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Sinus, middle-ear and mastoid radiological findings of severe acute respiratory syndrome coronavirus-2

Published online by Cambridge University Press:  20 October 2022

E Watts
Affiliation:
Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
E Balai
Affiliation:
Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
D Kwatra
Affiliation:
Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
S Banerjee
Affiliation:
Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
E Hoskison*
Affiliation:
Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK
*
Author for correspondence: Ms Emma Hoskison, Department of ENT Surgery, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK E-mail: emma.hoskison@uhcw.nhs.uk

Abstract

Objective

To assess the incidence of radiological inflammation within the paranasal sinuses, middle ear and mastoid in patients with confirmed severe acute respiratory syndrome coronavirus-2.

Methods

A retrospective cohort study was conducted to examine consecutive adults (aged over 18 years) with coronavirus disease 2019 (confirmed on polymerase chain reaction within 7 days of imaging) who underwent computed tomography of the head between 1 March 2020 and 24 June 2020. Lund–Mackay and mastoid and middle-ear opacification scores were used to categorise the extent of sinus and mastoid opacification on axial and coronal computed tomography images.

Results

Of 147 patients originally identified, only 83 met the inclusion criteria. Sinus opacification was present in 51.8 per cent of patients (n = 43), and middle-ear or mastoid opacification was observed in 24.1 per cent (n = 20). There was no statistically significant difference in sinus or middle-ear and mastoid opacification between patients after stratification based on 30-day all-cause mortality.

Conclusion

Radiological computed tomography findings suggest mild mucosal disease within the sinuses, middle ear and mastoid. There was no statistical correlation between such opacification and 30-day mortality.

Type
Main Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Ms E Watts takes responsibility for the integrity of the content of the paper

