Physical and Mental Health Impacts of the COVID-19 Pandemic among US Adults with Chronic Respiratory Conditions

Adults living with chronic respiratory diseases are at higher risk of death due to COVID-19. Our objective was to evaluate the physical and mental health symptoms among US adults living with chronic respiratory conditions. We used data of 10,760 US adults from the nationally representative COVID-19 Impact Survey. Chronic respiratory conditions were self-reported and included asthma (14.7%), chronic obstructive pulmonary disease or COPD (4.7%), and bronchitis/emphysema (11.6%). We used multivariable Poisson regression to evaluate physical health symptoms. We estimated associations of mental health symptoms using multinomial logistic regression. In multivariable models, adults with asthma were more likely to report physical symptoms including runny or stuffy nose, chest congestion, fever, and chills. In addition, adults with COPD were more likely to report several physical symptoms including fever (adjusted prevalence ratio [aPR]: 1.37, 95% confidence interval [CI]: 1.09–1.72), chills (aPR: 2.10, 95% CI: 1.67–2.64), runny or stuffy nose (aPR: 1.78, 95% CI: 1.39–2.27), chest congestion (aPR: 2.14, 95% CI: 1.74–2.61), sneezing (aPR: 1.59, 95% CI: 1.23–2.05), and muscle or body aches (aPR: 1.38, 95% CI: 1.06–1.81). Adults with chronic respiratory conditions are more likely to report physical and mental health symptoms during the COVID-19 pandemic compared to others. Providers should prioritize discussing mental health symptom management as the pandemic continues to be a public health concern in the US.

The Woes of a Stuffy Nose: A Case Report of Allergic Fungal Sinusitis

Introduction: Allergic fungal sinusitis (AFS) is a relatively uncommon cause of sinus pain and congestion. Extreme cases may require specialty evaluation and surgical treatment. Case Report: In this case, an otherwise healthy young man presented to the emergency department with sinus pain and congestion for two weeks and was admitted to surgery for resection of his AFS. Conclusion: This case demonstrates how a thorough history and physical exam can help catch potentially serious diseases, such as allergic fungal sinusitis, from the frequently benign chief complaint of sinus pain.

Healthcare workers in elderly care: a source of silent SARS-CoV-2 transmission?

Importance: Healthcare workers (HCWs), including those with mild symptoms, may be an important source of COVID-19 within elderly care. Objective: To gain insight into the spread of SARS-CoV-2 among HCWs working in elderly care settings. Design: Cross-sectional study among HCWs working in elderly care in the South-East of the Netherlands, testing for SARS-CoV-2, between March 31 and April 17, 2020. Setting: HCWs working in geriatric rehabilitation, somatic and psychogeriatric wards or small-scale living groups and district nursing, with a total of 5245 HCWs within 4 organisations. Participants: 621 HCWs with mild respiratory symptoms. Main Outcomes: Number of HCWs testing positive for SARS-CoV-2 in pharyngeal swabs, using real-time reverse-transcriptase PCR targeting the SARS-CoV-2 E-gene, N-gene, and RdRP. HCWs filled out a survey to collect information on symptoms and possible sources of infection. Results: 133/615 (21.6%) HCWs tested positive for SARS-CoV-2, ranging from 15.6 to 44.4% per elderly care organisation, and from 0 to 64.3% per separate location of the organizations, respectively. 74.6% of tested HCWs were nursing staff, 1.7% elderly care physicians, 20.3% other HCWs with patient contact and 3.4% HCWs without patient contact. In the univariate analysis, fever, runny or stuffy nose, anosmia, general malaise, myalgia, headache and ocular pain were associated with SARS-CoV-2 positivity, while gastro-intestinal symptoms and respiratory symptoms, other than runny or stuffy nose were not. Risk factors for SARS-CoV-2 positivity were contact with patients or colleagues with suspected or proven COVID-19. Whole genome sequencing of 22 samples in 2 facilities strongly suggests spread within facilities. Conclusions and Relevance: We found a high SARS-CoV-2 prevalence among HCWs in nursing homes and district nursing, supporting the hypothesis of undetected spread within elderly care facilities. Structural testing of elderly care HCWs, including track and trace of contacts, should be performed to control this spread, even when only mild symptoms are present.

