COVID-19’un sık görülen ve atipik kulak burun boğaz bulguları

Year 2021, , 780 - 788, 30.06.2021

Neslihan Sarı , Nurgül Arslan , Vasfiye Bayram Değer

https://doi.org/10.17826/cumj.871808

Abstract

Amaç: Literatürde, koku alma bozukluğu, konjuktivit, gastrointestinal bulgular vs gibi COVID-19’un birçok atipik sunumu mevcuttur. Bu çalışmanın amacı; acil ve Kulak Burun Boğaz (KBB) polikliniğine başvuran hastalarda COVID-19’un sık ve atipik semptomlarını araştırmaktır.
Gereç ve Yöntem: Bu vaka serisi 1 Nisan 2020 ile 30 Nisan 2020 tarihleri arasında hastaneye başvuran 49 hasta ile gerçekleştirilmiştir. Sık ve atipik görülen KBB bulguları kaydedildi. Sosyodemografik bulgular ve kan parametreleri değerlendirildi.
Bulgular: Hastaların %59.2’i 40 yaş ve üzeri, %55.1’i erkek, %46.9’u A kan grubu, %24.5’i sigara içen, %51 ’inin kronik hastalığı vardı. Ortak bulgular arasında; ateş %71.4, kuru öksürük %46.9, nefes darlığı %42.9, burun akıntısı %51, burun tıkanıklığı %42.9 görüldü. Boğaz ağrısı %22.4, baş ağrısı %32.7, koku alma bozukluğu %18.4, tat alma bozukluğu %26.5 ve ishal %49 olarak kaydedildi. Koku ve tat alma bozuklukları iyi prognoz ve hafif klinik seyir göstermektedir. Kadın ve erkek hastaların hemoglobin ve D-dimer düzeyleri arasındaki fark istatistiksel olarak anlamlı bulundu. Bu çalışmada belirlenen D-dimer seviyeleri literatürde bildirilenlerden anlamlı derecede yüksekti.
Sonuç: COVID-19 ortak semptomlarla ortaya çıkarken, bazen atipik semptomlar hastaneye başvuru da tek bulgu olabilir. Koku ve tat bozuklukları gibi bulgular COVID-19’un sinirler üzerine etkilerine dikkat çekmektedir. Koku tat bozuklukları gibi nöronal etkiler COVID -19 hastalarında uzun dönemde yakından takip edilmelidir.

Keywords

COVID-19, KBB bulguları, koku bozukluğu, tat bozukluğu

Common and atypical otorhinolaryngological findings of Covid-19

Abstract

Purpose: Several atypical presentations of COVID-19 like anosmia, conjuctivitis, and gastrointestinal findings are seen in the literature. The purpose of this study was to investigate the common and atypical symptoms of COVID-19 among the patients admitted to the otorhinolaryngology (ENT) outpatient clinic.
Materials and Methods: This case series was conducted with 49 patients who applied to hospital between April 1, 2020 and April 30, 2020. Common and atypical otolaryngological findings were recorded. Sociodemographic findings and blood parameters were also evaluated.
Results: Of the patients, 59.18% were aged 40 and over, 46.94% were of the A blood group, 55.10% were male and 24.49% were smokers, 51.02% had a chronic disease. Among typical symptoms; fever (71.43%), a dry cough (46.94%), shortness of breath (42.86%) was seen. Diarrhea (48.98%), runny nose (51.02%), nasal congestion (42.85%), sore throat (22.44%), headaches (32.65%), 18.36% olfactory disorder, 26.53% gustatory disturbance were noted. Olfactory and gustatory disturbances are found to be related to good prognosis and mild clinical course. The difference between Hg and D–dimer levels of the female and male patients were found to be statistically significant. The D-dimer levels determined in the present study were higher than those reported in the literature.
Conclusion: While COVID-19 present with common symptoms, sometimes atypical symptoms can be the only finding during initial application to the hospital. Olfactory and gustatory disturbances point to the effects of COVID-19 on neurons. Neuronal effects like olfactory and gustatory disturbances should be closely monitored in COVID-19 patients in long term.

