Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.
Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
J Intern Med. 2022 Jul;292(1):154-161. doi: 10.1111/joim.13470. Epub 2022 Mar 6.
The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS-CoV-2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID-19 patients seeking emergency care with symptoms similar to the life-threatening condition epiglottitis. Here, we present a case series and discuss management.
We performed a retrospective single-center case study of patients diagnosed with COVID-19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020-02579). Informed consent was obtained from all patients included in the study.
Twenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID-19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID-19-associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics.
Previous variants of SARS-CoV-2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID-19 patients.
本研究旨在呈现一种新型的 SARS-CoV-2 病毒奥密克戎变异株感染的临床表现，主要影响年轻、接种疫苗和健康的成年人。我们描述了一组新的 COVID-19 患者，他们因类似会危及生命的会厌炎的症状寻求紧急医疗护理。在此，我们提出了一系列病例并讨论了治疗方法。
我们对 2022 年 1 月 1 日至 1 月 23 日期间因急性咽痛、剧烈咽痛和发热等临床症状被转至耳鼻喉急诊（ENT ED）的 COVID-19 患者进行了回顾性单中心病例研究。该研究获得了瑞典伦理审查局的批准（2020-02579）。所有入组患者均获得了知情同意。
确定了符合纳入标准的 20 名患者。15 名患者已完全接种 COVID-19 疫苗。4 名患者因症状需要短期住院治疗。最常见的诊断是 COVID-19 相关急性病毒性喉气管炎和/或病毒性咽炎。6 名患者出现继发细菌感染迹象并接受了抗生素治疗。
以前的 SARS-CoV-2 变异株感染主要影响下呼吸道，并导致许多患者嗅觉和味觉丧失。奥密克戎变异株似乎主要影响上呼吸道并引起急性喉炎而没有嗅觉功能障碍。在一些患者中，临床表现类似于会厌炎的症状。在这种情况下，及时检查喉部是排除上呼吸道炎症性水肿的金标准。本研究中描述的患者均未发生会厌炎。在本研究中，我们讨论了 COVID-19 患者急性咽痛的治疗方法。
