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European Archives of Oto-Rhino-Laryngology

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01-06-2021 | COVID-19 | Rhinology

Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study

Authors: Mehtap Koparal, Ercan Kurt, Emine Elif Altuntas, Fatih Dogan

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2021

Abstract

Purpose

We assessed the effects of COVID-19 infection on nasal mucociliary activity.

Methods

The study was conducted in the pandemic wards of Adiyaman University Training and Research Hospital during April and May 2020. All patients admitted to the COVID-19 pandemic wards during the study period were invited to participate in the study. The study included 40 adults who agreed to participate and underwent a mucociliary clearance test successfully. The primary outcome was mucociliary clearance time and the secondary variables of interest were age, sex, and sino-nasal outcome test-22 scores. The control group included 40 concomitant healthy patients who visited the outpatient ear, nose and throat clinic with non-nasal symptoms.

Results

The study included 40 COVID-19-positive patients and 40 healthy controls. The mean mucociliary clearance times of the study (15.53 ± 5.57 min) and control (9.50 ± 3.70 min) groups were significantly different (Z = 4.675, p < 0.001). However, the mucociliary clearance time was not significantly different between males and females (t = 0.590, p = 0.558).

Conclusions

Nasal mucociliary clearance time was prolonged in COVID-19 patients compared to healthy controls. Thus, we conclude that smell and taste are crucial symptoms that should not be overlooked in patients suspected of COVID-19 disease.

Lescure FX, Bouadma L, Nguyen D et al (2020) Clinical and virological data of the first cases of COVID-19 in Europe: a case series. Lancet Infect Dis 20(6):697–706. https://doi.org/10.1016/S1473-3099(20)30200-0CrossRefPubMedPubMedCentral

WHO (2020) Rolling updates on coronavirus disease (COVID-19). WHO, Geneva

Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS (2020) Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol 10(7):806–813. https://doi.org/10.1002/alr.22579CrossRefPubMed

Duran M, Ulkü CH (2014) Effect of radiofrequency thermal ablation treatment on nasal mucociliary clearance in patients with isolated inferior turbinate hypertrophy. Kulak Burun Bogaz Ihtis Derg 24(4):185–189. https://doi.org/10.5606/kbbihtisas.2014.58998CrossRefPubMed

Kesimci E, Bercin S, Kutluhan A, Ural A, Yamanturk B, Kanbak O (2008) Volatile anesthetics and mucociliary clearance. Minerva Anestesiol 74(4):107–111PubMed

Jones N (2001) The nose and paranasal sinuses physiology and anatomy. Adv Drug Deliv Rev 51(1–3):5–19. https://doi.org/10.1016/s0169-409x(01)00172-7CrossRefPubMed

Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191. https://doi.org/10.3758/bf03193146CrossRefPubMed

Hancı D, Altun H, Sahin E, Altıntoprak N, Cingi C (2015) Turkish translation, cross-cultural adaptation and validation of the SinoNasal Outcome Test (SNOT)-22. ENT Updat 5(2):51–57. https://doi.org/10.2399/jmu.2015002001CrossRef

Asai K, Haruna S, Otori N, Yanagi K, Fukami M, Moriyama H (2000) Saccharin test of maxillary sinus mucociliary function after endoscopic sinus surgery. Laryngoscope 110(1):117–122. https://doi.org/10.1097/00005537-200001000-00021CrossRefPubMed

10.

Greenstone M, Cole PJ (1985) Ciliary function in health and disease. Br J Dis Chest 79(1):9–26. https://doi.org/10.1016/0007-0971(85)90003-8CrossRefPubMed

11.

Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP (2009) Psychometric validity of the 22-item sinonasal outcome test. Clin Otolaryngol 34(5):447–454. https://doi.org/10.1111/j.1749-4486.2009.01995.xCrossRefPubMed

12.

Wang L, Wang Y, Ye D, Liu Q (2020) Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents 55(6):105948. https://doi.org/10.1016/j.ijantimicag.2020.105948CrossRefPubMedPubMedCentral

13.

Yang J, Zheng Y, Gou X et al (2020) Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 94:91–95. https://doi.org/10.1016/j.ijid.2020.03.017CrossRefPubMedPubMedCentral

14.

Palaiodimos L, Kokkinidis DG, Li W et al (2020) Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx. New York Metab 108:154262. https://doi.org/10.1016/j.metabol.2020.154262CrossRef

15.

