Recent Travel History Research Articles

S1801 Lost Sleep over Melatonin Induced Colitis

Introduction: Lymphocytic colitis (LC), a subtype of microscopic colitis, is an uncommon cause of chronic diarrhea. It has a rising incidence of 12.6 per 100,000 person-years due to increased understanding and awareness of the disease. Aside from watery diarrhea, other signs and symptoms are nonspecific and may include abdominal pain, fatigue, and weight loss. LC has been associated with a number of medications including non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and selective serotonin re-uptake inhibitors (SSRIs). We present a rare case of LC induced by melatonin usage. Case Description/Methods: A 77-year-old male with new onset primary insomnia presented with complaint of diarrhea. Symptoms had been ongoing for 6 weeks characterized by 5 watery, non-bloody bowel movements per day. He denied recent dietary changes, travel history, infectious symptoms, or sick contacts. Notably, at symptom onset he had started taking melatonin for his insomnia, but otherwise, denied any other new medications. He was prescribed loperamide, which did not significantly improve his symptoms prompting further workup and a referral to a gastroenterologist. Comprehensive stool panel, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and immunoglobulin A (IgA) were all unremarkable. Patient eventually underwent flexible sigmoidoscopy, which showed grossly normal appearing colonic mucosa. Random biopsies were obtained with pathology showing 20 plus intraepithelial lymphocytes per 100 epithelial cells, which is consistent with LC. Given the temporal association between the initiation of melatonin and onset of symptoms it was suspected that melatonin was the causative agent. Patient declined budesonide treatment and fortunately with cessation of melatonin had resolution of symptoms 12 weeks later. Discussion: The etiology of lymphocytic colitis and related disorders is likely multifactorial involving environmental triggers in genetically susceptible individuals. Throughout our literary review this appears to be the first documented case report of LC secondary to melatonin use. Diagnosis of LC and related disorders is difficult given overlap with other chronic diarrheal diseases. However, management LC is considerably different than other diarrheal diseases highlighting the importance of accurate diagnosis. Treatment of LC includes cessation of any precipitating medications and dietary restrictions as well as initiation of budesonide, the standard drug of choice.

Cutaneous Larva Migrans in Urban Area: A Case Report

Cutaneous larva migrans (CLM) is a zoonotic skin disorder caused by the infestation of animal hookworm larvae, the most common being Ancylostoma braziliense. The larvae penetrate the skin surface and subsequently migrate to the epidermis, leaving a typical manifestation of linear or serpiginous erythematous burrow-like tracks, known as creeping eruption. This report presented a case of a young man with complaints of the serpiginous erupted lesion over the upper left thigh, following a recent history of beach travel. On dermatological examination, an erythematous serpiginous lesion and papules were found, portraying the clinical presentation of CLM. The administration of albendazole 400 mg was started, and the symptoms were completely resolved. Keywords: larva migrans, skin disease, creeping eruption, nematodes, albendazole.

Clinico-radiological profile of COVID-19 in a tertiary care hospital of western Rajasthan

Coronavirus disease 2019 (COVID-19) is a pandemic infectious disease caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection by COVID-19 can result in a range of clinical outcomes, from asymptomatic to severe life-threatening course or death. The purpose of our research was to evaluate the presentation of COVID19 disease based on the clinical and radiological characteristics of our population. 100 COVID19 patients recorded by RTPCR. Clinical, biochemical and radiological data from April-May, 2021. Of the 100 patients, in our study 66% were males and 26% patients had history of recent travel. Majority of patients were asymptomatic and don’t have comorbid illness. Thrombocytopenia and lymphopenia, increased levels of lactate dehydrogenase (LDH) and serum ferritin and C-reactive protein were common in these patients. CT finding were 63% had normal CT chest. Among the 37% patients who had CT chest findings, 25% had bilateral diseases, 8% patients had right lung involvement while 4% patients have left lung involvement. COVID-19 disease has a relatively mild course in this part of the subcontinent. Clinical and laboratory findings are similar to those found in viral diseases. Studies involving larger sample size and interventional trials are need of the hour.

1170Investigation of COVID-19 outbreak in a South West State of Nigeria: Preliminary findings

1170Investigation of COVID-19 outbreak in a South West State of Nigeria: Preliminary findings

Autochthonous Cases of Tick-Borne Encephalitis, Belgium, 2020.

We report 3 confirmed autochthonous tick-borne encephalitis cases in Belgium diagnosed during summer 2020. Clinicians should include this viral infection in the differential diagnosis for patients with etiologically unexplained neurologic manifestations, even for persons without recent travel history.