Keywords

COVID-19, Otorhinolaryngology, Olfactory disorder, taste disorder

References

• REFERENCES 1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020; 395(10223): 497-506. DOI: 10.1016/S0140-6736(20)30183-5.
• 2. Ather A, Patel B, Ruparel NB, Diogenes A, et al. Coronavirus disease 19 (COVID-19): İmplications for clinical dental care. Journal of Endodontics. 2020; 46(5): 584-595. DOI: 10.1016/j.joen.2020.03.008.
• 3. Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. Journal of Infection. 2020; 80(6): 656–665. DOI: 10.1016/j.jinf.2020.03.041.
• 4. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020; 382: 727-733. DOI: 10.1056/NEJMoa2001017. 5. Sohrabi C, Alsafi Z, O’Neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 2020; 76: 71–76. DOI: 10.1016/j.ijsu.2020.02.034.
• 6. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. European Archives of Oto-Rhino-Laryngology. 2020; 277: 2251–2261. https://doi.org/10.1007/s00405-020-05965-1.
• 7. Awadasseid A, Wu Y, Tanaka Y, et al. Initial success in the identification and management of the coronavirus disease 2019 (COVID-19) indicates human-to-human transmission in Wuhan, China. International Journal of Biological Sciences. 2020; 16(11): 1846-1860. DOI: 10.7150/ijbs.45018.
• 8. Harapan H, Itoh N, Yufika A, et al. Coronavirus disease 2019 (COVID-19): A literature review. Journal of Infection and Public Health. 2020; 13(5): 667-673.
• 9. Yan CH, Faraji F, Prajapati DP, et al. Association of chemosensory dysfunction and Covid‐19 in patients presenting with influenza‐like symptoms. International Forum of Allergy & Rhinology. 2020; 10(7): 806-813. https://doi.org/10.1002/alr.22579.
• 10. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology. 2020; 77(6): 683-690. doi:10.1001/jamaneurol.2020.1127.
• 11 . Giacomelli A, Pezzati L, Conti F, et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infections: a cross-sectional study. Clinical Infectious Diseases. 2020; 71(15): 889-890. https://doi.org/10.1093/cid/ciaa330.
• 12. Li F, Li W, Farzan M, et al. Structure of SARS coronavirus spike receptor-binding domain complexed with receptor. Science. 2005; 309(5742): 1864-1868.
• 13. Lai YH. Mechanisms and Models of Pain in Head and Neck Cancer Irradiation. A dissertation submitted to the Graduate Faculty of North Carolina State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Comparative Biomedical Sciences. Raleigh 2020, North Carolina.
• 14. Cascella M, Rajnik M, Cuomo A, et al. Features, evaluation and treatment coronavirus (COVID-19). In Statpearls [internet]: StatPearls Publishing 2020. PMID: 32150360. 15. Moein ST, Hashemian SM, Mansourafshar B, et al. Smell dysfunction: a biomarker for COVID‐19. Paper presented at the International Forum of Allergy & Rhinology. 2020; 10(8): 944-950. https://doi.org/10.1002/alr.22587.
• 16. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. International Journal of İnfectious Diseases 2020; 94: 91-95. DOI: 10.1016/j.ijid.2020.03.017.
• 17. Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine. 2020; 8(4), 420-422.
• 18. Kato H, Shimizu H, Shibue Y, et al. Clinical course of 2019 novel coronavirus disease (COVID-19) in individuals present during the outbreak on the Diamond Princess cruise ship. Journal of Infection and Chemotherapy. 2020; 26(8): 865-869. DOI: https://doi.org/10.1016/j.jiac.2020.05.005.
• 19. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020; 395(10229): 1054-1062. DOI: 10.1016/S0140-6736(20)30566-3.
• 20. Zhao D, Yao F, Wang L, et al. A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias. Clinical Infectious Diseases. 2020; 71(15): 756-761. https://dx.doi.org/10.1093%2Fcid%2Fciaa247.
• 21. Simonnet A, Chetboun M, Poissy J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation. Obesity. 2020; 28(7): 1195-1199. https://doi.org/10.1002/oby.22831.
• 22. Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. medRxiv. 2020. doi:10.1101/2020.04.08.20057794.
• 23. Lighter J, Phillips M, Hochman S, et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clinical Infectious Diseases. 2020; 71(15): 896-897. https://doi.org/10.1093/cid/ciaa415.
• 24. Sattar N, McInnes IB, McMurray JJ. Obesity a risk factor for severe COVID-19 infection: multiple potential mechanisms. Circulation. 2020; 142(1): 4-6. DOI: 10.1161/CIRCULATIONAHA.120.047659.
• 25. Liu W, Tao ZW, Wang L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chinese Medical Journal 2020; 133(9): 1032–1038. DOI: 10.1097/CM9.0000000000000775.
• 26. Dai X. ABO blood group predisposes to COVID-19 severity and cardiovascular diseases. European Journal of Preventive Cardiology. 2020; 2047487320922370. DOI: 10.1177/2047487320922370.
• 27. Vardavas CI, Nikitara K. COVID-19, and smoking: A systematic review of the evidence. Tobacco Induced Diseases. 2020; 18. DOI: https://doi.org/10.18332/tid/119324.
• 28. Liu K, Chen Y, Wu D, et al. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary Therapies in Clinical Practice. 2020; 39: 101132. DOI: 10.1016/j.ctcp.2020.101132.