scholarly journals Hypogeusia as the initial presenting symptom of COVID-19

2020 ◽  
Vol 13 (5) ◽  
pp. e236080 ◽  
Author(s):  
Lauren E Melley ◽  
Eli Bress ◽  
Erik Polan
Keyword(s):  
Cardiopulmonary Arrest ◽  
General Medicine ◽  
Initial Symptom ◽  
The Novel ◽  
Severe Respiratory Distress ◽  
Upper Respiratory Infection ◽  
Respiratory Involvement ◽  
Asymptomatic Patients ◽  
Flavour Perception ◽  
Novel Coronavirus

COVID-19 is the disease caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which first arose in Wuhan, China, in December 2019 and has since been declared a pandemic. The clinical sequelae vary from mild, self-limiting upper respiratory infection symptoms to severe respiratory distress, acute cardiopulmonary arrest and death. Otolaryngologists around the globe have reported a significant number of mild or otherwise asymptomatic patients with COVID-19 presenting with olfactory dysfunction. We present a case of COVID-19 resulting in intensive care unit (ICU) admission, presenting with the initial symptom of disrupted taste and flavour perception prior to respiratory involvement. After 4 days in the ICU and 6 days on the general medicine floor, our patient regained a majority of her sense of smell and was discharged with only lingering dysgeusia. In this paper, we review existing literature and the clinical course of SARS-CoV-2 in relation to the reported symptoms of hyposmia, hypogeusia and dysgeusia.

scholarly journals 458. Molecular SARS-CoV-2 Testing During the COVID-19 Outbreak: Experiences of a Hospital in Southeast Michigan, USA

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S296-S297
Author(s):  
Trini A Mathew ◽  
Jonathan Hopkins ◽  
Diane Kamerer ◽  
Shagufta N Ali ◽  
Daniel Ortiz ◽  
...  
Keyword(s):  
Clinical Features ◽  
Diagnostic Testing ◽  
Beaumont Hospital ◽  
High Capacity ◽  
Turnaround Time ◽  
Molecular Diagnostic ◽  
The Novel ◽  
Repeat Testing ◽  
Asymptomatic Patients ◽  
Novel Coronavirus

Abstract Background The novel Coronavirus SARS CoV-2 (COVID-19) outbreak was complicated by the lack of diagnostic testing kits. In early March 2020, leadership at Beaumont Hospital, Royal Oak Michigan (Beaumont) identified the need to develop high capacity testing modalities with appropriate sensitivity and specificity and rapid turnaround time. We describe the molecular diagnostic testing experience since initial rollout on March 16, 2020 at Beaumont, and results of repeat testing during the peak of the COVID-19 pandemic in MI. Methods Beaumont is an 1100 bed hospital in Southeast MI. In March, testing was initially performed with the EUA Luminex NxTAG CoV Extended Panel until March 28, 2020 when testing was converted to the EUA Cepheid Xpert Xpress SARS-CoV-2 for quicker turnaround times. Each assay was validated with a combination of patient samples and contrived specimens. Results During the initial week of testing there was > 20 % specimen positivity. As the prevalence grew the positivity rate reached 68% by the end of March (Figure 1). Many state and hospital initiatives were implemented during the outbreak, including social distancing and screening of asymptomatic patients to increase case-finding and prevent transmission. We also adopted a process for clinical review of symptomatic patients who initially tested negative for SARS-CoV-2 by a group of infectious disease physicians (Figure 2). This process was expanded to include other trained clinicians who were redeployed from other departments in the hospital. Repeat testing was performed to allow consideration of discontinuation of isolation precautions. During the surge of community cases from March 16 to April 30, 2020, we identified patients with negative PCR tests who subsequently had repeat testing based on clinical evaluation, with 7.1% (39/551) returning positive for SARS- CoV2. Of the patients who expired due to COVID-19 during this period, 4.3% (9/206) initially tested negative before ultimately testing positive. Figure 1 BH RO testing Epicurve Figure 2: Screening tool for repeat COVID19 testing and precautions Conclusion Many state and hospital initiatives helped us flatten the curve for COVID-19. Our hospital testing experience indicate that repeat testing may be warranted for those patients with clinical features suggestive of COVID-19. We will further analyze these cases and clinical features that prompted repeat testing. Disclosures All Authors: No reported disclosures

