COVID-19 in otolaryngologist practice: a review of current knowledge

Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1885-1897. doi: 10.1007/s00405-020-05968-y. Epub 2020 Apr 18.

Abstract

Purpose: Otorhinolaryngological manifestations are common symptoms of COVID-19. This study provides a brief and precise review of the current knowledge regarding COVID-19, including disease transmission, clinical characteristics, diagnosis, and potential treatment. The article focused on COVID-19-related information useful in otolaryngologist practice.

Methods: The Medline and Web of Science databases were searched without a time limit using terms "COVID-19", "SARS-CoV-2" in conjunction with "otorhinolaryngological manifestation", "ENT", and "olfaction".

Results: The most common otolaryngological dysfunctions of COVID-19 were cough, sore throat, and dyspnea. Rhinorrhea, nasal congestion and dizziness were also present. COVID-19 could manifest as an isolated sudden hyposmia/anosmia. Upper respiratory tract (URT) symptoms were commonly observed in younger patients and usually appeared initially. They could be present even before the molecular confirmation of SARS-CoV-2. Otolaryngologists are of great risk of becoming infected with SARS-CoV-2 as they cope with URT. ENT surgeons could be easily infected by SARS-CoV-2 during performing surgery in COVID-19 patients.

Conclusion: Ear, nose and throat (ENT) symptoms may precede the development of severe COVID-19. During COVID-19 pandemic, patients with cough, sore throat, dyspnea, hyposmia/anosmia and a history of travel to the region with confirmed COVID-19 patients, should be considered as potential COVID-19 cases. An otolaryngologist should wear FFP3/N95 mask, glasses, disposable and fluid resistant gloves and gown while examining such individuals. Not urgent ENT surgeries should be postponed. Additional studies analyzing why some patients develop ENT symptoms during COVID-19 and others do not are needed. Further research is needed to determine the mechanism leading to anosmia.

Keywords: COVID-19; ENT; Olfaction; Otolaryngological manifestations; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Cough
  • Humans
  • Otolaryngologists*
  • Otolaryngology
  • Otorhinolaryngologic Surgical Procedures / standards
  • Pandemics / prevention & control*
  • Pharyngitis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Respiratory System / virology
  • SARS-CoV-2