Upper Arm Pain - Lifting

HISTORY: 21 y/o F presents to the ED with progressive left arm pain and weakness. Eight months prior, she was diagnosed with Thoracic Outlet Syndrome (TOS) complicated by left arm thrombus. Additional workup identified antiphospholipid antibody syndrome. Two months prior, she underwent surgical decompression. One month prior, angiography revealed continued evidence of TOS despite surgical treatment. Patient was referred to the ED for evaluation. She otherwise denied chest pain, shortness of breath, cough, recent travel history, fever, and trauma. PHYSICAL EXAMINATION: Vital signs within normal limits. Well appearing and comfortable. Left upper extremity skin with mild blue color mottling. Strength and sensation intact and within normal limits. Normal respiratory effort with normal, equal, and bilateral lung sounds. DIFFERENTIAL DIAGNOSIS: Cervical radiculopathy, Brachial plexopathy, Paget Schroetter Syndrome, Post-operative lymphedema, TOS, Upper Extremity DVT TEST AND RESULTS: APTT: 32.9, PT: 15.0, INR: 1.2 CTA Chest: Stenosis of left subclavian vein with the arm raised and widely patent with the arm down. 2.2 right neck cystic lesion L Upper Extremity US: Positional loss of normal flow in the subclavian and axillary veins with left arm raised. Nonocclusive thrombus cannot be excluded due to basilic vein only visible in arm up position showing it is only partially compressible FINAL WORKING DIAGNOSIS: Upper Extremity DVT and TOS TREATMENT AND OUTCOMES: 1) Patient is currently on Rivaroxaban with a plan for serial US. Several months after the ED visit, she reported bilateral LE paresthesias. RLE US was negative, and neurology recommended neuropathy evaluation with MRI of cervical spine and EMG. 2) TOS is diagnosed clinically, however advanced studies can suggest mechanisms of compression to tailor potential interventions. 3) Anticoagulation coupled with surgical decompression are usually necessary for young athletes with repetitive activity, irrespective of underlying hypercoagulability. 4) Rehab coupled with anticoagulation therapy has a critical role in initial conservative strategies and in post operative recovery. This includes addressing postural mechanics, sports-specific modifications, and targeted cervical and shoulder soft tissue therapies to help guide a return to play strategy.

General Medicine - Weightlifting

HISTORY: A 49yo M, h/o prediabetes and hyperlipidemia, presented with R medial ankle pain and unilateral RLE swelling x5 days. Had acute onset of R medial ankle pain without a specific injury following a leg workout. Seen in urgent care and diagnosed with a deltoid ligament sprain; prescribed RICE, NSAIDs, crutches, and a CAM boot. The pain did not abate and the swelling progressed from the R ankle to the entire lower leg distal to the knee. Denied chest pain, dyspnea, history of malignancy, recent travel, and history of crystalline disease. Meds: None. Allergies: None. SH: Desk job, nonsmoker. PHYSICAL EXAMINATION: Obese male with normal vital signs. Normal cardiovascular, pulmonary, and neurologic exam. RLE notable for antalgic gait, 2+ pitting edema to the knee, no erythema, 2+ DP pulse, 2+ PT pulse. R ankle with full painless AROM; 5/5 strength in dorsiflexion, plantarflexion, inversion, eversion, toe flexion; intact distal sensation; non-focal tenderness to palpation over the posteromedial ankle; negative external rotation stress test, negative anterior drawer, negative talar tilt, and negative pronation talar tilt. DIFFERENTIAL DIAGNOSIS: 1. DVT 2. Gout 3. Deltoid Ligament Sprain 4. Osteoarthritis flare 5. Posterior tibialis tendinopathy TEST AND RESULTS: Imaging - Right ankle radiographs negative. BLE Venous Duplex Vascular Ultrasound negative. RLE MRI w/o Contrast showed diffuse circumferential subcutaneous edema about the lower leg, ankle, and foot with a small focus of bone marrow edema and periostitis at the posteromedial distal tibial cortex. Minimal posterior tibialis tendinopathy. No overlying ulceration or abscess. Labs - WBC 6.3 x 103 / uL. Creatinine 1.3 mg/dL. CRP 2.0 mg/L. ESR 6 mm/h. Uric Acid: 8.1 mg/dL FINAL WORKING DIAGNOSIS: Acute gout flare plus mild posterior tibialis tendinopathy TREATMENT AND OUTCOMES: 1. NSAIDs 2. Leg Elevation 3. Weight bearing as tolerated 4. Dietary modification 5. Pain free with markedly reduced RLE swelling at one-month follow-up. Returned to exercise. Did not start urate-lowering therapy.

