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1.
PLoS Med ; 18(9): e1003777, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34582457

RESUMEN

BACKGROUND: Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. METHODS AND FINDINGS: We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. CONCLUSIONS: Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.


Asunto(s)
COVID-19/complicaciones , COVID-19/diagnóstico , Modelos Biológicos , Ageusia/diagnóstico , Ageusia/etiología , Ageusia/virología , Anosmia/diagnóstico , Anosmia/etiología , Anosmia/virología , Apetito , Área Bajo la Curva , COVID-19/virología , Escalofríos/diagnóstico , Escalofríos/etiología , Escalofríos/virología , Control de Enfermedades Transmisibles , Tos/diagnóstico , Tos/etiología , Tos/virología , Inglaterra , Reacciones Falso Positivas , Femenino , Fiebre/diagnóstico , Fiebre/etiología , Fiebre/virología , Humanos , Masculino , Tamizaje Masivo , Mialgia/diagnóstico , Mialgia/etiología , Mialgia/virología , Faringitis/diagnóstico , Faringitis/etiología , Faringitis/virología , Reacción en Cadena de la Polimerasa , SARS-CoV-2/genética , Medicina Estatal
2.
Int J Mol Sci ; 22(16)2021 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-34445619

RESUMEN

The year 2020 became the year of the outbreak of coronavirus, SARS-CoV-2, which escalated into a worldwide pandemic and continued into 2021. One of the unique symptoms of the SARS-CoV-2 disease, COVID-19, is the loss of chemical senses, i.e., smell and taste. Smell training is one of the methods used in facilitating recovery of the olfactory sense, and it uses essential oils of lemon, rose, clove, and eucalyptus. These essential oils were not selected based on their chemical constituents. Although scientific studies have shown that they improve recovery, there may be better combinations for facilitating recovery. Many phytochemicals have bioactive properties with anti-inflammatory and anti-viral effects. In this review, we describe the chemical compounds with anti- inflammatory and anti-viral effects, and we list the plants that contain these chemical compounds. We expand the review from terpenes to the less volatile flavonoids in order to propose a combination of essential oils and diets that can be used to develop a new taste training method, as there has been no taste training so far. Finally, we discuss the possible use of these in clinical settings.


Asunto(s)
Ageusia/tratamiento farmacológico , Ageusia/virología , Anosmia/tratamiento farmacológico , Anosmia/virología , COVID-19/tratamiento farmacológico , Fitoquímicos/uso terapéutico , Ageusia/metabolismo , Anosmia/diagnóstico , Anosmia/metabolismo , COVID-19/complicaciones , Humanos , Fitoquímicos/farmacología , SARS-CoV-2/aislamiento & purificación
3.
Lancet Digit Health ; 3(9): e577-e586, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34305035

RESUMEN

BACKGROUND: Multiple voluntary surveillance platforms were developed across the world in response to the COVID-19 pandemic, providing a real-time understanding of population-based COVID-19 epidemiology. During this time, testing criteria broadened and health-care policies matured. We aimed to test whether there were consistent associations of symptoms with SARS-CoV-2 test status across three surveillance platforms in three countries (two platforms per country), during periods of testing and policy changes. METHODS: For this observational study, we used data of observations from three volunteer COVID-19 digital surveillance platforms (Carnegie Mellon University and University of Maryland Facebook COVID-19 Symptom Survey, ZOE COVID Symptom Study app, and the Corona Israel study) targeting communities in three countries (Israel, the UK, and the USA; two platforms per country). The study population included adult respondents (age 18-100 years at baseline) who were not health-care workers. We did logistic regression of self-reported symptoms on self-reported SARS-CoV-2 test status (positive or negative), adjusted for age and sex, in each of the study cohorts. We compared odds ratios (ORs) across platforms and countries, and we did meta-analyses assuming a random effects model. We also evaluated testing policy changes, COVID-19 incidence, and time scales of duration of symptoms and symptom-to-test time. FINDINGS: Between April 1 and July 31, 2020, 514 459 tests from over 10 million respondents were recorded in the six surveillance platform datasets. Anosmia-ageusia was the strongest, most consistent symptom associated with a positive COVID-19 test (robust aggregated rank one, meta-analysed random effects OR 16·96, 95% CI 13·13-21·92). Fever (rank two, 6·45, 4·25-9·81), shortness of breath (rank three, 4·69, 3·14-7·01), and cough (rank four, 4·29, 3·13-5·88) were also highly associated with test positivity. The association of symptoms with test status varied by duration of illness, timing of the test, and broader test criteria, as well as over time, by country, and by platform. INTERPRETATION: The strong association of anosmia-ageusia with self-reported positive SARS-CoV-2 test was consistently observed, supporting its validity as a reliable COVID-19 signal, regardless of the participatory surveillance platform, country, phase of illness, or testing policy. These findings show that associations between COVID-19 symptoms and test positivity ranked similarly in a wide range of scenarios. Anosmia, fever, and respiratory symptoms consistently had the strongest effect estimates and were the most appropriate empirical signals for symptom-based public health surveillance in areas with insufficient testing or benchmarking capacity. Collaborative syndromic surveillance could enhance real-time epidemiological investigations and public health utility globally. FUNDING: National Institutes of Health, National Institute for Health Research, Alzheimer's Society, Wellcome Trust, and Massachusetts Consortium on Pathogen Readiness.


