International forum of allergy & rhinology
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Int Forum Allergy Rhinol · Oct 2020
ReviewReview of Indoor Aerosol Generation, Transport and Control in the Context of COVID-19.
The coronavirus disease-2019 (COVID-19) pandemic has heightened the awareness of aerosol generation by human expiratory events and their potential role in viral respiratory disease transmission. Concerns over high severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) viral burden of mucosal surfaces has raised questions about the aerosol-generating potential and dangers of many otorhinolaryngologic procedures. However, the risks of aerosol generation and associated viral transmission by droplet or airborne routes for many otorhinolaryngology procedures are largely unknown. ⋯ Herein we elaborate on known aerosol vs droplet properties, indoor airflow, and aerosol-generating events to provide context for risks of aerosol infectious transmission. We also provide simple but typically effective measures for mitigating the spread and inhalation of viral aerosols in indoor settings. Understanding principles of infectious transmission, aerosol and droplet generation, as well as concepts of indoor airflow, will assist in the integration of new data on SARS-CoV-2 transmission and activities that can generate aerosol to best inform on the need for escalation or de-escalation from current societal and institutional guidelines for protection during aerosol-generating procedures.
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Int Forum Allergy Rhinol · Aug 2020
ReviewSkull-base surgery during the COVID-19 pandemic: the Italian Skull Base Society recommendations.
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is highly contagious with devastating impacts for healthcare systems worldwide. Medical staff are at high risk of viral contamination and it is imperative to know what personal protective equipment (PPE) is appropriate for each situation. Furthermore, elective clinics and operations have been reduced in order to mobilize manpower to the acute specialties combating the outbreak; appropriate differentiation between patients who require immediate care and those who can receive telephone consultation or whose treatment might viably be postponed is therefore crucial. ⋯ In all cases the use of drills, which promote the aerosolization of potentially infected mucous particles, should be avoided. Given the potential neurotropism of SARS-CoV-2, dura handling should be minimized. It is only through widely-agreed protocols and teamwork that we will be able to deal with the evolving and complex implications of this new pandemic.
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Int Forum Allergy Rhinol · Jul 2020
ReviewA primer on viral-associated olfactory loss in the era of COVID-19.
Early reports have suggested that smell loss may be an early symptom associated with the pandemic known as coronavirus disease 2019 (COVID-19). The possibility that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might cause olfactory dysfunction is certainly plausible. Patients presenting to specialized smell clinics are commonly diagnosed with upper respiratory infection (URI)-associated olfactory loss and most are presumed to be viral related. ⋯ This review provides a brief, practical overview of viral-associated olfactory loss, realizing that evidence related to COVID-19 will likely not be clear for some time. Our goal is to highlight the existence and importance of this condition and provide information geared for both providers and patients. Practical suggestions regarding evaluation and treatment will be provided, realizing that there may be constraints on medical resources and the nature of this pandemic remains dynamic.