Straburzyński Marcin, Romaszko-Wojtowicz Anna
Department of Family Medicine and Infectious Diseases, Collegium Medicum, School of Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Department of Pulmonology, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Front Med (Lausanne). 2024 Aug 29;11:1447467. doi: 10.3389/fmed.2024.1447467. eCollection 2024.
Upper respiratory tract infections (URTIs) are among the most common reasons for patients consulting a general practitioner (GP) during the infectious diseases season, with viruses being the predominant cause. The COVID-19 pandemic has significantly impacted GPs' perception of these infections. The pandemic's progression, especially with the emergence of the Omicron variant, has complicated the diagnosis and treatment of URTIs, with evolving symptoms.
The aim of this study was to assess the differences in symptoms reported by patients with various infections, such as COVID-19, influenza, common cold, and post-viral rhinosinusitis, during the infectious diseases season of November 2023 to March 2024.
The study was conducted in a primary health care clinic, providing care for a population of approximately 10,000 people, among adult patients presenting with URTI symptoms during the 2023/2024 infectious diseases season. Patients qualified for the study were swabbed for SARS-CoV-2, influenza A and B and respiratory syncytial virus (RSV) antigens. Symptoms were assessed with the use of a semi-structured questionnaire.
Of the 1810 patients presenting with symptoms of URTIs, 276 patients were included in the study. Among patients with COVID-19, symptoms of nasal obstruction ( = 0.005) and nasal discharge ( = 0.001) were less common than in those with influenza or common cold. However, these nasal symptoms were significantly more frequent among patients with COVID-19 who had confirmed previous immunization (COVID-19 history or vaccination) ( = 0.028).
The incidence of individual sinonasal symptoms varies significantly depending on the aetiological agent of the URTI. This observation may not only help clinicians make the correct diagnosis, but also suggests an inflammatory response in the nasal mucosa and paranasal sinuses that is dependent on the aetiological agent. The study also indicates that this response is altered within the same virus species following immunization.
The study's limitations include a small sample size (276 patients), focus on one season and one GP practice, and reliance on clinical signs and antigen tests. Nonetheless, the findings provide valuable insights. Further research with larger patient groups and extended follow-up periods is required to confirm these findings.
上呼吸道感染（URTIs）是传染病季节患者咨询全科医生（GP）的最常见原因之一，病毒是主要病因。新冠疫情对全科医生对这些感染的认知产生了重大影响。疫情的发展，尤其是奥密克戎变种的出现，使上呼吸道感染的诊断和治疗变得复杂，症状也不断演变。
本研究的目的是评估2023年11月至2024年3月传染病季节期间，患有各种感染（如新冠、流感、普通感冒和病毒感染后鼻窦炎）的患者报告的症状差异。
该研究在一家初级保健诊所进行，为约10000人的人群提供护理，研究对象为2023/2024传染病季节出现上呼吸道感染症状的成年患者。符合研究条件的患者接受了新冠病毒、甲型和乙型流感病毒以及呼吸道合胞病毒（RSV）抗原的拭子检测。使用半结构化问卷评估症状。
在1810名出现上呼吸道感染症状的患者中，276名患者被纳入研究。在新冠患者中，鼻塞（P = 0.005）和流涕（P = 0.001）症状比流感或普通感冒患者少见。然而，在之前已确认免疫（有新冠病史或接种过疫苗）的新冠患者中，这些鼻部症状明显更频繁（P = 0.028）。
根据上呼吸道感染的病原体不同，各个鼻窦症状的发生率有显著差异。这一观察结果不仅有助于临床医生做出正确诊断，还表明鼻黏膜和鼻窦的炎症反应取决于病原体。该研究还表明，免疫后同一病毒种类内的这种反应会发生改变。
该研究的局限性包括样本量小（276名患者）、关注一个季节和一家全科医生诊所，以及依赖临床体征和抗原检测。尽管如此，这些发现提供了有价值的见解。需要对更大的患者群体进行进一步研究并延长随访期以证实这些发现。
