sparsely studied. Hence, we evaluated the latter associations of chemosensory dysfunction, in hospitalized COVID-19 patients in the United Arab Emirates (UAE). MATERIALS AND METHODS: Information on chemosensory dysfunction and history of chronic systemic comorbidities, if any, was obtained from 149 COVID-19 patients in an infectious disease hospital in UAE, using their medical records, as well as from a face-to-face questionnaire survey. Additionally, a modified SNOT-22 questionnaire that measures disease-specific quality of life in patients with upper respiratory tract affections was also administered. RESULTS: Chemosensory dysfunction was reported by 94.6% of the cohort, and anosmia with dysgeusia was significantly more in males than females with severe COVID-19. Males with moderate COVID-19 and systemic comorbidities were more likely to present with chemosensory dysfunction in comparison with females. SNOT-22 questionnaire revealed that nasal blockage and runny nose were more prevalent in mild/moderate, than in the severe, state of COVID-19. CONCLUSION: Our data confirm the commonality of chemosensory dysfunction during COVID-19 progression, and the significantly more pronounced combined dysfunction in males with severe COVID-19, and comorbidities.


Subject(s)
COVID-19 , Anosmia/epidemiology , COVID-19/complications , Dysgeusia/epidemiology , Female , Humans , Male , Quality of Life , United Arab Emirates
11.
Recenti Prog Med ; 111(10): 614-618, 2020 10.
Article in Italian | MEDLINE | ID: covidwho-881244

ABSTRACT

AIM: The aim of the retrospective study is to determine whether CoViD-19 positive patients with olfactory and gustatory dysfunction have the ability to recover chemoreceptorial loss, unlike other viral and inflammatory diseases in which the damage is partial and in some cases is permanent. MATERIALS AND METHODS: The study examined 75 patients admitted, from March to April 2020, at the Poliambulanza Foundation with CoViD-19. In 53 out of 75 patients, chest X-rays were positive for infiltration and/or pleural effusion. Two weeks after discharge, two rhinopharyngeal swabs were performed with negative results for CoViD-19. Enlisted patients responded to a questionnaire, upon informed consent, called the Questionnaire for Olfactory Dysfunction (QOD) which evaluates the severity of the disorder and social impact. In the second phase of the study we carefully researched the recovery times of olfactory dysfunction and dysgeusia. RESULTS AND CONCLUSIONS: The analysis of the scores of the Olfactory Dysfunction Questionnaire CoViD-19 (QOD) recorded the total recovery in all patients of olfactory and gustatory function with an average time of 17.4 days. This study reveals that Coronavirus does not cause a permanent olfactory and gustatory loss. The olfactory and gustatory impairment has been recognized as a distinctive sign of CoViD-19, but should not be considered as a favorable prognostic index.


Subject(s)
Coronavirus Infections/complications , Dysgeusia/epidemiology , Olfaction Disorders/epidemiology , Pneumonia, Viral/complications , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/diagnosis , Dysgeusia/virology , Female , Humans , Male , Middle Aged , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral/diagnosis , Recovery of Function , Retrospective Studies , Severity of Illness Index , Surveys and Questionnaires , Time Factors
12.
J Formos Med Assoc ; 120(1 Pt 2): 311-317, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-880538