Genome Sequences of 15 SARS-CoV-2 Sublineage B.1.617.2 Strains in Bangladesh.

ABSTRACTWe report the coding-complete genome sequences of 15 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sublineage B.1.617.2 strains that were obtained from Bangladeshi individuals with a history of recent travel to India and from the Bangladeshi community. Genomic data were generated by Nanopore sequencing using the amplicon sequencing approach developed by the ARTIC Network.

The Emergence of Rift Valley Fever in Gedaref State Urges the Need for a Cross-Border One Health Strategy and Enforcement of the International Health Regulations.

This study investigated the causative agent of a haemorrhagic fever epidemic in Gedaref state, south-east Sudan. Six cases of febrile illness with haemorrhagic manifestations presented at outpatient health-clinics. Blood samples were collected from the patients and shipped to Khartoum where they were tested for dengue virus (DENV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV) using real-time qPCR. Fifty percent (3/6) of them tested positive for RVFV and neither DENV or CHIKV was detected. All patients were males between 20 and 48 years old who had no history of recent travel. This finding describes the first emergence of RVFV in Gedaref state. Considering that the state hosts a major market of livestock, and it has one of the largest-seasonal open pastures in the country that is usually flooded with herds from the neighbouring states and countries during the rainy season, this emergence could represent a major threat to public health in the region and countries importing animals and/or animal products from east Africa. Therefore, we urge the policymakers of the health and animal resources sectors to implement a one health strategy with a well-established early warning surveillance and response system to prevent the establishment of the disease in the area.

80-Year-Old Man With Orthopnea, Dyspnea, and Hemoptysis

An 80-year-old man presented to the emergency department with exertional dyspnea. His symptoms had begun 3 weeks prior to presentation and had progressively worsened. Additional review of systems elicited nonexertional chest pain, orthopnea, hemoptysis, and epistaxis. He reported no fever, chills, headaches, night sweats, weight changes, sputum production, abdominal pain, nausea, vomiting, or obstructive voiding symptoms. He lived in southeastern Minnesota and had no recent travel history. Forty years previously, he had discontinued his habits of smoking, drinking alcohol, and consuming illegal drugs.

Clinico-Epidemiological Profile of Patients with COVID-19 in a Tertiary Care Centre of Mid-Western Nepal

Introduction: With little to no research done that sheds light on the COVID-19 pandemic in the Mid-Western region of Nepal, this study attempts to educate the general populace and concerned authorities on the impact of the pandemic in the region.Materials and Methods: Patients presenting at Rapti Academy of Health Sciences between 14 May 2020 to December 21, 2020, diagnosed with COVID-19 were included in the study. These patients were reviewed for age, sex, address, recent travel history, and presenting symptoms.Results: A total of 3895 COVID -19 positive individuals were included in the study. The mean age of the patients was 33.6 ± 13.8 years, a majority (49.5%) of the cases were in the 20-29 years age group. 73.7% were male. 82.9% of the patients were from Dang, 86% of the cases of Dang were from urban areas, and the districts bordering India accounted for 88.5% of cases. Most of the positive patients were asymptomatic (97.1%), Amongst the symptomatic cases, the most frequent clinical manifestation was both fever and cough. 8.5% of the patients also reported travel history, of which a majority had returned from India.Conclusions: The patients were mostly young males belonging to the economically active age group who were mostly affected by COVID-19 in Mid-Western Nepal. It is important to carry out age-group targeted testing to flatten the infection curve. Testing must be done irrespective of observable symptoms to overcome this public health emergency.

Imaging findings of human hepatic fascioliasis: a case report and review of the literature

