Otolaryngologic Manifestation and Long-Term Outcome in Mild COVID-19: Experience from a Tertiary Care Centre in India (original) (raw)

ENT Symptomology in Active COVID-19 Patients in our Tertiary Care Centre

Indian Journal of Otolaryngology and Head & Neck Surgery

The aim of this study is to obtain a clear picture of ENT related symptoms in active COVID-19 patients. This study also intends to determine the association of ENT symptoms with Olfactory and Gustatory dysfunction in these patients. Material and Methods: This is a prospective study on 70 active COVID-19 patients who were admitted in the Tertiary Care Hospital. History of all symptoms including Olfactory and Gustatory function were enquired after obtaining Informed Consent. Results: Throat related symptoms was 77.78%, Nasal symptoms accounted for 63.49% and Ear related symptoms constituted 14.28%. It was seen that Rhinorrhoea and Sneezing was significantly more associated in the presence of Olfactory dysfunction. The most common ENT symptoms were Sore throat (49.21%), Rhinorrhoea (34.92%), Sneezing (33.33%), changes in Smell perception (36.51%), changes in Taste perception (47.62%) and Headache (30.16%). 17.14% of the patients in this study had both Olfactory and Gustatory dysfunction. Ear related symptoms were also observed where 11.11% had Aural fullness, 3.17% with Tinnitus and 6.35% of the patients complained of Hearing loss which was either noticed for the first time or had worsened on contracting the COVID-19 disease. Discussion: Knowledge of ENT symptomatology in COVID 19 patients will aid in early quarantine and hence limitation of viral transmission. The manifestation of Anosmia or Hyposmia, Ageusia and Aural Fullness in SARS-CoV-2 infected patients can also act as an important tool and help in early isolation and quicker initiation of COVID-19 therapy.

A Review of the Importance of Atypical Otorhinolaryngological Symptoms in the Screening of COVID-19 Patients

Indian Journal of Otolaryngology and Head & Neck Surgery, 2020

While the world is fighting against the newly emerged highly contagious coronavirus strain, new evolving ideas regarding symptoms and investigations are reverberating among health care professionals to combat the public health emergency. The study aims to review various presenting symptoms of COVID-19 especially the unusual one and analyzing the importance of olfactory and taste disturbances. 20 studies published recently in the last 1 year were analyzed and discussed for insights into the unusual presentation of symptoms in COVID-19 patients. All the findings and statements in this review regarding the pandemic are based on published information as listed in the references. Most research articles initially focused on fever and respiratory symptoms. Later gastrointestinal symptoms were also taken into consideration. Only 5 studies from the literature have mentioned any smell and taste disturbances after SARS-CoV-2 infection to date. So changing trends can be seen in publications and recognizing these symptoms has important to timely combat this disease. The majority of corona virus-infected patients suffer from mild to moderate severity of the disease. Much hyped up symptoms of the respiratory tract may not be shown by a greater number of patients. So the need of the hour especially in developing and densely populated nations is to recognize unusual symptoms of COVID-19 especially its influence over smell and taste sensation to prevent any delay or misdiagnosis.

Prevalence of Loss of Smell and/or Taste and other Otorhinolaryngology Symptoms in COVID-19 Patients

Kathmandu University Medical Journal, 2021

Background Loss of smell and/or taste have been described in COVID-19 patients. Studies have not been conducted to evaluate the loss of smell and/or taste in the context of Nepal. Objective To investigate the prevalence of Ear, Nose and Throat related symptoms and assess smell and taste disorders in laboratory-confirmed SARS-CoV-2 patients. Method This prospective cross-sectional study evaluated patients from September 2020 to March 2021 with preceding COVID-19 diagnosis from a tertiary centre in Kathmandu. COVID-19 positive patients visiting outpatient department, quarantined or admitted were included. Patients were given questionnaire consisting of demographic data, history of smoking and evaluation of presenting symptoms. Loss of smell and taste were subjectively tested and followed up via telephone for ten weeks to evaluate for recovery time and degree of recovery. Result A total of 226 patients participated in the study, 18-92 years old (mean age, 36.77 ± 15.23 years; 53.5% males, 69% non-smokers). Majority of the patients had Myalgia (n = 128, 56.6%) as their presenting symptoms followed by fever (n = 122, 53.9%), loss of smell (n = 117, 51.7%), cough (n = 107, 47.34) and sore throat (n = 102, 45.1%). Loss of sense of smell and taste was reported in 51.8% and 42% respectively. The association between loss of sense of smell and taste was statistically significant (p < .001). All patients had some degree of recovery with 64.1% recovery of smell and 64.2% recovery of taste within 14 days of onset of symptoms. The mean recovery time for sense of smell and taste was 14.34 ± 9.82 days and 15.03 ± 10.06 days, respectively. Conclusion Olfactory and gustatory dysfunctions are cardinal features of COVID-19. They recover spontaneously along with other symptoms within few weeks. The absence of smell or taste in times of pandemic can be suggestive of potential COVID-19 infection and be used as a screening tool for early diagnosis and reduce transmission of the infection.

