In this article, we sought to describe and analyze the interventions and experiences of a subgroup of psychologists from the psychology department of the Saint-Luc University Hospital, who rapidly stepped in to support care units receiving COVID-19 patients during the COVID-19 pandemic. Besides the setting up of a call center and speech groups aimed at relieving staff members, psychologists collectively and voluntarily decided to immerse themselves into these care units in order to support staff members, patients, and families overwhelmed by the strength of the crisis. Behavioral and psychological alarm signs in care unit staff members and psychologists themselves need to be considered and cared for. At the end of the article, a testimony of the involved psychologists provides an insight into the reality of the crisis.

COVID-19, which is caused by the SARS-CoV-2 virus, induces in 5 to 15% of cases a severe phenotype with bilateral pneumonia, sometimes complicated by an acute respiratory distress syndrome and respiratory failure. Patients present with lymphopenia and possibly neutrophilia, which are of prognostic relevance. In addition, some patients develop immune overactivation, which is associated with a cytokine storm and a poor prognosis. Although the underlying mechanisms remain poorly understood, the virus’ ability to escape immune mechanisms could play an important role. An improved understanding of the disease immunopathology should help defining a precision medicine to treat COVID-19 patients based on predictive (or early) biomarkers of severity.

Although fever, respiratory symptoms, cough, and fatigue were initially considered as the leading symptoms of COVID-19 infection, it has now become evident that patients often report ear, nose, and throat (ENT) symptoms. Notably, we are currently facing an outbreak of olfactory dysfunction along with the COVID-19 pandemic. Although the World Health Organization states that this symptom is less common, several studies have demonstrated that this symptom is often observed, and that anosmia may even constitute the only complaint of SARS-CoV-2 carriers in some cases. Consequently, it is now admitted that patients with isolated sudden anosmia and no nasal obstruction should be considered as potential COVID-19 patients. Hence, this symptom should motivate the initiation of quarantine and use of appropriate personal protective equipment for attending medical teams.

As SARS-CoV-2 has a tropism for ENT mucosa and given that ENT procedures may generate aerosolization, ENT examination is a procedure with a particularly high risk of transmission for medical doctors. Therefore, adequate personal protective equipment should be employed when performing ENT examination. Moreover, it is advised to limit procedures leading to aerosolization as much as possible, as well as to adapt ENT surgical techniques during the pandemic.

This paper has reviewed the ENT symptoms possibly related to COVID-19 infection, with a particular focus on anosmia. We have also provided a reminder concerning good clinical practice recommendations in the ENT setting.

The COVID-19 pandemia may affect pregnant women. Though the vast majority of infected pregnant patients are asymptomatic, about 9% exhibit symptoms of pneumonia, which must be diagnosed and appropriately treated. The first published papers suggested a management similar to that of non-pregnant patients in terms of diagnostic tests and therapies. Given the increased risk of preterm labor, corticosteroids for fetal lung maturation should be administrated in case of imminent labor. The delivery route should be chosen based on obstetrical data even if elective caesarian section was reported in most published patients. Loco-regional anesthesia is permitted. Only a few cases of maternal-fetal transmission have been reported to date, with transmission mainly occurring during and after delivery. Perinatal morbidity and mortality have been shown to be very low. Only one maternal death was reported so far. Breastfeeding is possible using specific hygiene measures, such as hand washing and surgical mask wearing. In conclusion, this up-to-date literature review suggests that COVID-19-infected pregnant women and their newborn face a good outcome. However, more information from large multicenter studies must be collected, in an effort to confirm these encouraging data.