ENT Manifestations of COVID-19 in a Dedicated Covid Hospital: Prospective Observational Study

Abstract

Background: The Coronavirus disease (COVID-19) is global challenge to public health. The study investigates all possible manifestations and their prevalence pertaining to ENT in COVID-19 in our cohort.
Methodology: Admitted laboratory-confirmed COVID-19 positive patients who fulfilled the inclusion and exclusion criteria will be randomly selected for a cross-sectional observational study. On the day of admission, various ENT symptoms are assessed and patients were prospectively studied by detailed ENT examination by using specific and measurable parameters like smell and taste sensation, vertigo, swallowing, voice, and hearing, using scoring scales. The patients were followed up on day 1, 3 and 7, 14, 21 and 28 days.
Results: There were 308 number of patients, 211(68.5%) were of male gender while 97(31.5%) number of patients were of female gender. In our cohort 256(83.1%) patients were of mild severity and 52(16.9%) patients were of moderate severity of COVID 19. 269(87.34%) patients had ENT manifestations and 39 (12.66%) had non-ENT manifestations. Most of these patients are having occult ENT manifestations, 263(97.77%). Association of ENT manifestations with COVID 19 severity is significant with a p value of 0.001. Greater the COVID 19 severity, greater was the ENT manifestations except for sore throat and vertigo. The prevalence of loss of taste is 250 (81.97%) is higher comparing to other occult symptoms. A colour coded check list has been proposed considering the COVID 19 severity and frequency of ENT manifestation.
Conclusion: Based on our study results, it implies that the overall prevalence of ENT manifestations in COVID 19 in our cohort is very high upwards of 87.3 % (269 patients in 308) and most of these patients are having occult ENT manifestations 263(97.77%) where in the patients themselves have not come with these chief complaints but on detailed enquiry and examination these manifestations have been detected. Hence it is prudent to include these symptoms in routine history taking and examination screening in fever clinic and at triage sites for early detection and appropriate COVID 19 directed treatments. The frequency of ENT manifestations in order of occurrence in mild COVID 19 cases were loss of taste 207(80.86%), loss of smell 142(55.47%), change of voice 32(12.50%), vertigo 17(6.64%), hearing deficit 1 (0.39%). The frequency of ENT manifestations in order of occurrence in moderate COVID 19 cases were loss of taste 46(88.46%), loss of smell 36(69.23%), swallowing difficulty 18(34.62%), hearing deficit 9(17.3%), change of voice 7(13.46%), vertigo 5(9.62%).(Clinical Trials Registry India number: CTRI/2020/10/028362)