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Zaid EA, Eltelety AM, Azooz KO, Ragab G, Nassar AA. Assessment of olfactory recovery after COVID-19: cross-sectional study. Eur Arch Otorhinolaryngol 2024; 281:4827-4834. [PMID: 38641737 PMCID: PMC11393144 DOI: 10.1007/s00405-024-08646-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/26/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease. METHODS The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin' Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). RESULTS Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed. CONCLUSION Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss.
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Affiliation(s)
- Ehab Abou Zaid
- Al Kasr Al Ainy School of Medicine, Cairo University, Cairo, 11562, Egypt
| | | | - Khaled Omar Azooz
- Al Kasr Al Ainy School of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Gouda Ragab
- Al Kasr Al Ainy School of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Ahmed Amin Nassar
- Al Kasr Al Ainy School of Medicine, Cairo University, Cairo, 11562, Egypt.
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Ho AZJ, Ishak NIB, Wong EHC. Effect of Olfactory Rehabilitation on the Recovery of Post-Coronavirus Disease Olfactory Dysfunction: A Randomized Controlled Trial. Cureus 2024; 16:e61855. [PMID: 38975544 PMCID: PMC11227608 DOI: 10.7759/cureus.61855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Persistent olfactory dysfunction was seen in many patients upon coronavirus disease 2019 (COVID-19) infection recovery. However, research on its management was very limited, especially among the Southeast Asian population. Objectives We aim to investigate the role of olfactory rehabilitation and topical corticosteroids among post-COVID-19 olfactory dysfunction patients in Malaysia, and at the same time to determine factors leading to olfactory recovery post-COVID-19 infection. Methods Adult Malaysians with persistent olfactory dysfunction one month post-COVID-19 recovery were recruited. Thirty-one patients were randomly assigned into three groups with 10 patients being given olfactory training (Group 1), another 10 being given mometasone furoate nasal spray/olfactory training (Group 2), and 11 patients being assigned to the control group (Group 3). All groups were followed up for an average duration of six months. Olfactory function was evaluated by Top International Biotech Smell Identification Test (TIBSIT) scores and Olfactory Disorder Questionnaire (eODQ) prior to randomization, at three and six months after recruitment. Results The baseline characteristics of patients were similar in all groups. Generally, patients of all three groups showed a statistically significant improvement in the TIBSIT scores after six months. The TIBSIT scores for Group 2 were statistically significantly higher than the control at three months but not at six months. As for Group 1, no statistically significant differences in TIBSIT scores at both three and six months were noted when compared to control. Statistically significant improvements were seen in the eODQ scores in all three groups. Conclusion No superiority of intervention for post-COVID-19 olfactory dysfunction was seen compared to control.
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Affiliation(s)
- Alex Zxi Jian Ho
- Department of Otorhinolaryngology, International Islamic University Malaysia, Kuantan, MYS
| | - Nur Izzati B Ishak
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
| | - Eugene Hung Chih Wong
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS
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Schmidt F, Azar C, Goektas O. Treatment of Olfactory Disorders After SARS - CoViD 2 Virus Infection. EAR, NOSE & THROAT JOURNAL 2024; 103:48S-53S. [PMID: 36976171 PMCID: PMC10051008 DOI: 10.1177/01455613231168487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/21/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE The benefit of a nasal corticosteroid in the treatment of persistent post-infectious smell disorders is not as clear in previous studies as is assumed for olfactory training. This study would therefore like to describe the treatment strategies using the example of a persistent olfactory dysfunction as a result of a proven infection with SARS-CoViD-2-virus. METHODS Twenty patients (average age of 33.9 ± 11.9 years) with hyposmia were included in this study from December 2020 to July 2021. Every second patient received additionally a nasal corticosteroid. The two resulting randomized groups of equal size were screened with the TDI test, a 20-item taste powder test for the assessment of retronasal olfaction and otorhinolaryngological examination. The patients were asked to train twice daily using a standardized odor training kit and followed up after 2 months and 3 months, respectively. RESULTS We documented a significant overall improvement in olfactory ability over the investigation period in both groups. While the TDI score steadily increased on average under the combination therapy, the rise under olfactory training alone was initially steeper. This short-term interaction effect over mean two months was not statistically significant. According to Cohen, however, a moderate effect (eta2 = 0.055, Cohen`s d = 0.5) can still be assumed. This effect could be explained by a possibly higher compliance at the beginning of the sole olfactory training due to the lack of further drug treatment offers. When the training intensity decreases, the recovery of the sense of smell stagnates. Adjunctive therapy ultimately outweighs this short-term benefit. CONCLUSIONS The results reinforce the recommendation of early and consistent olfactory training on patients with dysosmia due to COVID-19. For continuous improvement of the sense of smell, an accompanying topical treatment seems at least to be worth consideration. The results should be optimized with larger cohorts and using new objective olfactometric methods.
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Affiliation(s)
- F. Schmidt
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
| | - C. Azar
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
| | - O. Goektas
- Departement of ENT Practice, ENT Center, HNO Zentrum am Kudamm, Berlin, Germany
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Rogn Å, Jensen JL, Iversen PO, Singh PB. Post-COVID-19 patients suffer from chemosensory, trigeminal, and salivary dysfunctions. Sci Rep 2024; 14:3455. [PMID: 38342941 PMCID: PMC10859368 DOI: 10.1038/s41598-024-53919-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/06/2024] [Indexed: 02/13/2024] Open
Abstract
Recent literature indicates that post-COVID-19 patients suffer from a plethora of complications, including chemosensory dysfunction. However, little attention has been given to understand the interactions between chemosensory, trigeminal, and salivary dysfunctions in these patients. The aims of this study were (1) to investigate the prevalence and combinations of chemosensory, trigeminal, and salivary dysfunctions, (2) to identify the odorants/tastants that are compromised, and (3) to explore possible associations between the four dysfunctions in post-COVID-19 patients. One hundred post-COVID-19 patients and 76 healthy controls (pre-COVID-19) were included in this cross-sectional, case-controlled study. Participants' smell, taste, trigeminal, and salivary functions were assessed. The patients had a significantly higher prevalence of parosmia (80.0%), hyposmia (42.0%), anosmia (53.0%), dysgeusia (34.0%), complete ageusia (3.0%), specific ageusia (27.0%), dysesthesia (11.0%) and dry mouth (18.0%) compared to controls (0.0% for all parameters, except 27.6% for hyposmia). Complete loss of bitter taste was the most prevalent specific ageusia (66.7%) and coffee was the most common distorted smell (56.4%). Seven different combinations of dysfunction were observed in the patients, the most common being a combination of olfactory and gustatory dysfunction (48.0%). These findings indicate that post-COVID-19 patients experience a range of chemosensory, trigeminal, and salivary disturbances, occurring in various combinations.
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Affiliation(s)
- Åsmund Rogn
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway.
| | - Janicke Liaaen Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Per Ole Iversen
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Preet Bano Singh
- Department of Cariology and Gerodontology, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0455, Oslo, Norway
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5
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Leclercq C, Chiesa-Estomba CM, Horoi M, Le Bon SD, Hans S, Distinguin L, Chekkoury-Idrissi Y, Circiu MP, Khalife M, Saussez S, Lechien JR. Validity and Reliability of the French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). EAR, NOSE & THROAT JOURNAL 2024; 103:NP113-NP117. [PMID: 34463149 DOI: 10.1177/01455613211032004] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To develop a French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (Fr-sQOD) to assess the quality of life impairments of patients with olfactory dysfunction (OD). METHODS Patients with OD and controls were enrolled from 2 academic centers. Individuals completed the Fr-sQOD, an OD visual analog scale severity, and the French version of the sinonasal outcome tool-22 (SNOT-22). Cronbach α was used to measure the internal consistency of Fr-sQOD. The reliability and the external validity of Fr-sQOD were assessed through a test-retest approach and by correlating Fr-sQOD with SNOT-22 scores, respectively. The external validity was assessed by correlation analysis between Fr-sQOD and the result of an assessment of the severity of OD on a visual analog scale. RESULTS Eighty patients completed the evaluations. The internal consistency was adequate (Cronbach α .96), and the test-retest reliability was high in the entire cohort (rs = 0.877, P < .001). The correlation between Fr-sQOD total scores and the severity of OD was moderate but significant (rs = -0.431; P = .001) supporting an acceptable external validity. Patients with OD had a significantly higher score of Fr-sQOD than healthy individuals (P < .001), indicating a high internal validity. CONCLUSION The Fr-sQOD is a reliable and valid self-administered tool in the evaluation of the impact of OD on quality of life of French-speaking patients.
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Affiliation(s)
- Céline Leclercq
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Carlos M Chiesa-Estomba
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Mihaela Horoi
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge D Le Bon
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Stephane Hans
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Lea Distinguin
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Younes Chekkoury-Idrissi
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Marta P Circiu
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Mohamad Khalife
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otorhinolaryngology-Head & Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Sven Saussez
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Human Anatomy and Experimental Oncology, School of Medicine, Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Jérôme R Lechien
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), San Sebastian, Spain
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Department of Human Anatomy and Experimental Oncology, School of Medicine, Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
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Schepens EJA, Stegeman I, Kamalski DMA. Diagnostic accuracy of the screenings Sniffin' Sticks Test (SST-12) in COVID-19 induced olfactory disorders. PLoS One 2024; 19:e0295911. [PMID: 38198490 PMCID: PMC10781020 DOI: 10.1371/journal.pone.0295911] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
Objective olfactory function can be assessed using validated olfactory tests like the Sniffin' Sticks Test (SST). However, their extensive nature makes them less suitable for clinical practice. To address this, shorter olfactory tests like the screenings Sniffin' Sticks Test (SST-12) can be used for screening purposes and reduce testing time. The SST-12 serves as a diagnostic tool for screening olfaction in cases unrelated to COVID-19. However, these screening tests are uncertain regarding their accuracy in detecting olfactory dysfunction in patients with COVID-19 as the plausible cause. We aim to determine the diagnostic accuracy of the SST-12 in adults with post-COVID-19 olfactory dysfunction. We performed a diagnostic accuracy study with data from 113 consecutive COVID-19 diagnosed patients who experienced objectified smell loss ever since. At approximately 6 months after their diagnosis, all participants underwent the SST (reference standard), part of the SST was the SST-12 (index test). Diagnostic accuracy of the SST-12 is measured as negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity. The SST-12 detected smell loss in 85 patients among 91 patients with smell loss and ruled out smell loss in 15 patients among the 22 patients without smell loss based on the reference standard. Making sensitivity 93.4% (CI 0.87-0.97), and specificity 68.2% (CI 0.48-0.85). Out of the 92 patients with a positive test result on SST-12, 85 patients had indeed smell loss (PPV 92.4% CI 0.86-0.97), and out of the 21 patients with a negative test result, 15 patients had no smell loss regarding the reference standard (NPV 71.4% CI 0.50-0.88). The findings suggest that the SST-12 holds promise as a useful tool for identifying individuals with smell loss, also in individuals with COVID-19 as cause, but it is important to have a good understanding of the interpretation of the results of the SST-12 when considering its implementation in clinical practice.