Asunto(s)
Ageusia , Anosmia , COVID-19 , Tos , Disnea , Fiebre , Vigilancia de la Población/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ageusia/epidemiología , Ageusia/etiología , Anosmia/epidemiología , Anosmia/etiología , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/virología , Tos/epidemiología , Tos/etiología , Tecnología Digital , Disnea/epidemiología , Disnea/etiología , Femenino , Fiebre/epidemiología , Fiebre/etiología , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Pandemias , SARS-CoV-2 , Reino Unido/epidemiología , Estados Unidos/epidemiología , Adulto Joven
4.
J Correct Health Care ; 27(1): 8-10, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-34232758

RESUMEN

A prison setting with its congregate environment is at high risk for widespread transmission of respiratory illnesses. Identifying COVID-19 cases as early as possible and isolating cases and tracing contacts is critical to halting the spread of this disease. The Centers for Disease Control and Prevention (CDC) added new loss of taste or smell to its list of symptoms and, initially, only if associated with at least one of six other symptoms. The CDC has since updated the guidance to remove this qualifier as of May 13, 2020. New loss of taste or smell, alone, can help to identify COVID-19 cases. Solitary anosmia/ageusia should be strongly considered in routine symptom screening protocols for COVID-19.


Asunto(s)
Ageusia/diagnóstico , Anosmia/diagnóstico , COVID-19/diagnóstico , Prisiones/estadística & datos numéricos , Ageusia/epidemiología , Anosmia/epidemiología , COVID-19/epidemiología , Humanos , Tamizaje Masivo , SARS-CoV-2 , Olfato , Gusto
5.
Commun Biol ; 4(1): 880, 2021 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-34267318

RESUMEN

COVID-19 pandemic has given rise to a collective scientific effort to study its viral causing agent SARS-CoV-2. Research is focusing in particular on its infection mechanisms and on the associated-disease symptoms. Interestingly, this environmental pathogen directly affects the human chemosensory systems leading to anosmia and ageusia. Evidence for the presence of the cellular entry sites of the virus, the ACE2/TMPRSS2 proteins, has been reported in non-chemosensory cells in the rodent's nose and mouth, missing a direct correlation between the symptoms reported in patients and the observed direct viral infection in human sensory cells. Here, mapping the gene and protein expression of ACE2/TMPRSS2 in the mouse olfactory and gustatory cells, we precisely identify the virus target cells to be of basal and sensory origin and reveal the age-dependent appearance of viral entry-sites. Our results propose an alternative interpretation of the human viral-induced sensory symptoms and give investigative perspectives on animal models.


Asunto(s)
Ageusia/fisiopatología , Anosmia/fisiopatología , COVID-19/fisiopatología , SARS-CoV-2/fisiología , Factores de Edad , Ageusia/virología , Animales , Anosmia/virología , COVID-19/virología , Femenino , Masculino , Ratones , Percepción Olfatoria , Percepción del Gusto
6.
Minerva Dent Oral Sci ; 70(4): 161-168, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34269548

RESUMEN

INTRODUCTION: SARS-CoV-2 develops well in the oral mucosa because, it is the first contact area with the virus. The oral mucosa is highly expressed with angiotensin-converting enzyme 2 (ACE2) and makes the virus replicated in the epithelial cells and produce both oral lesions and oral symptoms. This review aimed to describe the oral mucosal symptoms and lesions related to SARS-CoV-2-infected patients that have been reported around the world. EVIDENCE ACQUISITION: A literature search was performed on PubMed, ScienceDirect and Google Scholar, from February to October 5, 2020, focusing on COVID-19 (SARS-CoV-2) oral lesions and oral symptoms. EVIDENCE SYNTHESIS: Eighteen studies were identified with a total of 25 cases describing the oral symptoms and oral mucosal lesions of the SARS-CoV-2 infection. The oral symptoms related to the SARS-CoV-2 infection included dysgeusia, ageusia, a burning mouth sensation, a dry mouth and severe halitosis. The oral mucosal lesions varied from ulceration and depapilation to pseudomembranous, maculae, nodules and plaque. The mucosal lesions related to the skin lesions were in the form of crusty lips, multiple ulcerations and rashes, targeted lesions, blisters and vesiculobullous lesions. CONCLUSIONS: The manifestations of the SARS-CoV-2 infection in the oral cavity are non-specific. The oral mucosal lesions that occur mimic the Herpes zoster virus infection, the Herpes simplex virus infection, Varicella and hand, foot and mouth disease, and the oral mucosal lesions with the skin manifestations (e.g. erythema multiforme).


Asunto(s)
Ageusia , COVID-19 , Úlceras Bucales , Humanos , Mucosa Bucal , SARS-CoV-2
7.
Sci Rep ; 11(1): 13580, 2021 06 30.
Artículo en Inglés | MEDLINE | ID: mdl-34193945

RESUMEN

In the DECODE project, data were collected from 3,114 surveys filled by symptomatic patients RT-qPCR tested for SARS-CoV-2 in a single university centre in March-September 2020. The population demonstrated balanced sex and age with 759 SARS-CoV-2( +) patients. The most discriminative symptoms in SARS-CoV-2( +) patients at early infection stage were loss of taste/smell (OR = 3.33, p < 0.0001), body temperature above 38℃ (OR = 1.67, p < 0.0001), muscle aches (OR = 1.30, p = 0.0242), headache (OR = 1.27, p = 0.0405), cough (OR = 1.26, p = 0.0477). Dyspnea was more often reported among SARS-CoV-2(-) (OR = 0.55, p < 0.0001). Cough and dyspnea were 3.5 times more frequent among SARS-CoV-2(-) (OR = 0.28, p < 0.0001). Co-occurrence of cough, muscle aches, headache, loss of taste/smell (OR = 4.72, p = 0.0015) appeared significant, although co-occurrence of two symptoms only, cough and loss of smell or taste, means OR = 2.49 (p < 0.0001). Temperature > 38℃ with cough was most frequent in men (20%), while loss of taste/smell with cough in women (17%). For younger people, taste/smell impairment is sufficient to characterise infection, whereas in older patients co-occurrence of fever and cough is necessary. The presented study objectifies the single symptoms and interactions significance in COVID-19 diagnoses and demonstrates diverse symptomatology in patient groups.


Asunto(s)
COVID-19/diagnóstico , COVID-19/epidemiología , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , SARS-CoV-2 , Evaluación de Síntomas/estadística & datos numéricos , Centros Médicos Académicos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ageusia/etiología , COVID-19/complicaciones , Niño , Preescolar , Tos/etiología , Diagnóstico Diferencial , Disnea/etiología , Femenino , Fiebre/etiología , Cefalea/etiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Trastornos del Olfato/etiología , Proyectos Piloto , Polonia/epidemiología , Infecciones del Sistema Respiratorio/complicaciones , Infecciones del Sistema Respiratorio/microbiología , Encuestas y Cuestionarios , Evaluación de Síntomas/clasificación , Adulto Joven
8.
Nat Med ; 27(9): 1607-1613, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34163090

RESUMEN

Long-term complications after coronavirus disease 2019 (COVID-19) are common in hospitalized patients, but the spectrum of symptoms in milder cases needs further investigation. We conducted a long-term follow-up in a prospective cohort study of 312 patients-247 home-isolated and 65 hospitalized-comprising 82% of total cases in Bergen during the first pandemic wave in Norway. At 6 months, 61% (189/312) of all patients had persistent symptoms, which were independently associated with severity of initial illness, increased convalescent antibody titers and pre-existing chronic lung disease. We found that 52% (32/61) of home-isolated young adults, aged 16-30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). Our findings that young, home-isolated adults with mild COVID-19 are at risk of long-lasting dyspnea and cognitive symptoms highlight the importance of infection control measures, such as vaccination.


