Upper respiratory tract and otolaryngological manifestations of coronavirus disease 2019 (COVID-19): A systemic review

Abstract

To detect, analyze, and discuss the different ear nose throat manifestations, those were reported in coronavirus disease-positive patients in the published and reviewed literature. Coronavirus disease has been reported to present with several symptoms. Common symptoms include new onset of fever, cough, fatigue, and myalgia. Other symptoms like sputum production, dyspnea, rhinorrhea, anosmia, nasal stuffiness, headache, and sore throat are less frequently reported, but the clinical presentation is highly variable among individuals. We review the otolaryngologic manifestations of coronavirus disease reported in the published literature to assess its importance in the early diagnosis of coronavirus disease. We searched PubMed database, MEDLINE, Web of Science, LILACS, SciELO, and Cochrane Library to find out relevant articles, using the following keywords: COVID-19, clinical features, characteristics, symptoms, clinical, manifestations, throat, cough, rhinorrhea, COVID-19 anosmia, headache, nasal, coronavirus, and coronavirus otolaryngologic. Article selection was based on their relevance to the research question. Totally, 14 articles and 2971 patients were recruited for our study. A wide variety of upper and lower airway manifestations were reported. Fever (34%-96.5%), cough (17.9%-83%), myalgia or fatigue (10%-31%), expectoration (20%-32.7%), dyspnea (7.6%-7.5%), rhinorrhea (1%-6.8%), sore throat (4%-61%), nasal congestion (3%-4.8%), and headache (3%-16.2%) were the most common symptoms reported. Our findings confirm that coronavirus disease infection presents with a wide spectrum of clinical presentation. The ear nose throat manifestations for coronavirus disease are not uncommon, but more attention should also be paid to patients with otolaryngologic symptoms which can appear early, as this could encourage an earlier diagnosis and treatment, which limits spread of the disease.

Keywords: Anosmia; COVID-19; clinical features; coronavirus; cough; ear nose throat; headache; manifestation; otolaryngologic; rhinorrhea; symptoms; throat.

PRISMA Flow Diagram.

Figure 1.

Male-to-female ratio in different studies.

Figure 2.

Median age of patients under study.

Figure 3.

Source of data.

Figure 4.

Maximally reported percentage of symptoms in different studies.