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Affiliation(s)
- Emma J. A. Schepens
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Digna M. A. Kamalski
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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7
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Assiri AM, Alamaa T, Elenezi F, Alsagheir A, Alzubaidi L, TIeyjeh I, Alhomod AS, Gaffas EM, Amer SA. Unveiling the Clinical Spectrum of Post-COVID-19 Conditions: Assessment and Recommended Strategies. Cureus 2024; 16:e52827. [PMID: 38406111 PMCID: PMC10884364 DOI: 10.7759/cureus.52827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
SARS-CoV-2 caused the pandemic of the rapidly evolving COVID-19. As of December 6, 2023, there were 765,152,854 COVID-19-recovering cases. Long-term consequences known as "long COVID" and "post-COVID-19 conditions" (PCCs) or "post-acute COVID-19 syndrome" are being reported more frequently in a subset of recovering patients. Systemic, neuropsychiatric, cardio-respiratory, and gastrointestinal symptoms are the most prevalent. The management of PCCs poses unique challenges due to the lack of official guidelines and the complex nature of the illness. This abstract highlights key principles derived from recent reviews and expert recommendations to provide healthcare professionals with a comprehensive approach to manage post-COVID-19 patients. Preventive medicine plays a crucial role in managing PCCs. While no specific medications are available for treatment, preventive measures such as COVID-19 vaccination, adherence to precautionary measures, regular consultations with medical professionals, monitoring symptoms and progress, and seeking information on symptom management are essential to assist patients in their recovery and improve their quality of life. Medical management requires transparent goal-setting and collaborative decision-making based on the patient's symptoms, comorbidities, and treatment objectives. Treatment plans for post-COVID-19 patients should focus on patient education, using registries and calendars to track symptoms and triggers, providing support and reassurance, and offering holistic support through peer networks and supportive psychotherapy techniques. Symptomatic and rehabilitative care, including well-established symptom management techniques, physical rehabilitation programs, and addressing mental health and well-being, are vital components of post-COVID-19 management. Lifestyle factors such as stress reduction, nutrition, and sleep should be incorporated into managing underlying medical conditions in post-COVID-19 patients. Regular follow-up visits and referrals to specialists are recommended to monitor the patient's progress and address specific organ system involvement or additional care needs. In summary, for the effective management of PCCs, a holistic approach should include preventive measures, patient education, supportive psychotherapy, symptomatic and rehabilitative care, medical management, counseling on lifestyle elements, and appropriate follow-up plans. However, it is crucial to stay updated with evolving guidelines and recommendations from healthcare authorities to provide the most effective and evidence-based care to post-COVID-19 patients.
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Affiliation(s)
| | - Tareef Alamaa
- Therapeutic Services, Saudi Ministry of Health, Riyadh, SAU
| | - Faisal Elenezi
- Assistant Agency for Hospital Affairs, Saudi Ministry of Health, Riyadh, SAU
| | - Aeshah Alsagheir
- Health Quality Index Measuring, Saudi Ministry of Health, Riyadh, SAU
| | - Lamya Alzubaidi
- Assistant Agency for Hospital Affairs, Saudi Ministry of Health, Riyadh, SAU
| | - Imad TIeyjeh
- Infectious Diseases, Mayo Clinic, Rochester, USA
- Infectious Diseases, King Fahad Medical City, Riyadh, SAU
| | | | - Eisha M Gaffas
- Mental Health and Social Services, Saudi Ministry of Health, Riyadh, SAU
| | - Samar A Amer
- Public Health and Community Medicine, Zagazig University, Zagazig, EGY
- General Administration of Health Programs and Non-communicable Diseases, Saudi Ministry of Health, Riyadh, SAU
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Sarıoğlu E, Sarıaltın SY, Çoban T. Neurological complications and effects of COVID-19: Symptoms and conceivable mechanisms. BRAIN HEMORRHAGES 2023; 4:154-173. [PMID: 36789140 PMCID: PMC9911160 DOI: 10.1016/j.hest.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, China. The new coronavirus disease (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in March 2020. SARS-CoV-2 can invade the nervous system aside from infecting the respiratory system as its primary target. The most common nervous system symptoms of COVID-19 are stated as headache, myalgia, fatigue, nausea, vomiting, sudden and unexplained anosmia, and ageusia. More severe conditions such as encephalomyelitis, acute myelitis, thromboembolic events, ischemic stroke, intracerebral hemorrhage, Guillain-Barré-syndrome, Bell's palsy, rhabdomyolysis, and even coma have also been reported. Cohort studies revealed that neurological findings are associated with higher morbidity and mortality. The neurological symptoms and manifestations caused by SARS-CoV-2 and COVID-19 are examined and summarized in this article.
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Affiliation(s)
- Elif Sarıoğlu
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Sezen Yılmaz Sarıaltın
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Tülay Çoban
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
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9
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Morozova M, Bikbavova A, Bulanov V, Lebedev MA. An olfactory-based Brain-Computer Interface: electroencephalography changes during odor perception and discrimination. Front Behav Neurosci 2023; 17:1122849. [PMID: 37397128 PMCID: PMC10309181 DOI: 10.3389/fnbeh.2023.1122849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Brain-Computer Interfaces (BCIs) are devices designed for establishing communication between the central nervous system and a computer. The communication can occur through different sensory modalities, and most commonly visual and auditory modalities are used. Here we propose that BCIs can be expanded by the incorporation of olfaction and discuss the potential applications of such olfactory BCIs. To substantiate this idea, we present results from two olfactory tasks: one that required attentive perception of odors without any overt report, and the second one where participants discriminated consecutively presented odors. In these experiments, EEG recordings were conducted in healthy participants while they performed the tasks guided by computer-generated verbal instructions. We emphasize the importance of relating EEG modulations to the breath cycle to improve the performance of an olfactory-based BCI. Furthermore, theta-activity could be used for olfactory-BCI decoding. In our experiments, we observed modulations of theta activity over the frontal EEG leads approximately 2 s after the inhalation of an odor. Overall, frontal theta rhythms and other types of EEG activity could be incorporated in the olfactory-based BCIs which utilize odors either as inputs or outputs. These BCIs could improve olfactory training required for conditions like anosmia and hyposmia, and mild cognitive impairment.
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Affiliation(s)
- Marina Morozova
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | - Alsu Bikbavova
- Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
| | | | - Mikhail A. Lebedev
- Faculty of Mechanics and Mathematics, Moscow State University, Moscow, Russia
- Laboratory of Neurotechnology, I. M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Saint-Petersburg, Russia
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Tsuchiya H. COVID-19 Oral Sequelae: Persistent Gustatory and Saliva Secretory Dysfunctions after Recovery from COVID-19. Med Princ Pract 2023; 32:166-177. [PMID: 37271130 PMCID: PMC10601698 DOI: 10.1159/000531373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/21/2023] [Indexed: 06/06/2023] Open
Abstract
Diverse manifestations have been recognized to last for a long time in patients infected with SARS-CoV-2. However, understanding of oral sequelae after recovery from COVID-19 is relatively poor compared to that of oral symptoms in the acute phase of COVID-19 and other COVID-19 sequelae. The aim of the present study was to characterize persistent gustatory and saliva secretory dysfunctions and to speculate on their pathogenic mechanisms. Articles were retrieved by searching scientific databases with a cutoff date of September 30, 2022. The literature search indicated that ageusia/dysgeusia and xerostomia/dry mouth are reported by 1-45% of COVID-19 survivors at follow-ups of 21-365 days and by 2-40% of COVID-19 survivors at follow-ups of 28-230 days, respectively. The prevalence of gustatory sequelae partly depends on difference in ethnicity, gender, age, and disease severity of subjects. Co-occurring gustatory and saliva secretory sequelae are pathogenically related to either or both of the following: expression of SARS-CoV-2 cellular entry-relevant receptors in taste buds and salivary glands, and SARS-CoV-2 infection-induced deficiency in zinc that is essential for normality of taste perception and saliva secretion. Given the long-term oral sequelae, hospital discharge is not the end of the disease; therefore, careful attention should be continuously paid to oral conditions of post-COVID-19 patients.
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Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Japan
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Almaamuri AM, Mohammed MM. COVID-19 olfactory dysfunction, evaluation of onset, and persistence. J Adv Pharm Technol Res 2023; 14:137-141. [PMID: 37255874 PMCID: PMC10226702 DOI: 10.4103/japtr.japtr_48_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 06/01/2023] Open
Abstract
Olfactory dysfunction (OD) is a common feature of COVID-19. The goal of the study was to define the modes of onset of OD in the clinical course of the disease and to follow the cases for 12-18 months in order to estimate the differences in the recovery time from OD over the course of the disease. We managed to follow a total of 325 patients (females: 198, males: 127) in the Babylon governorate in Iraq. All were COVID-19 patients who should have OD during the course of the disease. COVID-19 infection was established in all patients by swab test, i.e. polymerase chain reaction (PCR) and/or chest computed tomography findings of pneumonia compatible with COVID-19. Detailed medical records were obtained directly from the patients or their relatives. The patients were then followed up by telephone and questioned with structured questionnaires concentrating upon general clinical features and the sense of olfaction. Information about the presence of olfactory disorders, their occurrence, and development was recorded. Based on the onset of OD, the patients were categorized into three groups. Olfactory functions were assessed primarily by face-to-face interview and then (if necessary) by a telephone questionnaire assessing self-reported olfactory function and olfactory-related quality of life, which measures the subjective olfactory capability (SOC). In the first 2 weeks, 148 (45.5%) patients reported complete recovery from OD, of which 90 (73.2%) patients joined at the end of the 1st month. OD persistence was observed in 11 (3.3%) patients toward the end of the 1st year, in 5 (1.5%) patients at the end of the 15th month, and only in two (0.6%) patients at the end of the 18th month. We found no significant correlation between the type of onset of OD and the duration and persistence of OD. Most sufferers of COVID-associated OD recover their sense of smell within the 1st month.
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Affiliation(s)
| | - Mohammed M. Mohammed
- Department of Pediatric, Al-Tarmia General Hospital, Al-Karkh Health Directorate, Baghdad, Iraq
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韩 瑞, 孟 粹, 朱 冬, 修 倩. [Interpretation of the 2021 American Academy of Allergy, Asthma and Immunology expert consensus on the treatment of postinfectious olfactory dysfunction]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2023; 37:81-86. [PMID: 36756819 PMCID: PMC10208870 DOI: 10.13201/j.issn.2096-7993.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Indexed: 02/10/2023]
Abstract
Respiratory tract viruses are the second leading cause of olfactory dysfunction. Between 2019 to 2022, the world has been plagued by the problem of olfaction caused by the COVID-19. As we learn more about the impact of severe acute respiratory syndrome coronavirus 2（SARS-CoV-2）, with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction（PIOD）. The Clinical Olfactory Working Group has proposed theconsensus on the roles of PIOD. This paper is the detailed interpretation of the consensus.
