Objective: Olfactory dysfunction is relatively high in coronavirus disease 2019 (COVID-19) patients. The aim of this study is to investigate the incidence of olfactory disorder objectively in patients with laboratory-confirmed COVID-19 infection. Material and Method: The study included 31 healthy controls and 59 COVID-19 patients who were diagnosed and treated in the COVID departments in a tertiary hospital. The patients with corona virus infection were screened by a questionnaire and were classified into 2 groups as either group 2 (patients without self-reported smell loss) or group 3 (patients with self-reported smell loss). Age and gender matched healthy controls who do not have chronic nasal condition or nasal surgery history comprised the control group (group 1). All of the patients and subjects in the control group were tested by the Sniffin’ Sticks test. All of the answers and scores were recorded, and the comparisons were made. Results: The rate of self-reported smell and taste loss in all COVID-19 patients in this study was 52.5% and 42%, respectively. There was a significant difference in threshold, discrimination, identification, and Threshold, Discrimination, Identification (TDI) scores between groups 1 and 2. When the comparisons between group 1 and 3 were made, again threshold, discrimination, identification, and TDI scores were significantly different. The comparison between groups 2 and 3 demonstrated a significant difference in discrimination, identification, and TDI scores, but threshold score was not different statistically. With questionnaire, the rate of olfactory dysfunction in COVID-19 patients was 52.5%, but with objective test, the rate was calculated as 83%. Conclusion: Olfactory and gustatory dysfunctions are common in COVID-19 patients. According to findings with the objective test method in this study, smell disorder in COVID-19 patients was much higher than those detected by questionnaires.
Objective: The causative agent of COVID-19 is a novel member of coronaviridaes, SARS-CoV-2. It has been reported that the spike (S) protein of SARS-CoV-2 is responsible of infectivity. The S protein is demonstrated to be inactivated under environmental condition, such as hypertonicity and alkaline pH. The aim of the study was to investigate the effect of hypertonic alkaline nasal irrigation (HANI) on SARS-CoV-2.Methods: Sixty patients divided into two groups. The patients in Group 1 used hydroxychloroquine (HCQ), and the patients in Group 2 used HCQ and HANI. Nasopharyngeal samples were collected at the beginning, on 3rd and 7th day of the PCR test positivity. The nasopharyngeal viral load (NVL) changes analyzed with quantitative PCR.Results: NVL decrease in weekly period was statistically significant for both groups, when the difference between NVL day 0 and 3rd in Group 1 and NVL difference between day 0 and 3rd in Group 2 were compared. The difference between Groups 1 and 2 in terms of NVL change was statistically significant (P < 0.05). Conclusion:We demonstrated a significant decrease in nasopharyngeal SARS-CoV-2 load with HANI solution and suggest that HANI may be promising modality for the COVID-19 treatment.
Objective: The present study aimed to investigate the in vivo activity of nasal irrigation (NI) with saline, NI with povidone-iodine (PVP-I) 1%, NI with a mix of hypertonic alkaline and PVP-I 1% against Severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2). Design: This study was a prospective randomised clinical trial. Setting: A multicenter study involving tertiary care centres. Participants: The study included adult outpatients whose qualitative SARS-CoV-2 RT-PCR tests in nasopharyngeal swabs were positive. One hundred twenty patients were divided into four equal groups. Standard COVID-19 treatment was given to Group 1, NI containing saline was added to patients' treatment in Group 2, NI containing 1% PVP-I solution was added to patients' treatment in Group 3, and NI containing 1% PVP-I solution and the hypertonic alkaline solution was added to patients' treatment in Group 4. Main Outcome Measures: On the first day of diagnosis (Day 0), nasopharyngeal swab samples were taken, on the third and fifth days the nasopharyngeal viral load (NVL) reduction in quantitative RT-PCR test was calculated.Results: Between the zeroth to third days and zeroth to fifth days, the NVL reduction was significant in all groups (p < .05). In paired comparisons of groups, the NVL decrease in Group 4 in the first 3 days was significantly lower than all groups (p < .05). The NVL decrease in Groups 3 and 4 in the first 5 days were significantly lower than Group 1 (p < .05). Conclusion:This study revealed that the use of NI of 1% PVP-I and the hypertonic alkaline solution mixture was more effective in reducing NVL.
BackgroundCase reports or small case series suggest that Takayasu arteritis (TA) can co-exist with various chronic inflammatory disorders. Inflammatory bowel disease [(IBD; Crohn's disease (CD) or ulcerative colitis (UC)] has been the most common association.ObjectivesWe conducted a formal study to look specifically at the frequency of association of such chronic inflammatory disorders in a large cohort of patients with TA followed at a single tertiary center.MethodsThere were 226 (200 F/26 M) patients registered with a diagnosis of TA at the Rheumatology Department of Cerrahpasa Medical Faculty, between 1977 and December 2015. Of these, 17 (8%) had died and 15 (7%) were lost to follow-up. The remaining 194 patients were called back at the outpatient clinic for an interview and for a physical examination. A standardized form sought whether the patient was also diagnosed as IBD, ankylosing spondylitis (AS), Behçet's syndrome (BS), amyloidosis (AA), uveitis, rheumatoid arthritis (RA), systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, psoriatic arthritis, myositis, small vessel vasculitis, a demyelinating or any other autoimmune or inflammatory disorder. The presence of skin-mucosa lesions ascribed to BS and inflammatory back pain were also specifically sought for. In addition to the self-reported information, patient charts and all medical documentation available such as hospitalization reports, imaging studies and blood work were used as a source of information.ResultsOne hundred and fifty-three (136 F/17 M) patients were studied. The mean age at the onset of symptoms was 31±11 years and at the time of TA diagnosis was 34±12 years. Subclavian artery was the most common involved artery (83%), followed by common carotids (75%) and aorta (64%). Currently, while 25 (16%) patients were off treatment, 72 (47%) patients were using glucocorticoids, 47 (31%) azathioprine, 32 (21%) methotrexate and 44 (29%) biological agents.We identified 11 (7%) patients with IBD (CH/UC:7/4), 11 (7%) with AS, and 9 (6%) with BS. Ten patients (6 IBD and 4 BS) were diagnosed simultaneously. The onset of TA preceded AS in 6 patients, IBD in 2, and BS in 1 as shown in Table. Among the remaining 122 patients, when the 31 patients with IBD, AS and BS were excluded, recurrent oral ulcers were present in 19 (16%), erythema nodosum in 13 (11%), arthritis in 12 (10%), papulopustular lesions in 5 (4%), uveitis in 5 (4%), and genital ulcer in 1. Inflammatory back pain was reported by 44 (36%) patients; this was usually in the dorsal spine level alone (n=30), less commonly in both dorsal and lumbar spine (n=10) and in the lumbar spine alone (n=4).In addition, 3 patients had secondary amyloidosis, 1 had RA and 1 morphea. We also observed 2 patients with autoimmune hepatitis and 2 with psoriasis, all having onset after anti-TNF treatment.ConclusionsThis survey shows that TA co-occur with IBD, AS or BS in about 1/5 of the patients, at least in a hospital setting and this seems to be without a clear temporal pattern. The rather high preval...
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