In the current coronavirus disease 2019 (COVID-19) pandemic, anosmia and dysgeusia have been described as potential symptoms of the disease. On Mar. 21, 2020, a press release from ENT UK (a professional membership body representing ear, nose and throat surgeons in the United Kingdom) and the British Rhinological Society reported anosmia as a symptom in up to 40% of patients in China, South Korea, Germany and Italy. 1 Surprisingly, anosmia and dysgeusia were not reported in the first study describing the clinical characteristics of COVID-19 in China. 2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) damages primarily the respiratory tract. The most common symptoms of SARS-CoV-2 infection include fever, cough and muscle pain. 3,4 Although most patients generally experience mild to moderate disease, severe or critical disease requiring hospital admission develops in 15%-20% of patients, with an overall fatality rate of 2.3%. 5 A growing body of literature has mentioned anosmia and dysgeusia as potential symptoms of SARS-CoV-2 infection. 1,6,7 Anosmia is associated with other respiratory tract infections, and it is not clear whether this symptom is a consequence of nasal obstruction and congestion, or is a symptom specific to SARS-CoV-2 infection. 8 A better understanding of the association between these symptoms and SARS-CoV-2 infection might update the diagnostic criteria and alert people who experience these symptoms to isolate early and seek testing. Therefore, we aimed to delineate the value of anosmia and dysgeusia as potential specific symptoms of SARS-CoV-2 infection.

HCAP is associated with worse outcomes than CAP. MDR pathogens were implicated in only a small fraction of HCAP cases. In our study, unlike CAP, non-respect of current HCAP guidelines had no adverse effect on the ultimate outcome. Strategies for the empirical management of HCAP should be tailored to the local epidemiological context.

Background This study assessed the short and the long term safety of the 2009 AS03 adjuvanted monovalent pandemic vaccine through an active web-based electronic surveillance. We compared its safety profile to that of the seasonal trivalent inactivated influenza vaccine (TIV) for 2010–2011. Methodology/Principal Findings Health care workers (HCW) vaccinated in 2009 with the pandemic vaccine (Arepanrix ® from GSK) or HCW vaccinated in 2010 with the 2010–2011 TIV were invited to participate in a web-based active surveillance of vaccine safety. They completed two surveys the day-8 survey covered the first 7 days post-vaccination and the day-29 survey covered events occurring 8 to 28 days after vaccination. Those who reported a problem were called by a nurse to obtain details. The main outcome was the occurrence of a new health problem or the worsening of an existing health condition that resulted in a medical consultation or work absenteeism. For the pandemic vaccine, a six-month follow-up for the occurrence of serious adverse events (SAE) was conducted. Among the 6242 HCW who received the pandemic vaccine, 440 (7%) reported 468 events compared to 328 of the 7645 HCW (4.3%) who reported 339 events after the seasonal vaccine. The 2009 pandemic vaccine was associated with significantly more local reactions than the 2010–2011 seasonal vaccine (1% vs. 0.03%, p<0.001). Paresthesia was reported by 7 HCW (0.1%) after the pandemic vaccine but by none after the seasonal vaccine. For the pandemic vaccine, no clustering of SAE was found in the 6 month follow-up. Conclusion The 2009 pandemic vaccine seems to have a good safety profile, similar to the 2010–2011 TIV, with the exception of local reactions. This surveillance was adequately powered to identify AE associated with an excess risk ≥1 per 1000 vaccinations but is insufficient to detect rare AE. Trial Registration ClinicalTrials.gov NCT01289418 , NCT01318876

Background Early in the coronavirus disease 2019 (COVID-19) pandemic, before severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines became available, it was hypothesized that BCG (Bacillus Calmette−Guérin), which stimulates innate immunity, could provide protection against SARS-CoV-2. Numerous ecological studies, plagued by methodological deficiencies, revealed a country-level association between BCG use and lower COVID-19 incidence and mortality. We aimed to determine whether BCG administered in early life decreased the risk of SARS-CoV-2 infection in adulthood and the severity of COVID-19. Methods This case-control study was conducted in Quebec, Canada. Cases were patients with a positive SARS-CoV-2 polymerase chain reaction assay performed at two hospitals between March−October 2020. Controls were identified among patients with non-COVID-19 samples processed by the same microbiology laboratories during the same period. Enrolment was limited to individuals born in Quebec between 1956 and 1976, whose vaccine status was accessible in a computerized registry of 4.2 million BCG vaccinations. Results We recruited 920 cases and 2123 controls. Fifty-four percent of cases (n=424) and 53% of controls (n=1127) had received BCG during childhood (OR: 1.03; 95% CI: 0.89−1.21), while 12% of cases (n=114) and 11% of controls (n=235) had received two or more BCG doses (OR: 1.14; 95% CI: 0.88−1.46). After adjusting for age, sex, material deprivation, recruiting hospital and occupation there was no evidence of protection conferred by BCG against SARS-CoV-2 (AOR: 1.01; 95% CI: 0.84−1.21). Among cases, 77 (8.4%) needed hospitalization and 18 (2.0%) died. The vaccinated were as likely as the unvaccinated to require hospitalization (AOR: 1.01, 95% CI: 0.62−1.67) or to die (AOR: 0.85, 95% CI: 0.32−2.39). Conclusions BCG does not provide long-term protection against symptomatic COVID-19 or severe forms of the disease.

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