scholarly journals A Bittersweet Memoir

2021 ◽  
Vol 16 (1) ◽  
pp. 128-135
Author(s):  
Anita Y. N. Lim
Keyword(s):  
Video Clip ◽  
Early Period ◽  
General Medicine ◽  
University Hospital ◽  
World Health ◽  
Public Healthcare ◽  
The Novel ◽  
National University ◽  
Novel Coronavirus ◽  
Health Organization

Abstract I wrote this journal in March 2020 prior to the World Health Organization declaring the COVID-19 infection as a worldwide pandemic on March 11. The situation in Singapore was unfolding even as public healthcare institutions were tasked to lead the charge to contain the novel coronavirus as it was then called. This journal describes my experiences and impressions during my work in an isolation ward at the National University Hospital during this early period. I was to be catapulted into Pandemic Team 3 in the second and third weeks of February 2020. The urgency of hospital measures to respond to the novel coronavirus meant that the general medicine consultant roster which I was on was hijacked to support the pandemic wards. I thought wryly to myself that it was a stroke of genius to commandeer the ready-made roster of senior physicians; it would have been difficult for the roster monster to solicit senior physicians to volunteer when there were still so many unknowns about this virus. Graphic images of the dire situation in Wuhan, China, were circulating widely on social media. It was heart-wrenching to read of Dr. Li Wen Liang’s death. He had highlighted the mysterious pneumonia-causing virus. The video clip of him singing at a karaoke session that went viral underscored the tragedy of a young life cut short. Questions raced in my mind. “Are we helpless to prevent the spread of this virus?” “Is the situation in China to be replicated here in Singapore?” This seemed incredulous, yet, might it be possible? The immediate responses that jumped up within me was “yes, it’s possible, but let’s pray not. Whatever has to be done, must be done.”

scholarly journals Inferring True COVID19 Infection Rates From Deaths

2020 ◽  
Vol 3 ◽  
Author(s):  
Ian McCulloh ◽  
Kevin Kiernan ◽  
Trevor Kent
Keyword(s):  
Monte Carlo ◽  
The Novel ◽  
Infection Rates ◽  
Time To Death ◽  
Global Pandemic ◽  
Asymptomatic Patients ◽  
Co Morbidity ◽  
The World ◽  
Life Threatening ◽  
Novel Coronavirus

The novel coronavirus, SARS-CoV-2, commonly known as COVID19 has become a global pandemic in early 2020. The world has mounted a global social distancing intervention on a scale thought unimaginable prior to this outbreak; however, the economic impact and sustainability limits of this policy create significant challenges for government leaders around the world. Understanding the future spread and growth of COVID19 is further complicated by data quality issues due to high numbers of asymptomatic patients who may transmit the disease yet show no symptoms; lack of testing resources; failure of recovered patients to be counted; delays in reporting hospitalizations and deaths; and the co-morbidity of other life-threatening illnesses. We propose a Monte Carlo method for inferring true case counts from observed deaths using clinical estimates of Infection Fatality Ratios and Time to Death. Findings indicate that current COVID19 confirmed positive counts represent a small fraction of actual cases, and that even relatively effective surveillance regimes fail to identify all infectious individuals. We further demonstrate that the miscount also distorts officials' ability to discern the peak of an epidemic, confounding efforts to assess the efficacy of various interventions.

scholarly journals Preparation for Quarantine on the Cruise Ship Diamond Princess in Japan due to COVID-19 (Preprint)

2020 ◽  
Author(s):  
Yoshihiro Yamahata ◽  
Ayako Shibata
Keyword(s):  
Large Scale ◽  
Emerging Infectious Diseases ◽  
The Novel ◽  
Cruise Ship ◽  
Rt Pcr ◽  
Ventilator Support ◽  
Cruise Ships ◽  
Asymptomatic Patients ◽  
The Future ◽  
Novel Coronavirus

