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Klimek L, Hagemann J, Huppertz T, Bärhold F, Albrecht T, Klimek F, Casper I, Cuevas M, Bergmann C, Becker S. COVID-19 and chronic rhinosinusitis: management and comorbidity - what have we learned? Expert Rev Clin Immunol 2023; 19:1399-1406. [PMID: 37551742 DOI: 10.1080/1744666x.2023.2244673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION Approximately 5%-12% of the population worldwide suffer from chronic rhinosinusitis (CRS). CRS is defined as a chronic respiratory disease and is considered to be a risk factor for COVID-19 patients. AREAS COVERED A non-systematic literature research was conducted on COVID-19 and treatment options for CRSwNP. The latest international publications in medical databases, international guidelines, and the internet were reviewed. Since there were no publications on all aspects of this topic during the pandemic, we included our own experience in this report. Based on the conducted literature research in addition to our previously reported experience, we discuss the treatment of CRSwNP during the COVID-19 pandemic and what can be taken for future pandemics. EXPERT OPINION Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Indications for surgical treatment of CRS should be critically evaluated and reserved for patients with complications and those with no other treatment options. For this purpose, COVID-19 status should be known if possible and, in case of unclear status (emergency), using appropriate personal protective equipment. Systemic corticosteroids should be avoided were possible. Biological treatment should be continued under careful monitoring in uninfected patients and should be temporarily interrupted during COVID-19 infection.
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Affiliation(s)
- L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - J Hagemann
- Department of Otorhinolaryngology, Mainz University Medical Center, Mainz, Germany
| | - T Huppertz
- Department of Otorhinolaryngology, Mainz University Medical Center, Mainz, Germany
| | - F Bärhold
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
| | - T Albrecht
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
| | - F Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - I Casper
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - M Cuevas
- Clinic and Polyclinic for Otorhinolaryngology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Bergmann
- Practice for Ear, Nose and Throat Medicine, Clinic RKM 740, Düsseldorf, Germany
| | - S Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
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Shomorony A, Chern A, Long SM, Feit NZ, Ballakur SS, Gadjiko M, Liu K, Skaf DA, Tassler AB, Sclafani AP. Essential inpatient otolaryngology: what COVID-19 has revealed. Eur Arch Otorhinolaryngol 2021; 279:1053-1062. [PMID: 34247264 PMCID: PMC8272617 DOI: 10.1007/s00405-021-06963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022]
Abstract
Purpose To identify areas of critical otolaryngology contributions to inpatient care resistant to disruption by the COVID-19 pandemic. Methods Medical records of 614 otolaryngology consults seen between January and June of 2019 and 602 seen between January and June of 2020 were reviewed. Extracted data included patient demographics, SARS-CoV-2 status, medical comorbidities, consult location, consult category, reason for consult, procedures performed, and overall outcome. Prevalence of data items was compared using t tests and Chi-squared tests. Results The number of monthly consults to the otolaryngology service remained approximately stable after the onset of the COVID-19 pandemic. However, there was a substantial increase in ICU consults and a decrease in ER and floor consults. The proportion of otology, rhinology, and head and neck consults decreased while that of airway consults—most of which were tracheostomy-related—greatly increased. While the top ten reasons for consult remained essentially the same, they dramatically increased as a percentage of consults during COVID-19 (55–92%), whereas there was a dramatic decrease in the proportion of less frequent consults. Conclusion The changes in otolaryngology consultation patterns seen after the onset of the pandemic are multifactorial, but may be attributed to novel pathologies, attitudes, and policies. Nonetheless, these patterns reveal that a set of core otolaryngologic issues, including acute airway issues, head and neck lesions, severe sinusitis and epistaxis, are essential and need to be addressed in the inpatient setting, whereas the significant drop in other consults suggests that they may be appropriately managed on an outpatient basis. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06963-7.
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Affiliation(s)
- Andre Shomorony
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America.
| | - Alexander Chern
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Sallie M Long
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Noah Z Feit
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Sarita S Ballakur
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Mariam Gadjiko
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Katie Liu
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Daniel A Skaf
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Andrew B Tassler
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
| | - Anthony P Sclafani
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medical Center, 1305 York Avenue, 5thFloor, New York, NY, 10021, United States of America
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