Symptomatology of COVID-19 from the otorhinolaryngology perspective: a survey of 223 SARS-CoV-2 RNA-positive patients

European Archives of Oto-Rhino-Laryngology

Purpose To determine prevalence, severity, duration, and time from onset to diagnosis of general and Otorhinolaryngologic symptoms related to COVID-19 in whole disease spectrum: from mild to critical patients. Methods All adult patients with positive SARS-CoV-2 RNA found in nasopharyngeal and oropharyngeal swabs between March 10 and April 21, 2020 were surveyed by the authors for new onset symptoms during disease course. Demographic features, general symptoms, and Otorhinolaryngological symptoms were evaluated and compared by disease severity. Results Of 223 included patients, 18.4% had mild, 61.4%; moderate, 14.3%; severe, and 5.8%; critical disease. Median age was 51 (range 20-93), 113 (50.7%) were male and 110 (49.3%) were female. The most common general symptoms were fatigue, cough, and fever with respective frequencies of 71.3%, 54.3%, and 50.7%. The most common Otorhinolaryngologic symptoms were taste loss, smell loss, and sore throat with respective frequencies of 34.5%, 31.8%, and 26%. Fatigue, fever, and dyspnea were more common in severe-critical patients compared to mild-moderate patients (p = 0.029, p = 0.016, and p < 0.001, respectively). Only smell loss was more common in mild-moderate group (p = 0.003). Prevalence of other symptoms did not differ between groups. Symptom durations and onset time to diagnosis varied. Conclusion When compared to the previous studies, while general symptoms were less common, Otorhinolaryngologic symptoms were more common in our study population. Considering high infection risks, Otorhinolaryngologists should be aware of COVID-19 patients presenting with Otorhinolaryngologic complaints.

Clinical Characteristics of COVID-19 from the Otorhinolaryngologist’s Perspective: First Report from Oman, Middle East

Indian Journal of Otolaryngology and Head & Neck Surgery, 2021

To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms...

Prevalence of Otorhinolaryngological Symptoms in Covid 19 Patients

Indian Journal of Otolaryngology and Head & Neck Surgery, 2021

To determine prevelance of ENT symptoms in COVID 19 positive patients. A cross sectional study was performed at SRTR GMC AMBAJOGAI, a tertiary care hospital amongst the patients admitted in COVID 19 isolation ward with a positive RT-PCR report. Amongst the included 180 patients, 112 patients had one or more ENT related symptoms that included throat pain (47.2%), loss of smell (55.5%), loss of taste (58.8%) and hearing loss (54.44%) along with generalized COVID 19 symptoms. ENT symptoms can be considered as biomarkers for early diagnosis of Covid-19 patients ensuring faster treatment and isolation allowing better containment of the disease.

Study of Otorhinolaryngological Manifestations in Symptomatic COVID-19-Positive Patients at Tertiary Health Care Hospital: A Cross-sectional Study

Int Arch Otorhinolaryngol , 2024

Introduction The coronavirus disease 2019 (COVID-19), also referred to as the 2019 novel coronavirus, is caused by a single-stranded positive-sense RNA virus. This infectious agent spreads through respiratory routes, primarily utilizing aerosols. In our study, we shed light on ear, nose, and throat (ENT) manifestations, which can be considered as prognostic clinical biomarkers to reduce forthcoming complications among such critically ill patients. This makes it feasible for researchers to investigate or fetch early diagnosis in such cases with ease without the use of large, extensive hospital-base setups. Objective To study the otorhinolaryngological (ENT) manifestations in symptomatic COVID-19 patients. Methods From January to December 2021, a cross-sectional observational study was conducted at the Department of ENT of a tertiary care hospital in central India. All eligible symptomatic COVID-19 patients admitted to this institution during the study period were consecutively enrolled. The Institutional Ethics Committee gave its permission for the project. Results Out of the total of 1,375 patients, 78% of the patients diagnosed with COVID exhibited symptoms related to the ENT, while the remaining 22% did not display any ENT manifestations. Anosmia (71.2%), sore throat (55.62%), headache (44.3%), and loss of taste (66.3%) were among the most common ENT symptoms. Conclusion The present study highlights ENT manifestations, which play a crucial role in the early diagnosis of COVID-19 patients, ensuring faster treatment and isolation for better containment of the disease. Symptomatic treatment has shown efficacy, but objective tests are needed to prevent overestimation, understand pathogenesis, and enhance treatment.