BackgroundFascioliasis is a food-borne hepatobiliary zoonosis caused by Fasciola hepatica and Fasciola gigantica. Human infestations are predominantly seen in developing countries where the disease is endemic, but, due to the increase in international travel rates, hepatic fascioliasis is also appearing in nonendemic areas including Europe and the USA. The clinical and laboratory findings are usually nonspecific. Cross-sectional imaging can be very helpful in the diagnosis of fascioliasis as well as to differentiate it from other liver diseases with a very similar clinical picture. The objectives of this case report are to discuss imaging findings of hepatic fascioliasis and to review the literature.Case presentationWe report the case of a 35-year-old Iranian patient who presented with right upper quadrant pain, low-grade fever, fatigue, and anorexia. The patient had a history of recent travel to the Gilan Province of Iran, almost a month before the onset of symptoms, which is an endemic area of fascioliasis in the country. Laboratory examinations revealed eosinophilia, elevated hepatic enzymes, and slightly raised C-reactive protein. Contrast-enhanced computed tomography of the patient shows clusters of focal ill-defined hypodense lesions with mild peripheral enhancement in the right liver lobe and subcapsular regions. Magnetic resonance imaging of the liver revealed multiple ill-defined lesions of low signal intensity on the T1-weighted image and high signal intensity on the T2-weighted image, extending from the liver capsule into deeper parenchyma toward periportal regions, which shows mild peripheral enhancement on post-contrast images. Imaging-based diagnosis of fascioliasis was made depending on the characteristic distribution of subcapsular tracts/lesions on the above-mentioned imaging, which was then confirmed by serologic tests using enzyme-linked immunosorbent assay. The patient was treated with triclabendazole, showing great clinical improvement, and was eventually discharged in good health condition.ConclusionThe imaging findings in this case report highlight the importance of cross-sectional imaging for further evaluation of suspected cases of fluke-induced liver disease. The hypothesis of hepatic fascioliasis should be always considered when consistent radiological findings are observed. Clusters of tortuous subcapsular lesions with peripheral contrast enhancement extending into deeper liver parenchyma are characteristic imaging findings that strongly suggest hepatic fascioliasis.

Three clusters of carbapenemase-producing Citrobacter freundii in Finland, 2016-20.

Carbapenemase-producing Enterobacterales (CPE) have spread widely into health care facilities (HCF) but clusters caused by carbapenemase-producing (CP) Citrobacter freundii have been uncommon until recent years. Here we describe CP C. freundii clusters detected in Finland during 2016-20. As a part of the national CPE surveillance, clinical microbiology laboratories send potential CP C. freundii isolates to the reference laboratory for confirmation and further characterization. Whole genome sequencing (WGS) with Illumina MiSeq sequencer was used to detect clusters. Resistance genes and STs were analysed using SRST2 and typing with core genome (cg) MLST. A case was defined as a patient with a CP C. freundii isolate belonging to one of the detected clusters. We detected three CP C. freundii clusters: cluster 1 included 16 cases in five HCFs during 2016-20, cluster 2 had two cases in two HCFs during 2018-19 and cluster 3 had two cases in one HCF in 2020. The isolates (11 clinical and 5 screening) in cluster 1 had KPC-2 carbapenemase and were sequence type (ST)18. Cluster 2 (2 clinical isolates) had OXA-181/GES-5 carbapenemases and were ST604 and cluster 3 (two screening isolates) had KPC-3 carbapenemase and were ST116. None of the cases had a history of recent travel abroad. CP C. freundii also causes outbreaks and can be a reservoir of carbapenemase genes. The long intervals between successive cases, mostly found in clinical specimens in two clusters, suggest that besides unknown carriers, environmental contamination may play a role in transmission.

Increasing proportions of relapsing parasite species among imported malaria in China's Guangxi Province from Western and Central Africa

BackgroundTravel-related malaria in non-endemic areas returning from endemic areas presents important challenges to diagnosis and treatment. Imported malaria to newly malaria-free countries poses further threats of malaria re-introduction and potential resurgence. For those traveling to places with high Plasmodium falciparum prevalence, prophylaxis against this parasite is recommended, whereas causal prophylaxis against relapsing malaria is often overlooked. MethodsWe analyzed a cluster of imported malaria among febrile patients in Shanglin County, Guangxi Province, China, who had recent travel histories to Western and Central Africa. Malaria was diagnosed by microscopy and subsequently confirmed by species- and subspecies-specific PCR. Plasmodium vivax was genotyped using a barcode consisting of 42 single nucleotide polymorphisms. ResultsInvestigations of 344 PCR-confirmed malaria cases revealed that in addition to Plasmodium falciparum being the major parasite species, the relapsing parasites Plasmodium ovale and P. vivax accounted for ~40% of these imported cases. Of the 114 P. ovale infections, 65.8% and 34.2% were P. ovale curtisi and P. ovale wallikeri, respectively, with the two subspecies having a ~2:1 ratio in both Western and Central Africa. Phylogenetic analysis of 14 P. vivax isolates using a genetic barcode demonstrated that 11 formed a distinct clade from P. vivax populations from Eastern Africa. ConclusionThis study provides support for active P. vivax transmission in areas with the predominant Duffy-negative blood group. With relapsing malaria making a substantial proportion of the imported malaria, causal prophylaxis should be advocated to travelers with a travel destination to Western and Central Africa.