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Affiliation(s)
- 瑞铭 韩
- 吉林大学中日联谊医院耳鼻咽喉头颈外科(长春，130033)Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - 粹达 孟
- 吉林大学中日联谊医院耳鼻咽喉头颈外科(长春，130033)Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - 冬冬 朱
- 吉林大学中日联谊医院耳鼻咽喉头颈外科(长春，130033)Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - 倩 修
- 吉林大学中日联谊医院耳鼻咽喉头颈外科(长春，130033)Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
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Molnár A, Maihoub S, Mavrogeni P, Krasznai M, Tamás L, Kraxner H. The Correlation between the Results of the Sniffin' Sticks Test, Demographic Data, and Questionnaire of Olfactory Disorders in a Hungarian Population after a SARS-CoV-2 Infection. J Clin Med 2023; 12:jcm12031041. [PMID: 36769688 PMCID: PMC9917422 DOI: 10.3390/jcm12031041] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND After a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, smell disorders frequently occur, significantly affecting patients' quality of life (QoL). METHODS 110 patients with persistent olfactory disorder after coronavirus infection were enrolled. These patients underwent chemosensory testing using the Sniffin' Sticks test, and completed the Questionnaire of Olfactory Disorders (QOD). RESULTS 30% of the patients reported anosmia, and 70% reported hyposmia. Upon comparing subjective and chemosensory testing categories, good category matching was observed in 75.3% (i.e., anosmia based on both methods in 10 and hyposmia in 48 cases). Statistical analysis using the Chi-square test revealed a significant result (p = 0.001 *). Between the TDI (i.e., Threshold, Discrimination, Identification) results of the three subjective report groups (i.e., hyposmia, anosmia, and parosmia), no significant differences were observed. When the TDI and QOD results were compared, no consistent significant correlations were found in most TDI and QOD outcomes. Between the TDI and Scale 2 results, a significant, although slight correlation was observed by the Spearman's (rho = 0.213, p = 0.027 *) and Pearson's (rho = 0.201, p = 0.037 *) tests. CONCLUSIONS The nonsignificant correlation between objective and subjective methods suggests that these results should be interpreted independently. Moreover, adequate management is essential even in mild cases.
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Affiliation(s)
- András Molnár
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
- Correspondence:
| | - Stefani Maihoub
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
| | - Panayiota Mavrogeni
- Tóth Ilona Health Service Clinical Medical Institute, Görgey Artúr tér 8, 1212 Budapest, Hungary
| | - Magdolna Krasznai
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
| | - László Tamás
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
- Department of Voice, Speech and Swallowing Therapy, Faculty of Health Sciences, Semmelweis University, Vas u. 17, 1088 Budapest, Hungary
| | - Helga Kraxner
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
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von Bartheld CS, Wang L. Prevalence of Olfactory Dysfunction with the Omicron Variant of SARS-CoV-2: A Systematic Review and Meta-Analysis. Cells 2023; 12:430. [PMID: 36766771 PMCID: PMC9913864 DOI: 10.3390/cells12030430] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
The omicron variant is thought to cause less olfactory dysfunction than previous variants of SARS-CoV-2, but the reported prevalence differs greatly between populations and studies. Our systematic review and meta-analysis provide information regarding regional differences in prevalence as well as an estimate of the global prevalence of olfactory dysfunction based on 62 studies reporting information on 626,035 patients infected with the omicron variant. Our estimate of the omicron-induced prevalence of olfactory dysfunction in populations of European ancestry is 11.7%, while it is significantly lower in all other populations, ranging between 1.9% and 4.9%. When ethnic differences and population sizes are considered, the global prevalence of omicron-induced olfactory dysfunction in adults is estimated to be 3.7%. Omicron's effect on olfaction is twofold to tenfold lower than that of the alpha or delta variants according to previous meta-analyses and our analysis of studies that directly compared the prevalence of olfactory dysfunction between omicron and previous variants. The profile of the prevalence differences between ethnicities mirrors the results of a recent genome-wide association study that connected a gene locus encoding an odorant-metabolizing enzyme, UDP glycosyltransferase, to the extent of COVID-19-related loss of smell. Our analysis is consistent with the hypothesis that this enzyme contributes to the observed population differences.
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Affiliation(s)
- Christopher S. von Bartheld
- Department of Physiology and Cell Biology, Reno School of Medicine, University of Nevada, Reno, NV 89557-0352, USA
| | - Lingchen Wang
- School of Public Health, University of Nevada, Reno, NV 89557-0275, USA
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Singhal SK, Gupta N, Verma RR, Sharma J, Sah M, Jain S, Kashyap D. Olfactory and taste dysfunction in COVID-19-incidence and recovery. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2023. [PMCID: PMC9869294 DOI: 10.1186/s43163-023-00383-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
Background
Olfactory and taste dysfunctions have been identified as prominent signs of COVID-19 infection. The data on its prevalence, time of onset, and recovery is highly variable.
Objective
The study was aimed at establishing the incidence of and the factors influencing smell and taste disorders in COVID-19-affected patients.
Methodology
Telephonic interviews were used to collect data on the symptoms of COVID-19-positive patients, with an emphasis on smell and taste disorders. Patients have severe disease and a history of illnesses that may affect olfaction or taste, and those unwilling to participate were excluded.
Results
A total of 1488 COVID-19-positive patients were identified. A total of 772 were included and interviewed, and their data were analysed. A total of 242 (31.3%) patients developed symptoms related to smell and/or taste. Anosmia (149) and ageusia (152) were the most common. Younger patients were more commonly affected (p = 0.0016). The presence and degree of smell symptoms and taste symptoms showed a small positive correlation (r = .234, p < .001). A strong relationship was seen with fever (r = .825, p < .001) and a significantly moderate relationship with breathing difficulty. There was no significant difference based on age or sex for the recovery of smell or taste sensations. There was a significant correlation between taste recovery and smell recovery times (p < 0.00001).
Conclusion
Smell and taste disorders, as early clinical symptoms of COVID-19, may have a diagnostic as well as a prognostic value. Treatment protocols for these patients are yet to be defined. A positive association between these symptoms and breathing difficulty was found, and we recommend COVID-19 testing and monitoring of symptoms for all patients with new-onset OTD symptoms. A combination of active enquiry about these symptoms, along with objective testing when the patients present with COVID-19 symptoms may help in better understanding of the pathophysiology and timely initiation of treatment.
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Nguyen H, Albayay J, Höchenberger R, Bhutani S, Boesveldt S, Busch NA, Croijmans I, Cooper KW, de Groot JHB, Farruggia MC, Fjaeldstad AW, Hayes JE, Hummel T, Joseph PV, Laktionova TK, Thomas-Danguin T, Veldhuizen MG, Voznessenskaya VV, Parma V, Pepino MY, Ohla K. Covid-19 affects taste independently of smell: results from a combined chemosensory home test and online survey from a global cohort (N=10,953). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.16.23284630. [PMID: 36711499 PMCID: PMC9882440 DOI: 10.1101/2023.01.16.23284630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with ten household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 3,356 self-reported a positive and 602 a negative COVID-19 diagnosis (COVID+ and COVID-, respectively); 1,267 were awaiting test results (COVID?). The rest reported no respiratory illness and were grouped by symptoms: sudden smell/taste changes (STC, N=4,445), other symptoms excluding smell or taste loss (OthS, N=832), and no symptoms (NoS, N=416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% Confidence Interval (CI): 15-28%), 47% in smell (95%-CI: 37-56%), and 17% in oral irritation (95%-CI: 10-25%) intensity. In all groups, perceived intensity of smell (r=0.84), taste (r=0.68), and oral irritation (r=0.37) was correlated. Our findings suggest most reports of taste dysfunction with COVID-19 were genuine and not due to misinterpreting smell loss as taste loss (i.e., a classical taste-flavor confusion). Assessing smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and helps to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.
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Affiliation(s)
- Ha Nguyen
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Javier Albayay
- Università degli Studi di Trento, Centro Interdipartimentale Mente/Cervello, Rovereto, IT
| | | | - Surabhi Bhutani
- San Diego State University, School of Exercise and Nutritional Sciences, San Diego, CA, USA
| | - Sanne Boesveldt
- Wageningen University, Division of Human Nutrition and Health, Wageningen, NL
| | - Niko A Busch
- University of Münster, Institute for Psychology, Münster, DE
| | - Ilja Croijmans
- Radboud University, Language and communication, Nijmegen, Gelderland, NL
| | - Keiland W Cooper
- University of California Irvine, Department of Neurobiology and Behavior, Irvine, CA, USA
| | | | | | - Alexander W Fjaeldstad
- Gødstrup Regional Hospital, Department of Otorhinolaryngology, Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Herning, DK
| | - John E Hayes
- The Pennsylvania State University, Department of Food Science, University Park, PA, USA
| | - Thomas Hummel
- University of Dresden Medical School, Smell & Taste Clinic, Dept. of Otorhinolaryngology, Dresden, DE
| | - Paule V Joseph
- Paule Joseph, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, DIBCR, Section of Sensory Science and Metabolism, Bethesda, MD, USA
| | - Tatiana K Laktionova
- Tatiana K. Laktionova, A N Severtsov Institute of Ecology and Evolution RAS, Moscow, RU
| | - Thierry Thomas-Danguin
- Thierry Thomas-Danguin, INRAE CSGA, Research Center for Smell Taste and Feeding Behavior, Dijon, FR
| | | | - Vera V Voznessenskaya
- Tatiana K. Laktionova, A N Severtsov Institute of Ecology and Evolution RAS, Moscow, RU
| | | | - M Yanina Pepino
- University of Illinois at Urbana- Champaign, Department of Food Science and Human Nutrition, Division of Nutritional Sciences, and Carle Illinois College of Medicine, Urbana, IL, USA
| | - Kathrin Ohla
- The Pennsylvania State University, Department of Food Science, University Park, PA, USA
- Helmut-Schmidt-University / University of the Armed Forces Hamburg, Experimental Psychology Unit, Hamburg, DE
- Firmenich SA, Human Perception & Bioresponse, Satigny, CH
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 PMCID: PMC11320609 DOI: 10.1093/chemse/bjad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced,
Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research,
National Institutes of Health, Bethesda, MD,
USA
- Division of Intramural Research, National Institute of Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda,
MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
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18
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Nguyen H, Albayay J, Höchenberger R, Bhutani S, Boesveldt S, Busch NA, Croijmans I, Cooper KW, de Groot JHB, Farruggia MC, Fjaeldstad AW, Hayes JE, Hummel T, Joseph PV, Laktionova TK, Thomas-Danguin T, Veldhuizen MG, Voznessenskaya VV, Parma V, Pepino MY, Ohla K. Covid-19 affects taste independent of taste-smell confusions: results from a combined chemosensory home test and online survey from a large global cohort. Chem Senses 2023; 48:bjad020. [PMID: 37350646 PMCID: PMC10396355 DOI: 10.1093/chemse/bjad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Indexed: 06/24/2023] Open
Abstract
People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with 10 household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 5,225 self-reported a respiratory illness and were grouped based on their reported COVID test results: COVID-positive (COVID+, N = 3,356), COVID-negative (COVID-, N = 602), and COVID unknown for those waiting for a test result (COVID?, N = 1,267). The participants who reported no respiratory illness were grouped by symptoms: sudden smell/taste changes (STC, N = 4,445), other symptoms excluding smell or taste changes (OthS, N = 832), and no symptoms (NoS, N = 416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% confidence interval (CI): 15-28%), 47% in smell (95% CI: 37-56%), and 17% in oral irritation (95% CI: 10-25%) intensity. There were medium to strong correlations between perceived intensities and self-reported abilities (r = 0.84 for smell, r = 0.68 for taste, and r = 0.37 for oral irritation). Our study demonstrates that COVID-19-positive individuals report taste dysfunction when self-tested with stimuli that have little to none olfactory components. Assessing the smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and may help to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.
