COVID-19 findings revealed via otolaryngological examination: Findings of a Japan Otorhinolaryngologist Association questionnaire

• Published in: Auris, nasus, larynx Vol. 48; no. 6; pp. 1176 - 1180
• Main Authors: Kimura, Yurika, Nogami, Kenichiro, Watanabe, Kazuo, Yoshimura, Tadashi, Asai, Hideyo, Fujioka, Osamu, Kawasaki, Yoshiaki, Igarashi, Mitsuru, Inamura, Naoki, Kawashima, Kayoko, Nishino, Hiroshi, Fukuyo, Kazumasa
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2021; Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V
• Subjects: Centor score; COVID-19; Olfactory disturbances; Otolaryngological findings; COVID-19; Olfactory disturbances; Otolaryngological findings; Centor score
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2021.05.010

In Japan, many otolaryngologists provide primary care for patients with coronavirus disease 2019 (COVID-19). The purpose of this study was to analyze the characteristics of otorhinolaryngological findings in order to improve COVID-19 diagnostic systems in a primary care setting. A total of 351 patients (mean age, 36.0 ± 15.4 years) diagnosed with COVID-19 by otolaryngologists who belong to the Japan Otorhinolaryngologists Association were included in the study. A web-based questionnaire was used to collect information regarding the timing of positive identification of COVID-19, the route of infection, symptoms, and findings in the tonsils, nasal cavity, pharynx, ear, and neck. A modified Centor score was calculated for cases in which age, symptoms, and tonsil and neck findings were described. Symptoms included fever (56%), olfactory disturbance (46%), and a sore throat (56%). Of the individuals considered, 63% had ordinary rhinoscopic findings, 21% experienced watery rhinorrhea, and 12% had observable mucosal redness. Further, 87% had ordinary tonsillar findings, 13% displayed tonsillar redness, with enlargement and white mucus observe in 2% and 1% of participants, respectively. A total of 193 patients had a calculated Centor score of 3 points in 2%, and scores of the remaining participants were ≤2 points. Of all patients considered, 40% had nasal findings and 4% had purulent nasal discharge. In contrast, only 13% of the patients had tonsillar findings, and no patients had Centor scores ≥4 points. Symptom differentiation from that of bacterial infections is difficult. In areas where COVID-19 is prevalent, the disease should be considered in patients presenting with fever, olfactory disturbances, and sore throat with minimal or no clinical findings in the nasal cavity and pharynx.