Primary oral cryptococcosis in an HIV-positive woman with suppressed viral load and normal CD4 count: a rare case

A 55-year-old HIV-positive woman presented with 16 days of fever, malaise and 10 days of oral mucocutaneous lesions, and a left supraclavicular swelling. She had no history of recent travel,...

Atypical Presentation of Frontal Lobe Tumor (Glioblastoma) in an Adolescent: A Case Report

<strong>Introduction:</strong> Malignant brain tumors in childhood occur less frequently than nonmalignant ones and glioblastoma multiforme has been identified as the most common and aggressive [1]. These tumors usually present with typical neurologic symptoms including signs of raised intracranial pressure [2]. The case study describes an atypical presentation of glioblastoma in a previously healthy adolescent male with several distractors that could have led to a delay in diagnosis. This highlights the need to have a high index of suspicion for serious underlying illness when managing pediatric patients presenting with apparently trivial symptoms. <strong>Case Presentation:</strong> A 15-year-old previously healthy adolescent male presented with a 2-week history of non-projectile, non-bilious, non-bloody vomiting, usually post-prandial, about 4–5 episodes per day. He had associated periumbilical pain, burning sensation during voiding, chills, poor feeding, weakness, and weight loss. Physical examination was significant for dry mouth and generalized abdominal tenderness. He was initially managed with famotidine and polyethylene glycol in the pediatrician’s clinic prior to presentation in the ED for persistent symptoms. Results of investigations, including complete blood count, complete metabolic panel, urine analysis, culture, and toxicology were unremarkable. He tested positive for Influenza A and Respiratory Syncytial Virus. Abdominal x-ray was suggestive of constipation. On admission, he received intravenous fluids, pantoprazole, famotidine, and oseltamivir with some improvement in symptoms. On day 2, he complained of throat pain and intermittent low intensity bitemporal headache rated 5/10 which subsided with acetaminophen. On day 3, urinary and fecal incontinence were noted. Additional history of recent travel to Ecuador and prolonged contact with a family member with gastrointestinal tuberculosis was obtained so Quantiferon Gold was sent. Psychiatry was consulted because of his flat affect and poor communication and assessment of adjustment disorder from medical illness was made. On day 4 of admission, neurologic exam revealed significant neck stiffness and suspicion of left abducens nerve palsy. Urgent brain computed tomography scan without contrast showed a large slightly hyperdense mass centered within the left frontal lobe that appeared to cross the anterior corpus callosum and measured roughly 7.6 × 5.8 × 4.3 cm (<em><strong>Figure 1</strong></em>). The patient was transferred to the Pediatric Intensive Care Unit where he received a dose of intravenous Dexamethasone and then transferred to a tertiary hospital with a Pediatric Neurosurgery service. The patient had persistent raised intracranial pressure with waxing and waning neurologic findings. He underwent tumor resection on day 6 of admission. Frozen section was suggestive of glioblastoma multiforme and pathology showed grade IV glioblastoma. Surgery was followed by radiation and chemotherapy with temozolomide [3]. <strong>Conclusion:</strong> Vomiting, typically early morning projectile vomiting, is a classic presenting symptom of increased intracranial pressure. However, this patient had several red herrings on presentation and history that could explain his symptoms. Premature closure and anchoring can lead to missing serious diagnoses presenting as a seemingly routine pediatric illness.

African Trypanosomiasis in Young Female in North India - A Rare Case Report

Human African trypanosomiasis, also known as sleeping sickness, is a vector-borne parasitic disease. It is caused by infection with protozoan parasites belonging to the genus Trypanosoma. They are transmitted to humans by tsetse fly (Glossina genus) bites which have acquired their infection from human beings or from animals harboring human pathogenic parasites. Tsetse flies are found just in sub-Saharan Africa though only certain species transmit the disease. We report a case of human African trypanosomiasis in a 28-year-old Indian female who had a travel history to sub–Saharan Africa, Uganda and she presented with a history of fever, body ache, headache, decreased oral intake, pain lower abdomen, swelling and discharge from forearm chancre since last 4-5 days. Peripheral smear showed heavy parasitemia by flagellated forms of Trypanosoma and the diagnosis of Trypanosoma brucei was given on Peripheral smear report. Serological testing was also done and a diagnosis of West-African trypanosomiasis was confirmed. The patient was successfully treated and made a good recovery. So West-African trypanosomiasis should be considered in the differential diagnosis with presentation of fever with chancre in every person with recent history of travel to African countries as it is universally fatal without treatment.