ABSTRACT

BACKGROUND/PURPOSE: To investigate the characteristics of dysosmia and dysgeusia among patients diagnosed with coronavirus disease 2019 (COVID-19) in Taiwan. METHODS: Prospective data collection between January 22, 2020 to May 7, 2020 of nucleic acid confirmed COVID-19 hospitalized patients in northern Taiwan by the Taiwan Centers for Disease Control were analyzed. RESULTS: Of 217 patients enrolled, 78 (35.9%) reported dysosmia (n = 73, 33.6%) and/or dysgeusia (n = 62, 28.6%). The median duration of COVID-19 associated symptom-onset to development of dysosmia and/or dysgeusia was <1 days (interquartile range [IQR], <1-6 days) and 53 of 78 (67.9%) patients developed dysosmia and/or dysgeusia as one of the initial symptoms of COVID-19. Of 59 closely monitored patients, 41 (69.5%) patients recovered within 3 weeks after symptoms onset and the median time to recovery was 12 days (IQR, 7-20 days). Only 6 of the 59 (10.2%) patients reported persistent dysosmia and/or dysgeusia before discharge from hospitals. Multivariate analysis showed that younger individuals (adjusted hazard ratio [AHR], 0.93 per one-year increase; 95% confidence interval [95% CI], 0.89-0.97; P = 0.001), women (AHR, 2.76; 95% CI, 1.05-7.25; P = 0.04) and travel to North America (AHR, 2.35; 95% CI, 1.05-5.26; P = 0.04) were the significant factors associated with dysosmia and/or dysgeusia. CONCLUSION: Dysosmia and/or dysgeusia are common symptoms and clues for the diagnosis of COVID-19, particularly in the early stage of the disease. Physicians should be alerted to these symptoms to make timely diagnosis and management for COVID-19 to limit spread.


Subject(s)
COVID-19/complications , Dysgeusia/virology , Olfaction Disorders/virology , Adult , COVID-19/diagnosis , COVID-19 Testing , Case-Control Studies , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Early Diagnosis , Female , Hospitalization , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Prognosis , Prospective Studies , Risk Factors , Taiwan
13.
Laryngoscope ; 131(6): 1254-1265, 2021 06.
Article in English | MEDLINE | ID: covidwho-866144

ABSTRACT

OBJECTIVES/HYPOTHESIS: The objective of this meta-analysis was to look at the pooled prevalence of symptoms, laboratory tests, and imaging of all COVID-19 infected patients. This will allow better identification of potential COVID-19 patients and take appropriate precautions. STUDY DESIGN: Meta analysis. METHODS: We searched three databases, PubMed, EMBASE, and Ovid to identify studies published between Dec-2019 and May-2020. All studies reporting upper-aerodigestive symptoms of COVID-19 infection were included. The meta-analysis was conducted following meta-analyses of observational studies in epidemiology (MOOSE) guidelines, which have evaluated the pooled prevalence of 14 symptoms and nine laboratory investigations. RESULTS: Based on inclusion criteria, 67 publications consisting of 8302 patients were included. Among adults, the pooled proportion of hypertensive and diabetic patients was 18% and 7%. Cough (53% [0.46-0.61]), anosmia (38% [0.19-0.58]), loss/distortion of taste (31% [0.17-0.45]), and nasal obstruction (26% [0.12-0.39]) were the most common ear, nose & throat (ENT) symptoms. Fever (69% [0.62-0.76]) and fatigue (31% [0.26-0.37]) were the commonest generalized symptoms. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were raised in 56% (0.41-0.71) and 49% (0.21-0.77), respectively. Interestingly, lymphopenia (41% [0.30-0.53]) and leucopenia (22% [0.16-0.29]) were more common than lymphocytosis (33% [0.02-0.64]) and leucocytosis (12% [0.09-0.16]). Fever (69% vs. 44%), cough (53% vs. 33%), and dyspnea (20% vs. 4%) were more common in adults as compared to the pediatric population. Diarrhea was more common among the pediatric cases (12%) versus (9%). The pooled estimate of fatality was 4%. CONCLUSIONS: The most commonly experienced ENT symptom was cough followed by anosmia and dysguesia. Raised ESR and CRP with leukopenia and lymphopenia are common laboratory findings. Majority of the infected patients had abnormal computed tomography findings. COVID infection is less severe in pediatric patients. Laryngoscope, 131:1254-1265, 2021.


Subject(s)
COVID-19/diagnosis , Clinical Laboratory Techniques , Adult , Anosmia/epidemiology , Anosmia/etiology , COVID-19/epidemiology , Child , Cough/epidemiology , Cough/etiology , Cross-Sectional Studies , Databases, Bibliographic , Diagnosis, Differential , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Tomography, X-Ray Computed
14.
CJEM ; 22(5): 595-602, 2020 09.
Article in English | MEDLINE | ID: covidwho-834800

ABSTRACT

OBJECTIVES: To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms. METHODS: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre. We identified 1,345 patients (102 positive and 1,243 negative) who visited the assessment centre between March 16 and April 15, 2020. We randomly sampled negative patients in a 1:3 ratio. The primary outcome was the prevalence of self-reported anosmia/hyposmia and dysgeusia/ageusia. Logistic regression was performed to evaluate the association between COVID-19 positivity and loss of smell and taste. RESULTS: Fifty-six of 102 (50%) positive patients and 72 of 306 (23.5%) negative patients completed the survey. Anosmia/hyposmia and dysgeusia/ageusia were more prevalent among COVID-19 positive patients (41.1% v. 4.2%, p < 0.001 for smell and 46.4% v. 5.6%, p < 0.001 for taste). Anosmia/hyposmia and dysgeusia/ageusia were independently highly associated with COVID-19 positivity (adjusted odds ratios 14.4 and 11.4 for smell and taste, respectively). CONCLUSION: In this Canadian study, smell and taste loss may be key symptoms of COVID-19. This evidence can be helpful in the clinical diagnosis of COVID-19, particularly settings of limited testing capacity.


Subject(s)
Coronavirus Infections/diagnosis , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Pneumonia, Viral/diagnosis , Adult , COVID-19 , COVID-19 Testing , Canada , Clinical Laboratory Techniques/methods , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Reference Values , Risk Assessment , Self Report , Sensitivity and Specificity
15.
Int Forum Allergy Rhinol ; 10(11): 1255-1257, 2020 11.
Article in English | MEDLINE | ID: covidwho-734214

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has been identified as the pathogen causing the outbreak of coronavirus disease-2019 (COVID-19) commencing in Wuhan, China, in December 2019. Multiple reports have shown subjective loss of taste and smell as an early and hallmark symptom for COVID-19. METHODS: A retrospective study was performed in our clinical practice during July 2020 on patients positive for SARS-CoV-2 via polymerase chain reaction. All patients were categorized into 3 groups (supertasters, tasters, and nontasters) via taste sensitivity to phenylthiocarbamide, thiourea, and sodium benzoate with taste strip testing. The results of the taste strip tests were correlated with clinical course. RESULTS: A total of 100 patients (mean, 51 [range, 24-82] years of age; 44 [44%] women) were assessed. We found that 21 of 100 (21%) were nontasters, 79 of 100 (79%) were tasters, and 0 of 100 (0%) were supertasters (p < 0.001). Twenty-one of 21 (100%) (p < 0.001) of the patients requiring inpatient admission were classified as nontasters. All 79 (100%) (p < 0.001) of the patients who displayed mild to moderate symptoms not requiring admission were classified as tasters. CONCLUSION: Our results show objective data that taste disturbance, specifically global loss of taste, appears to correlate with the clinical course specific to each individual, because 100% of the patients requiring inpatient admission were classified as nontasters.


Subject(s)
Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Receptors, G-Protein-Coupled/metabolism , Taste/physiology , Adult , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Dysgeusia/epidemiology , Dysgeusia/etiology , Dysgeusia/physiopathology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Phenotype , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
16.
J Laryngol Otol ; 134(8): 710-716, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-728953

ABSTRACT

OBJECTIVE: A study was carried out to evaluate the relationship between anosmia and hospital admission in coronavirus disease 2019 patients. METHODS: The clinical data of 1534 patients with confirmed coronavirus disease 2019 virus were analysed. The study was conducted with medical records of 1197 patients (78 per cent). The basic characteristics of patients and symptoms related to otolaryngology practice were examined. The patients were divided into two groups according to their follow up: an out-patient group and an in-patient group. RESULTS: The majority of patients presented with anosmia (44.2 per cent), dysgeusia (43.9 per cent) and fever (38.7 per cent). Anosmia was observed in 462 patients (47 per cent) in the out-patient group, and in only 67 patients (31.2 per cent) in the in-patient group. Younger age (odds ratio = 1.05, 95 per cent confidence interval = 1.03-1.06) and the presence of anosmia (odds ratio = 2.04, 95 per cent confidence interval = 1.39-3) were significantly related to out-patient treatment. CONCLUSION: Anosmia could be a symptom in the clinical presentation of the coronavirus disease 2019 infection.


