ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
kulak burun boğaz
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ORIGINAL RESEARCH

The Prognostic Impact of Otorhinolaryngology Symptoms on COVID-19 Patients
Kulak Burun Boğaz Semptomlarının COVID-19 Hastalarında Prognoza Etkisi
Received Date : 08 Jul 2020
Accepted Date : 08 Sep 2020
Available Online : 30 Oct 2020
Doi: 10.24179/kbbbbc.2020-77914 - Makale Dili: EN
KBB ve BBC Dergisi. 2020;28(3):208-15
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Although corona virus disseminates by aerosol or droplet and colonizes in nasal cavity and nasopharynx, symptoms related to upper respiratory tract are uncommon in coronavirus-disease-2019 (COVID-19). In this report we aimed to classify the patients applying to COVID-19 outpatient clinics according to ear-nose-throat (ENT) specific and COVID-19 specific symptoms and to compare these patients’ prognosis. Material and Methods: Sixty-five patients with COVID-19 were included to the study. The patients were classified according to their presenting symptoms. The symptom categories were COVID- 19 specific (Group 1) and Covid-19+ENT specific (Group 2) symptoms. As specific symptoms of COVID-19; fever, cough, headache, myalgia and dyspnea were assumed. Mild ENT symptoms were also included to this group. As otolaryngology- specific symptoms; dysfunction in smell, nasal congestion, runny nose, sneezing, postnasal drip, sore throat, dysphagia, dysphonia, hearing loss, tinnitus, dizziness/vertigo and aural fullness were considered. C-reactive protein, leukocyte, lymphocyte, platelet levels in peripheral blood, and oxygen saturation levels were also recorded. The symptom scores were analyzed by visual analog scale scoring system. Results: The most common presenting symptom of the patients in Group 1 was fever followed by constitutional symptoms and cough, whereas the most common presenting symptom in Group 2 was constitutional followed by myalgia and fever. Olfactory dysfunction was prevalent in the patients in Group 2 with a significant difference. Average nasal symptom scores of the patients in Group 2 were; none: 3, mild: 0, moderate: 25, severe: 12 and the difference was statistically significant. Oral cavity/oropharynx symptoms were again more prevalent in Group 2. The average ear symptom scores of the patients among groups did not differ significantly. Fourteen of the patients in Group 1 had better prognosis and 15 had worse outcome. In Group 2 better prognosis was seen in 25 patients and worse prognosis was detected in 11 patients. Conclusion: The evaluation of the parameters concluded that although the patients with ENT predominant symptoms were doing better than the patients with more systemic symptoms, the difference was not statistically significant.
ÖZET
Amaç: Koronavirüs, aerosol veya damlacıkla yayılıp burun boşluğu ve nazofarenkste kolonize olsa da koronavirüs hastalığı-2019 [coronavirus disease- 2019 (COVID-19)]’da üst solunum yoluyla ilgili semptomlar nadirdir. Bu çalışmada, COVID-19 polikliniklerine başvuran hastaları kulak-burun-boğaz (KBB) spesifik ve COVID-19 spesifik semptomlara göre sınıflandırmayı ve bu hastaların prognozlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya, 65 COVID-19 hastası dâhil edildi. Hastalar, başvuru semptomlarına göre sınıflandırıldı. Semptom kategorileri COVID-19'a özgü (Grup 1) ve COVID- 19+KBB'ye özgü (Grup 2) olarak ayrıldı. COVID-19'un spesifik semptomları ateş, öksürük, baş ağrısı, kas ağrısı ve nefes darlığı olarak kabul edildi. Hafif KBB semptomları da bu gruba dâhil edildi. KBB’ye özgü semptomlar ise koku bozukluğu, burun tıkanıklığı, burun akıntısı, hapşırma, postnazal akıntı, boğaz ağrısı, yutma güçlüğü, ses kısıklığı, işitme kaybı, kulak çınlaması, baş dönmesi ve kulakta dolgunluk olarak kabul edildi. Periferik kanda bakılan C-reaktif protein, lökosit, lenfosit, trombosit düzeyleri ve oksijen saturasyon düzeyleri de kaydedildi. Semptom skorları vizüel analog skala ile analiz edildi. Bulgular: Grup 1'deki hastaların en sık başvuru semptomu ateş, ardından nonspesifik semptomlar ve öksürük iken, Grup 2'deki en sık başvuru semptomu ise nonspesifik semptomlar ve ardından miyalji ve ateş idi. Olfaktör disfonksiyonun Grup 2'deki hastalarda anlamlı olarak daha fazla izlendiği gösterildi. Grup 2'deki hastaların ortalama burun semptom skorları; yok: 3, hafif: 0, orta: 25, şiddetli: 12 olarak görüldü ve fark istatistiksel olarak anlamlı bulundu. Oral kavite/orofarinks semptomları da Grup 2'de aynı şekilde daha yaygın saptandı. Gruplar arasında hastaların ortalama kulak semptom skorları anlamlı farklılık göstermedi. Grup 1'deki hastaların 14'ünde daha iyi prognoz ve 15'inde daha kötü sonuç vardı. Grup 2'de 25 hastada daha iyi prognoz, 11 hastada daha kötü prognoz saptandı. Sonuç: Elde edilen parametreler değerlendirildiğinde ulaşılan sonuca göre, KBB baskın semptomları olan hastalar daha sistemik semptomları olan hastalardan daha iyi klinik gidişat gösterse de fark istatistiksel olarak anlamlı bulunmadı.
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