Otorhinolaryngological manifestations of COVID-19

COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard

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Sarcoidosis Presenting as Nasal Obstruction

American Journal of Rhinology ◽

10.2500/105065893781976366 ◽

1993 ◽

Vol 7 (3) ◽

pp. 133-138 ◽

Cited By ~ 4

Author(s):

Mark J. Shikowitz ◽

Aijaz Alvi

Keyword(s):

Respiratory Tract ◽

Nasal Obstruction ◽

Clinical Presentation ◽

Multiple Organ ◽

Diagnostic Workup ◽

Unknown Etiology ◽

Granulomatous Disease ◽

Upper Respiratory Tract ◽

Important Symptom ◽

Upper Respiratory

Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology. The histology of this disease was first reported by Boeck in 1899. Since that time many reports of multiple organ involvement have been published. Symptoms relating to the upper respiratory tract are not uncommon. Nasal obstruction as the presenting and primary complaint in sarcoidosis however is a rare but important symptom as it may lead to the diagnosis of this treatable disease. We present three patients whose initial complaint of progressive nasal obstruction heralded the diagnosis of sarcoidosis upon further workup. The clinical presentation, diagnostic workup, histology, and management of nasal sarcoidosis are discussed.

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CLINIC AND COMPLICATIONS OF COVID-19 CORONAVIRUS DISEASE WITH PATHOGENESIS ELEMENTS

International Medical Journal ◽

10.37436/2308-5274-2020-3-14 ◽

2020 ◽

pp. 72-79

Author(s):

I. V. Аndrusovich

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Tract ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Clinical Symptoms ◽

Clinical Course ◽

Clinical Manifestations ◽

Second Phase ◽

Upper Respiratory Tract

The longer the COVID−19 coronavirus pandemic lasts, the more information about its clinical manifestations is accumulated. The incubation period of COVID−19 ranges from 2 to 14 days, rarely up to 3 weeks, but in a significant number of cases an infection is not accompanied with the appearance of clinical symptoms. Currently, the following variants of the clinical course of COVID−19 can be identified as follows: viral load; subclinical; slight; uncomplicated with damage to only the upper respiratory tract; mild pneumonia, severe pneumonia, acute respiratory distress syndrome, etc. The clinical course of COVID−19 depends on the severity, the criteria of which are the intoxication manifestation, the degree of fever and the dominant syndrome. Mild / moderate forms are manifested by frequent increase in body temperature up to 38 ° C, respiratory symptoms, headache, myalgias, palpitations and general malaise. Patients stop distinguishing smells and feel the taste of food. Approximately from the 7th to the 9th days of the disease there are problems with breathing, which indicates the impairment of the lower respiratory tract and the beginning of the second phase of the disease, and its course is regarded as severe. Severe forms of the disease can also be manifested by impaired coordination of movements, slurred speech. In 1 to 4 % of patients there is developed the psychosis in the form of hallucinations. In the elderly, COVID−19 may be accompanied by delirium, lowering blood pressure. The risks of adverse disease are associated with somatic diseases: cardiovascular and nervous systems, respiratory tract, hormonal disorders, etc. Otitis, sinusitis, sepsis, bronchopulmonary infection, thrombosis, myocarditis etc. can be the complications of COVID−19. Computer tomography is an instrumental test that demonstrates the damage of lungs with coronavirus and allows to assess its severity. Key words: coronavirus infection, COVID−19, clinical variants, severity, pneumonia, acute respiratory distress syndrome.

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Challenges in the delivery of critical care in India during the COVID-19 pandemic

Journal of the Intensive Care Society ◽

10.1177/1751143720952590 ◽

2020 ◽

pp. 175114372095259

Author(s):

Bharath Kumar Tirupakuzhi Vijayaraghavan ◽

Sheila Nainan Myatra ◽

Meghena Mathew ◽

Nirmalyo Lodh ◽

Jigeeshu Vasishtha Divatia ◽

...

Keyword(s):

Critical Care ◽

Acute Respiratory Distress Syndrome ◽

Intensive Care ◽

Respiratory Tract ◽

Respiratory Distress Syndrome ◽

Distress Syndrome ◽

Upper Respiratory Tract ◽

Care Services ◽

Life Threatening ◽

Upper Respiratory

Coronavirus disease 2019 cases in India continue to increase and are expected to peak over the next few weeks. Based on some projection models, India is expected to have more than 10 million cases by September 2020. The spectrum of disease can vary from mild upper respiratory tract symptoms to life-threatening acute respiratory distress syndrome and multi-organ failure requiring intensive care. Even if less than 5% of patients require critical care services, this will still rapidly overwhelm the healthcare system in a country, where intensive care services and resources are scarce and unevenly distributed. In this perspective article, we highlight the critical care preparedness of India for the pandemic and the associated challenges.