The Association between QuantiFERON-TB Gold Test and Clinical Manifestations of Uveitis in the United States

To report the prevalence of QuantiFERON-TB Gold (QFT-G) positivity among uveitis patients compared to general population and to evaluate the differences in clinical features of uveitis. Retrospective cohort study. SETTING: Institutional. 418 consecutive new uveitis patients, regardless of clinical suspicion, were tested for QFT-G. Demographics, TB risk factors, clinical characteristics of uveitis were collected. The frequency of QFT-G positivity among uveitis patients and characteristic clinical features among QFT-G positive patients. QFT-G positivity was found in 60/418 patients with uveitis (14.4%, 95% CI: 11.18 - 18.14) higher than the general US population (5%, 95% CI: 4.2 - 5.8, p<.001). Age, gender and residence were similar between QFT-G positive and negative groups. Uveitis patients with positive QFT-G were more likely to be foreign born or have a recent travel history (OR:5.84; 95% CI: 2.83 - 12.05; p<.001). QFT-G positive patients were more likely to present with granulomatous uveitis (OR 2.90; 95%CI 1.36 - 6.21; p=.006). No significant association was found with specific clinical features such as choroiditis, retinal vasculitis, occlusive vasculitis, and serpiginoid choroiditis (p>.05 for each). Prevalence of TB-uveitis based on treatment response was 1.19%. Our study demonstrates significantly higher prevalence of QFT-G positivity among uveitis patients compared to average US population. Characteristic signs of TB uveitis reported in endemic countries were not seen in this cohort. Implications of higher prevalence of QFT-G positivity among uveitis patients require further investigation.

New Brazilian variant of the SARS-CoV-2 (P1/Gamma) of COVID-19 in Alagoas state

Since the beginning of 2020, health authorities have been monitoring the cases of Coronavirus Disease 2019 (COVID-19), which has grown every day in Brazil and around the world, becoming pandemic. The new coronavirus, also called SARS-CoV-2 by scientists spreads rapidly, causing fear, deaths, and threats for the economy of several countries. This work aimed to describe the clinical characterization of the first cases of a new Brazilian variant of SARS-CoV-2 (P1) in the State of Alagoas, which occurred on February 16th, 2021. Two cases are described: first, a person infected in Amazonas State, where the new variant P1 was first described, who migrated to Alagoas State, and second, a case of probable community transmission within Alagoas, since the patient had no history of recent travel. In both confirmed cases the symptoms were mild. Further studies are necessary to better understand the clinical behavior of P1 SARS-CoV-2 variant and also the associated sequelae in the context of COVID-19.

Prevalence of Anosmia &amp; Ageusia in confirmed COVID-19 patients at teaching hospitals of District Bannu and Swat, Pakistan.

Background: Recent evidence suggests olfactory and gustatory sensory deficits among Coronavirus Disease 2019 (COVID-19) patients. It is important to assess the occurrence of anosmia and ageusia among infected individuals as it may be the potential symptom and assist in controlling the viral load. The objective of the present study was to determine the prevalence of ageusia and anosmia among COVID-19 patients admitted to the teaching hospitals of District Bannu and Swat-Pakistan.&#x0D; Methodology: This retrospective cohort study was conducted between April to November 2020. A total of 100 confirmed COVID-19 cases, tested through polymerase chain reaction (PCR), were included in the study. Data including gender, age, smoking status, recent travelling history, nasal and paranasal disorder (NPND) history and COVID-19 severity were obtained from the patients’ records. The symptomatology, including frequency of anosmia and ageusia was recorded.&#x0D; Results: Out of 100 patients, 43.75% of patients had anosmia and 31.25% had ageusia, while 68% of patients were presented without olfactory and gustatory dysfunction. Most of the enrolled patients had no recent travel history (91.46%) and none of them were asymptomatic. Moreover, 88% of patients with a previous history of NPND did not have olfactory and gustatory dysfunction. Various characteristics features, including recent travel history, smoking, gender and disease severity, were significantly associated with anosmia and ageusia.&#x0D; Conclusion: The COVID-19 patients were exclusively suffering from ageusia and anosmia. It can be concluded that amongst asymptomatic-to-mild disease severity patients, the existence of smell and taste might be an important differential demonstration for the apprehension and analysis of COVID-19.