In the current coronavirus disease 2019 (COVID-19) pandemic, anosmia and dysgeusia have been described as potential symptoms of the disease. On Mar. 21, 2020, a press release from ENT UK (a professional membership body representing ear, nose and throat surgeons in the United Kingdom) and the British Rhinological Society reported anosmia as a symptom in up to 40% of patients in China, South Korea, Germany and Italy. 1 Surprisingly, anosmia and dysgeusia were not reported in the first study describing the clinical characteristics of COVID-19 in China. 2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) damages primarily the respiratory tract. The most common symptoms of SARS-CoV-2 infection include fever, cough and muscle pain. 3,4 Although most patients generally experience mild to moderate disease, severe or critical disease requiring hospital admission develops in 15%-20% of patients, with an overall fatality rate of 2.3%. 5 A growing body of literature has mentioned anosmia and dysgeusia as potential symptoms of SARS-CoV-2 infection. 1,6,7 Anosmia is associated with other respiratory tract infections, and it is not clear whether this symptom is a consequence of nasal obstruction and congestion, or is a symptom specific to SARS-CoV-2 infection. 8 A better understanding of the association between these symptoms and SARS-CoV-2 infection might update the diagnostic criteria and alert people who experience these symptoms to isolate early and seek testing. Therefore, we aimed to delineate the value of anosmia and dysgeusia as potential specific symptoms of SARS-CoV-2 infection.

L yme disease, a multisystem infection primarily caused byBorrelia burgdorferi in North America and by Borrelia afzelii and Borrelia garinii in Europe and Asia, 1,2 progresses in 3 stages: early localized stage, early disseminated stage and late disseminated stage. 3 Cases of Lyme disease reported in Canada increased from 144 in 2009 to 992 in 2016, representing an increase from 0.4 to 2.7 per 100 000 population. 4 In Quebec, Lyme disease has been notifiable since November 2003, with the first locally acquired case reported in 2006. 5,6 Reported cases of Lyme disease and the proportion of cases with acquired infection have increased each year. 6 In 2017, 329 cases were declared to the public health authorities in Quebec, including 249 (76%) acquired in that province, particularly in Estrie (n = 138, 55% of Quebec-acquired cases) and Montérégie (n = 75, 30% of Quebec-acquired cases). 6 Despite the increase in cases, little is known about the management and clinical course of Lyme disease in Canada.Published evidence has focused on epidemiologic surveillance, risk of acquisition and clinical case characteristics. [7][8][9] We aimed to describe case management of Lyme disease in acute care facilities in Quebec and adherence to the 2006 guideline of the Infectious Diseases Society of America (IDSA). 3 We assessed the clinical course of patients treated in Quebec and temporal changes in case severity from 2004 to 2017.

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