Otolaryngological manifestations of hospitalised patients with confirmed COVID-19 infection

European Archives of Oto-Rhino-Laryngology

The aim of our study is to evaluate the incidence and characteristics of otolaryngology symptoms in COVID 19 patients. Methods 116 patients with positive PCR test results for COVID-19 and followed up by otolaryngologists at a tertiary referral center/COVID-19 pandemic hospital were questioned in terms of otolaryngology symptoms associated with COVID-19 infection. Data including demographics, disease severity, concomitant diseases, previous otolaryngologic diseases,incidence and duration of new onset symptoms were collected and categorically analyzed. In addition, the severity of loss of smell and taste was evaluated by visual analogue score (VAS). Results A total of 58 men and 58 women participated. The mean age of the patients was 57.24 ± 14.32 (19-83). The most common otolaryngological findings were hyposmia/anosmia (37.9%) and hypogeusia/ageusia (41.37%), respectively. These complaints were followed by headache (37.1%), and nausea/vomiting (31%). The most common oropharyngeal symptoms were sore throat (32.7%) and dysphagia (20.6%). The rate of otological/vestibular symptoms was dizziness (31.8%), tinnitus (11%), true vertigo (6%), and hearing impairment (5.1%), respectively. The most of symptoms were more frequent in > 60 years and women. There was a significant correlation between nasal itching and smell disturbance in patients with allergic rhinitis. Considering the duration of symptoms, the longest were hyposmia/anosmia and hypogeusia/ageusia. The mean VAS's in patients with hyposmia/anosmia and hypogeusia/ageusia were 5.52 ± 2.08 and 5.79 ± 2.21, respectively. Conclusion The most common otolaryngologic symptoms of COVID-19 infection are known as sore throat, smell and/ or taste disturbances. However, our study showed that these patients can be seen with different symptoms in otological or laryngeal areas. Therefore, a more careful evaluation should be made in terms of otolaryngologic symptoms when COVID 19 infection is suspected.

Otorhinolaryngological Manifestations in COVID-19 Patients

Scholarly Journal of Otolaryngology, 2020

Introduction:The World Health Organization confirmed COVID 19 as a pandemic on 11th March 2020. Though the most common symptoms of COVID-19 are fever, cough, myalgia, fatigue, and difficulty breathing, ear, nose, and throat (ENT) symptoms, including loss of sense of smell and/or loss of sense of taste have been reported as symptoms caused by the virus. Aims and Objectives:To detect and discuss the different otorhinolaryngology (ORL) manifestations reported in COVID-19 positive patients. Materialsand Methods: This observational study was done on 2000 patients with a positive COVID 19 test admitted to a tertiary care hospital. The patients were assessed for their signs and symptoms and the findings were analysed. Results: The patients ranged in age from 18 to 70 years, including 1090 males (54.5%) and 910 females (45.5%). The most common presenting symptom was fever seen in 1500 (75%) patients. Other symptoms included cough in 1100 (55%) patients, expectoration seen in 446 (22.3%), breathlessness in 302(15.1%), nausea and vomiting in 80(4%) patients, fatigue/malaise in 568 (28.4%) patients.The most common otorhinolaryngological manifestation were sore throat seen in 460 (23%) patients, running nose in 292 (14.6%), olfactory disturbances in 180 (9%), nasal obstruction in 156(7.8%) , headache in 222(11.1%), pharyngeal congestion in 208(10.4%), tonsillar hypertrophy seen in 62(3.1%) patients. Conclusion: Though, the most common presenting symptoms in COVID-19 patients are fever and cough, a significant proportion of patients does have ENT manifestations which may go unnoticed. Hence it becomes necessary to screen all COVID patients for ENT symptoms so that high quality care can be provided for patients.This also facilitates care givers to take necessary precautions to protect themselves.

Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

European Archives of Oto-Rhino-Laryngology, 2021

Objective To investigate prevalence and epidemiological and clinical factors associated with olfactory dysfunction (OD) and gustatory dysfunction (GD) in COVID-19 patients according to the disease severity. Study design Cross-sectional study. Methods A total of 2579 patients with a positive diagnosis of COVID-19 were identified between March 22 and June 3, 2020 from 18 European hospitals. Epidemiological and clinical data were extracted. Otolaryngological symptoms, including OD and GD, were collected through patient-reported outcome questionnaire and Sniffin'Sticks tests were carried out in a subset of patients. Results A total of 2579 patients were included, including 2166 mild (84.0%), 144 moderate (5.6%) and 269 severe-to-critical (10.4%) patients. Mild patients presented an otolaryngological picture of the disease with OD, GD, nasal obstruction, rhinorrhea and sore throat as the most prevalent symptoms. The prevalence of subjective OD and GD was 73.7 and 46.8%, and decreases with the severity of the disease. Females had higher prevalence of subjective OD and GD compared with males. Diabetes was associated with a higher risk to develop GD. Among the subset of patients who benefited from psychophysical olfactory evaluations, there were 75 anosmic, 43 hyposmic and 113 normosmic patients. The prevalence of anosmia significantly decreased with the severity of the disease. Anosmia or hyposmia were not associated with any nasal disorder, according to SNOT-22. Conclusion OD and GD are more prevalent in patients with mild COVID-19 compared with individuals with moderate, severe or critical diseases. Females might have a higher risk of developing OD and GD compared with males.