Otolaryngology consultations for COVID-19 patients: A retrospective cohort study of indications, interventions, and considerations

Kunal R Shetty; Brady J Anderson; Jumah G Ahmad; Lucy X Liu; Kevin Chow; Samuel G Erickson; Shohan Shetty; Amber U Luong

doi:10.1016/j.anl.2022.08.002

Otolaryngology consultations for COVID-19 patients: A retrospective cohort study of indications, interventions, and considerations

Auris Nasus Larynx. 2023 Apr;50(2):292-298. doi: 10.1016/j.anl.2022.08.002. Epub 2022 Aug 4.

Authors

Kunal R Shetty¹, Brady J Anderson², Jumah G Ahmad³, Lucy X Liu⁴, Kevin Chow³, Samuel G Erickson⁵, Shohan Shetty⁶, Amber U Luong⁷

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States. Electronic address: kunal.r.shetty@uth.tmc.edu.
² Department of Otolaryngology-Head and Neck Surgery, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
³ Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
⁴ Department of Otolaryngology-Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA, United States.
⁵ Department of Otolaryngology-Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
⁶ Washington University in St. Louis, St. Louis, MO, United States.
⁷ Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States; Center for Immunology and Autoimmune Diseases, Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.

Abstract

Objective: To identify differences in inpatient otolaryngology consultations and interventions for patients based on COVID-19.

Methods: Records were reviewed for all patients for whom otolaryngology was consulted at a high-volume tertiary care hospital from April 30, 2020 to October 1, 2020. Demographic information, length of stay, COVID-19 status, indication for consultation, and otolaryngology interventions were recorded. Statistical analysis was performed using R software.

Results: Bleeding composed a significantly higher proportion of otolaryngology consults in COVID-19 positive patients (28% vs. 8.4%, p<0.0001). Management of bleeding was the most common procedure performed in positive patients (n=37, 35%), and they had a higher median number of interventions performed when compared to bleeding patients who tested negative (1, IQR 1-2 vs. 1, IQR 0-1, p=0.04). COVID-19 positive patients with bleeding were more likely to expire than those with other indications for otolaryngology consultation (50% vs. 7%, p<0.001).

Conclusion: Bleeding and associated interventions comprised the predominant discrepancy between COVID-19 positive and negative patients in our cohort. We encourage routine use of simple and cost-effective methods to decrease risk of bleeding.

Keywords: Anticoagulation; Covid-19; Epistaxis; Otolaryngology consults; Otorhinolaryngologic diseases.

MeSH terms

COVID-19*
Hemorrhage
Humans
Otolaryngology*
Referral and Consultation
Retrospective Studies