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Affiliation(s)
- Ha Nguyen
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Javier Albayay
- Centro Interdipartimentale Mente/Cervello, Università degli Studi di Trento, Rovereto, Italy
| | | | - Surabhi Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Niko A Busch
- Institute for Psychology, University of Münster, Münster, Germany
| | - Ilja Croijmans
- Department of Language and Communication, Radboud University, Nijmegen, Netherlands
| | - Keiland W Cooper
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | | | - Michael C Farruggia
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alexander W Fjaeldstad
- Department of Otorhinolaryngology, Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Gødstrup Regional Hospital, Herning, Denmark
| | - John E Hayes
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
| | - Thomas Hummel
- Department of Otorhinolaryngology, University of Dresden Medical School, Smell & Taste Clinic, Dresden, Germany
| | - Paule V Joseph
- National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, DIBCR, Section of Sensory Science and Metabolism, Bethesda, MD, USA
| | | | | | | | | | | | - M Yanina Pepino
- Department of Food Science and Human Nutrition, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kathrin Ohla
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
- Experimental Psychology Unit, Helmut-Schmidt-University/University of the Armed Forces Hamburg, Hamburg, Germany
- Science & Research, dsm-firmenich, Satigny, Switzerland
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19
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Jensen MM, Larsen KD, Homøe AS, Simonsen AL, Arndal E, Koch A, Samuelsen GB, Nielsen XC, Todsen T, Homøe P. Subjective and psychophysical olfactory and gustatory dysfunction among COVID-19 outpatients; short- and long-term results. PLoS One 2022; 17:e0275518. [PMID: 36191024 PMCID: PMC9529127 DOI: 10.1371/journal.pone.0275518] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/19/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Olfactory and gustatory dysfunctions are early symptoms of SARS-CoV-2 infection. Between 20-80% of infected individuals report subjective altered sense of smell and/or taste during infection. Up to 2/3 of previously infected experience persistent olfactory and/or gustatory dysfunction after 6 months. The aim of this study was to examine subjective and psychophysical olfactory and gustatory function in non-hospitalized individuals with acute COVID-19 up to 6 months after infection. METHODS Individuals aged 18-80-years with a positive SARS-CoV-2 PCR test no older than 10 days, were eligible. Only individuals able to visit the outpatient examination facilities were included. Gustatory function was tested with the Burgharts Taste Strips and olfactory function was examined with the Brief Smell Identifications test (Danish version). Subjective symptoms were examined through an online questionnaire at inclusion, day 30, 90 and 180 after inclusion. RESULTS Fifty-eight SARS-CoV-2 positive and 56 negative controls were included. 58.6% (34/58) of SARS-CoV-2 positive individuals vs. 8.9% (5/56) of negative controls reported subjective olfactory dysfunction at inclusion. For gustatory dysfunction, 46.5% (27/58) of positive individuals reported impairment compared to 8.9% (5/56) of negative controls. In psychophysical tests, 75.9% (46/58) had olfactory dysfunction and 43.1% (25/58) had gustatory dysfunction among the SARS-CoV-2 positive individuals at inclusion. Compared to negative controls, SARS-CoV-2 infected had significantly reduced olfaction and gustation. Previously infected individuals continued to report lower subjective sense of smell 30 days after inclusion, whereafter the difference between the groups diminished. However, after 180 days, 20.7% (12/58) positive individuals still reported reduced sense of smell and taste. CONCLUSION Olfactory and gustatory dysfunctions are prevalent symptoms of SARS-CoV-2 infection, but there is inconsistency between subjective reporting and psychophysical test assessment of especially olfaction. Most individuals regain normal function after 30 days, but approximately 20% report persistent olfactory and gustatory dysfunction 6 months after infection.
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Affiliation(s)
- Mads Mose Jensen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- * E-mail:
| | - Kasper Daugaard Larsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Sophie Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otorhinolaryngology, Nordsjaellands Hospital, Hilleroed, Denmark
| | | | - Elisabeth Arndal
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anders Koch
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Staten Serum Institut (SSI), Copenhagen, Denmark
| | | | - Xiaohui Chen Nielsen
- Department of Clinical Microbiology, Zealand University Hospital, Koege, Denmark
| | - Tobias Todsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Błochowiak K. Smell and Taste Function and Their Disturbances in Sjögren's Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12472. [PMID: 36231772 PMCID: PMC9564460 DOI: 10.3390/ijerph191912472] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Chemosensory disorders are a possible disturbance in Sjögren's syndrome (SS). The aim of the study is to comprehensively present chemosensory disorders in SS and to indicate their possible causes. The possible causes of taste and smell disorders in SS are changes in the structure of exocrine glands and their dysfunction, damage to receptors and weakening of their ability to regenerate, and neurological changes in the form of peripheral neuropathy and impaired cognitive function. Other postulated causes of chemosensory disorders are autoimmune mechanisms, adverse effects of drugs used in SS, and primary potentially SS-triggering viral infections. They are multifactorial and may occur independently of each other. The time of their onset and correlation with other disease symptoms may facilitate the determination of their primary cause in each patient. Awareness of chemosensory disorders in SS may help to ease their progress and eliminate other factors responsible for their more severe manifestation. In the prevention and treatment of chemosensory disorders in SS, the most important thing is to alleviate xerostomia and dryness in the nasal cavity and their effects in the form of chronic local inflammations, counteract receptor atrophy, and an implementation of appropriate neurological diagnosis and treatment.
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Affiliation(s)
- Katarzyna Błochowiak
- Department of Oral Surgery and Periodontology, Poznan University of Medical Sciences, 61-812 Poznan, Poland
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21
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Vigliar MFR, Pomini KT, Buchaim DV, Buchaim RL. Anatomophysiological relationships and clinical considerations of taste and smell loss in patients with COVID-19. World J Virol 2022; 11:362-374. [PMID: 36188742 PMCID: PMC9523329 DOI: 10.5501/wjv.v11.i5.362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/24/2022] [Accepted: 08/12/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There are numerous conflicting discussions about the outbreak of the new coronavirus 2019 (COVID-19). AIM To present some anatomical and physiological considerations about two of the symptoms reported by patients: The loss or reduction of smell and taste. METHODS The loss or reduction of smell and taste is presented in a peculiar way, with some cases of persistence even after COVID-19. For this, it was searched in three databases, PubMed/MEDLINE, Web of Science, and Scopus, using the following keywords: "Smell", "Taste", "Smell AND COVID-19", "Taste AND COVID-19", with no publication time restriction, only in English with full text available, excluding also brief communications, letters to the editor, editorials, reviews, comments, and conference abstracts. RESULTS The search found 776 articles in the PubMed/MEDLINE database, 1018 in the Web of Science database, and 552 in the Scopus database, from which duplicates were removed (104 articles). Finally, 17 studies were selected for detailed analysis within the eligibility criteria, with titles and abstracts related to central nervous system lesions responsible for smell and taste. This review suggests that viral mechanisms of action may be related to lesions both at the local level and at the level of the central nervous system, lasting up to 3 to 4 wk. It is considered persistent if it exceeds this period, as reported in one case in this review. There are still few studies about the treatment, and among those addressed in this review, only two studies reported possible treatments and emphasized the scarcity of data, with the best option being treatments that do not cause harm, such as gustatory and olfactory physiotherapy. CONCLUSION Given the scarcity of data, this review emphasizes the importance of prevention, through the correct use of personal protective equipment by health professionals and respect for local behavioral indications. It is also emphasized, through five studies, that there is a predominance of such symptoms in patients with COVID-19, which can be a tool to control dissemination, through the early isolation of patients until the results are ready.
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Affiliation(s)
- Maria Fernanda Rossi Vigliar
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru 17012901, São Paulo, Brazil
| | - Karina Torres Pomini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru 17012901, São Paulo, Brazil
- University of Marilia, Marilia 17525902, São Paulo, Brazil
| | - Daniela Vieira Buchaim
- University of Marilia, Marilia 17525902, São Paulo, Brazil
- University Center of Adamantina, Adamantina 17800000, São Paulo, Brazil
| | - Rogerio Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru 17012901, São Paulo, Brazil
- Faculty of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508270, São Paulo, Brazil
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22
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Narayanan SN, Shivappa P, Padiyath S, Bhaskar A, Li YW, Merghani TH. The Prevalence and Pathophysiology of Chemical Sense Disorder Caused by the Novel Coronavirus. Front Public Health 2022; 10:839182. [PMID: 35734755 PMCID: PMC9207763 DOI: 10.3389/fpubh.2022.839182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/20/2022] [Indexed: 12/27/2022] Open
Abstract
Emerging viral infections are a ceaseless challenge and remain a global public health concern. The world has not yet come back to normal from the devastating effects of the highly contagious and pathogenic novel coronavirus, or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Olfactory and taste dysfunction is common in patients infected by the novel coronavirus. In light of the emergence of different coronavirus variants, it is important to update the prevalence and pathophysiology of these side effects. In this review, articles published on the prevalence of olfactory and taste dysfunction from coronavirus disease (COVID-19) and their possible pathophysiologic mechanisms have been reviewed and reported. The modulatory role of different SARS-CoV-2 variants on the chemical senses is then described. The clinical relevance of chemical sense disorder and its long-term morbidity and management is also discussed.
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Affiliation(s)
- Sareesh Naduvil Narayanan
- Department of Physiology, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
- *Correspondence: Sareesh Naduvil Narayanan ; orcid.org/0000-0002-2980-2352
| | - Pooja Shivappa
- Department of Basic Sciences, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Sreeshma Padiyath
- Independent Microbiology Researcher, Ras Al Khaimah, United Arab Emirates
| | - Anand Bhaskar
- Department of Biomedical Sciences, Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Yan Wa Li
- Department of Biomedical Sciences, Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Tarig Hakim Merghani
- Department of Physiology, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
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23
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Weir EM, Hannum ME, Reed DR, Joseph PV, Munger SD, Hayes JE, Gerkin RC. The Adaptive Olfactory Measure of Threshold (ArOMa-T): A rapid test of olfactory function. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.03.08.22272086. [PMID: 35313597 PMCID: PMC8936104 DOI: 10.1101/2022.03.08.22272086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Many widely-used psychophysical tests of olfaction have limitations that can create barriers to adoption outside research settings. For example, tests that measure the ability to identify odors may confound sensory performance with memory recall, verbal ability, and past experience with the odor. Conversely, threshold-based tests typically avoid these issues, but are labor intensive. Additionally, many commercially available olfactory tests are slow and may require a trained administrator, making them impractical for use in a short wellness visit or other broad clinical assessment. METHODS We tested the performance of the Adaptive Olfactory Measure of Threshold (ArOMa-T) -- a novel odor detection threshold test that employs an adaptive Bayesian algorithm paired with a disposable odor-delivery card -- in a non-clinical sample of individuals (n=534) at the 2021 Twins Day Festival in Twinsburg, OH. RESULTS Participants successfully completed the test in under 3 min with a false alarm rate of 9.6% and a test-retest reliability of 0.61. Odor detection thresholds differed by sex (~3.2-fold) and between the youngest and oldest age groups (~8.7-fold), consistent with prior work. In an exploratory analysis, we failed to observe evidence of detection threshold differences between participants who reported a history of COVID-19 and matched controls who did not. We also found evidence for broad-sense heritability of odor detection thresholds. CONCLUSION Together, these data indicate the ArOMa-T can determine odor detection thresholds. The ArOMa-T may be particularly valuable in clinical or field settings where rapid and portable assessment of olfactory function is needed.
