Otorhinolaryngological manifestation in COVID-19
Keywords:COVID-19, Symptomatology, Observational study
Background: Coronaviruses (CoV) disease caused by the seventh member of enveloped RNA coronavirusdisease. The COVID-19 is presented mainly by lower respiratory tract related symptoms such as fever, cough, dyspnea and chest tightness that could progress rapidly to acute respiratory distress syndrome (ARDS) whereas the different upper respiratory tract related symptoms include nasal congestion, sore throat and smell dysfunction. The aim of this study is to contribute to current knowledge about COVID-19 and to study about the otorhinolaryngological manifestations and its effects in COVID-19 patients.
Methods: This prospective observational study was done on 644 patients who got admitted to COVID suspect ward of a tertiary care centre in middle India. The patients were assessed for the signs and symptoms and the findings were analysed.
Results: Within the included 664 cases, 423 (64%) were males and 241(36%) were females. The maximum number of patients in 50 to 60 years of age ,128(19%). Among which 97% (646) from urban area and 3% (18) from rural area. 564 (85%) were symptomatic with 459 patients had symptoms for 1-4 days,112 patients for 5-10 days,4 patients between 11-15 days. The most common symptoms with which these patients presented were cough (68%), fever (62%), signs of breathlessness (61%). The most common ENT manifestations were sore throat 333 (59%), nasal discharge 120 (12%), anosmia 65 (12%), ear discharge 46 (8%).
Conclusions: Even though the most common manifestations of COVID-19 were cough, fever, breathlessness significant proportions of patients do manifest with ENT symptoms like sorethroat, nasal discharge, anosmia, ear discharge which may go unnoticed. Recognizing the cases and addressing them properly is important for curbing the rapid spread of COVID-19 pandemic.
Perlman S. Another decade, another coronavirus. N Engl J Med. 2020;382:760-2.
Wu, Chi Y, Chen, Sung C, Chan, Jiun Y. Journal of the Chinese Medical Association. 200;83(3):217-20.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hos-pitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061-9.
Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristicsof novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J(Engl). 2020;133(9):1025-31.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics ofcoronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A et al. Objective evaluation of anosmia and ageusia in COVID-19 patients: single-center experience on 72 cases. Head Neck. 2020.
Shen M, Zhou Y, Ye J. Recent advances and perspectives of nucleic acid detection for coronavirus. J Pharm Anal. 2020.
Wan Z, Zhang Y, He Z. a melting curve-based multiplex RT-qPCR assay for simultaneous detection of four human coronaviruses. Int J Mol Sci. 2016;17(11):E1880.
Noh JY, Yoon SW, Kim DJ. Simultaneous detection of severe acute respiratory syndrome, middle east respiratory syndrome, and related bat coronaviruses by real-time reverse transcription PCR. Arch Virol. 2017;162(6):1617-23.
World Health Organization. Novel coronavirus (2019-nCoV) advice for the public: myth busters (Z): 2020.
Monod M, Blenkinsop A. Science. 2021;371(6536):eabe8372.
Jian-Min Jin, Peng Bai, Wei He, Fei Wu, Xiao-Fang Liu, De-Min Han, Shi Liu, Jin-Kui Yangdoi. Frontiers in Public Health doi: 10.3389/fpubh.2020.00152.
Omer SB, Malani P, Del Rio C. The COVID-19 pandemic in the US: a clinical update. JAMA. 2020;323(18):1767-8.
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). InStatpearls. StatPearls Publishing; 2020.
Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro. Surveill. 2020;25:20001.
Woelfel R, Corman V, Guggemos W, Seilmaier M, Zange S, Mueller M, et al. Clinical Presentation and Virological Assessment of Hospitalized Cases of Coronavirus Disease 2019 in a Travel-Associated Transmission Cluster: 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1. Accessed on 24 April, 2021.
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382:1177-9.
Gostic K, Gome AC, Mummah RO, Kucharski AJ, Lloyd-Smith JO. Estimated effectiveness of symptom and risk screening to prevent the spread of COVID-19. Elife. 2020;9:e55570.
Schmitt PP. Virologe Hendrik Streeck: Wir haben neue Symptome entdeckt.’ FAZ.NET. https://www.faz.net/1.6681450. Accessed 25 April 2020.
Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2020;163(1):3-11.
El.Anwar M, Elzayat S, Fouad Y. ENT manifestation in COVID 19 patients. Auris Nasus Larynx. 2020;47(4):559-64.
Salepci E, Turk B, Ozcan SN. Symptomatology of COVID-19 from the otorhinolaryngology perspective: a survey of 223 SARS-CoV-2 RNA-positive patients. Eur Arch Otorhinolaryngol. 2020.
El. Anwar M, Elzayat S, Fouad Y. ENT manifestation in COVID 19 patients. Auris Nasus Larynx. 2020;47(4):559-64.
Sakalli E, Temirbekov D, Bayri E, Alis E, Erdurak S. Ear nose throat-related symptoms with a focus on loss of smell and/or taste in COVID-19 patients. American Journal of Otolaryngology. 2020;41(6):102622.