Asunto(s)
Anticuerpos Antivirales/sangre , COVID-19/complicaciones , COVID-19/patología , Disfunción Cognitiva/virología , Disnea/virología , Fatiga/virología , Adolescente , Adulto , Ageusia/virología , Anosmia/virología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Noruega , Aislamiento de Pacientes , Estudios Prospectivos , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Adulto Joven
9.
Med Sci Monit ; 27: e932962, 2021 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-34145211

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative pathogen of the recent pandemic of coronavirus disease 19 (COVID-19). As the infection spreads, there is increasing evidence of neurological and psychiatric involvement in COVID-19. Headache, impaired consciousness, and olfactory and gustatory dysfunctions are common neurological manifestations described in the literature. Studies demonstrating more specific and more severe neurological involvement such as cerebrovascular insults, encephalitis and Guillain-Barre syndrome are also emerging. Respiratory failure, a significant condition that leads to mortality in COVID-19, is hypothesized to be partly due to brainstem impairment. Notably, some of these neurological complications seem to persist long after infection. This review aims to provide an update on what is currently known about neurological involvement in patients with COVID-19 due to SARS-CoV-2 infection. In this review, we demonstrate invasion routes of SARS-CoV-2, provide evidence to support the neurotropism hypothesis of the virus, and investigate the pathological mechanisms that underlie neurological complications associated with SARS-CoV-2.


Asunto(s)
COVID-19/fisiopatología , Enfermedades del Sistema Nervioso/virología , Ageusia/virología , Anosmia/virología , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/metabolismo , COVID-19/virología , Encefalitis/virología , Cefalea/fisiopatología , Cefalea/virología , Humanos , Enfermedades del Sistema Nervioso/epidemiología , Enfermedades del Sistema Nervioso/etiología , Neuroinmunomodulación/fisiología , Pandemias , SARS-CoV-2/aislamiento & purificación , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/virología
10.
Med Hypotheses ; 153: 110627, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34139598

RESUMEN

Different mechanisms forwarded to understand anosmia and ageusia in coronavirus patients are not adequate to explain reversible anosmia and ageusia, which are resolved quickly. In addition, the reason behind the impaired chemesthetic sensations in some coronavirus patients remains unknown. In the present paper it is proposed that SARS-CoV-2 patients suffer from depletion of tryptophan, as ACE2, a key element in the process of absorption of tryptophan from the food, is significantly reduced in the patients as coronavirus uses ACE2 as the receptor to enter the host cells. The tryptophan depletion leads to a deficit of serotonin (5-HT) in SARS-COV-2 patients because tryptophan is the precursor in the synthesis of 5-HT. Such 5-HT deficiency can explain anosmia, ageusia and dysfunctional chemesthesis in COVID-19, given the fact that 5-HT is an important neuromodulator in the olfactory neurons, taste receptor cells and transient receptor potential channels (TRP channels) involved in chemesthesis. In addition, 5-HT deficiency worsens silent hypoxemia and depresses hypoxic pulmonary vasoconstriction leading to increased severity of the disease. Also, the levels of anti-inflammatory melatonin (synthesized from 5-HT) and nicotinamide adenine dinucleotide (NAD+, produced from niacin whose precursor is the tryptophan) might decrease in coronavirus patients resulting in the aggravation of the disease. Interestingly, selective serotonin reuptake inhibitors (SSRIs) may not be of much help in correcting the 5-HT deficiency in COVID-19 patients, as their efficacy goes down significantly when there is depletion of tryptophan in the system. Hence, tryptophan supplementation may herald a radical change in the treatment of COVID-19 and accordingly, clinical trials (therapeutic / prophylactic) should be conducted on coronavirus patients to find out how tryptophan supplementation (oral or parenteral, the latter in severe cases where there is hardly any absorption of tryptophan from the food) helps in curing, relieving or preventing the olfactory, gustatory and chemesthetic dysfunctions and in lessening the severity of the disease.


