Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden

Objective The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS‐CoV‐2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID‐19 patients seeking emergency care with symptoms similar to the li...

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Bibliographic Details
Published in:Journal of internal medicine Vol. 292; no. 1; pp. 154 - 161
Main Authors: Piersiala, Krzysztof, Kakabas, Lara, Bruckova, Anna, Starkhammar, Magnus, Cardell, Lars Olaf
Format: Journal Article
Language:English
Published: England Blackwell Publishing Ltd 01-07-2022
John Wiley and Sons Inc
Subjects:
Adult
Antibiotics
Bacterial diseases
Brief Report
Brief Reports
COVID-19
COVID-19 - complications
COVID-19 - diagnosis
COVID-19 vaccines
Edema
Emergency medical care
Emergency medical services
Epiglottitis
Ethics
Fever
Humans
Infections
Inflammation
Informed consent
Laryngitis
Laryngotracheitis
Larynx
Medicin och hälsovetenskap
Olfaction
Omicron
Pain
Patients
Pharyngitis
Respiratory tract
Retrospective Studies
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Smell
Sweden - epidemiology
Viral diseases
Viruses
Sweden
COVID-19
laryngitis
SARS-CoV-2
Omicron
epiglottitis
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Summary:Objective The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS‐CoV‐2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID‐19 patients seeking emergency care with symptoms similar to the life‐threatening condition epiglottitis. Here, we present a case series and discuss management. Methods We performed a retrospective single‐center case study of patients diagnosed with COVID‐19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020‐02579). Informed consent was obtained from all patients included in the study. Results Twenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID‐19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID‐19‐associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics. Conclusion Previous variants of SARS‐CoV‐2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID‐19 patients.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:0954-6820
1365-2796
1365-2796
DOI:10.1111/joim.13470