Short-Term Follow-Up of Self-Isolated COVID-19 Patients with Smell and Taste Dysfunction in Greece: Two Phenotypes of Recovery.
13 Oct 2020-Operations Research Letters (ORL J Otorhinolaryngol Relat Spec)-Vol. 82, Iss: 6, pp 295-303
TL;DR: Chemosensory deficits associated with COVID-19 infection were quite frequent among the Greek patients with mild or moderate disease who, in most cases, returned to normal within 4 weeks, however, 1 in 3 patients presented with persistent olfactory and gustatory dysfunction in the short term.
About: This article is published in Operations Research Letters.The article was published on 2020-10-13 and is currently open access. It has received 31 citations till now. The article focuses on the topics: Ageusia & Anosmia.
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TL;DR: In this article, the authors did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms.
Abstract: Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a "post-COVID syndrome." The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.
118 citations
TL;DR: In this article, a scoping review of the literature was conducted using the Arksey and O'Malley framework to aggregate type and prevalence of symptoms in people with long COVID.
Abstract: Background: Persistent coronavirus disease 2019 (COVID-19) symptoms are increasingly well-reported in cohort studies and case series. Given the spread of the pandemic, number of individuals suffering from persistent symptoms, termed 'long COVID', are significant. However, type and prevalence of symptoms are not well reported using systematic literature reviews. Objectives: In this scoping review of the literature, we aggregated type and prevalence of symptoms in people with long COVID. Eligibility Criteria: Original investigations concerning the name and prevalence of symptoms were considered in participants ≥4-weeks post-infection. Sources of Evidence: Four electronic databases [Medline, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL)] were searched. Methods: A scoping review was conducted using the Arksey and O'Malley framework. Review selection and characterisation was performed by three independent reviewers using pretested forms. Results: Authors reviewed 2,711 titles and abstracts for inclusion with 152 selected for full-text review. 102 articles were subsequently removed as this did not meet inclusion criteria. Thus, fifty studies were analysed, 34 of which were described as cohort studies or prospective cohort studies, 14 were described as cross-sectional studies, one was described as a case control study, and one was described as a retrospective observational study. In total, >100 symptoms were identified and there was considerable heterogeneity in symptom prevalence and setting of study. Ten studies reported cardiovascular symptoms, four examined pulmonary symptoms, 25 reported respiratory symptoms, 24 reported pain-related symptoms, 21 reported fatigue, 16 reported general infection symptoms, 10 reported symptoms of psychological disorders, nine reported cognitive impairment, 31 reported a sensory impairment, seven reported a dermatological complaint, 11 reported a functional impairment, and 18 reported a symptom which did not fit into any of the above categories. Conclusion: Most studies report symptoms analogous to those apparent in acute COVID-19 infection (i.e., sensory impairment and respiratory symptoms). Yet, our data suggest a larger spectrum of symptoms, evidenced by >100 reported symptoms. Symptom prevalence varied significantly and was not explained by data collection approaches, study design or other methodological approaches, and may be related to unknown cohort-specific factors.
52 citations
TL;DR: It was obtained that all symptoms have an associated risk in those recovered from COVID-19, and public health strategies must be rethought, to treat or rehabilitate, avoiding chronic problems in patients recovered from CoV-19.
Abstract: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease (COVID-19), a highly contagious infectious disease that has caused many deaths worldwide. Despite global efforts, it continues to cause great losses, and leaving multiple unknowns that we must resolve in order to face the pandemic more effectively. One of the questions that has arisen recently is what happens, after recovering from COVID-19. For this reason, the objective of this study is to identify the risk of presenting persistent symptoms in recovered from COVID-19. This case-control study was conducted in one state of Mexico. Initially the data were obtained from the participants, through a questionnaire about symptoms that they had at the moment of the interview. Initially were captured the collected data, to make a dataset. After the pre-processed using the R project tool to eliminate outliers or missing data. Obtained finally a total of 219 participants, 141 recovered and 78 controls. It was used confidence level of 90% and a margin of error of 7%. From results it was obtained that all symptoms have an associated risk in those recovered. The relative risk of the selected symptoms in the recovered patients goes from 3 to 22 times, being infinite for the case of dyspnea, due to the fact that there is no control that presents this symptom at the moment of the interview, followed by the nausea and the anosmia with a RR of 8.5. Therefore, public health strategies must be rethought, to treat or rehabilitate, avoiding chronic problems in patients recovered from COVID-19.