References

Yamamoto, S, Saito, M, Tamura, A, Prawisuda, D, Mizutani, T, Yotsuyanagi, H. The human microbiome and COVID-19: a systematic review. PLoS One 2021;16:e0253293CrossRefGoogle ScholarPubMed
Cereda, PM, Pagani, L, Romero, E. Prevalence of antibody to human coronaviruses 229E, OC43 and neonatal calf diarrhea coronavirus (NCDCV) in patients of Northern Italy. Eur J Epidemiol 1986;2:112–17CrossRefGoogle ScholarPubMed
Liu, DX, Liang, JQ, Fung, TS. Human coronavirus-229E, -OC43, -NL63, and -HKU1 (Coronaviridae). In: Bamford, DH, Zuckerman, M, eds. Encyclopaedia of Virology, 4th edn. Cambridge, MA: Academic Press, 2021;428–40CrossRefGoogle Scholar
Su, S, Wong, G, Shi, W, Liu, J, Lai, ACK, Zhou, J et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol 2016;24:490502CrossRefGoogle ScholarPubMed
Zhou, F, Yu, T, Du, R, Fan, G, Liu, Y, Liu, Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–62CrossRefGoogle ScholarPubMed
Desforges, M, Gurdasani, D, Hamdy, A, Leonardi, AJ. Uncertainty around the long-term implications of COVID-19. Pathogens 2021;10:1267CrossRefGoogle ScholarPubMed
Li, Q, Guan, X, Wu, P, Wang, X, Zhou, L, Tong, Y et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382:1199–207CrossRefGoogle ScholarPubMed
Liaw, J, Saadi, R, Patel, VA, Isildak, H. Middle ear viral load considerations in the COVID-19 era: a systematic review. Otol Neurotol 2021;42:217–26CrossRefGoogle ScholarPubMed
Sungnak, W, Huang, N, Bécavin, C, Berg, M, Queen, R, Litvinukova, M et al. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 2020;26:681–7CrossRefGoogle ScholarPubMed
Zou, L, Ruan, F, Huang, M, Liang, L, Huang, H, Hong, Z et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020;382:1177–9CrossRefGoogle ScholarPubMed
Hasanoglu, I, Korukluoglu, G, Asilturk, D, Cosgun, Y, Kalem, AK, Altas, AB et al. Higher viral loads in asymptomatic COVID-19 patients might be the invisible part of the iceberg. Infection 2021;49:117–26CrossRefGoogle ScholarPubMed
Elkhatieb, A, Hipskind, G, Woerner, D, Hayden, FG. Middle ear abnormalities during natural rhinovirus colds in adults. J Infect Dis 1993;168:618–21CrossRefGoogle ScholarPubMed
Brennan, T, Saadia-Redleaf, M. Occult middle ear and mastoid fluid in acute otitis externa. Laryngoscope 2012;122:2067–70CrossRefGoogle ScholarPubMed
Bulut, Y, Güven, M, Otlu, B, Yenişehirli, G, Aladağ, I, Eyibilen, A et al. Acute otitis media and respiratory viruses. Eur J Pediatr 2007;166:223–8CrossRefGoogle ScholarPubMed
Pitkäranta, A, Jero, J, Arruda, E, Virolainen, A, Hayden, FG. Polymerase chain reaction-based detection of rhinovirus, respiratory syncytial virus, and coronavirus in otitis media with effusion. J Pediatr 1998;133:390–4CrossRefGoogle Scholar
Frazier, KM, Hooper, JE, Mostafa, HH, Stewart, CM. SARS-CoV-2 virus isolated from the mastoid and middle ear: implications for COVID-19 precautions during ear surgery. JAMA Otolaryngol Head Neck Surg 2020;146:964–6CrossRefGoogle ScholarPubMed
Koumpa, FS, Forde, CT, Manjaly, JG. Sudden irreversible hearing loss post COVID-19. BMJ Case Rep 2020;13:e238419CrossRefGoogle ScholarPubMed
Kilic, O, Kalcioglu, MT, Cag, Y, Tuysuz, O, Pektas, E, Caskurlu, H et al. Could sudden sensorineural hearing loss be the sole manifestation of COVID-19? An investigation into SARS-COV-2 in the etiology of sudden sensorineural hearing loss. Int J Infect Dis 2020;97:208–11CrossRefGoogle ScholarPubMed
Degen, C, Lenarz, T, Willenborg, K. Acute profound sensorineural hearing loss after COVID-19 pneumonia. Mayo Clin Proc 2020;95:1801–3CrossRefGoogle ScholarPubMed
Abdel, Rhman S, Abdel, Wahid A. COVID-19 and sudden sensorineural hearing loss, a case report. Otolaryngol Case Rep 2020;16:100198CrossRefGoogle Scholar
Mustafa, MWM. Audiological profile of asymptomatic Covid-19 PCR-positive cases. Am J Otolaryngol 2020;41:102483CrossRefGoogle ScholarPubMed
Sriwijitalai, W, Wiwanitkit, V. Hearing loss and COVID-19: a note. Am J Otolaryngol 2020;41:102473CrossRefGoogle ScholarPubMed
Brann, DH, Tsukahara, T, Weinreb, C, Lipovsek, M, Van den Berge, K, Gong, B et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv 2020;6:eabc5801CrossRefGoogle ScholarPubMed
Zhang, Q, Shan, KS, Abdollahi, S, Nace, T. Anosmia and ageusia as the only indicators of coronavirus disease 2019 (COVID-19). Cureus 2020;12:e7918Google ScholarPubMed
Mughal, Z, Charlton, A, Clark, M. The prevalence of incidental mastoid opacification and the need for intervention: a meta-analysis. Laryngoscope 2021;132:422–32CrossRefGoogle ScholarPubMed
Nazri, M, Bux, SI, Tengku-Kamalden, TF, Ng, KH, Sun, Z. Incidental detection of sinus mucosal abnormalities on CT and MRI imaging of the head. Quant Imaging Med Surg 2013;3:82–8Google Scholar
Naeini, AS, Karimi-Galougahi, M, Raad, N, Ghorbani, J, Taraghi, A, Haseli, S et al. Paranasal sinuses computed tomography findings in anosmia of COVID-19. Am J Otolaryngol 2020;41:102636CrossRefGoogle ScholarPubMed
Keshavarz, P, Haseli, S, Yazdanpanah, F, Bagheri, F, Raygani, N, Karimi-Galougahi, M. A systematic review of imaging studies in olfactory dysfunction secondary to COVID-19. Acad Radiol 2021;28:1530–40CrossRefGoogle ScholarPubMed
Moonis, G, Mitchell, R, Szeto, B, Lalwani, AK. Radiologic assessment of the sinonasal tract, nasopharynx and mastoid cavity in patients with SARS-Cov-2 infection presenting with acute neurological symptoms. Ann Otol Rhinol Laryngol 2021;130:1228–35CrossRefGoogle ScholarPubMed
İslamoğlu, Y, Ayhan, M, Bercin, S, Kalem, A, Kayaaslan, B, Güner, R. Evaluation of middle ear and mastoid cells of COVID-19 patients. J Ankara Univ Fac Med 2021;74:130–3CrossRefGoogle Scholar
Gwaltney, JM, Phillips, CD, Miller, RD, Riker, DK. Computed tomographic study of the common cold. N Engl J Med 1994;330:2530CrossRefGoogle ScholarPubMed
Lovato, A, de Filippis, C. Clinical presentation of COVID-19: a systematic review focusing on upper airway symptoms. Ear Nose Throat J 2020;99:569–76CrossRefGoogle ScholarPubMed
Huang, C, Wang, Y, Li, X, Ren, L, Zhao, J, Hu, Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497506CrossRefGoogle ScholarPubMed
Krajewska, J, Krajewski, W, Zub, K, Zatoński, T. COVID-19 in otolaryngologist practice: a review of current knowledge. Eur Arch Otorhinolaryngol 2020;277:1885–97CrossRefGoogle Scholar
Zhang, JJ, Dong, X, Cao, YY, Yuan, YD, Yang, YB, Yan, YQ et al. Clinical characteristics of 140 patients infected by SARS-CoV-2 in Wuhan, China. Allergy 2020;75:1730–41CrossRefGoogle ScholarPubMed
Laurendon, T, Radulesco, T, Mugnier, J, Gérault, M, Chagnaud, C, El Ahmadi, AA et al. Bilateral transient olfactory bulb edema during COVID-19-related anosmia. Neurology 2020;95:224–5CrossRefGoogle ScholarPubMed
Kandemirli, SG, Altundag, A, Yildirim, D, Tekcan Sanli, DE, Saatci, O. Olfactory bulb MRI and paranasal sinus CT findings in persistent COVID-19 anosmia. Acad Radiol 2021;28:2835CrossRefGoogle ScholarPubMed
Strauss, SB, Lantos, JE, Heier, LA, Shatzkes, DR, Phillips, CD. Olfactory bulb signal abnormality in patients with COVID-19 who present with neurologic symptoms. AJNR Am J Neuroradiol 2020;41:1882–7CrossRefGoogle ScholarPubMed
Kucirka, LM, Lauer, SA, Laeyendecker, O, Boon, D, Lessler, J. Variation in false-negative rate of reverse transcriptase polymerase chain reaction-based SARS-CoV-2 tests by time since exposure. Ann Intern Med 2020;173:262–7CrossRefGoogle ScholarPubMed
Walker, A, Pottinger, G, Scott, A, Hopkins, C. Anosmia and loss of smell in the era of covid-19. BMJ 2020;370:2808CrossRefGoogle ScholarPubMed