RESUMEN
SARS-CoV-2 variants pose a significant threat to global public health. However, their influence on disease severity, especially among young adults who may exhibit different clinical characteristics, is debatable. In this retrospective study of 229 young adults hospitalized with COVID-19, we investigated the differences between Poland's second and third waves of the pandemic. To identify potential predictors of severe COVID-19 in young adults, we analyzed patient characteristics and laboratory findings between survivors and non-survivors and we performed logistic regression to assess the risk of death, mechanical ventilation, and intensive care unit treatment. We found no increase in COVID-19 severity comparing the third and second waves of the pandemic, indicating that the alpha variant had no influence on disease severity. In addition, we found that factors, such as obesity, comorbidities, lung involvement, leukocytosis, neutrophilia, lymphopenia, higher IG count, the neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin, interleukin-6, D-Dimer, lactate dehydrogenase, high-sensitive troponin I, creatine kinase-myocardial band, myoglobin, N-terminal-pro-B-type natriuretic peptide, creatinine, urea and gamma-glutamyl transferase, lower estimated glomerular filtration rate, albumin, calcium and vitamin D3, possibly a decrease in red blood cell counts, hemoglobin and hematocrit, and an increase in creatine kinase during hospitalization may be associated with poor outcomes of COVID-19.
Asunto(s)
COVID-19 , Pandemias , COVID-19/epidemiología , Creatina Quinasa , Hospitalización , Humanos , Polonia/epidemiología , Estudios Retrospectivos , SARS-CoV-2 , Adulto JovenRESUMEN
Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized laboratory settings. We aimed to develop a quick, simple, affordable, and reliable test to objectively assess the prevalence and diagnostic accuracy of OD in COVID-19. The olfactory function of 64 COVID-19 inpatients and 34 controls was evaluated using a questionnaire and a simple disposable odor identification test (SDOIT) developed for this study. Four SDOIT models were assessed: 10-SDOIT, 9-SDOIT, 8-SDOIT, and 4-SDOIT, with 10, 9, 8 and 4 samples, respectively. We found a high frequency of self-reported OD in COVID-19 patients, with 32.8% and 42.2% reporting current and recent OD, respectively. Different SDOIT models revealed smell impairment in 54.7-64.1% of COVID-19 patients. The combination of either 10-SDOIT results and self-reported OD, or 8-SDOIT results and self-reported OD, were the best predictors of COVID-19, both with an AUC value of 0.87 (0.85 and 0.86 for the age-matched subjects). OD is a common symptom of COVID-19. A combination of self-reported smell deterioration and OD psychophysically evaluated using SDOIT appears to be a good predictor of COVID-19.
Asunto(s)
COVID-19 , Trastornos del Olfato , Humanos , Odorantes , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/epidemiología , Pandemias , SARS-CoV-2 , OlfatoRESUMEN
In this article the authors describe a rare case of olfactory neuroblastoma in a 55-year-old woman surgically treated because of nasal polyposis. Three years earlier she had been operated for nasal polyposis on the same side in another ENT department. Unfortunately these lesions may had not been evaluated histologically. One of the surgically removed polyps was atypical. In histopathological examination it was confirmed to be olfactory neuroblastoma. CT scan revealed abnormal thickness of the mucosa in the upper part of the nose and ethmoidal sinuses on the right side. The tumor was classified as stage B in Kadish classification of olfactory neuroblastoma. The histopathologic diagnosis and CT scan made after the surgery resulted in necessity of further oncological treatment. The olfactory neuroblastoma is rare, difficult to diagnose, malignant, slowly growing tumor arising from the olfactory epithelium in the upper nasal cavity. The treatment includes surgery, radiotherapy and chemotherapy. Another objective of this paper is to point out that histopathological examination is crucial in each surgically removed tissue.