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Approaching Otolaryngology Patients During the COVID-19 Pandemic.
Otolaryngol Head Neck Surg. 2020 07; 163(1):121-131.OH

Abstract

Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.

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Authors+Show Affiliations

Cui C
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Yao Q
Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhang D
Department of Otolaryngology, The Third People's Hospital of Shenzhen, Longgang District, Shenzhen, China.
Zhao Y
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Zhang K
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Nisenbaum E
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Cao P
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China. Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China.
Zhao K
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China. Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China.
Huang X
Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Leng D
Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Liu C
Department of Otolaryngology, The Third People's Hospital of Shenzhen, Longgang District, Shenzhen, China.
Li N
Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China.
Luo Y
Department of Hospital-Acquired Infection Control, Eye and ENT Hospital, Fudan University, Shanghai, China.
Chen B
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Casiano R
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Weed D
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Sargi Z
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Telischi F
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Lu H
Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China.
Denneny JC
American Academy of Otolaryngology-Head and Neck Surgery, Alexandria, Virginia, USA.
Shu Y
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Liu X
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.

MeSH

AdultAgedBetacoronavirusCOVID-19ChinaCoronavirus InfectionsDisease Transmission, InfectiousFemaleHumansMaleMiddle AgedOtolaryngologyOtorhinolaryngologic DiseasesPandemicsPersonal Protective EquipmentPneumonia, ViralRetrospective StudiesSARS-CoV-2

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32396445

Citation

Cui, Chong, et al. "Approaching Otolaryngology Patients During the COVID-19 Pandemic." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 163, no. 1, 2020, pp. 121-131.
Cui C, Yao Q, Zhang D, et al. Approaching Otolaryngology Patients During the COVID-19 Pandemic. Otolaryngol Head Neck Surg. 2020;163(1):121-131.
Cui, C., Yao, Q., Zhang, D., Zhao, Y., Zhang, K., Nisenbaum, E., Cao, P., Zhao, K., Huang, X., Leng, D., Liu, C., Li, N., Luo, Y., Chen, B., Casiano, R., Weed, D., Sargi, Z., Telischi, F., Lu, H., ... Liu, X. (2020). Approaching Otolaryngology Patients During the COVID-19 Pandemic. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 163(1), 121-131. https://doi.org/10.1177/0194599820926144
Cui C, et al. Approaching Otolaryngology Patients During the COVID-19 Pandemic. Otolaryngol Head Neck Surg. 2020;163(1):121-131. PubMed PMID: 32396445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Approaching Otolaryngology Patients During the COVID-19 Pandemic. AU - Cui,Chong, AU - Yao,Qi, AU - Zhang,Di, AU - Zhao,Yu, AU - Zhang,Kun, AU - Nisenbaum,Eric, AU - Cao,Pengyu, AU - Zhao,Keqing, AU - Huang,Xiaolong, AU - Leng,Dewen, AU - Liu,Chunhan, AU - Li,Ning, AU - Luo,Yan, AU - Chen,Bing, AU - Casiano,Roy, AU - Weed,Donald, AU - Sargi,Zoukaa, AU - Telischi,Fred, AU - Lu,Hongzhou, AU - Denneny,James C,3rd AU - Shu,Yilai, AU - Liu,Xuezhong, Y1 - 2020/05/12/ PY - 2020/5/13/pubmed PY - 2020/7/16/medline PY - 2020/5/13/entrez KW - COVID-19 KW - SARS-CoV-2 KW - health care worker (HCW) KW - infection control measures KW - personal protective equipment (PPE) KW - preexamination KW - tracheotomy SP - 121 EP - 131 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 163 IS - 1 N2 - Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/32396445/Approaching_Otolaryngology_Patients_During_the_COVID_19_Pandemic_ DB - PRIME DP - Unbound Medicine ER -