45 citations
Cites background from "Short-Term Follow-Up of Self-Isolat..."
...Studies in Greece have also reported recovered cases of COVID-19, with persistent symptoms, anosmia and dysgeusia being common [28]....
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...In the United Kingdom, a study was carried out in patients hospitalized for COVID-19, both those who required a stay in the intensive care unit (ICU), and those hospitalized in the ward, finding asthenia, with a frequency of 72% in the ICU group and 60% in the ward group, dyspnea (65% in patients in the ICU group and 42% in the ward group), in addition they found psychological alterations in both groups [28]....
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TL;DR: In this paper, a living systematic review was conducted to summarize the prevalence of symptoms and sequelae reported by people ≥ 4 weeks after COVID-19 diagnosis. But, the authors did not consider the long-term effects of post-COVID19 conditions.
Abstract: Objective: Post COVID-19 condition refers to persisting or recurring symptoms weeks after acute COVID-19 illness which can significantly impact quality of life and health systems. It is important to understand the manifestation and magnitude of this condition. The objective of this living systematic review is to summarize the prevalence of symptoms and sequelae reported by people ≥4 weeks after COVID-19 diagnosis.
Design: Systematic review, meta-analysis and narrative synthesis.
Data sources: Embase, Medline, PsychInfo, Cochrane Central and select grey literature up to April 14, 2021.
Methods: We adapted a previous search strategy used by the U.K. National Institute for Health and Care Excellence and updated it to search for new literature. Two reviewers screened references independently; one extracted data and assessed risk of bias and certainty of the evidence while another verified them. Prevalence data from laboratory-confirmed populations were meta-analyzed using a random effects model and synthesized separately in the short-term (4-12 weeks) and long-term (>12 weeks) periods after diagnosis. Data from clinically-diagnosed populations were synthesized narratively.
Results: Of the 4444 unique citations, 84 observational studies met our inclusion criteria. Over 100 post COVID-19 symptoms and sequelae were reported. Sixty-one percent (95% CI: 44-76%, low certainty) and 53% (95% CI: 41-65%, low certainty) of laboratory-confirmed individuals reported persistence or presence of one or more symptoms in the short- and long-term periods, respectively. The most prevalent symptoms in both periods included: fatigue, general pain or discomfort, shortness of breath, cognitive impairment and mental health symptoms.
Conclusions: A substantial proportion of individuals reported a variety of symptoms ≥4 weeks after COVID-19 diagnosis. Due to gaps in the research base, and the low certainty of the evidence currently available, further research is needed to determine the true burden of post COVID-19 condition in the general population and in specific subgroups.
PROSPERO registration number: CRD42021231476.
29 citations
TL;DR: In this paper, the authors conducted a systematic review to understand the extent of loss and time to olfactory recovery following COVID-19 infection and found that most patients recovered olfaction within 30 days.
Abstract: Olfactory loss has been identified as one of the common symptoms related to COVID-19 infection. Although olfactory loss is recognized, our understanding of both the extent of loss and time to olfactory recovery following infection is less well known. Similarly, knowledge of potential impactful patient factors and therapies that influence olfactory recovery is desirable but is not overtly clear in the literature. Our systematic review sought to fill this knowledge gap. We included studies that: involved either an observational or an interventional design that reported data on patients with olfactory dysfunction due to Reverse Transcription Polymerase Chain Reaction (RT-PCR) diagnosed COVID-19 infection; and reported data regarding olfactory recovery measured by an objective olfactory test, Likert scale and/or visual analog scale (VAS). The study methods were determined a priori and registered in PROSPERO (Registration Number CRD42020204354). An information specialist searched Medline, Embase, LitCovid and the Cochrane Register of Controlled Trials up to March 2021, and two reviewers were involved in all aspects of study selection and data collection. After screening 2788 citations, a total of 44 studies of assorted observational designs were included. Patients had undergone objective COVID-19 testing, and most were adult patients with mild to moderate COVID-19. Olfactory recovery was found to occur as early as 7 days, with most patients recovering olfaction within 30 days. Few studies included prolonged follow-up to 6 months or longer duration. Poor olfaction at initial presentation was associated with poor recovery rates. Only a small number of studies assessed olfactory retraining and steroid therapy. Additional trials are underway.