CLINICAL FEATURES IN CHRONIC SINUSITIS IN ADULTS IN NATIONAL OTORHINORARYNOLOGY HOSPITAL OF VIET NAM, 2019

ABSTRACT Objective: describe the clinical features in chronic sinusitis in adults in National Otorhinorarynology Hospital of Vietnam. Subjects and research methods: use the transverse descriptive method to describe the clinical features in chronic sinusitis in adults in the inpatient department - National otolaryngology hospital of Viet Nam. Results: the study involved 58 patients aged 18 and over suffering from chronic sinusitis in the inpatient department - National Otorhinorarynology Hospital of Vietnam from August 2019 to December 2019. The average age of the patients is 47,17 ± 15,32, with a male to female ratio of 1.1:1; most of the reason for being hospitalized is runny nose (72,4%) and stuffy nose (87,9%). Symptoms encountered in chronic sinusitis are runny nose, stuffy nose, headache, smell disorders and cough, in addition, with systemic symptoms such as fever, fatigue, weakness. Conclusion: on the clinical characteristics of chronic sinusitis in adults, the common symptoms in chronic sinusitis are runny nose, stuffy nose, headache, smell disorders and cough, duration of illness lasts from 6 months to many years, in both men and women.

4-month-old boy coinfected with COVID-19 and adenovirus

A 4-month-old boy with a history of muscular ventricular septal defect and atopic dermatitis presented with decreased oral intake, loose stools, stuffy nose, mild cough and diaphoresis. The patient had an in-home exposure to COVID-19. The initial respiratory pathogen panel was positive for adenovirus, consistent with his symptoms. The following day, the COVID-19 PCR was also positive. The patient was treated with supportive care, isolation precautions were implemented and the patient was discharged on day 4. This case demonstrates the importance of testing for COVID-19 even if a patient tests positive for another virus due to the possibility of coinfection, especially in children, in order to limit spread of COVID-19 to others.

Quantifying the relationship between diseases and symptoms using big data (Preprint)

BACKGROUND Crises in endemic transmitted diseases affect humans worldwide, and the symptoms these diseases cause may provide firsthand information about these disorders. OBJECTIVE We suggest that massive new data sources resulting from human interaction with the Internet may offer a unique perspective on the relationship between illness and symptoms. METHODS By analyzing changes in Google query volumes for search terms related to disease, we find a pattern that may define the relationship between symptoms and disorders. We first retrieved pattern data from Google Trend using the common cold as the primary disease, and sore throat, stuffy nose, sneeze, fever, cough, and headache as symptoms. Pearson’s correlation coefficient was calculated using SPSS to determine the relationship between the symptoms and the disease. RESULTS Data created since 2013/1/13 was retrieved from Google Trend on a weekly basis. A total of 261 sets of data were calculated to create a high correlation coefficient of 0.925 between the common cold and the stuffy nose symptom. The cough symptom has the second highest correlation coefficient of 0.925, sore throat has a correlation coefficient of 0.853, and fever has a correlation coefficient of 0.626, which was significant at the 0.01 level in a two-tailed test. CONCLUSIONS Data on the relationship between diseases and symptoms often comes from facilities such as government, hospitals, and clinics, where the data is collected through the documentation of physicians and nurses. A conventional study can be limited by the region, the number of patients and the interpretation of the specialist. However, with access to Google Trend’s big data, millions or even billions of data points are accumulated directly from the patient. Another contribution of this study is that the quantified relationship between symptoms and diseases can be used to educate future physicians or even artificial intelligence.