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Affiliation(s)
- Elisabeth M. Weir
- Sensory Evaluation Center, The Pennsylvania State University, University Park PA 16802
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park PA 16802
| | | | | | - Paule V. Joseph
- Division of Intramural Clinical and Biological Research (DICBR), National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda MD, 20892
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda MD, 20892
| | - Steven D. Munger
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville FL, 32610
- Department of Otolaryngology, College of Medicine, University of Florida, Gainesville FL, 32610
- Center for Smell and Taste, University of Florida, Gainesville FL, 32610
| | - John E. Hayes
- Sensory Evaluation Center, The Pennsylvania State University, University Park PA 16802
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park PA 16802
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24
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Weir EM, Reed DR, Pepino MY, Veldhuizen MG, Hayes JE. Massively collaborative crowdsourced research on COVID19 and the chemical senses: Insights and outcomes. Food Qual Prefer 2022; 97:104483. [PMID: 34848930 PMCID: PMC8616712 DOI: 10.1016/j.foodqual.2021.104483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/12/2021] [Accepted: 11/21/2021] [Indexed: 11/24/2022]
Abstract
In March 2020, the Global Consortium of Chemosensory Research (GCCR) was founded by chemosensory researchers to address emerging reports of unusual smell and taste dysfunction arising from the SARS-CoV-2 pandemic. Over the next year, the GCCR used a highly collaborative model, along with contemporary Open Science practices, to produce multiple high impact publications on chemosensation and COVID19. This invited manuscript describes the founding of the GCCR, the tools and approaches it used, and a summary of findings to date. These findings are contextualized within a summary of some of the broader insights about chemosensation (smell, taste, and chemesthesis) and COVID19 gained over the last 18 months, including potential mechanisms of loss. Also, it includes a detailed discussion of some current Open Science approaches and practices used by the GCCR to increase transparency, rigor, and reproducibility.
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Affiliation(s)
- Elisabeth M Weir
- Sensory Evaluation Center, United States
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA 16802, United States
| | - Danielle R Reed
- Monell Chemical Senses Center, Philadelphia, PA 19104, United States
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition, and College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61801, United States
- Division of Nutritional Sciences, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61801, United States
| | - Maria G Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Çiftlikköy Campus, Yenişehir, 33343 Mersin, Turkey
| | - John E Hayes
- Sensory Evaluation Center, United States
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA 16802, United States
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25
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Trecca EM, Cassano M, Longo F, Petrone P, Miani C, Hummel T, Gelardi M. Results from psychophysical tests of smell and taste during the course of SARS-CoV-2 infection: a review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:S20-S35. [PMID: 35763272 PMCID: PMC9137382 DOI: 10.14639/0392-100x-suppl.1-42-2022-03] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/23/2023]
Abstract
Only a few studies have assessed smell and taste in Coronavirus Disease 2019 (COVID-19) patients with psychophysical tests, while the majority performed self-rating evaluations. Given the heterogeneity of the published literature, the aim of this review was to systematically analyse the articles on this topic with a focus on psychophysical testing. A search on PubMed and Web of Science from December 2019, to November 2021, with cross-references, was executed. The main eligibility criteria were English-language articles, investigating the clinical features of olfaction and gustation in COVID-19 patients using self-rating assessment, psychophysical testing and imaging techniques. A total of 638 articles were identified and 66 were included. Self-rating assessment was performed in 31 studies, while psychophysical testing in 30 and imaging techniques in 5. The prevalence of chemosensory dysfunction was the most investigated topic, followed by the recovery time. About the psychophysical assessment, the extended version of the Sniffin’ Sticks was used in 11 articles and the Connecticut Chemosensory Clinical Research Center test in another 11. The olfactory threshold performance was the most impacted compared to the discrimination and identification capacities in accordance with the hypothesis of a tropism of SARS-CoV-2 for the olfactory mucosa. The timing significantly influenced the results of the psychophysical testing with 20% of patients presenting olfactory dysfunction at one month after infection.
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Affiliation(s)
- Eleonora M.C. Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
- Department of Maxillofacial Surgery and Otorhinolaryngology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Michele Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - Francesco Longo
- Department of Maxillofacial Surgery and Otorhinolaryngology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Cesare Miani
- Department of Otorhinolaryngology, Hospital of Tolmezzo, ASUFC Udine, Udine, Italy
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Matteo Gelardi
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
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26
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Systematic review and meta-analysis of olfactory and gustatory dysfunction in COVID-19. Int J Infect Dis 2022; 117:155-161. [PMID: 35134561 PMCID: PMC8817419 DOI: 10.1016/j.ijid.2022.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/20/2022] Open
Abstract
Background Chemosensory disorders associated with COVID-19 have been widely discussed during the pandemic. We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19. Methods Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 1, 2019, and August 31, 2021. We selected random-effects model or fixed-effects model to pool data based on heterogeneity. The results were reported as odds ratios (ORs) or standardized mean differences (SMDs) and the corresponding 95% confidence intervals (CIs). Heterogeneity was reported as I2. Results Twenty-six studies with a total of 13,813 patients were included. The pooled data indicated that sex (OR 1.47; 95% CI 0.93–2.31), age (SMD −5.80; 95% CI −13.35 to 1.75), smoking (OR 2.04; 95% CI 0.72–5.79), and comorbidity (OR 1.21; 95% CI 0.58–2.53) of patients with COVID-19 had no effect on gustatory dysfunction. Olfactory dysfunction was more likely to occur in older patients with COVID-19 (SMD, −5.22; 95% CI, −8.28 to −2.16). Patients with COVID-19 with nasal congestion (OR 3.41; 95% CI 2.30–5.06) and rhinorrhea (OR 2.35; 95% CI 1.60–3.45) were more prone to olfactory dysfunction. Conclusion These findings emphasize that older patients with COVID-19 are more likely to experience olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction.
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27
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Esposito F, Cirillo M, De Micco R, Caiazzo G, Siciliano M, Russo AG, Monari C, Coppola N, Tedeschi G, Tessitore A. Olfactory loss and brain connectivity after COVID-19. Hum Brain Mapp 2022; 43:1548-1560. [PMID: 35083823 PMCID: PMC8886650 DOI: 10.1002/hbm.25741] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/01/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
To address the impact of COVID‐19 olfactory loss on the brain, we analyzed the neural connectivity of the central olfactory system in recently SARS‐CoV‐2 infected subjects with persisting olfactory impairment (hyposmia). Twenty‐seven previously SARS‐CoV‐2 infected subjects (10 males, mean age ± SD 40.0 ± 7.6 years) with clinically confirmed COVID‐19 related hyposmia, and eighteen healthy, never SARS‐CoV‐2 infected, normosmic subjects (6 males, mean age ± SD 36.0 ± 7.1 years), were recruited in a 3 Tesla MRI study including high angular resolution diffusion and resting‐state functional MRI acquisitions. Specialized metrics of structural and functional connectivity were derived from a standard parcellation of olfactory brain areas and a previously validated graph‐theoretic model of the human olfactory functional network. These metrics were compared between groups and correlated to a clinical index of olfactory impairment. On the scanning day, all subjects were virus‐free and cognitively unimpaired. Compared to control, both structural and functional connectivity metrics were found significantly increased in previously SARS‐CoV‐2 infected subjects. Greater residual olfactory impairment was associated with more segregated processing within regions more functionally connected to the anterior piriform cortex. An increased neural connectivity within the olfactory cortex was associated with a recent SARS‐CoV‐2 infection when the olfactory loss was a residual COVID‐19 symptom. The functional connectivity of the anterior piriform cortex, the largest cortical recipient of afferent fibers from the olfactory bulb, accounted for the inter‐individual variability in the sensory impairment. Albeit preliminary, these findings could feature a characteristic brain connectivity response in the presence of COVID‐19 related residual hyposmia.
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Affiliation(s)
- Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Gerardo Russo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," University of Salerno, Baronissi (Salerno), Italy
| | - Caterina Monari
- Department of Mental and Physical Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Coppola
- Department of Mental and Physical Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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28
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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Abstract
Several studies have recently been conducted showing persistent COVID-19 symptoms in patients recovering after the acute phase of the disease. Energy imbalance plays a leading role in the pathogenesis of post-COVID syndrome. The choice of a metabolic cytoprotection drug with anti-asthenic activity will be decisive for the further tactics of managing the patient not only in the hospital, but also during the entire further period of recovery after the infection.
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30
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Recent evidence for the impacts of olfactory disorders on food enjoyment and ingestive behavior. Curr Opin Food Sci 2021. [DOI: 10.1016/j.cofs.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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31
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Prem B, Liu DT, Besser G, Sharma G, Dultinger LE, Hofer SV, Matiasczyk MM, Renner B, Mueller CA. Long-lasting olfactory dysfunction in COVID-19 patients. Eur Arch Otorhinolaryngol 2021; 279:3485-3492. [PMID: 34757458 PMCID: PMC8578909 DOI: 10.1007/s00405-021-07153-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022]
Abstract
Objectives Olfactory dysfunction (OD) is a common symptom of Coronavirus Disease 2019 (COVID-19). Although many patients have been reported to regain olfactory function within the first month, long-term observation reports vary. Therefore, we aimed to assess the course of chemosensory function in patients diagnosed with COVID-19 within 3–15 months after the infection. Methods One hundred and two patients (71 females and 31 males; mean age 38.8 years) diagnosed with laboratory-confirmed COVID-19 and subjective OD participated in this single-center study 111–457 days after onset of OD. Patients first performed chemosensory tests at home, followed by psychophysical testing (Sniffin’ Sticks (TDI), 27-item Candy Smell Test (CST), Taste Strips Test (TST)) in the clinic. Questionnaires regarding importance of olfaction (IOQ) and olfactory-specific quality of life (QOD) were applied at both timepoints. Results After a mean 216 days (SD 73; range 111–457) between OD onset and follow-up testing, the mean Sniffin’ Sticks (TDI) score was 27.1 points (SD 5.8; range 4.25–38.5): 4.0% were anosmic, 72.5% hyposmic, and 23.5% normosmic. At follow-up testing, 73.5% of patients reported improvement, 5.9% deterioration, and 20.6% no change in OD. Moreover, full recovery of self-perceived smell, flavor, and taste was not observed. According to questionnaires, the individual importance of smell did not change, but participants showed improvement in OD-related quality of life (p < 0.001) and had increased parosmia scores (p = 0.014) at follow-up. Conclusion Our results show that long-lasting OD after SARS-CoV-2 infection is a common symptom. The majority of patients had OD in the range of hyposmia, which was confirmed by comprehensive smell tests.
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Affiliation(s)
- Bernhard Prem
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Gunjan Sharma
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Laura E Dultinger
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Sissy V Hofer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Martina M Matiasczyk
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, 1090, Vienna, Austria.