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CoViD-19: An early intervention therapeutic strategy to prevent developing a severe disease as an alternative approach to control the pandemic

10.14293/s2199-1006.1.sor-.ppurwmt.v1 ◽

2020 ◽

Author(s):

HAMID MERCHANT

Keyword(s):

Early Intervention ◽

Respiratory Tract ◽

Therapeutic Strategy ◽

Wide Spectrum ◽

Severe Disease ◽

Antimicrobial Properties ◽

The Body ◽

Upper Respiratory Tract ◽

Holistic Treatment ◽

Upper Respiratory

While we wait for a confirmed drug or a vaccine for CoViD-19, it may be possible to intervene early to prevent the virus causing a severe disease to offer an alternative therapeutic strategy to control the pandemic. The global burden of CoViD-19 on the healthcare system can be significantly reduced by targeting CoViD-19 patients with or without symptoms who are self-isolating at home or in quarantine. If any therapeutic support can be offered to this group of patients that could attenuate the virus within the upper respiratory tract during the early stages of CoViD-19, it can give the body the time to produce enough antibodies to recover naturally from the disease before progressing into severe disease. An early intervention can, therefore, prevent the virus to get down the lower respiratory tract, reduce the number of cases with severe disease involving pneumonia and the need for hospitalisation. This article presents a simple yet holistic treatment strategy that involves inhaling steam supplemented with essential oils possessing wide spectrum antimicrobial properties in conjunction with oropharyngeal sanitisation to all those who are CoViD-19 positive or are under self-isolation due to symptoms. The approach is very simple, cheap, and effective in relieving the symptoms of the disease and is likely to reduce the viral load in the upper respiratory tract that may help recover from the infection. Since there is no vaccine or treatment yet approved to prevent or treat the CoViD-19, the importance of early intervention is invaluable in reducing the global disease burden. In the authors opinion, this strategy may be very effective to nip the infection in the bud before it gets difficult to treat and therefore, have a potential to significantly reduce the CoViD-19 associated hospitalisation.

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Acute Respiratory Distress Syndrome Caused by Human Adenovirus in Adults: A Prospective Observational Study in Guangdong, 2019–2020

10.21203/rs.3.rs-641948/v1 ◽

2021 ◽

Author(s):

Zhan Wu ◽

Rong Zhang ◽

Dongdong Liu ◽

Xuesong Liu ◽

Jierong Zhang ◽

...

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Clinical Characteristics ◽

Distress Syndrome ◽

Early Stage ◽

Invasive Mechanical Ventilation ◽

Viral Pneumonia ◽

Upper Respiratory Tract ◽

Shortness Of Breath ◽

Upper Respiratory

Abstract Background: Viral causes of acute respiratory distress syndrome (ARDS) are mostly limited to influenza. However, adenovirus has been emerging as a cause of ARDS with a high mortality rate and described in adults are rare.Methods: We conducted a prospective, single-center observational study of viral pneumonia with ARDS and confirmed adenovirus-associated ARDS in adults at our quaternary referral institution between March 2019 and June 2020. We prospectively analyzed clinical characteristics, laboratory test results, radiological characteristics, viral load from nasopharyngeal swabs and endotracheal aspirates, treatments, and outcomes for the study participants.Results: The study enrolled 143 ARDS patients, including 47 patients with viral pneumonia-related ARDS, among which there were 14 adenovirus-associated ARDS patients, which accounted for 29.79% of the viral pneumonia-related ARDS cases. Among the adenovirus-associated ARDS patients, 78.57% were men with a mean age of 54.93 ± 19.04 years. Adenovirus-associated ARDS patients had no specific clinical characteristics, but they presented with shortness of breath and fever, and their initial chest radiographic findings were multifocal or showed diffuse opacity. The viral load and the positivity rate in the lower respiratory tract were higher than that of the upper respiratory tract in the patients with adenovirus-associated ARDS, and 85.71% of the patients had a significant decrease in the number of CD3+CD4+ T cells during the early stage. All patients required invasive mechanical ventilation treatment. The average time from shortness of breath to the application of invasive ventilation was 24 hours. The median duration of invasive mechanical ventilation was 22 days (14–75 days). Six patients (42.86%) required renal replacement therapy, and three patients (21.43%) required extracorporeal membrane oxygenation support. Additionally, 85.71% of the 14 adenovirus-associated ARDS patients survived.Conclusion: Adenovirus infection is an important cause of virus-related ARDS. The positivity rate of adenovirus infection in lower respiratory tract secretions was higher than that in upper respiratory tract secretions in these patients. Most of the patients had a significant decrease in the number of CD3+CD4+ T cells during the early stage. Early identification and intervention to prevent disease progression are essential for reducing the mortality rate in these patients.

