-
The Lancet. Digital Health Sep 2021Multiple voluntary surveillance platforms were developed across the world in response to the COVID-19 pandemic, providing a real-time understanding of population-based... (Observational Study)
Observational Study
Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study.
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.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ageusia; Anosmia; COVID-19; Cough; Digital Technology; Dyspnea; Female; Fever; Humans; Israel; Male; Middle Aged; Odds Ratio; Pandemics; Population Surveillance; SARS-CoV-2; United Kingdom; United States; Young Adult
PubMed: 34305035
DOI: 10.1016/S2589-7500(21)00115-1 -
Annals of the Royal College of Surgeons... Jan 2019Nasal polyposis is a benign hyperplastic growth of nasal mucosa. There is a paucity of evidence on the prevalence and incidence of nasal polyposis. Although nasal polyps... (Review)
Review
BACKGROUND
Nasal polyposis is a benign hyperplastic growth of nasal mucosa. There is a paucity of evidence on the prevalence and incidence of nasal polyposis. Although nasal polyps can be asymptomatic, they can cause a spectrum of nasal problems including nasal obstruction, rhinorrhoea, nasal congestion, anosmia resulting in ageusia. Nasal polyps are mostly associated with chronic rhinosinusitis, The current management of chronic rhinosinusitis with nasal polyps is controversial and is not curative.
METHODS
A Medline search was conducted, using the keywords 'rhinosinusitis', 'sinusitis', 'classification' and ''aetiology.
FINDINGS
The current treatment of nasal polyposis in chronic rhinosinusitis with nasal polyps is still challenging. Emerging research through endotypes profiling aims to better understand the complexities of this heterogeneous disease to personalise treatment and provide a cure. Randomised controlled trials aim to provide robust evidence for current management options.
Topics: Humans; Nasal Polyps; Rhinitis; Sinusitis
PubMed: 30286644
DOI: 10.1308/rcsann.2018.0149 -
Cancers Jul 2021Cancer patients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer...
Cancer patients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer treatments. We aimed to identify symptoms associated with COVID-19 and to assess the strength of their association in cancer and cancer-free populations. The multicenter cohort study PAPESCO-19 included 878 cancer patients and 940 healthcare workers (HCWs). At baseline and quarterly thereafter, they reported the presence or absence of 13 COVID-19 symptoms observed over 3 months and the results of routine screening RT-PCR, and they were systematically tested for SARS-CoV-2-specific antibodies. We identified the symptom combinations significantly associated with COVID-19. Eight percent of cancer patients were COVID-19 positive, and 32% were symptomatic. Among the HCWs, these proportions were 9.5 and 52%, respectively. Anosmia, anorexia, fever, headache, and rhinorrhea together accurately discriminated (c-statistic = 0.7027) COVID-19 cases from cancer patients. Anosmia, dysgeusia/ageusia, muscle pain, intense fatigue, headache, and chest pain better discriminated (c-statistic = 0.8830) COVID-19 cases among the HCWs. Anosmia had the strongest association in both the cancer patients (OR = 7.48, 95% CI: 2.96-18.89) and HCWs (OR = 5.71, 95% CI: 2.21-14.75). COVID-19 symptoms and their diagnostic performance differ in the cancer patients and HCWs. Anosmia is associated with COVID-19 in cancer patients, while dysgeusia/ageusia is not. Cancer patients deserve tailored preventive measures due to their particular COVID-19 symptom pattern.
PubMed: 34298605
DOI: 10.3390/cancers13143389 -
Oral Diseases Nov 2022
Topics: Humans; Ageusia; Anosmia; COVID-19; Prevalence; Olfaction Disorders
PubMed: 34002923
DOI: 10.1111/odi.13919 -
Emerging Infectious Diseases Feb 2021To improve recognition of coronavirus disease (COVID-19) and inform clinical and public health guidance, we randomly selected 600 COVID-19 case-patients in Colorado. A... (Review)
Review
To improve recognition of coronavirus disease (COVID-19) and inform clinical and public health guidance, we randomly selected 600 COVID-19 case-patients in Colorado. A telephone questionnaire captured symptoms experienced, when symptoms occurred, and how long each lasted. Among 128 hospitalized patients, commonly reported symptoms included fever (84%), fatigue (83%), cough (73%), and dyspnea (72%). Among 236 nonhospitalized patients, commonly reported symptoms included fatigue (90%), fever (83%), cough (83%), and myalgia (74%). The most commonly reported initial symptoms were cough (21%-25%) and fever (20%-25%). In multivariable analysis, vomiting, dyspnea, altered mental status, dehydration, and wheezing were significantly associated with hospitalization, whereas rhinorrhea, headache, sore throat, and anosmia or ageusia were significantly associated with nonhospitalization. General symptoms and upper respiratory symptoms occurred earlier in disease, and anosmia, ageusia, lower respiratory symptoms, and gastrointestinal symptoms occurred later. Symptoms should be considered alongside other epidemiologic factors in clinical and public health decisions regarding potential COVID-19 cases.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; COVID-19; Child; Child, Preschool; Colorado; Cough; Disease Progression; Dyspnea; Fatigue; Female; Fever; Humans; Infant; Inpatients; Male; Middle Aged; Myalgia; Outpatients; SARS-CoV-2; Symptom Assessment; Young Adult
PubMed: 33496225
DOI: 10.3201/eid2702.203729 -
The Lancet. Neurology Jan 2021
Topics: Ageusia; Anosmia; COVID-19; Cerebrovascular Disorders; Guillain-Barre Syndrome; Humans; Inflammation
PubMed: 33340476
DOI: 10.1016/S1474-4422(20)30451-8 -
European Neurology 2013
Topics: Ageusia; Epilepsy; Female; History, 19th Century; History, 20th Century; Humans
PubMed: 23328255
DOI: 10.1159/000346032 -
Neurology Perspectives Dec 2021Post-COVID-19 syndrome is a series of chronic signs and symptoms that may appear after SARS-CoV-2 infection, including fatigue, dyspnoea, chest pain, palpitations,... (Review)
Review
INTRODUCTION
Post-COVID-19 syndrome is a series of chronic signs and symptoms that may appear after SARS-CoV-2 infection, including fatigue, dyspnoea, chest pain, palpitations, anxiety, depression, and joint and muscle pain. The purpose of this study was to review the controversies on post-COVID-19 syndrome, the frequency of neurological symptoms, and the potential pathophysiological mechanisms.