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Kavaz E, Tahir E, Kurnaz SÇ, Deveci A, Tanyel EA. Clinical, Prognostic, and Predictive Value of Olfactory Dysfunction for COVID-19: A Prospective Controlled Study. Otolaryngol Head Neck Surg 2021; 167:187-196. [PMID: 34726987 DOI: 10.1177/01945998211057024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the effect of olfactory dysfunction on the course and severity of COVID-19 and its prognostic and predictive significance for COVID-19. STUDY DESIGN Prospective case-control study. SETTING Ondokuz Mayıs University School of Medicine. METHODS Reverse transcription polymerase chain reaction (PCR)-positive patients, patients with COVID-19-related symptoms who had a negative PCR result, and healthy controls were included in the study. Clinicodemographic characteristics, inflammatory markers, and computed tomography stages were recorded. Disease progression and intensive care unit admission were registered. The visual analog scale (0, worst; 10, best) was used to evaluate subjective olfactory, taste, and nasal breathing ability, and the Sniffin' Sticks identification (SS-ID) test was used for psychophysical olfactory assessment. RESULTS Mean SS-ID scores were significantly lower in the positive group (8.77) than in the negative (10.43) and healthy control (12.17) groups. VAS-smell scores were significantly lower and anosmia was more prevalent in PCR-positive patients (P < .01). SS-ID and VAS-smell scores were significantly correlated (r = 0.681, P < .001). The inflammatory parameters, pulmonary infiltration stage, disease progression, and ICU admission were not associated with SS-ID scores. A cutoff SS-ID score <9 resulted in 55.56% sensitivity in predicting COVID-19 positivity, and a cutoff VAS-smell score <8 yielded 72.22% sensitivity. CONCLUSION Olfactory dysfunction was detected objectively and subjectively in the PCR-positive group, and no difference was found in terms of taste function and nasal breathing. The severity and prognosis of COVID-19 are not exclusively dependent on olfactory dysfunction. The degree of olfactory dysfunction can be useful in predicting PCR positivity.
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Affiliation(s)
- Esra Kavaz
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Emel Tahir
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Senem Çengel Kurnaz
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Aydın Deveci
- Department of Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Esra Aksakal Tanyel
- Department of Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Damiano RF, Di Santi T, Beach S, Pan PM, Lucchetti AL, Smith FA, Forlenza OV, Fricchione GL, Miguel EC, Lucchetti G. Mental health interventions following COVID-19 and other coronavirus infections: a systematic review of current recommendations and meta-analysis of randomized controlled trials. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:665-678. [PMID: 33852690 PMCID: PMC8639008 DOI: 10.1590/1516-4446-2020-1582] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To review the most common mental health strategies aimed at alleviating and/or preventing mental health problems in individuals during the coronavirus disease 2019 (COVID-19) and other coronavirus pandemics. METHODS We conducted a systematic review of the literature assessing three databases (PubMed, SCOPUS, and PsycINFO). A meta-analysis was performed with data from randomized controlled trials (RCTs). For non-RCT studies, a critical description of recommendations was performed. RESULTS From a total of 2,825 articles, 125 were included. Of those, three RCTs were included in the meta-analysis. The meta-analysis revealed that the interventions promoted better overall mental health outcomes as compared to control groups (standardized mean difference [SMD] = 0.87 [95%CI 0.33-1.41], p < 0.001, I2 = 69.2%), but did not specifically improve anxiety (SMD = 0.98 [95%CI -0.17 to 2.13], p > 0.05; I2 = 36.8%). Concerning the systematic review, we found a large body of scientific literature proposing recommendations involving psychological/psychiatric interventions, self-care, education, governmental programs, and the use of technology and media. CONCLUSIONS We found a large body of expert recommendations that may help health practitioners, institutional and governmental leaders, and the general population cope with mental health issues during a pandemic or a crisis period. However, most articles had a low level of evidence, stressing the need for more studies with better design (especially RCTs) investigating potential mental health interventions during COVID-19. PROSPERO REGISTRATION CRD42020190212.
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Affiliation(s)
- Rodolfo F. Damiano
- Departamento de Psiquiatria, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Talita Di Santi
- Departamento de Psiquiatria, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Scott Beach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Pedro M. Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Alessandra L. Lucchetti
- Departamento de Medicina, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Felicia A. Smith
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Orestes V. Forlenza
- Departamento de Psiquiatria, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gregory L. Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Eurípedes C. Miguel
- Departamento de Psiquiatria, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Giancarlo Lucchetti
- Departamento de Medicina, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Vandersteen C, Payne M, Dumas LÉ, Plonka A, D'Andréa G, Chirio D, Demonchy É, Risso K, Robert P, Fernandez X, Askenazy-Gittard F, Savoldelli C, Guevara N, Castillo L, Manera V, Gros A. What about using sniffin' sticks 12 items test to screen post-COVID-19 olfactory disorders? Eur Arch Otorhinolaryngol 2021; 279:3477-3484. [PMID: 34716806 PMCID: PMC8556789 DOI: 10.1007/s00405-021-07148-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 01/02/2023]
Abstract
Background Post-COVID-19 Olfactory impairment has a negative impact on quality of life. The Sniffin Sticks test 12 items (SST-12) can be used in quick olfactory disorders screening. Its evaluation in a post-covid-19 situation was the main objective of this work. Methods All patient impaired with a post-COVID olfactory loss were included while consulting to the ENT department. The clinical examination included an olfaction recovery self-assessment (VAS), a nasofibroscopy, a quality of life (QoL) assessment, the complete Sniffin’ Sticks Test (SST), and the SST-12. Results Among the 54 patients included, 92% (n = 50) were correctly screened as olfactory impaired by SST-12. We report excellent correlations between SST-12 and SST (rho (52) = 0.98, p < 0.001), QoL(rho(52) = 0.33 p = 0.016), or VAS (rho(52) = 0.49, p < 0.001) assessments. Conclusions SST-12 is a quick and reliable tool to screen large-scale population of post-COVID-19 olfactory impaired patients and could be used in a general daily clinical practice.
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Affiliation(s)
- Clair Vandersteen
- Institut Universitaire de La Face Et du Cou, 31 Avenue de Valombrose, 06100, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, Alpes-Maritimes, France. .,Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.
| | - Magali Payne
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.,Université Côte d'Azur, Département d'Orthophonie de Nice, UFR Medecine, Nice, France
| | - Louise-Émilie Dumas
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.,Hôpitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire, Université Côte d'Azur, 57 Avenue de la Californie, 06200, Nice, Alpes-Maritimes, France
| | - Alexandra Plonka
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.,Institut NeuroMod, INRIA Centre de Recherche Sophia Antipolis, Université Côte d'Azur, 2004 Route des Lucioles, 06902, Sophia Antipolis, Alpes-Maritimes, France
| | - Grégoire D'Andréa
- Institut Universitaire de La Face Et du Cou, 31 Avenue de Valombrose, 06100, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, Alpes-Maritimes, France
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de L'archet, Centre Hospitalier Universitaire, Université Côte d'Azur, 151 route de Saint-Antoine, 06200, Nice, Alpes-Maritimes, France
| | - Élisa Demonchy
- Département de Médecine Infectiologique, Hôpital de L'archet, Centre Hospitalier Universitaire, Université Côte d'Azur, 151 route de Saint-Antoine, 06200, Nice, Alpes-Maritimes, France
| | - Karine Risso
- Département de Médecine Infectiologique, Hôpital de L'archet, Centre Hospitalier Universitaire, Université Côte d'Azur, 151 route de Saint-Antoine, 06200, Nice, Alpes-Maritimes, France
| | - Philippe Robert
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France
| | - Xavier Fernandez
- Institut de Chimie de Nice, Université Côte d'Azur, Nice, Alpes-Maritimes, France
| | - Florence Askenazy-Gittard
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France
| | - Charles Savoldelli
- Institut Universitaire de La Face Et du Cou, 31 Avenue de Valombrose, 06100, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, Alpes-Maritimes, France
| | - Nicolas Guevara
- Institut Universitaire de La Face Et du Cou, 31 Avenue de Valombrose, 06100, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, Alpes-Maritimes, France
| | - Laurent Castillo
- Institut Universitaire de La Face Et du Cou, 31 Avenue de Valombrose, 06100, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, Alpes-Maritimes, France
| | - Valeria Manera
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.,Institut NeuroMod, INRIA Centre de Recherche Sophia Antipolis, Université Côte d'Azur, 2004 Route des Lucioles, 06902, Sophia Antipolis, Alpes-Maritimes, France
| | - Auriane Gros
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau Et du Mouvement, Nice, France.,Université Côte d'Azur, Département d'Orthophonie de Nice, UFR Medecine, Nice, France
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.09.21264771. [PMID: 34671775 PMCID: PMC8528083 DOI: 10.1101/2021.10.09.21264771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 35.34-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
- Department of Public Health, University of California Merced, Merced, CA 95348
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
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Cecchini MP, Brozzetti L, Cardobi N, Sacchetto L, Gibellini D, Montemezzi S, Cheli M, Manganotti P, Monaco S, Zanusso G. Persistent chemosensory dysfunction in a young patient with mild COVID-19 with partial recovery 15 months after the onset. Neurol Sci 2021; 43:99-104. [PMID: 34601698 PMCID: PMC8487402 DOI: 10.1007/s10072-021-05635-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/24/2021] [Indexed: 01/05/2023]
Abstract
Objective It is reported that recovery from COVID-19 chemosensory deficit generally occurs in a few weeks, although olfactory dysfunction may persist longer. Here, we provide a detailed follow-up clinical investigation in a very young female patient (17-year-old) with a long-lasting anosmia after a mild infection, with partial recovery 15 months after the onset. Methods Neuroimaging and neurophysiologic assessments as well as olfactory mucosa swabbing for microbiological and immunocytochemical analyses were performed. Olfactory and gustatory evaluations were conducted through validated tests. Results Chemosensory evaluations were consistent with anosmia associated with parosmia phenomena and gustatory impairment, the latter less persistent. Brain MRI (3.0 T) showed no microvascular injury in olfactory bulbs and brain albeit we cannot rule out slight structural abnormalities during the acute phase, and a high-density EEG was negative. Immunocytochemistry of olfactory mucosa swabs showed high expression of ACE2 in sustentacular cells and lower dot-like cytoplasmic positivity in neuronal-shaped cells. Discussion The occurrence of long-term persistent olfactory deficit in spite of the absence of structural brain and olfactory bulb involvement supports the view of a possible persistent dysfunction of both sustentacular cells and olfactory neurons. The gustatory dysfunction even if less persisting for the described features could be related to a primary gustatory system involvement. Future longitudinal studies are needed to investigate the persistence of chemosensory impairment, which could have a relevant impact on the daily life. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05635-y.
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Affiliation(s)
- Maria Paola Cecchini
- Department of Neurosciences, Biomedicine, and Movement Sciences, Anatomy and Histology Section, University of Verona, Strada le Grazie, 8 37134, Verona, Italy.
| | - Lorenzo Brozzetti
- Department of Neurosciences, Biomedicine, and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Nicolò Cardobi
- Department of Pathology and Diagnostic, Radiology Unit, Verona, Italy
| | - Luca Sacchetto
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Otolaryngology Unit, University of Verona, Verona, Italy
| | - Davide Gibellini
- Department of Diagnostic and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | | | - Marta Cheli
- Department of Medical Sciences, Neurology Unit, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Department of Medical Sciences, Neurology Unit, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Salvatore Monaco
- Department of Neurosciences, Biomedicine, and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
| | - Gianluigi Zanusso
- Department of Neurosciences, Biomedicine, and Movement Sciences, Neurology Unit, University of Verona, Verona, Italy
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Simple Disposable Odor Identification Tests for Predicting SARS-CoV-2 Positivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910185. [PMID: 34639486 PMCID: PMC8507979 DOI: 10.3390/ijerph181910185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized laboratory settings. We aimed to develop a quick, simple, affordable, and reliable test to objectively assess the prevalence and diagnostic accuracy of OD in COVID-19. The olfactory function of 64 COVID-19 inpatients and 34 controls was evaluated using a questionnaire and a simple disposable odor identification test (SDOIT) developed for this study. Four SDOIT models were assessed: 10-SDOIT, 9-SDOIT, 8-SDOIT, and 4-SDOIT, with 10, 9, 8 and 4 samples, respectively. We found a high frequency of self-reported OD in COVID-19 patients, with 32.8% and 42.2% reporting current and recent OD, respectively. Different SDOIT models revealed smell impairment in 54.7-64.1% of COVID-19 patients. The combination of either 10-SDOIT results and self-reported OD, or 8-SDOIT results and self-reported OD, were the best predictors of COVID-19, both with an AUC value of 0.87 (0.85 and 0.86 for the age-matched subjects). OD is a common symptom of COVID-19. A combination of self-reported smell deterioration and OD psychophysically evaluated using SDOIT appears to be a good predictor of COVID-19.