Asunto(s)
Ageusia , COVID-19 , Trastornos del Olfato , Anosmia , Humanos , SARS-CoV-2 , Serotonina
11.
Evid Based Dent ; 22(2): 78-79, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-34172916

RESUMEN

Data sources A series of eight patients with active COVID-19 who also presented with associated oral lesions seen at a hospital in Sao Paulo, Brazil provided the information in this report.Study selection The authors reported a case series with eight COVID-19 patients.Data extraction and synthesis Demographic information, hospitalisation details including signs, symptoms and severity of COVID-19, along with presence of anosmia, dysgeusia, ageusia and oral lesions from all eight patients were documented and reported by the authors.Results All eight patients in this report presented for medical care with well-established respiratory symptoms of COVID-19. These patients also presented with oral ulcers that resembled aphthous ulcers, of which some also had necrosis and haemorrhagic ulcerations. The time to onset ranged between two to ten days and duration lasted between 5-15 days. The painful ulcers were empirically managed using daily photobiomodulation (PBMT) therapy using a PBMT device (Twin Flex, MMOptics, Sao Carlos, Brazil).Conclusions Oral lesions may precede COVID-19 and progressively worse oral lesions are seen in severe COVID-19 patients. Some of these oral lesions also tend to occur early along with loss of taste and smell in some patients. Taken together, these oral manifestations could serve as early indication of COVID-19 and prompt referral for further testing is recommended.


Asunto(s)
Ageusia , COVID-19 , Brasil , Humanos , Boca , SARS-CoV-2
12.
Rev. cient. odontol ; 9(2): e057, abr.-jun. 2021. tab
Artículo en Español | LILACS, LIPECS | ID: biblio-1254596

RESUMEN

Objetivo: Determinar la prevalencia de trastornos del gusto en pacientes niños y adolescentes diagnosticados con infección por coronavirus, a través de la evidencia en la literatura científica. Materiales y métodos: Una revisión sistemática de los artículos publicados entre el 19 de diciembre del 2019 y el 20 de diciembre del 2020 en las bases de datos Medline, Lilacs, BVS, Cochrane, SCOPUS y ScienceDirect. La estrategia de búsqueda de información se basó en el diagrama de flujo clásico de PRISMA. Para la evaluación del riesgo de sesgo, se usó la escala Newcastle-Ottawa. Resultados: Se encontraron 443 artículos en seis bases de datos y se incluyó un total de 7 artículos después de la evaluación, según los criterios de selección. Los artículos abordaron la variable de trastornos del gusto en tres formas: ageusia, disgeusia e hipogeusia, y se halló que esta manifestación clínica estaba presente desde los inicios de la infección. Conclusiones: Se ha encontrado una prevalencia de trastornos del gusto en niños y adolescentes diagnosticados con infección por coronavirus desde un 3,3% hasta un 26,9%. (AU)


Aim: To assess the prevalence of taste disorders in children and adolescents diagnosed with coronavirus infection according to the evidence reported in the scientific literature. Materials and Methods: A systematic review of articles published between December 19, 2019, and December 20, 2020 in the Medline, Lilacs, BVS, Cochrane, SCOPUS and ScienceDirect databases. The information search strategy was based on the classic PRISMA flow diagram. The Newcastle-Ottawa scale was used to assess the risk of bias. Results: 443 articles were found in six databases, and a total of 7 articles were included after evaluation according to the selection criteria. The articles addressed the variable of taste disorders in three ways: ageusia, dysgeusia and hypogeusia; finding that this clinical manifestation was present from the beginning of the infection. Conclusions: The prevalence of taste disorders in children and adolescents diagnosed with coronavirus infection is from 3.3% to 26.9%. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Trastornos del Gusto , Infecciones por Coronavirus , Ageusia , Disgeusia
13.
Front Public Health ; 9: 666442, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34123991

RESUMEN

The aim of this study was to investigate the correlation between psychological distress and taste and sense of smell dysfunctions on healthcare workers (HCW) who contracted the COVID-19 infection in the midst of the disease outbreak. Reports of sudden loss of taste and smell which persist even after recovery from COVID-19 infection are increasingly recognized as critical symptoms for COVID-19 infections. Therefore, we conducted a cross-sectional study on COVID-19 HCW (N = 104) who adhered to respond to a phone semistructured interview addressing the virus symptoms and associated psychological distress. Data were collected from June to September 2020. Findings confirm the association between experienced taste/olfactory loss and emotional distress and suggest that dysfunctions of taste and smell correlate positively with anxiety and depression. Furthermore, their psychological impact tends to persist even after the recovery from the disease, suggesting the need for appropriate psychological interventions to prevent people from developing more serious or long-lasting psychological disorders and, as far as HCW, to reduce the risk of work-related distress.


