Epistaxis as a marker for severe acute respiratory syndrome coronavirus-2 status - a prospective study

J Laryngol Otol. 2020 Aug;134(8):717-720. doi: 10.1017/S0022215120001863. Epub 2020 Aug 25.

Abstract

Objective: To evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 infection in patients presenting with epistaxis to a tertiary otolaryngology unit.

Methods: A prospective study was conducted of 40 consecutive patients presenting with epistaxis referred to our tertiary otolaryngology unit. A group of 40 age-matched controls were also included. All patients underwent real-time reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2. Symptoms of fever, cough and anosmia were noted in the study group.

Results: The mean age was 66.5 ± 22.4 years in the study group. There were 22 males (55 per cent) and 18 females (45 per cent). The mean age in the control group was 66.3 ± 22.4 years (p = 0.935). There were six positive cases for severe acute respiratory syndrome coronavirus-2 (15 per cent) in the epistaxis group and one case (2.5 per cent) in the control group. The difference was statistically significant (p = 0.05).

Conclusion: Epistaxis may represent a presenting symptom of severe acute respiratory syndrome coronavirus-2 infection. This may serve as a useful additional criterion for screening patients.

Keywords: COVID-19; Coronavirus; Epistaxis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus / genetics*
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Case-Control Studies
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / virology
  • Cough / diagnosis
  • Cough / virology
  • Epistaxis / diagnosis*
  • Epistaxis / epidemiology
  • Epistaxis / virology
  • Female
  • Fever / diagnosis
  • Fever / virology
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / diagnosis
  • Olfaction Disorders / virology
  • Otolaryngology / standards
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Prevalence
  • Prospective Studies
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2
  • Tertiary Care Centers / standards
  • United Kingdom / epidemiology