METHODS
We present a narrative review of studies published in PubMed since the beginning of the pandemic (January 2020-July 2021).
RESULTS
Patients with history of COVID-19 have been found to present persistent neurological symptoms, including cognitive complaints, memory and concentration problems, headache, anosmia, ageusia, vertigo, and insomnia. Post-COVID-19 syndrome is a heterogeneous disease that lacks a universally accepted definition, which may explain the great variability in the estimated prevalence (2.3%-85%) and symptom duration. The criteria differentiating post-COVID-19 syndrome from chronic fatigue syndrome or critical illness syndrome are ambiguous. Risk factors include older age, female sex, certain comorbidities, and greater number of symptoms in the acute phase. The pathophysiology of the syndrome is largely unknown, although it is probably multifactorial, including immunological mechanisms, neural network dysfunction, neurotransmitter alterations, persistent viral damage, and functional impairment.
CONCLUSIONS
Post-COVID-19 syndrome may present after mild or even asymptomatic SARS-CoV-2 infection, causing limitations in activities of daily living and in quality of life. Further research will clarify the origin and most appropriate management of these neurological alterations.
PubMed: 36798683
DOI: 10.1016/j.neurop.2021.07.005 -
ACS Chemical Neuroscience Mar 2021COVID-19 disease induced by coronavirus SARS-CoV-2 presents among its symptoms alterations of the chemosensory functions. In the first studies on the Chinese population,... (Review)
Review
COVID-19 disease induced by coronavirus SARS-CoV-2 presents among its symptoms alterations of the chemosensory functions. In the first studies on the Chinese population, this symptomatology was not particularly relevant, and hyposmia and hypogeusia were excluded from the symptoms to be evaluated to diagnose the disease. With the pandemic spread of the illness, there has been an augment in reports on chemosensory dysfunctions among patients. The first data analysis showed the presence of these disorders mainly in paucisymptomatic and asymptomatic patients. The interest in chemosensory systems therefore increased considerably, because the olfactory and gustatory symptoms could be the key to stop the infection spread. Furthermore, the degree of alert and attention grew, considering that these types of dysfunctions are prognostic symptoms of serious neurodegenerative diseases. About 9 months have passed since the first anecdotal reports on the involvement of the olfactory and gustatory systems in the COVID-19 pathology. For this reason, a careful review of the literature was conducted to understand if it is clearer which people present chemosensory symptoms and if these are related to the severity of the disease. Furthermore, we have identified which aspects still remain to be clarified.
Topics: Ageusia; Asian People; COVID-19; China; Female; Humans; Male; Olfaction Disorders; Sensation Disorders; Taste Disorders
PubMed: 33559466
DOI: 10.1021/acschemneuro.0c00788 -
Dentistry Journal Nov 2021Patients with coronavirus disease 2019 (COVID-19) have become known to present with different oral symptoms. However, xerostomia remains poorly recognized compared with... (Review)
Review
Patients with coronavirus disease 2019 (COVID-19) have become known to present with different oral symptoms. However, xerostomia remains poorly recognized compared with taste dysfunction. For better understanding of COVID-19 symptomatology, xerostomia associated withCOVID-19 was characterized and its possible pathogenesis was speculated by a narrative literature review. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, Google Scholar, medRxiv and bioRxiv from 1 April 2020 with a cutoff date of 30 September 2021. Results of the literature search indicated that xerostomia is one of prevalent and persistent oral symptoms associated with COVID-19. In contrast to taste dysfunction, the prevalence and persistence of xerostomia do not necessarily depend on ethnicity, age, gender and disease severity of patients. COVID-19 xerostomia is pathogenically related to viral cellular entry-relevant protein expression, renin-angiotensin system disturbance, salivary gland inflammation, zinc deficiency, cranial neuropathy, intercurrent taste dysfunction, comorbidities and medications. Despite a close association with COVID-19, xerostomia, dry mouth and hyposalivation tend to be overlooked unlike ageusia, dysgeusia and hypogeusia. Although mouth dryness per se is not life-threating, it has an impact on the oral health-related quality of life. More attention should be paid to xerostomia in COVID-19 patients and survivors.
PubMed: 34821594
DOI: 10.3390/dj9110130