Asunto(s)
Ageusia , COVID-19 , Estudios Transversales , Personal de Salud , Humanos , SARS-CoV-2 , Olfato , Gusto
14.
Infect Dis Now ; 51(6): 556-559, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34000458

RESUMEN

A broad-based SARS-CoV-2 testing program for all symptomatic healthcare workers (HCWs) was implemented in Tenon hospital, Paris, France. From February 26 to April 22, 2020, 701 symptomatic HCWs were screened, of whom 247 (35.2%) tested positive for SARS-Cov-2. Myalgia, fever, anosmia and ageusia were associated with RT-PCR positivity. Testing of HCWs is an essential step toward control of the epidemic. Further studies could establish clinical algorithms for SARS-CoV-2 diagnosis to compensate for RT-PCR test and chest CT limits or unavailability.


Asunto(s)
Prueba de COVID-19/métodos , COVID-19/diagnóstico , Personal de Salud , Hospitales , SARS-CoV-2/aislamiento & purificación , Adolescente , Adulto , Anciano , Ageusia/epidemiología , Anosmia/epidemiología , COVID-19/epidemiología , Femenino , Fiebre/epidemiología , Francia , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Mialgia/epidemiología , Paris , Atención Primaria de Salud , Factores de Riesgo , Adulto Joven
15.
Int J Infect Dis ; 107: 72-77, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33887455

RESUMEN

BACKGROUND: The cutaneous manifestations of coronavirus disease 2019 (COVID-19) have been covered insufficiently in the literature. METHODS: Thirty-nine patients admitted to the study hospital with confirmed COVID-19 who experienced various skin manifestations during hospitalization or in the convalescence period, were analysed retrospectively. RESULTS: Thirty-nine patients with COVID-19, admitted to the study hospital between 23 March and 12 September 2020, had intra-infectious rash or lesions of cutaneous vasculitis during convalescence. The most common cutaneous manifestations of COVID-19 were erythematous and erythematous papular rash. Twenty-seven of the 39 patients had anosmia (69.2%), 26 patients had ageusia (66.7%), 34 patients had pneumonia (87.2%) and 24 patients had intra-infectious enterocolitis (61.5%). Skin biopsies were rarely performed in these patients. This article reports the results of biopsies performed in two patients, showing histopathological and immunohistochemical changes in erythematous rash and erythema multiforme-like lesions. Both skin biopsies revealed early fibrous remodelling of the dermis, suggesting similarity with changes that occur in the lungs and other tissues in patients with COVID-19. CONCLUSIONS: Correlations between skin lesions and anosmia, ageusia and enteritis in patients with COVID-19 do not seem to be accidental, but are associated with a similar response to ACE2 receptor expression in these tissues.


Asunto(s)
Ageusia/etiología , Anosmia/etiología , COVID-19/complicaciones , Enteritis/etiología , SARS-CoV-2 , Enfermedades de la Piel/etiología , Femenino , Humanos , Masculino , Estudios Retrospectivos
16.
Int J Infect Dis ; 106: 329-337, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33819604

RESUMEN

OBJECTIVES: The aim of this study was to investigate the association between taste and smell losses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and to elucidate whether taste preference influences such taste loss. METHODS: A matched case-control study was conducted in 366 Thai participants, including 122 who were confirmed SARS-CoV-2-positive by RT-PCR (case group) and 244 who were SARS-CoV-2-negative (control group). Taste, smell, and appetite changes were assessed by self-reported visual analog scale. Preference for sweet, salty, umami, sour, bitter, and spicy were judged using the validated TASTE-26 questionnaire. RESULTS: Partial taste and smell losses were observed in both groups, while complete losses (ageusia and anosmia) were detected only in the case group. Moreover, only ageusia and anosmia were associated with SARS-CoV-2 positivity (P < 0.001, odds ratio of 14.5 and 27.5, respectively). Taste, smell, and appetite scores were more severely reduced in the case group (P < 0.0001). Multivariate analysis showed that anosmia and ageusia were the best predictors of SARS-CoV-2 positivity, followed by appetite loss and fever. Simultaneous losses of taste and smell but not taste preferences were associated with SARS-CoV-2 positivity (P < 0.01, odds ratio 2.28). CONCLUSIONS: Complete, but not partial, losses of taste and smell were the best predictors of SARS-CoV-2 infection. During the current COVID-19 pandemic, healthy persons with sudden simultaneous complete loss of taste and smell should be screened for COVID-19.