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38
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Peterson CJ, Sarangi A, Bangash F. Neurological sequelae of COVID-19: a review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021; 57:122. [PMID: 34511868 PMCID: PMC8424148 DOI: 10.1186/s41983-021-00379-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/26/2021] [Indexed: 01/28/2023] Open
Abstract
Background The COVID-19 pandemic has produced a myriad of challenges, including identifying and treating neurological sequelae. Main body COVID-19 can cause olfactory and respiratory dysfunction with average recovery within 1 month and a minority of patients experiencing symptoms at 8-month follow-up. Headaches are also very common (up to 93%) amongst patients with persistent COVID-19 symptoms. COVID-19 illness may also affect cognition, although results are mixed. Conclusion While many studies have focused on acute COVID-19 symptoms, more longitudinal studies will need to assess the neurological sequelae of the disease. Furthermore, care must be taken when attributing sequelae to COVID-19 illness and not an unrelated cause. Finally, there is concern that COVID-19 may be associated with secondary illnesses, such as Guillain–Barre, and may even contribute to the development of diseases, such as Alzheimer’s.
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Affiliation(s)
- Christopher J Peterson
- Menninger Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 USA
| | - Ashish Sarangi
- Department of Psychiatry, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430 USA
| | - Fariha Bangash
- SUNY Upstate Medical University, 750E Adams St, Syracuse, NY 13210 USA
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39
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Bacon DR, Onuorah P, Murr A, Wiesen CA, Oakes J, Thorp BD, Zanation AM, Ebert CS, Wohl D, Senior BA, Kimple AJ. COVID-19 related olfactory dysfunction prevalence and natural history in ambulatory patients. RHINOLOGY ONLINE 2021; 4:131-139. [PMID: 34485883 DOI: 10.4193/rhinol/21.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Evidence regarding prevalence of COVID-19 related Olfactory dysfunction (OD) among ambulatory patients is highly variable due to heterogeneity in study population and measurement methods. Relatively few studies have longitudinally investigated OD in ambulatory patients with objective methods. Methods We performed a longitudinal study to investigate OD among COVID-19 ambulatory patients compared to symptomatic controls who test negative. Out of 81 patients enrolled, 45 COVID-19 positive patients and an age- and sex-matched symptomatic control group completed the BSIT and a questionnaire about smell, taste and nasal symptoms. These were repeated at 1 month for all COVID-19 positive patients, and again at 3 months for those who exhibited persistent OD. Analysis was performed by mixed-effects linear and logistic regression. Results 46.7% of COVID-19 patients compared to 3.8% of symptomatic controls exhibited OD at 1-week post diagnosis (p<0.001). At 1 month, 16.7%, (6 of 36), of COVID-19 patients had persistent OD. Mean improvement in BSIT score in COVID-19 patients between 1-week BSIT and 1 month follow-up was 2.0 (95% CI 1.00 - 3.00, p<0.001). OD did not correlate with nasal congestion (r= -0.25, 95% CI, -0.52 to 0.06, p=0.12). Conclusions Ambulatory COVID-19 patients exhibited OD significantly more frequently than symptomatic controls. Most patients regained normal olfaction by 1 month. The BSIT is a simple validated and objective test to investigate the prevalence of OD in ambulatory patients. OD did not correlate with nasal congestion which suggests a congestion-independent mechanism of OD.
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Affiliation(s)
- Daniel R Bacon
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Princess Onuorah
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Alexander Murr
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | | | - Jonathan Oakes
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian D Thorp
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Adam M Zanation
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Charles S Ebert
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - David Wohl
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brent A Senior
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Adam J Kimple
- Department of Otolaryngology/Head & Neck Surgery, University of North Carolina Chapel Hill, Chapel Hill, NC.,Marsico Lung Institute, Chapel Hill, NC
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40
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Goyal R, Kapoor A, Goyal MK, Singh R. Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India. Indian J Otolaryngol Head Neck Surg 2021; 73:371-377. [PMID: 34123736 PMCID: PMC8185497 DOI: 10.1007/s12070-021-02670-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September-November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.
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Affiliation(s)
- Rashmi Goyal
- Department of ENT, Jaipuria Hospital, RUHS-CMS, Jaipur, Rajasthan India
| | - Anju Kapoor
- Department of Paediatrics, Peoples College of Medical Sciences, Bhopal, MP India
| | | | - Rekha Singh
- RDBP Jaipuria Hospital, Jaipur, Rajasthan India
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Cecchetto C, Di Pizio A, Genovese F, Calcinoni O, Macchi A, Dunkel A, Ohla K, Spinelli S, Farruggia MC, Joseph PV, Menini A, Cantone E, Dinnella C, Cecchini MP, D’Errico A, Mucignat-Caretta C, Parma V, Dibattista M. Assessing the extent and timing of chemosensory impairments during COVID-19 pandemic. Sci Rep 2021; 11:17504. [PMID: 34471196 PMCID: PMC8410776 DOI: 10.1038/s41598-021-96987-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023] Open
Abstract
Chemosensory impairments have been established as a specific indicator of COVID-19. They affect most patients and may persist long past the resolution of respiratory symptoms, representing an unprecedented medical challenge. Since the SARS-CoV-2 pandemic started, we now know much more about smell, taste, and chemesthesis loss associated with COVID-19. However, the temporal dynamics and characteristics of recovery are still unknown. Here, capitalizing on data from the Global Consortium for Chemosensory Research (GCCR) crowdsourced survey, we assessed chemosensory abilities after the resolution of respiratory symptoms in participants diagnosed with COVID-19 during the first wave of the pandemic in Italy. This analysis led to the identification of two patterns of chemosensory recovery, partial and substantial, which were found to be associated with differential age, degrees of chemosensory loss, and regional patterns. Uncovering the self-reported phenomenology of recovery from smell, taste, and chemesthetic disorders is the first, yet essential step, to provide healthcare professionals with the tools to take purposeful and targeted action to address chemosensory disorders and their severe discomfort.
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Affiliation(s)
- Cinzia Cecchetto
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padova, Padua, Italy
| | - Antonella Di Pizio
- grid.506467.6Leibniz-Institute for Food Systems Biology at the Technical University of Munich, Munich, Germany
| | - Federica Genovese
- grid.250221.60000 0000 9142 2735Monell Chemical Senses Center, Philadelphia, USA
| | | | - Alberto Macchi
- ENT Department, Italian Academy of Rhinology-ASST sette laghi, Varese, Italy
| | - Andreas Dunkel
- grid.506467.6Leibniz-Institute for Food Systems Biology at the Technical University of Munich, Munich, Germany
| | - Kathrin Ohla
- grid.49096.320000 0001 2238 0831Experimental Psychology Unit, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Sara Spinelli
- grid.8404.80000 0004 1757 2304Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Michael C. Farruggia
- grid.47100.320000000419368710Interdepartmental Neuroscience Program, Yale University, New Haven, USA
| | - Paule V. Joseph
- National Institutes of Nursing Research, Bethesda, USA ,grid.420085.b0000 0004 0481 4802National Institute of Alcohol Abuse and Alcoholism, Bethesda, USA ,grid.94365.3d0000 0001 2297 5165National Institutes of Health, Bethesda, USA
| | - Anna Menini
- grid.5970.b0000 0004 1762 9868Neurobiology Section, SISSA, International School for Advanced Studies, Trieste, Italy
| | - Elena Cantone
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive and Odontostomatological Sciences, Ear, Nose and Throat (ENT) Section, University of Naples Federico II, Naples, Italy
| | - Caterina Dinnella
- grid.8404.80000 0004 1757 2304Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Maria Paola Cecchini
- grid.5611.30000 0004 1763 1124Department of Neurosciences, Biomedicine and Movement Sciences, Anatomy and Histology Section, University of Verona, Verona, Italy
| | - Anna D’Errico
- grid.7839.50000 0004 1936 9721Department of Neurobiology, Goethe Universität Frankfurt, Frankfurt, Germany
| | - Carla Mucignat-Caretta
- grid.5608.b0000 0004 1757 3470Department of Molecular Medicine, University of Padova, Padua, Italy
| | - Valentina Parma
- grid.250221.60000 0000 9142 2735Monell Chemical Senses Center, Philadelphia, USA ,grid.264727.20000 0001 2248 3398Department of Psychology, Temple University, Philadelphia, USA
| | - Michele Dibattista
- grid.7644.10000 0001 0120 3326Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari A. Moro, Piazza Giulio Cesare n.11, 70124 Bari, Italy
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D V, Sharma A, Kumar A, Flora SJS. Neurological Manifestations in COVID-19 Patients: A Meta-Analysis. ACS Chem Neurosci 2021; 12:2776-2797. [PMID: 34260855 PMCID: PMC8291134 DOI: 10.1021/acschemneuro.1c00353] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
Common symptoms such as dizziness, headache, olfactory dysfunction, nausea, vomiting, etc. in COVID-19 patients have indicated the involvement of the nervous system. However, the exact association of the nervous system with COVID-19 infection is still unclear. Thus, we have conducted a meta-analysis of clinical studies associated with neurological problems in COVID-19 patients. We have searched for electronic databases with MeSH terms, and the studies for analysis were selected based on inclusion and exclusion criteria and quality assessment. The Stats Direct (version 3) was used for the analysis. The pooled prevalence with 95% confidence interval of various neurological manifestations reported in the COVID-19 patients was found to be headache 14.6% (12.2-17.2), fatigue 33.6% (29.5-37.8), olfactory dysfunction 26.4% (21.8-31.3), gustatory dysfunction 27.2% (22.3-32.3), vomiting 6.7% (5.5-8.0), nausea 9.8% (8.1-11.7), dizziness 6.7% (4.7-9.1), myalgia 21.4% (18.8-24.1), seizure 4.05% (2.5-5.8), cerebrovascular diseases 9.9% (6.8-13.4), sleep disorders 14.9% (1.9-36.8), altered mental status 17.1% (12.3-22.5), neuralgia 2.4% (0.8-4.7), arthralgia 19.9% (15.3-25.0), encephalopathy 23.5% (14.3-34.1), encephalitis 0.6% (0.2-1.3), malaise 38.3% (24.7-52.9), confusion 14.2% (6.9-23.5), movement disorders 5.2% (1.7-10.4), and Guillain-Barre syndrome 6.9% (2.3-13.7). However, the heterogeneity among studies was found to be high. Various neurological manifestations related to the central nervous system (CNS) and peripheral nervous system (PNS) are associated with COVID-19 patients.