BACKGROUND Japan implemented a large-scale quarantine on the Diamond Princess cruise ship in an attempt to control the spread of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in February 2020. OBJECTIVE We aim to describe the medical activities initiated and difficulties in implementing quarantine on a cruise ship. METHODS Reverse transcription–polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 were performed for all 3711 people (2666 passengers and 1045 crew) on board. RESULTS Of those tested, 696 (18.8%) tested positive for coronavirus disease (COVID-19), of which 410 (58.9%) were asymptomatic. We also confirmed that 54% of the asymptomatic patients with a positive RT-PCR result had lung opacities on chest computed tomography. There were many difficulties in implementing quarantine, such as creating a dividing traffic line between infectious and noninfectious passengers, finding hospitals and transportation providers willing to accept these patients, transporting individuals, language barriers, and supporting daily life. As of March 8, 2020, 31 patients (4.5% of patients with positive RT-PCR results) were hospitalized and required ventilator support or intensive care, and 7 patients (1.0% of patients with positive RT-PCR results) had died. CONCLUSIONS There were several difficulties in implementing large-scale quarantine and obtaining medical support on the cruise ship. In the future, we need to prepare for patients’ transfer and the admitting hospitals when disembarking the passengers. We recommend treating the crew the same way as the passengers to control the infection. We must also draw a plan for the future, to protect travelers and passengers from emerging infectious diseases on cruise ships.

scholarly journals Do COVID-19 Pandemic-Related Behavior Changes Affect Perioperative Respiratory Adverse Events in Children Undergoing Cardiac Interventional Catheterization?

2021 ◽  
Author(s):  
Wei Ji ◽  
Kan Zhang ◽  
Mengqi Li ◽  
Siyuan Wang ◽  
Liping Sun ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cardiac Catheterization ◽  
Behavior Changes ◽  
The Novel ◽  
Upper Respiratory Infection ◽  
Airway Secretion ◽  
Potential Risk Factors ◽  
Interventional Catheterization ◽  
Upper Respiratory ◽  
Novel Coronavirus

Abstract Background: The Novel Coronavirus Disease (COVID-19) pandemic-related behavior changes could affect the perioperative respiratory adverse events in children with congenital heart disease (CHD). This study was designed to compare the incidence of perioperative respiratory adverse events (PRAEs) in children with and without upper respiratory infection (URI) undergoing the cardiac catheterization before and during COVID-19 pandemic.Methods：COVID-19 was outbreak in January 2020 in China. 260 pediatric patients scheduled for elective therapeutic cardiac catheterization were included from January 2019 to March 2021 and 154 were completed during the pandemic. Recent URI was diagnosed by the attending anesthesiologist owing to different PRAEs incidence in non-URI and URI children. The overall incidence of PRAEs (laryngospasm, bronchospasm, coughing, airway secretion, airway obstruction, and oxygen desaturation) in non-URI and URI children undergoing the elective cardiac catheterization were compared before and during the COVID-19 pandemic. Logistic regression model was fitted to identify the potential risk factors associated with PRAEs.Results: Of 564 children enrolled, 359 completed the study and was analyzed finally. URI incidence decreased substantially during the COVID-19 pandemic (14% vs. 41%, P<0.001). Meanwhile, the overall PRAEs also significantly declined no matter whether or not the child had recent URI (22.3% vs. 42.3%, P=0.001 for non-URI and 29.2% vs. 58.7%, P=0.012 for URI respectively). Post-operative agitation in non-URI children occurred less frequently during the pandemic than before (2.3% vs. 16.2%, P=0.001). Behaviors before the COVID-19 pandemic (odd ratio=2.84, 95%CI 1.76 to 4.58) and recent URI (odd ratio =1.79, 95%CI 1.09 to 2.92) were associated with the PRAEs.Conclusions: COVID-19 pandemic-related behavior changes were associated with the reduction of PRAEs in non-URI and URI children undergoing elective therapeutic cardiac catheterization.

scholarly journals Hyponatremic Unconsciousness as a Presenting Symptom of COVID-19: A Case Series

