Jia Xiaoqing, Shao Shan, Ren Hong, Xu Yuan, Zhao Jinming, Zhao Yan, Wang Yue, Bao Shiping, Yan Junping, Wang Xiangdong, Zhang Luo
Department of Respiration, Third Hospital of Baotou City, Baotou, China.
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otorhinolaryngology-Head & Neck Surgery Ministry of Education, Capital Medical University, Beijing, China; Department of Otolaryngology Head and Neck Surgery, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4174-4183. doi: 10.21037/apm-20-2493. Epub 2021 Mar 23.
Sinonasal symptoms were usually reported to appear initially, yielding the symptoms important for the early detection of coronavirus disease 2019 (COVID-19). This study was conducted retrospectively to investigate the detailed sinonasal manifestations and dynamic profile of real-time reverse transcription polymerase chain reaction (RT-PCR) results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in COVID-19 patients longitudinally.
This retrospective study included 11 consecutive patients. The prevalence, timing and severity of sinonasal manifestations were analyzed. Oropharyngeal, nasal, sputum and stool specimens were collected to detect RT-PCR for SARS-CoV-2 over COVID-19 period.
Among the 11 patients, 6 (54.5%) were female, and the median age was 51 (IQR, 36-62) years. Seven patients (63.6%) experienced sinonasal symptoms, with 6 (54.5%) exhibiting sinonasal symptoms on the onset day. Seven patients (63.6%) demonstrated nasal obstruction, 5 (45.5%) had rhinorrhea, and 4 (36.4%) exhibited olfactory dysfunction. All six patients with sinonasal symptoms on the onset day had non-severe infections. Most patients (85.7%) with sinonasal symptoms had non-severe infections. Sinonasal symptoms commonly appeared early. The positive RT-PCR rate for SARS-CoV-2 in various specimens was highest in the first week (73.3%), then gradually decreased over the disease course, but 3 patients (27.3%) had experienced a long-lasting fluctuated positive RT-PCR results since 29 days of illness in both groups, especially for two patients with airway comorbidities.
Sinonasal symptoms were more prevalent in patients with mild or moderate COVID-19 and usually appeared early. In addition, regular nucleic acid testing for SARS-CoV-2 should be considered for COVID-19 patients with certain airway comorbidities.
据报道，鼻窦症状通常最初出现，这些症状对于2019冠状病毒病（COVID-19）的早期检测很重要。本研究进行回顾性分析，以纵向调查COVID-19患者中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的详细鼻窦表现及实时逆转录聚合酶链反应（RT-PCR）结果的动态变化情况。
这项回顾性研究纳入了11例连续患者。分析鼻窦表现的发生率、出现时间及严重程度。在COVID-19病程中收集口咽、鼻腔、痰液和粪便标本以检测SARS-CoV-2的RT-PCR情况。
11例患者中，6例（54.5%）为女性，中位年龄为51岁（四分位间距为36 - 62岁）。7例（63.6%）患者出现鼻窦症状，其中6例（54.5%）在发病当天出现鼻窦症状。7例（63.6%）患者出现鼻塞，5例（45.5%）有流涕，4例（36.4%）出现嗅觉障碍。发病当天出现鼻窦症状的所有6例患者均为非重症感染。大多数有鼻窦症状的患者（85.7%）为非重症感染。鼻窦症状通常较早出现。SARS-CoV-2在各种标本中的RT-PCR阳性率在第一周最高（73.3%），然后在病程中逐渐下降，但两组中有3例患者（27.3%）自发病29天起RT-PCR结果呈长期波动阳性，尤其是两名有气道合并症的患者。
鼻窦症状在轻度或中度COVID-19患者中更为常见，且通常较早出现。此外，对于患有某些气道合并症的COVID-19患者，应考虑定期进行SARS-CoV-2核酸检测。
