Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Allergy Asthma Proc ; 43(2): 106-115, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1760175

ABSTRACT

Background: The clinical effects of intranasal corticosteroids (INC) on nasal symptoms and the clinical course of coronavirus disease 2019 (COVID-19) in subjects with chronic rhinitis (CR) seem unclear. Objective: To evaluate the clinical effects of INCs on nasal symptoms in subjects with CR and with COVID-19. Methods: In subjects with CR and diagnosed with COVID-19 at four tertiary centers, quality of life and nasal symptoms were assessed by using the 22-item Sino-Nasal Outcome Test (SNOT-22) and the visual analog scale (VAS), respectively. In subjects with allergic rhinitis, nasal symptoms were also assessed on the total symptom score-6 (TSS-6) scale. The subjects were then allocated into two groups according to whether or not they used INCs while infected with the severe acute respiratory syndrome coronavirus 2 (group 1 and group 2, respectively). The subjects in group 2 were divided into two subgroups according to the use of antihistamines and/or leukotriene receptor antagonist or not (group 2a and group 2b, respectively). All the scores were compared before and during COVID-19 among the three groups. Results: A total of 71 subjects (21 in group 1, 24 in group 2a, and 26 in group 2b) were enrolled. The total scores of the SNOT-22 increased remarkably in all the groups during the infection when compared with the pre-COVID-19 scores (p < 0.001 in each group). However, the difference between the pre-COVID-19 and COVID-19 values revealed a lower decrease in the senses of smell and/or taste in group 1 than in group 2a and group 2b (p = 0.015, adjusted p = 0.045; and p = 0.001, adjusted p = 0.002, respectively). There were no significant differences in other COVID-19 findings, VAS, and TSS-6 scores among the groups (all p > 0.05). Conclusion: INCs in subjects with CR seemed protective against the decrease in smell and/or taste observed during COVID-19 and do not aggravate the clinical course of COVID-19.


Subject(s)
COVID-19 , Rhinitis , Administration, Intranasal , Adrenal Cortex Hormones/therapeutic use , COVID-19/complications , COVID-19/drug therapy , Humans , Quality of Life , Rhinitis/drug therapy
3.
Rhinology ; 59(6): 490-500, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1528969

ABSTRACT

We look back at the end of what soon will be seen as an historic year, from COVID-19 to real-world introduction of biologicals influencing the life of our patients. This review describes the important findings in Rhinology over the past year. A large body of evidence now demonstrates loss of sense of smell to be one of the most common symptoms of COVID-19 infection; a meta-analysis of 3563 patients found the mean prevalence of self-reported loss to be 47%. A number of studies have now shown long-term reduced loss of smell and parosmia. Given the high numbers of people affected by COVID-19, even with the best reported recovery rates, a significant number worldwide will be left with severe olfactory dysfunction. The most prevalent causes for olfactory dysfunction, besides COVID-19 and upper respiratory tract infections in general, are trauma and CRSwNP. For these CRSwNP patients a bright future seems to be starting with the development of treatment with biologics. This year the Nobel prize in Medicine 2021 was awarded jointly to David Julius and Ardem Patapoutian for their discoveries of receptors for temperature and touch which has greatly enhanced our understanding of nasal hyperreactivity and understanding of intranasal trigeminal function. Finally, a new definition of chronic rhinitis has been proposed in the last year and we have seen many papers emphasizing the importance of endotyping patients in chronic rhinitis and rhinosinusitis in order to optimise treatment effect.


Subject(s)
Biological Products , COVID-19 , Nasal Polyps , Olfaction Disorders , Rhinitis , Sinusitis , Biological Products/therapeutic use , Chronic Disease , Humans , Rhinitis/drug therapy , SARS-CoV-2 , Smell
5.
Tohoku J Exp Med ; 254(2): 71-80, 2021 06.
Article in English | MEDLINE | ID: covidwho-1262562

