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Approaching Otolaryngology Patients During the COVID-19 Pandemic.

Abstract
Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.
AuthorsChong Cui, Qi Yao, Di Zhang, Yu Zhao, Kun Zhang, Eric Nisenbaum, Pengyu Cao, Keqing Zhao, Xiaolong Huang, Dewen Leng, Chunhan Liu, Ning Li, Yan Luo, Bing Chen, Roy Casiano, Donald Weed, Zoukaa Sargi, Fred Telischi, Hongzhou Lu, James C Denneny 3rd, Yilai Shu, Xuezhong Liu
JournalOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 163 Issue 1 Pg. 121-131 (07 2020) ISSN: 1097-6817 [Electronic] England
PMID32396445 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Aged
  • Betacoronavirus
  • COVID-19
  • China (epidemiology)
  • Coronavirus Infections (complications, epidemiology, transmission)
  • Disease Transmission, Infectious (prevention & control)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Otolaryngology (standards)
  • Otorhinolaryngologic Diseases (complications, therapy)
  • Pandemics
  • Personal Protective Equipment (standards)
  • Pneumonia, Viral (complications, epidemiology, transmission)
  • Retrospective Studies
  • SARS-CoV-2

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