COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Pandian, Vinciya; Brodsky, Martin B.; Brigham, Emily; Parker, Ann M.; Hillel, Alexander T.; Levy, Joshua M.; Rassekh, Christopher H.; Lalwani, Anil K.; Brenner, Michael

doi:10.1016/j.amjoto.2021.102917

Cited by 16 publications

(21 citation statements)

References 37 publications

(26 reference statements)

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“…We reported dizziness in only 20% of our patients, whereas it was a more prominent feature in other studies [ 4 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. However, the vague and imprecise feeling of dizziness was easily disregarded by patients who were overwhelmed by the much more prominent symptoms of their COVID-19 medical condition.…”

Section: Discussioncontrasting

confidence: 78%

Neurological Manifestations in a Cohort of Egyptian Patients with COVID-19: A Prospective, Multicenter, Observational Study

et al. 2022

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Background: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million deaths as of 22nd December 2021. COVID-19-associated acute and long-term neurological manifestations are well recognized. The exact profile and the timing of neurological events in relation to the onset of infection are worth exploring. The aim of the current body of work was to determine the frequency, pattern, and temporal profile of neurological manifestations in a cohort of Egyptian patients with confirmed COVID-19 infection. Methods: This was a prospective study conducted on 582 hospitalized COVID-19 patients within the first two weeks of the diagnosis of COVID-19 to detect any specific or non-specific neurological events. Results: The patients’ mean (SD) age was 46.74 (17.26) years, and 340 (58.42%) patients were females. The most commonly encountered COVID-19 symptoms were fever (90.72%), cough (82.99%), and fatigue (76.98%). Neurological events (NE) detected in 283 patients (48.63%) and were significantly associated with a severe COVID-19 at the onset (OR: 3.13; 95% CI: 2.18–4.51; p < 0.0001) and with a higher mortality (OR: 2.56; 95% CI: 1.48–5.46; p = 0.019). The most frequently reported NEs were headaches (n = 167) and myalgias (n = 126). Neurological syndromes included stroke (n = 14), encephalitis (n = 12), encephalopathy (n = 11), transverse myelitis (n = 6) and Guillain-Barré syndrome (n = 4). Conclusions: Neurological involvement is common (48.63%) in COVID-19 patients within the first two weeks of the illness. This includes neurological symptoms such as anosmia, headaches, as well as a constellation of neurological syndromes such as stroke, encephalitis, transverse myelitis, and Guillain-Barré syndrome. Severity of acute COVID-19 illness and older age are the main risk factors.

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Section: Discussioncontrasting

confidence: 78%

Neurological Manifestations in a Cohort of Egyptian Patients with COVID-19: A Prospective, Multicenter, Observational Study

et al. 2022

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“…Despite the negative findings on MMSE, cognitive, physical, and psychological factors all contribute to the burden of COVID-19 survivorship [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Combined mental clouding and headache was strongly linked to increased severity of smell alterations (OR: 41), whereas patients with mental clouding alone had an OR of 19, and those with headache had an OR of 21. SARS-CoV-2-induced inflammation of the brain [ 23 ] may contribute to various Long-COVID symptoms, including vestibulocochlear impairment [ 1 ] and persistent cough [ 25 ]. Cognitive impairment and headache may both degrade an individual’s ability to correctly identifying the odors, as memory is necessary for odor recognition.…”

Section: Discussionmentioning

confidence: 99%

Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study

et al. 2022

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Smell alteration and cognitive impairment are common features of the Long-COVID Syndrome. Mental clouding, often described as brain fog, might affect smell by altering recollection of odors or through a share mechanism of neuroinflammation. We investigated mental clouding, headache, and cognitive function in adult patients with persistent COVID-19 olfactory dysfunction. This multi-center cross-sectional study enrolled 152 adults with self-reported olfactory dysfunction from 3 tertiary centers specialized in COVID-19 olfactory disorders. Inclusion criteria were smell alterations after COVID-19 persisting over 6 months from infection, age >18 and < 65. Exclusion criteria included smell alterations, headache, or memory problems prior to COVID-19 infection. The patients were evaluated by olfactometry, nasal endoscopy, headache scale, cognitive assessment, Mini Mental State Examination (MMSE), and self-reported measures. Smell dysfunction was stratified and classified based on olfactory deficit severity and presence of olfactory distortion (parosmia, cacosmia). Data on smell disorder, mental clouding, MMSE, and headache were analyzed to assess correlations. Among the 152 patients studied, 50 (32.8%) presented with anosmia, 25 (16.4%) with hyposmia, 10 (6.6%) with parosmia/cacosmia, and 58 patients (38.2%) with a combination of hyposmia and parosmia; seven (4.6%) patients suffered from headache exclusively, and two (1.4%) had headache and mental clouding as their primary symptom. Headache was reported by 76 (50%) patients, and mental clouding by 71 (46.7%). The patients reporting headache, mental clouding, or both, had significantly increased risk of suffering from anosmia and/or hyposmia when compared with their counterparts without these neurological symptoms. No patients had reduced MMSE scores. In our cohort of adult patients with post-COVID-19, smell alterations persisting over 6 months, cognitive impairment and headache were associated with more severe olfactory loss, consistent with neuroinflammatory mechanisms mediating a variety of Long-COVID symptoms.

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“…A holistic rehabilitation framework to recovery must encompass function, activities, and societal participation [59] . Persistent functional impairment of breathing, speaking, and swallowing as sequelae of device-related injury will have lasting effects on the wellbeing of many COVID-19 survivors [60] . Quality of life is commonly hindered further by the persistent loss of taste and smell, which typically occurs after other COVID-19 symptoms and can persist for up to two weeks and beyond [61] , impacting nutrition [62] , [63] .…”

Section: Discussionmentioning

confidence: 99%

Tracheostomy care and communication during COVID-19: Global interprofessional perspectives

Moser

Freeman‐Sanderson

Keeven

et al. 2022

American Journal of Otolaryngology

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COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Cited by 16 publications

References 37 publications

Neurological Manifestations in a Cohort of Egyptian Patients with COVID-19: A Prospective, Multicenter, Observational Study

Neurological Manifestations in a Cohort of Egyptian Patients with COVID-19: A Prospective, Multicenter, Observational Study

Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study

Tracheostomy care and communication during COVID-19: Global interprofessional perspectives

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