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Haemophilus parasuis and Glässer’s disease in pigs: a review

Veterinární Medicína ◽

10.17221/5537-vetmed ◽

2012 ◽

Vol 51 (No. 5) ◽

pp. 168-179 ◽

Cited By ~ 36

Author(s):

K. Nedbalcova ◽

P. Satran ◽

Z. Jaglic ◽

R. Ondriasova ◽

Z. Kucerova

Keyword(s):

Respiratory Tract ◽

Clinical Symptoms ◽

Animal Husbandry ◽

Haemophilus Parasuis ◽

Upper Respiratory Tract ◽

Virulent Strains ◽

Upper Respiratory ◽

High Doses ◽

The Brain ◽

Very High

Haemophilus parasuis is a common epiphyte of the upper respiratory tract of pigs. The factors of H. parasuis pathogenicity that enable some strains to be virulent and consequently cause a clinical disease have not been established yet. Fifteen serovars of H. parasuis have been described at present. Individual serovars differ in virulence, and considerable differences in virulence also exist within each serovar. Virulent strains can particularly participate as microorganisms secondary to pneumonia, cause septicaemia without polyserositis or Glässer’s disease characterized by polyserositis, pericarditis, arthritis and meningitis. Clinical symptoms of this disease are highly variable. Therefore, culture detection of causative agent, particularly from the brain, joints and polyserositis is an essential diagnostic tool. The disease caused by H. parasuis can be treated with antibiotics; however, oral or parenteral administration of very high doses of antibiotics is necessary. The level of animal hygiene and animal husbandry are important factors for prevention of this disease. Commercial or autogenous vaccines can be used in the immunoprophylaxis of pre-parturient sows and their progeny after weaning. For the production of autogenous vaccines, it is most effective to use isolates from animals with lesions present in CNS. Isolates recovered from arthritic and systemic sites of infection are less suitable and isolates recovered from lungs are not suitable at all because of their heterogeneity.

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Ciliary Ultrastructure and Mucociliary Transport in Upper Respiratory Tract Infections

American Journal of Rhinology ◽

10.2500/105065894782537307 ◽

1994 ◽

Vol 8 (5) ◽

pp. 211-216 ◽

Cited By ~ 3

Author(s):

Tommi Torkkeli ◽

Markus Rautiainen ◽

Juhani Nuutinen

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Clinical Symptoms ◽

Upper Respiratory Tract Infections ◽

Mucociliary Transport ◽

Upper Respiratory Tract ◽

Severe Infections ◽

Upper Respiratory ◽

Tract Infections ◽

Ciliary Ultrastructure

The ciliary ultrastructure in transmission electron microscopy and nasal mucociliary transport rate (MTR) by a radioisotopic method were studied in 50 patients with longstanding upper respiratory tract infections. The clinical symptoms correlated well with MTR. The symptoms in patients with MTR 3 mm/min or better were mild, but the patients with poor MTR (less than 3 mm/min) suffered from recurrent or severe infections. The completely normal ultrastructural findings were found only in patients with MTR better than 3 mm/min. All the patients with poor MTR had pathological ciliary ultrastructure, with numerous tubular anomalies and disorientation of ciliary beat direction. The outer dynein arms were found to be short in 16% of cases with poor MTR.

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COVID-19 Vaccinated Individuals Can Be a Source of SARS-CoV-2 Transmission—A Systematic Review

Hygiene ◽

10.3390/hygiene1010001 ◽

2021 ◽

Vol 1 (1) ◽

pp. 1-11

Author(s):

Günter Kampf

Keyword(s):

Respiratory Tract ◽

Animal Studies ◽

Current Knowledge ◽

Vaccine Dose ◽

Fundamental Rights ◽

Phase Iii ◽

Upper Respiratory Tract ◽

Similar Frequency ◽

Control Subjects ◽

Upper Respiratory

Fundamental rights are probably given back earlier to COVID-19 vaccinated individuals assuming that they cannot spread SARS-CoV-2 anymore. The objective of the study was to determine if COVID-19 vaccinated individuals can still be the source of SARS-CoV-2 transmission. PubMed was searched for studies on 4 April 2021. All studies with original data on COVID-19 cases among vaccinated individuals (phase III RCTs) and on viral load in the upper respiratory tract of vaccinated macaques after a SARS-CoV-2 challenge were included. Symptomatic COVID-19 cases were found in four trials among vaccinated participants although less frequently than among control subjects. One study revealed asymptomatic COVID-19 cases in a similar frequency among 2.168 AZD1222-vaccinated subjects (1.0%) compared to 2.223 control subjects (1.0%). In 15 studies with vaccinated macaques, it was found that the load of SARS-CoV-2 RNA, subgenomic RNA and infectious virus in the upper respiratory tract is variable. Sterilizing immunity was found in none of the animal studies. Major limitations of the animal studies are that the SARS-CoV-2 challenge took place within a few weeks of the final or only vaccine dose, that the viral challenge was often high and, in some studies, administered by up to four routes. Based on current knowledge it seems clear that COVID-19 vaccinated individuals can still be the source of SARS-CoV-2 transmission.