ABSTRACT

Olfactory disorders are one of the characteristic symptoms of the coronavirus disease of 2019 (COVID-19), which causes infection and inflammation of the upper and lower respiratory tract. To our knowledge, there are no treatments for COVID-19-related olfactory disorder. Here, we report five olfactory disorder cases in COVID-19, treated using the Japanese traditional (Kampo) medicine, kakkontokasenkyushin'i. We treated five patients with mild COVID-19 at an isolation facility using Kampo medicine, depending on their symptoms. Patients with the olfactory disorder presented with a blocked nose, nasal discharge or taste impairment. Physical examination using Kampo medicine showed similar findings, such as a red tongue with red spots and sublingual vein congestion, which presented as blood stasis and inflammation; thus, we prescribed the Kampo medicine, kakkontokasenkyushin'i. After administration, the numeric rating scale scores of the smell impairment improved within 3 days from 9 to 3 in case 1, from 10 to 0 in case 2, from 9 to 0 in case 3, from 5 to 0 in case 4, and from 9 to 0 within 5 days in case 5. Following the treatment, other common cold symptoms were also alleviated. Kakkontokasenkyushin'i can be used for treating nasal congestion, rhinitis, and inflammation in the nasal mucosa. The olfactory disorder in COVID-19 has been reportedly associated with inflammation and congestion, especially in the olfactory bulb and olfactory cleft. Kakkontokasenkyushin'i may be one of the treatment alternatives for the olfactory disorder with rhinitis in patients with COVID-19.


Subject(s)
COVID-19/drug therapy , Medicine, Kampo/methods , Olfaction Disorders/drug therapy , Plant Preparations/therapeutic use , Adolescent , Adult , COVID-19/complications , Drugs, Chinese Herbal/administration & dosage , Drugs, Chinese Herbal/pharmacology , Female , Humans , Japan , Male , Olfaction Disorders/complications , Olfaction Disorders/virology , Plant Preparations/chemistry , Plant Preparations/pharmacology , Rhinitis/complications , Rhinitis/drug therapy , Rhinitis/virology , SARS-CoV-2/physiology , Smell/drug effects , Treatment Outcome , Young Adult
6.
Otolaryngol Head Neck Surg ; 166(1): 183-185, 2022 01.
Article in English | MEDLINE | ID: covidwho-1181047

ABSTRACT

Chronic rhinosinusitis (CRS) management frequently comprises conservative treatment, including a combination of topical and oral corticosteroids (OCSs). However, in the midst of the coronavirus disease 2019 (COVID-19) pandemic, providers may have been reluctant to prescribe OCSs out of possible concern for an increased risk of contracting COVID-19 or developing more severe COVID-19 symptoms. This study thus sought to explore the association between the use of OCSs and the development of COVID-19 in patients with CRS. We found no statistically significant difference in the rates of patients with a positive diagnosis of COVID-19 who underwent an OCS treatment regimen compared to those who did not, both within 28 days (P = .389) and 14 days (P = .676) prior to the COVID-19 test. Given OCSs are often a major component of medical management of CRS, this study proves helpful in counseling patients on risks of steroid use in CRS treatment during the COVID-19 pandemic.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19/etiology , Rhinitis/drug therapy , Sinusitis/drug therapy , Administration, Oral , Adrenal Cortex Hormones/adverse effects , Chronic Disease , Cohort Studies , Female , Humans , Male , Middle Aged , Rhinitis/complications , Sinusitis/complications
7.
Laryngoscope ; 131(7): E2121-E2124, 2021 07.
Article in English | MEDLINE | ID: covidwho-968241

ABSTRACT

OBJECTIVES/HYPOTHESIS: Determine if antibiotic prescribing patterns differ for in-person versus virtual clinic visits for acute rhinosinusitis (ARS). STUDY DESIGN: Cross sectional study. METHODS: All adult virtual clinical encounters from March to May 2020 with a principal diagnosis of ARS were reviewed for demographic data and the presence or absence of an antibiotic prescription during the coronavirus shut down in Massachusetts. In-person clinical encounters from March to May 2019 were similarly examined as a control. The rate of antibiotic prescription was compared between virtual (2020) and in-person (2019) visits for ARS diagnoses. RESULTS: There were 2,075 patients in March to May 2020 and 3,654 patients March to May 2019 who received an ARS principal diagnosis at their virtual and in-person outpatient visits, respectively. There was a statistically significant lower rate of antibiotic prescriptions for ARS in 2020 (72.1%) versus 2019 (76.7%).The odds ratio for an antibiotic prescription for ARS was 0.783 (95% confidence interval, 0.693-0.86; P < .001) for patients seen in the 2020 cohort versus the 2019 cohort. The compared rates for antibiotic prescribing for 2020 versus 2019 were not different in individual month-to-month comparisons. When stratified by otolaryngology providers there was no statistically significant difference of antibiotic prescriptions between the 2019 and 2020 cohort (P = .781). CONCLUSIONS: During the massive transition to virtual visits for March to May 2020 due to the coronavirus pandemic shut down in Massachusetts, the total rate of outpatient antibiotic prescribing for ARS was lower in the virtual visit environment compared to the traditional in-person visit. In this scenario, telemedicine did not result in an increase in antibiotic prescribing despite the lack of an in-person physical exam. LEVEL OF EVIDENCE: IV Laryngoscope, 131:E2121-E2124, 2021.


