RESUMO
ObjectiveTo assess the association between the lockdowns due to COVID-19 and online searches for toothache in Iran using Google Trends (GT). MethodsWe investigated GT online searches for the search term [Formula] within the past five years. The time frame for data gathering was considered as the initiation and end dates of lockdown in Iran. Relative search volumes (RSVs) for online Google Search queries in 2019 was considered as the control. We performed one-way ANOVA statistical test to identify whether there is a statistical difference for RSV scores between the year 2020 and 2016-2019 for the whole country. Then we investigated the possible association of RSVs in provinces with dentists density, prevalence of current daily smokers, Human Development Index (HDI), Internet access, and fluoride concentration in water with linear regression. A p-value<0.05 was considered as statistically significant. ResultsWhen comparing 2020 with previous four years, there is a statistically significant difference between RSVs of 2020 with all previous years combined and each of these years (P<0.001 for all of them). In the linear model for the year 2020, HDI (B=-3.29, 95% CI: (-5.80, - 0.78), P=0.012), fluoride concentration (B=-0.13, 95% CI: (-0.24, -0.03), P=0.017), and prevalence of daily smokers (B=0.33, 95% CI: (0.13, 0.53), P=0.002) were significantly associated with RSVs. These covariates were not statistically significant for other years, except for Internet access in 2016 (B=-1.13, 95% CI: (-2.26, 0.00), P=0.050). ConclusionThe RSVs for toothache in 2020 have significantly increased due to COVID-19-imposed lockdowns compared to the same period of the year in the past four years. Knowing that this period mostly overlaps with the national holidays of Nowruz in Iran, reinforces the impacts of lockdowns on peoples CSB about the toothache. In the subnational scale, the RSVs were significantly correlated with HDI, fluoride concentration, and prevalence of daily smokers which emphasises the role of socioeconomic factors in dental health and care-seeking behaviour.
RESUMO
ObjectiveTo assess the association between the lockdowns due to COVID-19 and global online searches for toothache using Google Trends (GT). MethodsWe investigated GT online searches for the search terms "toothache" and "tooth pain", within the past five years. The time frame for data gathering was considered as the initiation and end dates of national/regional lockdowns in each country. Relative search volumes (RSVs) for online Google Search queries in 2019 was considered as the control. We analysed data after normalising based on the Internet penetration rate. We used one-way ANOVA to identify statistical difference for RSVs between 2020 and 2016-2019 for each country. A linear regression model was used to assess whether there is a correlation between RSVs in 2020 and gross domestic production, COVID-19 deaths, dentists density, YLDs of oral conditions, Internet access, lockdown duration, Education Index, and dental expenditure per capita. ResultsThe results of worldwide RSVs for toothache and tooth pain also showed significantly higher values in 2020 compared to the previous four years. Of 23 included countries in our study, 16 showed significantly increased RSVs during the lockdown period compared to the same periods in the past four years. There was a statistically significant relationship between difference of RSVs means in 2020 and in 2016-2019 combined with percent of urban residency (B=-1.82; 95% CI: (-3.38, -0.26); p=0.026) and dental expenditure per capita (B=-0.42; 95% CI: (-0.80, -0.05); p=0.031) (R2=0.66). ConclusionGenerally, the interest in toothache and tooth pain has significantly increased in 2020 compared to the last four years. This could implicitly reinforce the importance of dental care, as urgent medical care worldwide. Governments expenditure on oral healthcare and the rate of urban residency, could be mentioned as important factors to direct general populations online care-seeking behaviour with regard to dental pain.
RESUMO
ObjectiveTo evaluate the association of olfactory dysfunction (OD) with hospitalization for COVID-19. Study DesignMulti-center cohort study. SettingEmergency departments of thirteen COVID-19-designed hospitals in Kurdistan province, Iran. Subjects and MethodsPatients presenting with flu-like symptoms who tested positive by RT-PCR for COVID-19 between May 1st and 31st, 2020. At the time of presentation and enrollment, patients were asked about the presence of OD, fever, cough, shortness of breath, headache, rhinorrhea and sore throat. The severity of OD was assessed on an 11-point scale from 0 (none) to 10 (anosmia). Patients were either hospitalized or sent home for outpatient care based on standardized criteria. ResultsOf 203 patients, who presented at a mean of 6 days into the COVID-19 disease course, 25 patients (12.3%) had new OD and 138 patients (68.0%) were admitted for their COVID-19. Patients admitted for COVID-19 had a higher prevalence of all symptoms assessed, including OD (p<0.05 in all cases), and OD identified admitted patients with 84.0% sensitivity and 34.3% specificity. On univariate logistic regression, hospitalization was associated with OD (odds ratio [OR] = 2.47, 95%CI: 1.085-6.911, p=0.049). However, hospitalization for COVID-19 was not associated with OD (OR=3.22, 95% CI: 0.57-18.31, p=0.188) after controlling for confounding demographics and comorbidities. ConclusionOD may be associated with hospitalization for (and therefore more severe) COVID-19. However, this association between OD and COVID-19 severity is more likely driven by patient characteristics linked to OD, such as greater numbers of COVID-19 symptoms experienced or high-risk comorbidities.
