Sinonasal complications of severe acute respiratory syndrome coronavirus-2: A single center case series.

Autor: Lee SE; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Ghodke AN; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Stepp WH; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Kong KA; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Chaskes M; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Quinsey CS; Department of Neurosurgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Ebert CS Jr; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Thorp BD; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Senior BA; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA., Kimple AJ; Department of Otolaryngology/Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill North Carolina USA.
Jazyk: angličtina
Zdroj: Laryngoscope investigative otolaryngology [Laryngoscope Investig Otolaryngol] 2023 Jan 19; Vol. 8 (1), pp. 16-24. Date of Electronic Publication: 2023 Jan 19 (Print Publication: 2023).
DOI: 10.1002/lio2.1006
Abstrakt: Background: The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in an unprecedented global pandemic. Most infected patients are either asymptomatic or have mild upper respiratory infection symptoms. However, life-threatening sequelae have been observed. In this report, we reviewed nine cases of patients with severe complications from sinonasal disease in the setting of acute SARS-CoV-2 infection.
Methods: IRB approval was obtained prior to study initiation. A retrospective chart review was performed of patients admitted to a tertiary hospital with complex sinonasal symptoms that required otolaryngologic evaluation and management in the setting of concomitant SARS-CoV-2 infection.
Results: Nine patients, ranging from ages 3 to 71 years, with sinonasal disease and simultaneous SARS-CoV-2 infection were identified. Initial presentations ranged from asymptomatic infection to mild/moderate disease (nasal obstruction, cough) or more severe sequelae including epistaxis, proptosis, or neurologic changes. SARS-CoV-2 tests were positive from one to 12 days after symptom onset, with three patients receiving SARS-CoV-2-directed treatment. Complex disease presentations included bilateral orbital abscesses, suppurative intracranial infection, cavernous sinus thrombosis with epidural abscess, systemic hematogenous spread with abscess development in four distinct anatomic locations, and hemorrhagic benign adenoidal tissue. Eight of nine patients (88.8%) required operative intervention. Patients with abscesses also required prolonged, culture-directed antibiotic courses.
Conclusion: Though most SARS-CoV-2 infections are asymptomatic and/or self-limited, there is significant morbidity and mortality in patients with severe disease sequela as outlined in our reported cases. This suggests early identification and treatment of sinonasal disease in this patient population is critical to minimizing poor outcomes. Further research on the pathophysiology of these atypical presentations is needed.
Level of Evidence: 4 (Case Series).
Competing Interests: The authors declare no conflict of interest.
(© 2023 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje