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2020 ; 42
(6
): 1259-1267
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology
and head and neck surgery practice
#MMPMID32270581
Kowalski LP
; Sanabria A
; Ridge JA
; Ng WT
; de Bree R
; Rinaldo A
; Takes RP
; Mäkitie AA
; Carvalho AL
; Bradford CR
; Paleri V
; Hartl DM
; Vander Poorten V
; Nixon IJ
; Piazza C
; Lacy PD
; Rodrigo JP
; Guntinas-Lichius O
; Mendenhall WM
; D'Cruz A
; Lee AWM
; Ferlito A
Head Neck
2020[Jun]; 42
(6
): 1259-1267
PMID32270581
show ga
The 2019 novel coronavirus disease (COVID-19) is a highly contagious zoonosis
produced by SARS-CoV-2 that is spread human-to-human by respiratory secretions.
It was declared by the WHO as a public health emergency. The most susceptible
populations, needing mechanical ventilation, are the elderly and people with
associated comorbidities. There is an important risk of contagion for
anesthetists, dentists, head and neck surgeons, maxillofacial surgeons,
ophthalmologists, and otolaryngologists. Health workers represent between 3.8%
and 20% of the infected population; some 15% will develop severe complaints and
among them, many will lose their lives. A large number of patients do not have
overt signs and symptoms (fever/respiratory), yet pose a real risk to surgeons
(who should know this fact and must therefore apply respiratory protective
strategies for all patients they encounter). All interventions that have the
potential to aerosolize aerodigestive secretions should be avoided or used only
when mandatory. Health workers who are: pregnant, over 55 to 65?years of age,
with a history of chronic diseases (uncontrolled hypertension, diabetes mellitus,
chronic obstructive pulmonary diseases, and all clinical scenarios where
immunosuppression is feasible, including that induced to treat chronic
inflammatory conditions and organ transplants) should avoid the clinical
attention of a potentially infected patient. Health care facilities should
prioritize urgent and emergency visits and procedures until the present condition
stabilizes; truly elective care should cease and discussed on a case-by-case
basis for patients with cancer. For those who are working with COVID-19 infected
patients' isolation is compulsory in the following settings: (a) unprotected
close contact with COVID-19 pneumonia patients; (b) onset of fever, cough,
shortness of breath, and other symptoms (gastrointestinal complaints, anosmia,
and dysgeusia have been reported in a minority of cases). For any care or
intervention in the upper aerodigestive tract region, irrespective of the setting
and a confirmed diagnosis (eg, rhinoscopy or flexible laryngoscopy in the
outpatient setting and tracheostomy or rigid endoscopy under anesthesia), it is
strongly recommended that all health care personnel wear personal protective
equipment such as N95, gown, cap, eye protection, and gloves. The procedures
described are essential in trying to maintain safety of health care workers
during COVID-19 pandemic. In particular, otolaryngologists, head and neck, and
maxillofacial surgeons are per se exposed to the greatest risk of infection while
caring for COVID-19 positive subjects, and their protection should be considered
a priority in the present circumstances.