22 citations
References
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TL;DR: It is demonstrated that SARS-CoV-2 uses the SARS -CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming, and it is shown that the sera from convalescent SARS patients cross-neutralized Sars-2-S-driven entry.
15,362 citations
TL;DR: During the epidemic period of COVID-19, clinicians should suspect severe acute respiratory syndrome coronavirus 2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
Abstract: Importance The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, is serious and has the potential to become an epidemic worldwide. Several studies have described typical clinical manifestations including fever, cough, diarrhea, and fatigue. However, to our knowledge, it has not been reported that patients with COVID-19 had any neurologic manifestations. Objective To study the neurologic manifestations of patients with COVID-19. Design, Setting, and Participants This is a retrospective, observational case series. Data were collected from January 16, 2020, to February 19, 2020, at 3 designated special care centers for COVID-19 (Main District, West Branch, and Tumor Center) of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China. The study included 214 consecutive hospitalized patients with laboratory-confirmed diagnosis of severe acute respiratory syndrome coronavirus 2 infection. Main Outcomes and Measures Clinical data were extracted from electronic medical records, and data of all neurologic symptoms were checked by 2 trained neurologists. Neurologic manifestations fell into 3 categories: central nervous system manifestations (dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia, and seizure), peripheral nervous system manifestations (taste impairment, smell impairment, vision impairment, and nerve pain), and skeletal muscular injury manifestations. Results Of 214 patients (mean [SD] age, 52.7 [15.5] years; 87 men [40.7%]) with COVID-19, 126 patients (58.9%) had nonsevere infection and 88 patients (41.1%) had severe infection according to their respiratory status. Overall, 78 patients (36.4%) had neurologic manifestations. Compared with patients with nonsevere infection, patients with severe infection were older, had more underlying disorders, especially hypertension, and showed fewer typical symptoms of COVID-19, such as fever and cough. Patients with more severe infection had neurologic manifestations, such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]), and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]). Conclusions and Relevance Patients with COVID-19 commonly have neurologic manifestations. During the epidemic period of COVID-19, when seeing patients with neurologic manifestations, clinicians should suspect severe acute respiratory syndrome coronavirus 2 infection as a differential diagnosis to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
5,153 citations
TL;DR: The vascular endothelium is an active paracrine, endocrine, and Endothelial cell infection and endotheliitis in COVID-19 and recruitment of immune cells can result in widespread endothelial dysfunction associated with apoptosis.
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TL;DR: Olfactory and gustatory disorders are prevalent symptoms in European CO VID-19 patients, who may not have nasal symptoms, and the sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.
Abstract: To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.
2,030 citations
TL;DR: In this paper, the expression of viral entry-associated genes in single-cell RNA-sequencing data from multiple tissues from healthy human donors was investigated, and co-detected these transcripts in specific respiratory, corneal and intestinal epithelial cells, potentially explaining the high efficiency of SARS-CoV-2 transmission.
Abstract: We investigated SARS-CoV-2 potential tropism by surveying expression of viral entry-associated genes in single-cell RNA-sequencing data from multiple tissues from healthy human donors. We co-detected these transcripts in specific respiratory, corneal and intestinal epithelial cells, potentially explaining the high efficiency of SARS-CoV-2 transmission. These genes are co-expressed in nasal epithelial cells with genes involved in innate immunity, highlighting the cells' potential role in initial viral infection, spread and clearance. The study offers a useful resource for further lines of inquiry with valuable clinical samples from COVID-19 patients and we provide our data in a comprehensive, open and user-friendly fashion at www.covid19cellatlas.org.
2,024 citations