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2020 ; 163
(1
): 121-131
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Approaching Otolaryngology Patients During the COVID-19 Pandemic
#MMPMID32396445
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
; Denneny JC 3rd
; Shu Y
; Liu X
Otolaryngol Head Neck Surg
2020[Jul]; 163
(1
): 121-131
PMID32396445
show ga
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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