Asunto(s)
Ageusia/complicaciones , Anosmia/complicaciones , COVID-19/fisiopatología , Adulto , COVID-19/epidemiología , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Pandemias
17.
J Laryngol Otol ; 135(5): 436-441, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33888166

RESUMEN

BACKGROUND: The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. METHODS: Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. RESULTS: A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. CONCLUSION: Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance.


Asunto(s)
COVID-19/complicaciones , Trastornos del Olfato/etiología , Psicofísica/métodos , Recuperación de la Función/fisiología , Trastornos del Gusto/etiología , Adulto , Ageusia/epidemiología , Anosmia/epidemiología , COVID-19/diagnóstico , COVID-19/psicología , COVID-19/virología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Italia/epidemiología , Masculino , Persona de Mediana Edad , Trastornos del Olfato/diagnóstico , Estudios Prospectivos , SARS-CoV-2/aislamiento & purificación , Olfato/fisiología , Gusto/fisiología , Trastornos del Gusto/diagnóstico
18.
Acta Otolaryngol ; 141(6): 626-629, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33823752

RESUMEN

BACKGROUND: Smell disorders persist in about half of the patients with other symptoms of COVID-19 disease, but the exact duration of the symptoms is yet unknown. Especially, only a few studies used validated olfactory tests for this. AIMS/OBJECTIVES: The aim of this study was to investigate how many patients with olfactory function impairment, which was detected in a validated olfactory test 3 months after COVID-19 disease, showed improvement in olfactory function after 6 months. METHODS: About 26 patients with a PCR-confirmed, former COVID-19 disease, with an impaired olfactory function after three months, were included in the study. The olfactory function was evaluated with the sniffing sticks test, the taste function with taste sprays. RESULTS: Smelling function improved in all but one patient (96%). All measured subitems, i.e. olfactory threshold, identification and discrimination of odours significantly improved. In the whole mouth taste test all patients showed normal taste function. CONCLUSIONS AND SIGNIFICANCE: 6 months after COVID-19 disease, olfactory function improves in just about all patients. Long-term measurements must investigate whether complete regeneration of the olfactory function will occur in all patients.


Asunto(s)
COVID-19/complicaciones , Trastornos del Olfato/virología , Recuperación de la Función , Umbral Sensorial , Ageusia/virología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad
19.
J Biomed Inform ; 117: 103748, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33774203

RESUMEN

OBJECTIVE: Identifying symptoms and characteristics highly specific to coronavirus disease 2019 (COVID-19) would improve the clinical and public health response to this pandemic challenge. Here, we describe a high-throughput approach - Concept-Wide Association Study (ConceptWAS) - that systematically scans a disease's clinical manifestations from clinical notes. We used this method to identify symptoms specific to COVID-19 early in the course of the pandemic. METHODS: We created a natural language processing pipeline to extract concepts from clinical notes in a local ER corresponding to the PCR testing date for patients who had a COVID-19 test and evaluated these concepts as predictors for developing COVID-19. We identified predictors from Firth's logistic regression adjusted by age, gender, and race. We also performed ConceptWAS using cumulative data every two weeks to identify the timeline for recognition of early COVID-19-specific symptoms. RESULTS: We processed 87,753 notes from 19,692 patients subjected to COVID-19 PCR testing between March 8, 2020, and May 27, 2020 (1,483 COVID-19-positive). We found 68 concepts significantly associated with a positive COVID-19 test. We identified symptoms associated with increasing risk of COVID-19, including "anosmia" (odds ratio [OR] = 4.97, 95% confidence interval [CI] = 3.21-7.50), "fever" (OR = 1.43, 95% CI = 1.28-1.59), "cough with fever" (OR = 2.29, 95% CI = 1.75-2.96), and "ageusia" (OR = 5.18, 95% CI = 3.02-8.58). Using ConceptWAS, we were able to detect loss of smell and loss of taste three weeks prior to their inclusion as symptoms of the disease by the Centers for Disease Control and Prevention (CDC). CONCLUSION: ConceptWAS, a high-throughput approach for exploring specific symptoms and characteristics of a disease like COVID-19, offers a promise for enabling EHR-powered early disease manifestations identification.


Asunto(s)
COVID-19/diagnóstico , Procesamiento de Lenguaje Natural , Evaluación de Síntomas/métodos , Adulto , Ageusia , Prueba de Ácido Nucleico para COVID-19 , Tos , Femenino , Fiebre , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estados Unidos
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