Subject(s)
Coronavirus Infections/complications , Hospitalization/statistics & numerical data , Olfaction Disorders/diagnosis , Otolaryngology/standards , Pneumonia, Viral/complications , Adult , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , COVID-19 , Case-Control Studies , Comorbidity , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Female , Fever/diagnosis , Fever/epidemiology , Hospitalization/trends , Humans , Inpatients/statistics & numerical data , Male , Middle Aged , Olfaction Disorders/etiology , Olfaction Disorders/virology , Outpatients/statistics & numerical data , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Turkey/epidemiology
17.
Medwave ; 20(7): e7994, 2020 Aug 13.
Article in Spanish | MEDLINE | ID: covidwho-725747

ABSTRACT

INTRODUCTION: Health personnel, including physicians, are a fundamental part of the first line of defense against the SARS-CoV-2 pandemic. OBJECTIVE: To characterize the clinical manifestations and course of the first cases of contagion by SARS-CoV-2 in doctors of Peru. METHODOLOGY: We present a series of six cases of doctors infected by SARS-CoV-2, with confirmed positivity for COVID-19, showing the daily evolution from the diagnosis of the disease, its main signs and symptoms, evolution, and until the outcome in each case. RESULTS: Five were men. The median age was 28 years (interquartile range: 27 to 33). In three cases the physician worked more than 12 hours a day in emergency and hospitalization services and not wear a mask at all times. The most frequent symptoms were axillary temperature above 38°C, malaise, dry cough, and odynophagia (the latter in three of the cases). The diagnosis was made at a median of 3 days (interquartile range: 3 to 4 days). The symptoms that persisted the most were dry cough (present during ten days in four doctors). Dysgeusia was the only symptom with the most extended duration (15 days in only one doctor). In the six cases, the course was favorable. However, these doctors found it difficult to return to functions in their hospital centers adequately. DISCUSSION: Despite a small number of cases, it is the first report detailing the evolution of symptoms day by day, which can help for occupational health and even for case surveillance and monitoring.


INTRODUCCIÓN: El personal de salud, entre ellos los médicos, es parte fundamental en primera línea de defensa ante la pandemia de COVID-19, causada por SARS-Cov-2. OBJETIVO: Caracterizar la clínica y evolución de los primeros casos de contagio por coronavirus en médicos de Perú. METODOLOGÍA: Se presentan una serie de seis casos de médicos infectados por coronavirus, con positividad confirmada para COVID-19, mostrando la evolución diaria desde el diagnóstico de la enfermedad, sus principales signos y síntomas, la evolución de los mismos y hasta el desenlace en cada caso. RESULTADOS: De los casos estudiados, cinco fueron hombres, tenían una mediana de edad de 28 años (rango intercuartílico: 27 a 33). Tres de ellos trabajaban más de 12 horas al día en servicios de hospitalización y emergencia; y tres no contaban con mascarilla como método de protección personal. Los síntomas más frecuentes fueron la temperatura axilar superior a 38 grados Celsius, el malestar general, la tos seca y la odinofagia (este último en tres pacientes). En cuanto al diagnóstico con la prueba molecular, tuvo una mediana de tres días de demora (con rango: de 2 a 6 días). Los síntomas que más persistieron fueron la tos seca (presente durante 10 días en cuatro médicos), y la disgeusia como síntoma único, que tuvo la mayor duración (15 días en un solo médico). En los seis casos la evolución fue favorable. Sin embargo, aún se tienen deficiencias para la definición de reincorporación laboral a sus centros hospitalarios. DISCUSIÓN: A pesar de ser un número pequeño de casos, es el primer reporte en personal de salud y que detalla día a día la evolución de los síntomas de COVID-19. Esto puede servir para la salud ocupacional, e incluso como base para la vigilancia y monitorización de los casos en una población mayor.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/physiopathology , Infectious Disease Transmission, Patient-to-Professional , Physicians , Pneumonia, Viral/physiopathology , Adult , COVID-19 , COVID-19 Testing , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Cough/epidemiology , Cough/virology , Dysgeusia/epidemiology , Dysgeusia/virology , Female , Fever/epidemiology , Fever/virology , Humans , Male , Masks/statistics & numerical data , Pandemics , Peru , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission
19.
Eur Arch Otorhinolaryngol ; 277(10): 2775-2781, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-612301