Fu L, Fei J, Xiang HX et al (2020) Analysis of death risk factors among 200 COVID-19 patients in Wuhan, China: a hospital-based case-cohort study. Lancet Respir Med. https://doi.org/10.2139/ssrn.3551430CrossRefPubMed

16.

Kao CH, Jiang RS, Wang SJ, Yeh SH (1994) Influence of age, gender, and ethnicity on nasal mucociliary clearance function. Clin Nucl Med 19(9):813–816. https://doi.org/10.1097/00003072-199409000-00015CrossRefPubMed

17.

Mortensen J, Lange P, Nyboe J, Groth S (1994) Lung mucociliary clearance. Eur J Nucl Med 21(9):953–961. https://doi.org/10.1007/BF00238119CrossRefPubMed

18.

Petrov VV (2016) Age features of mucociliary system the mucous membrane of the nasal cavity of the human. Adv Gerontol 29(3):507–510PubMed

19.

Lale AM, Mason JD, Jones NS (1998) Mucociliary transport and its assessment: a review. Clin Otolaryngol Allied Sci 23(5):388–396. https://doi.org/10.1046/j.1365-2273.1998.00173.xCrossRefPubMed

20.

De España R, Franch M, García A, Pavía J (1986) Measurement of nasal mucociliary transport rate in normal man. Rhinology 24(4):241–247PubMed

21.

Yergin BM, Saketkhoo K, Michaelson ED, Serafini SM, Kovitz K, Sackner MA (1978) A roentgenographic method for measuring nasal mucous velocity. J Appl Physiol Respir Environ Exerc Physiol 44(6):964–968. https://doi.org/10.1152/jappl.1978.44.6.964CrossRefPubMed

22.

Izquierdo-Dominguez A, Rojas-Lechuga MJ, Mullol J, Alobid I (2020) Olfactory dysfunction in the COVID-19 outbreak. J Investig Allergol Clin Immunol. https://doi.org/10.18176/jiaci.0567CrossRefPubMed

23.

Jaume F, Quintó L, Alobid I, Mullol J (2018) Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study). BMJ Open 8(1):e018788. https://doi.org/10.1136/bmjopen-2017-018788CrossRefPubMedPubMedCentral

24.

Brann DH, Tsukahara T, Weinreb C, Lipovsek M, Van den Berge K, Gong B et al (2020) Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv 5801:1–29. https://doi.org/10.1126/sciadv.abc5801CrossRef

25.

Stannard W, O’Callaghan C (2006) Ciliary function and the role of cilia in clearance. J Aerosol Med 19(1):110–115. https://doi.org/10.1089/jam.2006.19.110CrossRefPubMed

26.

Bustamante-Marin XM, Ostrowski LE (2017) Cilia and mucociliary clearance. Cold Spring Harb Perspect Biol 9(4):a028241. https://doi.org/10.1101/cshperspect.a028241CrossRefPubMedPubMedCentral

27.

Chinnapaiyan S, Parira T, Dutta R et al (2017) HIV infects bronchial epithelium and suppresses components of the mucociliary clearance apparatus. PLoS ONE 12(1):e0169161. https://doi.org/10.1371/journal.pone.0169161CrossRefPubMedPubMedCentral

28.

Durmuş K, Engin A, Karataş TD, Gözel MG, Altuntas EE (2017) Determination of nasal mucociliary clearance time and nasal symptom in patients with Crimean-Congo hemorrhagic fever. J Med Virol 89(6):960–965. https://doi.org/10.1002/jmv.24727CrossRefPubMed

29.

Alho OP (2004) Nasal airflow, mucociliary clearance, and sinus functioning during viral colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis. Am J Rhinol 18(6):349–355CrossRef

30.

Scambler T, Jarosz-Griffiths HH, Lara-Reyna S et al (2019) ENaC-mediated sodium influx exacerbates NLRP3-dependent inflammation in cystic fibrosis. Elife 8:e49248. https://doi.org/10.7554/eLife.49248CrossRefPubMedPubMedCentral

31.

Lee Y, Min P, Lee S, Kim SW (2020) Prevalence and duration of acute loss of smell or taste in COVID-19 patients. J Korean Med Sci 35(18):e174. https://doi.org/10.3346/jkms.2020.35.e174CrossRefPubMedPubMedCentral

Title: Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study
Authors: Mehtap Koparal
Ercan Kurt
Emine Elif Altuntas
Fatih Dogan
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keyword: COVID-19
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06457-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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