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Epiglottic retroversion in nine dogs

Vlaams Diergeneeskundig Tijdschrift ◽

10.21825/vdt.v89i3.16536 ◽

2020 ◽

Vol 89 (3) ◽

pp. 152-158

Author(s):

K. Van Ginneken ◽

B. Van Goethem ◽

N. Devriendt ◽

T. Bosmans ◽

H. De Rooster

Keyword(s):

Surgical Technique ◽

Respiratory Tract ◽

Clinical Improvement ◽

Clinical Symptoms ◽

Exercise Intolerance ◽

Respiratory Disorder ◽

Upper Respiratory Tract ◽

Long Term Outcome ◽

Laryngeal Paralysis ◽

Upper Respiratory

Epiglottic retroversion (ER) is an uncommon and poorly understood disorder of the upper respiratory tract in small breed dogs. In this retrospective study, perioperative characteristics, surgical technique, outcome, and complications in nine dogs that underwent surgical treatment for ER and/or concurrent upper respiratory tract disorders, were evaluated. The most frequently reported clinical symptoms were chronic intermittent inspiratory stridor (89%), exercise intolerance (78%), and dyspnea (67%). Concurrent respiratory disorders were highly prevalent (78%). Five dogs initially underwent a temporary epiglottopexy and two a permanent epiglottopexy. In two dogs, both suffering from concurrent laryngeal paralysis, only a unilateral cricoarytenoid lateralization was performed. After initial clinical improvement, temporary and permanent epiglottopexy eventually failed in 4/6 dogs (67%) that were available for follow-up, necessitating partial epiglottectomy as revision surgery. This resulted in a successful long-term outcome in 5/6 of these dogs (83%). In the dogs with primary ER or in cases where the presence of secondary ER led to significant respiratory symptoms, partial epiglottectomy as a primary surgical technique appeared to be a more permanent treatment option than epiglottopexy. Both dogs with surgically corrected concurrent laryngeal paralysis without epiglottopexy or epiglottectomy showed clinical improvement. This might indicate that, in case of secondary ER, positive results can be achieved after management of the underlying respiratory disorder.

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Experimental infection of specific-pathogen-free domestic lambs with Mycoplasma ovipneumoniae causes asymptomatic colonization of the upper airways that is resistant to antibiotic treatment

10.1101/2021.05.03.442471 ◽

2021 ◽

Author(s):

Thea Johnson ◽

Kerri Jones ◽

Bryan Tegner Jacobson ◽

Julia Schaerer ◽

Cassie Mosdal ◽

...

Keyword(s):

Respiratory Tract ◽

Antibiotic Treatment ◽

Clinical Symptoms ◽

Respiratory Pathogen ◽

Domestic Sheep ◽

Upper Respiratory Tract ◽

Specific Pathogen Free ◽

Specific Pathogen ◽

Upper Respiratory ◽

Mycoplasma Ovipneumoniae

Mycoplasma ovipneumoniae (M. ovipneumoniae) is a respiratory pathogen associated with the development of mild to moderate respiratory disease in domestic lambs and severe pneumonia outbreaks in wild ruminants such as bighorn sheep. However, whether M. ovipneumoniae by itself causes clinical respiratory disease in domestic sheep in the absence of secondary bacterial pathogens is still a matter of debate. The goal of our study was to better understand the role of M. ovipneumoniae as a respiratory pathogen in domestic sheep and to explore potential antibiotic treatment approaches. Therefore, we inoculated four-month-old, specific-pathogen-free lambs with field isolates of M. ovipneumoniae and monitored the lambs for eight weeks for colonization with the bacteria, M. ovipneumoniae-specific antibodies, clinical symptoms, and cellular and molecular correlates of lung inflammation. After eight weeks, lambs were treated with the macrolide antibiotic gamithromycin and observed for an additional four weeks. Stable colonization of the upper respiratory tract with M. ovipneumoniae was established in all four M. ovipneumoniae-inoculated, but in none of the four mock-infected lambs. All M. ovipneumoniae-infected lambs developed a robust antibody response to M. ovipneumoniae within 2 weeks. However, we did not observe significant clinical symptoms or evidence of lung damage or inflammation in any of the infected lambs. Interestingly, treatment with gamithromycin failed to reduce M. ovipneumoniae colonization. These observations indicate that, in the absence of co-factors, M. ovipneumoniae causes asymptomatic colonization of the upper respiratory tract of that is resistant to clearance by the host immune response as well as by gamithromycin treatment in domestic lambs.

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