ABSTRACT

PURPOSE: At the time of writing, there is a pandemic affecting virtually every country on Earth. There is considerable discussion amongst clinicians as well as lay people about anosmia and ageusia in COVID-19 sufferers. We aimed to report the results from comprehensive olfactory and gustatory testing in a series of hospital in-patients. METHODS: The prospective study evaluated 81 individuals with a COVID-19 infection, as confirmed by 2019 n-cov Real-Time PCR laboratory testing. The control group consisted of forty individuals with COVID-19 negative. Olfactory and gustatory testings were carried out by an examiner utilizing stringent safety standards and wearing full personal protective equipment. The results obtained in the case group were then compared with those obtained for the controls. RESULTS: In the case group, 41(50.6%) of patients were male and 40 (49.4%) were female, mean age of 54.16 ± 16.98 years (18-95). In the control group, 21 (52.5%) of subjects were male and 19 (47.5%) were female, and mean age was 55 ± 15.39 years (18-90). Fifty (61.7%) COVID-19-positive patients had complaints related to olfaction. The distribution of olfactory symptoms in the case group differed at the level of statistical significance from the control group (p < 0.001). Turning to gustatory abnormalities, within the case group, 22 individuals (27.2%) had taste malfunction. A statistically significant difference was found in the distribution of gustatory abnormalities between cases and controls (p < 0.001). CONCLUSIONS: Olfactory and gustatory dysfunctions are strongly associated with SARS-CoV-2 infection. Hyposmia with or without hypogeusia is potentially a reliable indicator of latent COVID-19.


Subject(s)
Ageusia/etiology , Betacoronavirus , Coronavirus Infections/complications , Dysgeusia/etiology , Olfaction Disorders/etiology , Pneumonia, Viral/complications , Adolescent , Adult , Aged , Aged, 80 and over , Ageusia/epidemiology , COVID-19 , Dysgeusia/epidemiology , Female , Humans , Male , Middle Aged , Olfaction Disorders/epidemiology , Pandemics , Personal Protective Equipment , Prospective Studies , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Young Adult
20.
Eur Arch Otorhinolaryngol ; 277(9): 2637-2640, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-343393

ABSTRACT

PURPOSE: To estimate the prevalence of smell or taste impairment in household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. METHODS: Cross-sectional study based on ad hoc questions. RESULTS: Of 214 mildly symptomatic COVID-19 patients managed at home under self-isolation, 179 reported to have at least one household contact, with the total number of no study participants contacts being 296. Among 175 household contacts not tested for SARS-CoV-2 infection, 67 (38.3%) had SARS-CoV-2 compatible symptoms, 39 (22.3%) had loss of smell or taste with 7 (4.0%) having loss of smell or taste in the absence of other symptoms. The prevalence of smell or taste impairment was 1.5% in patients tested negative compared to 63.0% of those tested positive for SARS-CoV-2 (p < 0.001). CONCLUSION: Smell or taste impairment are quite common in not-tested household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. This should be taken into account when estimating the burden of loss of sense of smell and taste during COVID-19 pandemic, and further highlights the value of loss of sense of smell and taste as a marker of infection.


Subject(s)
Dysgeusia/etiology , Olfaction Disorders/etiology , Taste Disorders/etiology , Taste/physiology , Betacoronavirus , COVID-19 , Contact Tracing , Coronavirus Infections , Cross-Sectional Studies , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Family , Female , Humans , Male , Olfaction Disorders/diagnosis , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral , Prevalence , SARS-CoV-2 , Smell , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Taste Disorders/virology
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