Objectives/Hypothesis: The objective of this meta‐analysis was to look at the pooled prevalence of symptoms, laboratory tests, and imaging of all COVID‐19 infected patients. This will allow better identification of potential COVID‐19 patients and take appropriate precautions.Study design: Meta analysis.Methods: We searched three databases, PubMed, EMBASE, and Ovid to identify studies published between Dec‐2019 and May‐2020. All studies reporting upper‐aerodigestive symptoms of COVID‐19 infection were included. The meta‐analysis was conducted following meta‐analyses of observational studies in epidemiology (MOOSE) guidelines, which have evaluated the pooled prevalence of 14 symptoms and nine laboratory investigations.Results: Based on inclusion criteria, 67 publications consisting of 8302 patients were included. Among adults, the pooled proportion of hypertensive and diabetic patients was 18% and 7%. Cough (53% [0.46–0.61]), anosmia (38% [0.19–0.58]), loss/distortion of taste (31% [0.17–0.45]), and nasal obstruction (26% [0.12–0.39]) were the most common ear, nose & throat (ENT) symptoms. Fever (69% [0.62–0.76]) and fatigue (31% [0.26–0.37]) were the commonest generalized symptoms. C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were raised in 56% (0.41–0.71) and 49% (0.21–0.77), respectively. Interestingly, lymphopenia (41% [0.30–0.53]) and leucopenia (22% [0.16–0.29]) were more common than lymphocytosis (33% [0.02–0.64]) and leucocytosis (12% [0.09–0.16]). Fever (69% vs. 44%), cough (53% vs. 33%), and dyspnea (20% vs. 4%) were more common in adults as compared to the pediatric population. Diarrhea was more common among the pediatric cases (12%) versus (9%). The pooled estimate of fatality was 4%.Conclusions: The most commonly experienced ENT symptom was cough followed by anosmia and dysguesia. Raised ESR and CRP with leukopenia and lymphopenia are common laboratory findings. Majority of the infected patients had abnormal computed tomography findings. COVID infection is less severe in pediatric patients. Laryngoscope, 131:1254–1265, 2021

Background: Extracapsular spread (ECS) is the extension of cancer cells beyond the lymph node capsule and is a significant prognostic factor in head and neck cancers. This meta-analysis compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. Methodology: The authors conducted a systematic review and meta-analysis of studies that compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. They included studies that were published between 1990 and December 2023 and that used histopathology as the reference standard for ECS. Results: The pooled sensitivity and specificity of CT scan were 0.63 (95% CI = 0.53–0.73) and 0.85 (95% CI = 0.74–0.91), respectively. The pooled sensitivity and specificity of MRI were 0.83 (95% CI = 0.71–0.90) and 0.85 (95% CI = 0.73–0.92), respectively. The pooled sensitivity and specificity of PET were 0.80 (95% CI = 0.74–0.85) and 0.93 (95% CI = 0.92–0.94), respectively. The pooled sensitivity and specificity of USG were 0.80 (95% CI = 0.68–0.88) and 0.84 (95% CI = 0.74–0.91), respectively. MRI had significantly higher sensitivity than CT scan (p-0.05). The specificity of CT and MRI was not significantly different (p-0.99). PET scan had the highest specificity among all imaging modalities. Conclusion: MRI is the most accurate imaging modality for detecting ECS in head and neck cancers. CT scan is a reasonable alternative, but PET scan may be considered when high specificity is required. USG may not add any further benefit in detecting ECS.

According to the Global Adult Tobacco Survey part 2 (GATS-2), approximately 200 million adult Indians consume smokeless tobacco (SLT). Circumvention of SLT product ban has been observed. We conducted a review of the literature to summarize the ill effects of tobacco for the articles published from 2019 to 2020. A systematic search of the databases PubMed (2019 onward) and Web of Science (2019 onward), through February 2021 was done. Search yielded 1,061 articles and after excluding articles based on the inclusion criteria, 37 articles were taken in to consideration. The review shows that differential SLT product has specific odds of oral carcinogenesis. Review also indicates the emerging data of cardiovascular risk due to higher use of SLT products along with its known cause of oral cancer. It also cautions about the adverse consequences of pregnancy associated with SLT use.