Subject(s)
Ambulatory Care , Anti-Bacterial Agents/therapeutic use , COVID-19 , Drug Prescriptions/statistics & numerical data , Rhinitis/drug therapy , Sinusitis/drug therapy , Telemedicine , Acute Disease , Adult , Aged , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Practice Patterns, Physicians' , Retrospective Studies , Rhinitis/complications , Sinusitis/complications
8.
Allergy ; 76(3): 677-688, 2021 03.
Article in English | MEDLINE | ID: covidwho-873214

ABSTRACT

BACKGROUND: Chronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID-19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type-2 (T2) inflammation endotypes. METHODS: The current knowledge on COVID-19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. RESULTS: Based on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID-19 pandemic. CONCLUSION: Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Rhinitis/drug therapy , SARS-CoV-2 , Sinusitis/drug therapy , Adrenal Cortex Hormones/administration & dosage , Asthma/drug therapy , Biological Products/therapeutic use , Chronic Disease , Humans , Nasal Polyps/drug therapy
9.
Am J Otolaryngol ; 41(5): 102604, 2020.
Article in English | MEDLINE | ID: covidwho-628588

ABSTRACT

OBJECTIVES: The role of topical anti-infectives in acute exacerbations of chronic rhinosinusitis is controversial. Povidone-iodine is an anti-bacterial and anti-viral that is affordable and available over-the-counter and may demonstrate advantages over mupirocin as a sinus irrigation therapy. The objective was to compare povidone-iodine or mupirocin versus saline sinus irrigations for sinusitis exacerbations in post-surgery subjects as well as to assess tolerability of povidone-iodine sinus irrigations. MATERIALS AND METHODS: This was a prospective single-blinded (clinician only) randomized controlled trial. Subjects were post-surgery with acute exacerbations of chronic rhinosinusitis and gram-positive bacteria on culture. They received povidone-iodine, mupirocin, or saline sinus irrigations, twice daily for 30 days. Outcomes were post-treatment culture negativity (primary) and Sinonasal Outcome Test-20 and Lund-Kennedy endoscopic score change (secondary). RESULTS: Of the 62 subjects analyzed, post-treatment culture negativity rate was higher in the MUP (14/20, 70%) group compared to the PI (9/21, 43%) and SAL (9/19, 47%) groups, although this was not significant (p = 0.29). Povidone-iodine sinus irrigations at the 1% concentration were very well-tolerated, similar to saline irrigations. There were no significant differences in Sinonasal Outcome Test-20 score (povidone-iodine -0.3 [-0.6, 0.05] vs. mupirocin -0.3 [-0.7, 0.05] vs. saline -0.4 [-0.8, 0.05]; p = 0.86) or Lund-Kennedy endoscopic score (povidone-iodine -3.5 [-7, -0.5] vs. mupirocin -2 [-4, 2] vs. saline -3 [-5, 0]; p = 0.45) change. No serious adverse effects were reported. CONCLUSIONS: In patients who have had prior sinus surgery with acute exacerbations of CRS and gram-positive bacteria on culture, mupirocin sinus irrigations achieved a better post-treatment culture "control" rate compared to saline and povidone-iodine. In addition, 1% povidone-iodine solution was well-tolerated as a sinus irrigation and may represent a feasible method for temporarily disinfecting the sinonasal cavity of bacteria and viruses such as COVID-19.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Mupirocin/therapeutic use , Postoperative Complications/drug therapy , Povidone-Iodine/therapeutic use , Rhinitis/drug therapy , Sinusitis/drug therapy , Adult , Anti-Infective Agents, Local , Chronic Disease , Female , Humans , Male , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Prospective Studies , Rhinitis/diagnosis , Rhinitis/etiology , Saline Solution , Single-Blind Method , Sinusitis/diagnosis , Sinusitis/etiology , Therapeutic Irrigation
SELECTION OF CITATIONS
SEARCH DETAIL