Objectives To determine the prevalence of olfactory and taste dysfunction (OD; TD) among COVID‐19 positive health care workers (HCWs), their associated risk factors and prognosis. Methods Between May and June 2020, a longitudinal multicenter study was conducted on symptomatic COVID‐19 PCR confirmed HCWs (COVID‐19 positive) in London and Padua. Results Hundred and fourteen COVID‐19 positive HCWs were surveyed with a response rate of 70.6% over a median follow‐up period of 52 days. UK prevalence of OD and TD was 73.1% and 69.2%, respectively. There was a male to female ratio of 1:3 with 81.6% being white, 43.7% being nurses/health care assistants (HCAs), and 39.3% being doctors. In addition, 53.2% of them worked on COVID‐19 wards. Complete recovery was reported in 31.8% for OD and 47.1% for TD with a 52 days follow‐up. The job role of doctors and nurses negatively influenced smell ( P = .04 and P = .02) and taste recovery ( P = .02 and P = .01). Ethnicity (being white) showed to positively influence only taste recovery ( P = .04). Sex (being female) negatively influenced OD and TD recovery only in Paduan HCWs ( P = .02 and P = .011, respectively). Working on a COVID‐19 ward did not influence prognosis. Conclusions The prevalence of OD and TD was considerably higher in HCWs. The prognosis for OD and TD recovery was worse for nurses/HCAs and doctors but working on a COVID‐19 ward did not influence prognosis. Sixty‐eight percent of surveyed HCWs at 52 days continued to experience OD or TD requiring additional future medical management capacity. Level of Evidence 4.
BackgroundFew is known about the long-term pulmonary sequelae after COVID-19 infection. Hence, the aim of this study is to characterize patients with persisting pulmonary sequelae at follow-up after hospitalization. We also aimed to explore clinical and radiological predictors of pulmonary fibrosis following COVID-19.MethodsTwo hundred and 20 consecutive patients were evaluated at 3–6 months after discharge with high-resolution computed tomography (HRCT) and categorized as recovered (REC) or not recovered (NOT-REC). Both HRCTs at hospitalization (HRCT0), when available, and HRCT1 during follow-up were analyzed semiquantitatively as follows: ground-glass opacities (alveolar score, AS), consolidations (CONS), and reticulations (interstitial score, IS).ResultsA total of 175/220 (80%) patients showed disease resolution at their initial radiological evaluation following discharge. NOT-REC patients (45/220; 20%) were mostly older men [66 (35–85) years vs. 56 (19–87); p = 0.03] with a longer in-hospital stay [16 (0–75) vs. 8 (1–52) days; p < 0.0001], and lower P/F at admission [233 (40–424) vs. 318 (33–543); p = 0.04]. Moreover, NOT-REC patients presented, at hospital admission, higher ALV [14 (0.0–62.0) vs. 4.4 (0.0–44.0); p = 0.0005], CONS [1.9 (0.0–26.0) vs. 0.4 (0.0–18.0); p = 0.0064], and IS [11.5 (0.0– 29.0) vs. 0.0 (0.0–22.0); p < 0.0001] compared to REC patients. On multivariate analysis, the presence of CONS and IS at HRCT0 was independent predictors of radiological sequelae at follow-up [OR 14.87 (95% CI: 1.25–175.8; p = 0.03) and 28.9 (95% CI: 2.17–386.6; p = 0.01, respectively)].ConclusionsIn our population, only twenty percent of patients showed persistent lung abnormalities at 6 months after hospitalization for COVID-19 pneumonia. These patients are predominantly older men with longer hospital stay. The presence of reticulations and consolidation on HRCT at hospital admission predicts the persistence of radiological abnormalities during follow-up.
Precision medicine applied to risk stratification and diagnosis, together with rapid microbiologic molecular testing, may contribute to optimizing the management of CAP, with potential additional reduction of mortality rates.
scale (VAS) and the 22-item Sino-Nasal Outcome Test (SNOT-22). 1 However, self-reported OD poorly correlates with olfactory tests such as Sniffin' Sticks (S'S). 3 The aim of this study is to provide a prospective longterm assessment of COVID-19-related OD using PROMs 4 and S'S 5 and to investigate their correlation. METHODSPatients with laboratory-confirmed SARS-CoV-2 infection and OD/TD were selected from our Infectious Disease
By increasing life expectancy of people living with HIV, the most clinical challenge is managing both drug-to-drug interactions and comorbidities (especially metabolic). Doravirine (DOR), a new non-nucleoside reverse transcriptase inhibitor, recently approved for the treatment of HIV, could be a good companion of dolutegravir (DTG) in a dual regimen for experienced elderly patients with multimorbidity and polypharmacy. We herein report our preliminary experience in a small cohort of elderly patients (>50 years of age) with multimorbidity and on polypharmacy who were switched to DOR/DTG dual regimen and followed-up for 3 months. The study was conducted at the Infectious and Tropical Diseases Unit of Padua University Hospital, Italy. Eighteen patients were included, 72.2% males and 27.8% postmenopausal women, mean age was of 61.3 years (7.6), 50% experienced AIDS events. Switches to DOR and DTG were mainly due to high cardiovascular and metabolic risk (72.2%), and interactions among comedications (50%). Antiretrovirals that subjects were switched off were mostly boosted protease inhibitors 66.7%. We observed a viral suppression among all subjects. Interestingly, we observed a statistically significant reduction in body mass index, body weight and waist circumference, eGFR, and a significant increase in serum creatinine levels. No significant changes in CD4+ T cell count was observed from the baseline. Lipid and fasting glucose values did not change significantly. To the best of our knowledge this is the first experience reporting real-life outcome of switch to DTG + DOR in elderly with multimorbidity and on polypharmacy. From our very preliminary data the dual combination of DTG and DOR could be a good treatment strategy for these subjects. However, our findings need to be validated on a greater number of patients.
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