2021 ◽  
Author(s):  
Ajay Chauhan ◽  
Asmita Gupta ◽  
Kari Suguna ◽  
Shashikant Shukla ◽  
Parul Goyal
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
Case Series ◽  
The Novel ◽  
Altered Sensorium ◽  
Respiratory Involvement ◽  
New Concepts ◽  
Novel Coronavirus

The novel Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can present with a multitude of clinical symptoms. The virus, disease symptomatology, pathogenesis and complications are being studied and new concepts are evolving rapidly. The current worldwide situation caused by the disease makes it exceedingly important to recognise varied presentations of the disease. Three cases are being discussed hereby, wherein the patients presented with altered sensorium secondary to hyponatremia as the initial and only presentation of SARS-CoV-2 infection, in the absence of fever or any respiratory involvement. Acute symptomatic hyponatremia is an under-recognised presentation with only a few cases reported till date and needs further awareness and understanding.

scholarly journals Estimation of the percentages of asymptomatic patients and undiagnosed patients of the novel coronavirus (SARS-CoV-2) infection in Hokkaido, Japan by using birth-death process with recursive full tracing

2020 ◽  
Author(s):  
Takuma Tanaka ◽  
Takayuki Yamaguchi ◽  
Yohei Sakamoto
Keyword(s):  
The State ◽  
Death Process ◽  
The Novel ◽  
State Of Emergency ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Novel Coronavirus ◽  
Birth Death

AbstractEstimating the percentages of undiagnosed and asymptomatic patients is essential for controlling the outbreak of SARS-CoV-2, and for assessing any strategy for controlling the disease. In this paper, we propose a novel analysis based on the birth-death process with recursive full tracing. We estimated the numbers of undiagnosed symptomatic patients and total infected individuals per diagnosed patient before and after the declaration of the state of emergency in Hokkaido, Japan. The median of the estimated number of undiagnosed symptomatic patients per diagnosed patient decreased from 1.9 to 0.77 after the declaration, and the median of the estimated number of total infected individuals per diagnosed patient decreased from 4.7 to 2.4. We will discuss the limitations and possible expansions of the model.

scholarly journals Incidence of Missed Diagnosed COVID-19 Pneumonia on Patients Who Admitted Urology Outpatient Clinic

2021 ◽  
Author(s):  
Mehmet Serkan Ozkent ◽  
Burak Yılmaz ◽  
Mustafa Hamarat ◽  
Esma Eroglu
Keyword(s):  
Outpatient Clinic ◽  
Renal Colic ◽  
Demographic Data ◽  
Active Role ◽  
The Novel ◽  
Abdominal Ct ◽  
Asymptomatic Patients ◽  
The World ◽  
Novel Coronavirus ◽  
Lung Base

Purpose: The novel coronavirus disease 2019 (COVID-19) has spread all over the world. The diagnosis of COVID-19 in asymptomatic patients and patients with non-respiratory symptoms remains a big concern. In this study, we aimed to evaluate the incidence of missed diagnosed COVID-19 pneumonia on abdominal computed tomography (CT) performed in patients admitted to our urology outpatient clinic. Methods: We reviewed the files of patients who were admitted to the urology outpatient clinic from 1 April to 1 November retrospectively. We included the patients who performed abdominal CT at the urology outpatient clinic for any reason and recorded demographic data and abdominal CT findings. We excluded patients with pulmonary symptoms and previously diagnosed with COVID-19. Also, patients without abdominal CT were excluded. We evaluated the rates of missed diagnosed COVID-19 pneumonia detection on the lung base images of abdominal CT. Results: 1024 patients were included in this study. We observed that 99 (9.7%) of these patients had findings related to COVID-19 pneumonia on the lung base images of abdominal CT. Although 885 (86.4%) patients had no pathological pulmonary findings, 40 (3.9%) patients had other pathological pulmonary findings. Conclusion: COVID-19 disease has become a pandemic all over the world. All healthcare professionals, including urologists, play an active role in the diagnosis and treatment of this disease. So, it should be kept in mind that COVID-19 pneumonia should be evaluated in patients admitted to the urology outpatient clinic with renal colic or abdominal pain.

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