Table 2.
Managements of COVID-19 Patients With Otolaryngologic Complaints.
| Complaints and symptoms consulted by otolaryngologists | Therapy for COVID-19 before consultation | Therapy for ENT symptoms | Length of intubation | Complications of treatment | Posttreatment outcome | Medical protection class for ENTs | ENT infectiona |
|---|---|---|---|---|---|---|---|
| Tracheotomy (n = 7)b | |||||||
| Prolonged intubation for 16 days, intra-airway bleeding | Intubation, CRRT, ECMO | PDT | 16 days | None | Deceased 19 days later | Third level | None |
| Prolonged intubation for 10 days | High-flow oxygen, intubation | PDT | 10 days | None | Improved but still hospitalized | Third level | None |
| Prolonged intubation for 10 days | Intubation | PDT | 10 days | Lung secretions, discharge | Improved but still hospitalized | Third level | None |
| Prevention of hypostatic pneumonia | None | ST | None | None | Lung infection recovered, comatose | Third level | None |
| Dyspnea after extubation | High-flow oxygen, noninvasive assisted ventilation, intubation, CRRT | ST | 17 days | None | Comatose | Third level | None |
| Repeated extubation, then intra-airway bleeding | Noninvasive assisted ventilation, intubation, ECMO | ST (×2) | 10 days | Intra-airway hemorrhage on day 9 after the first ST, epistaxis occurred on day 7 after the second tracheotomy | Died of cardiac arrest during a lung transplant 10 days after the second ST | Third level | None |
| Epistaxis (n = 6) | |||||||
| Unilateral (3) | Noninvasive assisted ventilation (2), nasal high-flow oxygen (1) | Hemostasis with packing | None | Hemoptysis (3) | Resolution of epistaxis (3) | Third level | None |
| Bilateral (3) | Noninvasive assisted ventilation (1), nasal high-flow oxygen (1) | Hemostasis with packing | None | Hemoptysis (2) | Resolution of epistaxis (2) | Third level | None |
| ECMO (1) | Hemostasis with packing | None | None | Resolution of epistaxis, comatose (1) | Third level | None | |
| Pharyngitis (n = 2) | Noninvasive assisted ventilation (2), CRRT (1), ECMO (1) | Compound borax mouthwash (1), compound chlorhexidine mouthwash (1) | None | Pharyngeal reflex (1) | Symptoms alleviated (2) | Third level (Wuhan)/second level (Shenzhen) | None |
| Nasal congestion (n = 1) | None | Oxymetazoline nasal spray | None | Sneeze | Symptoms alleviated | Third level (Wuhan) | None |
| Nasal congestion and hyposmia (n = 1) | None | Renault Court nasal spray | None | None | Nasal congestion alleviated, hyposmia not alleviated | Second level (Shenzhen) | None |
| Rhinitis (n = 1) | Nasal high-flow oxygen | Fluticasone propionate nasal spray | None | Sneeze | Symptoms alleviated | Third level (Wuhan) | None |
| Dizziness and tinnitus (n = 1) | Nasal high-flow oxygen | Betahistine in remission | None | None | Symptoms alleviated | Third level (Wuhan) | None |
| Otitis externa (n = 1) | Noninvasive assisted ventilation | Mupirocin | None | None | Symptoms alleviated | Third level (Wuhan) | None |
Abbreviations: COVID-19, coronavirus disease 2019; CRRT, continuous renal replacement therapy; ECMO, extracorporeal membrane oxygenation; ENT, ear, nose, and throat department; PDT, percutaneous dilational tracheostomy; ST, surgical tracheostomy.
a
Health care workers (HCWs) in Wuhan and Shenzhen took their temperature 4 times every day and took nucleic acid tests twice spanning a 24-hour period. HCWs in Shanghai took their temperature twice every day and took nucleic acid tests on days 7, 12, and 14.
b
One patient declined tracheotomy after comprehensive assessment of the patient’s condition.