Diagnosis and Treatment Strategy of Nasogenic Olfactory Dysfunction.

Since the global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a symptom of the onset of SARS-CoV-2, olfactory dysfunction (OD), has attracted tremendous attention. OD is not only a negative factor for quality of life but also an independent hazard and early biomarker for various diseases, such as Parkinson's and Huntington's diseases. Therefore, early identification and treatment of OD in patients are critical. Many etiological factors are responsible for OD based on current opinions. Sniffin'Sticks are recommended to identify the initial position (central or peripheral) for OD when treating patients clinically. It is worth emphasizing that the olfactory region in nasal cavity is recognized as the primary and critical olfactory receptor. Many nasal diseases, such as those with traumatic, obstructive and inflammatory causes, can lead to OD. The key question is no refined diagnosis or treatment strategy for nasogenic OD currently. This study summarizes the differences in medical history, symptoms, auxiliary examination, treatment and prognosis of different types of nasogenic OD by analyzing the current studies. We propose using olfactory training after 4-6 weeks of initial treatment for nasogenic OD patients with no significant improvement in olfaction. We hope that our research can provide valuable clinical guidance by systematically summarizing the clinical characteristics of nasogenic OD.

Comparison of laboratory parameters, clinical symptoms and clinical outcomes of COVID-19 and influenza in pediatric patients: A systematic review and meta-analysis.

BACKGROUND: New and more severe clinical manifestations associated with the coronavirus disease 2019 (COVID-19) are emerging constantly in the pediatric age group. Patients in this age group are also primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies comparing influenza and COVID-19 to show which condition causes a more severe form of disease amongst the pediatric age group are scarce. AIM: To compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza. METHODS: A systematic and comprehensive search was carried out in databases and search engines, including EMBASE, Cochrane, MEDLINE, ScienceDirect and Google Scholar from 1964 until January 2022. A meta-analysis was carried out using a random-effects model and pooled odds ratio (OR) or standardized mean difference (SMD) and 95%CI. RESULTS: A total of 16 studies satisfied the inclusion criteria. Pediatric COVID-19 patients had a significantly reduced risk of cough (pooled OR = 0.16; 95%CI: 0.09 to 0.27), fever (pooled OR = 0.23; 95%CI: 0.12 to 0.43), and dyspnea (pooled OR = 0.54; 95%CI: 0.33 to 0.88) compared to influenza patients. Furthermore, total hemoglobin levels (pooled SMD = 1.22; 95%CI: 0.29 to 2.14) in COVID-19 patients were significantly higher as compared to pediatric influenza patients. There was no significant difference in symptoms such as sore throat, white blood cell count, platelets, neutrophil and lymphocytes levels, and outcomes like mortality, intensive care unit admission, mechanical ventilation or length of hospital stay. CONCLUSION: COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group. However, further longitudinal studies of the outcomes between influenza and COVID-19 pediatric patients are needed.

Preliminary Evaluation of a New Initiative to Centralize Colorectal Cancer Care During the COVID-19 Epidemic in Shanghai, China: A Retrospective Study (preprint)

Background: A novel colorectal cancer center (CCC) was developed in the Tenth Hospital of Shanghai during the coronavirus disease 2019 (COVID-19) epidemic. We aimed to evaluate the CCC for the centralized management of colorectal cancer (CRC) on three dimensions during this distinctive period. Methods: This retrospective study used data from the Tenth Hospital’s patient databases. The research hypothesis was that the CCC reduces preoperative waiting time (PWT), length of stay (LOS) during hospitalization, and costs of hospitalization, without reducing the quality of surgery. Thus, we analyzed three dimensions: time, cost, and quality. We compared the expected outcomes between March 1–December 31, 2019, and March 1–December 31, 2020. Descriptive and inferential analyses of patient demographic characteristics, time, postoperative outcomes, and inpatient costs were conducted. Findings: A total of 965 hospitalizations for CRC were identified. In the CCC, PWT declined by 26.2 hours (p<0.01). Patients who entered the CCC express group only needed to wait for 24.5 hours before undergoing surgery, with shorter LOS during hospitalization than the normal group (p<0.01). No patients had any symptoms of COVID-19 or high-risk COVID-19 contacts, and the immediate postoperative complication incidence was low. The mean total inpatient cost (TIC) for all patients with CRC was 78309.824 Chinese yuan in 2020, which was slightly lower than this cost in 2019. Interpretation: This study examined the efficiency of the centralized management model for CRC care during the COVID-19 epidemic in terms of time, cost, and quality. Funding Information: This study was sponsored by the Clinical Research Plan of SHDC (No. SHDC2020CR5006-002), the National Natural Science Foundation of China (No.71804128, 71904145), the Special Funds for Fundamental Research Expenses of Central Universities (No. 22120200407) and the Personnel Development Plan of Shanghai Tenth People's Hospital of Tongji University (No. 2021SYPDRC014).Declaration of Interests: None declared.Ethics Approval Statement: This study has been approved by the Ethics Committee of the Shanghai Tenth People's Hospital of Tongji University (SHSY-IEC-4.1/20-272/01).