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Affiliation(s)
- Vitalakumar D
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Raeberali, Lucknow 226002, India
| | - Ankita Sharma
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER)-Raeberali, Lucknow 226002, India
| | - Anoop Kumar
- Department of Pharmacology and Clinical Research, Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR), Delhi Pharmaceutical Sciences & Research University (DPSRU), New Delhi 110017, India
| | - S J S Flora
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Raeberali, Lucknow 226002, India
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43
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Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
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Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
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Huart C, Philpott CM, Altundag A, Fjaeldstad AW, Frasnelli J, Gane S, Hsieh JW, Holbrook EH, Konstantinidis I, Landis BN, Macchi A, Mueller CA, Negoias S, Pinto JM, Poletti SC, Ramakrishnan VR, Rombaux P, Vodicka J, Welge‐Lüessen A, Whitcroft KL, Hummel T. Systemic corticosteroids in coronavirus disease 2019 (COVID-19)-related smell dysfunction: an international view. Int Forum Allergy Rhinol 2021; 11:1041-1046. [PMID: 33728824 PMCID: PMC8251281 DOI: 10.1002/alr.22788] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.
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Affiliation(s)
- Caroline Huart
- Department of OtorhinolaryngologyCliniques universitaires Saint‐LucBrusselsBelgium
- Institute of NeuroscienceUniveristé catholique de LouvainBrusselsBelgium
| | - Carl M. Philpott
- The Norfolk Smell and Taste ClinicNorfolk and Waveney ENT ServiceGorlestonUK
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Aytug Altundag
- Department of OtorhinolaryngologyBiruni UniversityIstanbulTurkey
| | - Alexander W. Fjaeldstad
- Flavour ClinicDepartment of OtorhinolaryngologyRegional Hospital West JutlandHolstebroDenmark
- Flavour InstituteAarhus UniversityAarhusDenmark
| | - Johannes Frasnelli
- Department of AnatomyUniversité du Québec à Trois‐RivièresTrois‐RivièresQuebecCanada
| | - Simon Gane
- Department of RhinologyRoyal National ENT Hospital, University College London Hospitals NHS Foundation TrustLondonUK
- UCL Ear Institute, University College LondonLondonUK
| | - Julien W. Hsieh
- Department of Otorhinolaryngology–Head and Neck Surgery, Rhinology‐Olfactory UnitGeneva University HospitalsGenevaSwitzerland
| | | | | | - Basile N. Landis
- Department of Otorhinolaryngology–Head and Neck Surgery, Rhinology‐Olfactory UnitGeneva University HospitalsGenevaSwitzerland
| | - Alberto Macchi
- ENT clinic Asst‐Settelaghi‐University of InsubriaeVareseItaly
| | | | - Simona Negoias
- Department of OtorhinolaryngologyHead and Neck SurgeryUniversity Hospital BaselCH‐4051BaselSwitzerland
| | - Jayant M. Pinto
- Section of Otolaryngology–Head and Neck SurgeryThe University of ChicagoChicagoIllinois
| | - Sophia C. Poletti
- Department of OtorhinolaryngologyInselspital University Hospital BernBernSwitzerland
| | - Vijay R. Ramakrishnan
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Colorado Anschutz Medical CampusAuroraColorado
| | - Philippe Rombaux
- Department of OtorhinolaryngologyCliniques universitaires Saint‐LucBrusselsBelgium
- Institute of NeuroscienceUniveristé catholique de LouvainBrusselsBelgium
| | - Jan Vodicka
- Department of Otorhinolaryngology and Head and Neck SurgeryHospital of PardubicePardubiceCzech Republic
| | - Antje Welge‐Lüessen
- Department of OtorhinolaryngologyHead and Neck SurgeryUniversity Hospital BaselCH‐4051BaselSwitzerland
| | - Katherine L. Whitcroft
- UCL Ear Institute, University College LondonLondonUK
- The Centre for Olfactory Research and ApplicationsInstitute of PhilosophySchool of Advanced StudyLondonUK
| | - Thomas Hummel
- Smell and Taste ClinicDepartment of OtorhinolaryngologyTU DresdenDresdenGermany
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Jeyashree K, Raju M, Ponnaiah M, Muthappan S, Rozario AGA, Raichel R, Jeris WL, Gangakhedkar RR, Murhekar MV. Self-reported and clinically identified loss of smell and taste among persons tested for COVID-19 in Chennai, southern India, July-August 2020: A cross sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 11:100718. [PMID: 33754133 PMCID: PMC7955804 DOI: 10.1016/j.cegh.2021.100718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Early detection of symptoms of loss of smell and taste lately added for Coronavirus disease 2019 (COVID-19) has the potential for improving pandemic response. In the Indian context, we compared proportion experiencing new loss of smell or taste among COVID-19 positive and negative individuals in Chennai city, Southern India. METHODS We did an analytical cross-sectional study among individuals aged 18-80 years undergoing testing at COVID-19 sample collection centres. We ascertained loss of smell and taste using standardised self-reporting and clinical examination procedures. We administered Sino Nasal Outcome (SNOT 22) questionnaire for comprehensive understanding of these symptoms. We compared proportion having symptoms between COVID-19 positive and negative persons. We compared the two assessment methods to compute diagnostic validity indicators. RESULTS Of the 277 participants, 169 (61%) were men and mean age of 40.7 years [SD = 13.3]. Fifty eight (21%) had COVID-19 and 12 (36%) of them were asymptomatic. Predominantly reported symptoms were fever (30%), headache (18%) and cough (18%). Self-reported or clinically identified new loss of smell or taste was higher among COVID-19 positive (n = 13; 22%) than negative persons (n = 23; 11%) [p = 0.02]. Sensitivity was higher for self-reported or clinically identified loss of smell (17.2%) than that of loss of taste (6.9%). Negative predictive value for loss of smell or taste, self-reported or clinically identified was 81%. Likelihood ratio of positive test was 2.13. CONCLUSION Loss of smell or taste are predominantly reported by COVID-19 confirmed individuals. Objective and subjective assessments of smell and taste may be required to identify those requiring COVID-19 testing.
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Affiliation(s)
| | - Mohankumar Raju
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | | | - Rose Raichel
- Dr.Mehta's Hospitals, Chennai, Tamil Nadu, India
| | | | - Raman R Gangakhedkar
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Manoj V Murhekar
- ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
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Mathis S, Le Masson G, Soulages A, Duval F, Carla L, Vallat JM, Solé G. Olfaction and anosmia: From ancient times to COVID-19. J Neurol Sci 2021; 425:117433. [PMID: 33848701 PMCID: PMC9755649 DOI: 10.1016/j.jns.2021.117433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/30/2022]
Abstract
Olfaction, one of our five main qualitative sensory abilities, is the action of smelling or the capacity to smell. Olfactory impairment can be a sign of a medical problem, from a benign nasal/sinus problem up to a potentially serious brain injury. However, although clinicians (neurologists or not) usually test the olfactory nerves in specific clinical situations (for example, when a neurodegenerative disorder is suspected), they may omit such tests in many other situations. With the recent COVID-19 pandemic, the resurgence of anosmia has reminded us of the importance of testing this sensorineural function. We retrace here the main historical steps and discoveries concerning olfaction and anosmia.
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Affiliation(s)
- Stéphane Mathis
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Grand Sud-Ouest' National Reference Center for neuromuscular disorders, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; ALS Center, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France.
| | - Gwendal Le Masson
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Grand Sud-Ouest' National Reference Center for neuromuscular disorders, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; ALS Center, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Neurocentre François Magendie, Unité INSERM 1215, 146 Rue Léo Saignat, 33077 Bordeaux Cedex, France
| | - Antoine Soulages
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Grand Sud-Ouest' National Reference Center for neuromuscular disorders, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; ALS Center, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France
| | - Fanny Duval
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Grand Sud-Ouest' National Reference Center for neuromuscular disorders, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France
| | - Louis Carla
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France
| | - Jean-Michel Vallat
- Department and Laboratory of Neurology, National Reference Center for 'Rare Peripheral Neuropathies', University Hospital of Limoges (CHU Limoges), Dupuytren Hospital, 2 avenue Martin Luther King, 87042 Limoges, France
| | - Guilhem Solé
- Department of Neurology (Nerve-Muscle Unit), University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France; Grand Sud-Ouest' National Reference Center for neuromuscular disorders, University Hospital of Bordeaux (CHU Bordeaux), Pellegrin Hospital, 1 place Amélie Raba-Léon, 33076 Bordeaux, France
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Prajapati DP, Shahrvini B, Said M, Srinivas S, DeConde AS, Yan CH. Assessment of patient recognition of coronavirus disease 2019 (COVID-19)-associated olfactory loss and recovery: a longitudinal study. Int Forum Allergy Rhinol 2021; 11:1529-1537. [PMID: 34096193 PMCID: PMC8222875 DOI: 10.1002/alr.22820] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/01/2021] [Accepted: 05/03/2021] [Indexed: 12/21/2022]
Abstract
Background The clinical course of coronavirus disease 2019 (COVID‐19) olfactory dysfunction remains poorly characterized, often limited by self‐reported measures. Given the logistical challenges of psychophysical testing, understanding the longitudinal relationship between self‐reported and quantitative measures can help accurately identify patients with persistent olfactory dysfunction. This study aimed to longitudinally correlate measured and subjective olfactory function in COVID‐19 subjects. Methods A prospective, longitudinal study evaluating subjective and measured olfaction was conducted on ambulatory COVID‐19 subjects. Olfaction scores were obtained using a visual analogue scale (VAS) (0 = anosmia, 10 = normosmia) and the validated 12‐item Brief Smell Identification Test (BSIT). Weekly testing was performed until recovery (BSIT ≥ 9/12 and/or VAS = 10/10) or study completion. Results Eighty‐six polymerase chain reaction (PCR)‐positive COVID‐19 subjects were recruited ≤3 days from diagnosis and 52 completed longitudinal testing. Among those with self‐reported smell loss at recruitment, similar levels (75.8%) of objective (BSIT ≥ 9/12) and subjective recovery were obtained using a VAS cutoff ≥8, yet only 30.3% reported complete subjective recovery (VAS = 10). Median times to objective and complete subjective olfactory recovery were 12 ± 2.3 and 24 ± 3.5 days, respectively. Although both measures showed chemosensory improvement, the distributions of objective and full subjective olfactory recovery differed significantly (log rank test χ2 = 6.46, degrees of freedom [df] = 1, p = 0.011). Overall correlation between BSIT and VAS scores was moderate to strong across longitudinal follow‐up (rs = 0.41–0.65). Conclusion Self‐reported and psychophysically measured COVID‐19 olfactory dysfunction improve at similar levels and are moderately correlated longitudinally, yet there is a significant delay in complete subjective recovery. Psychophysical testing in conjunction with qualitative assessments may be considered for counseling and follow‐up of patients with COVID‐19 smell loss.
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Affiliation(s)
- Divya P Prajapati
- University of California San Diego School of Medicine, University of California San Diego, La Jolla, California, USA.,Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Bita Shahrvini
- University of California San Diego School of Medicine, University of California San Diego, La Jolla, California, USA.,Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Mena Said
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Shanmukha Srinivas
- University of California San Diego School of Medicine, University of California San Diego, La Jolla, California, USA.,Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Adam S DeConde
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Carol H Yan
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
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48
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Le Bon SD, Payen L, Prunier L, Steffens Y, Horoi M, Vaira LA, Hopkins C, Lechien JR, Saussez S. Making scents of loss of taste in COVID-19: Is self-reported loss of taste due to olfactory dysfunction? A prospective study using psychophysical testing. Int Forum Allergy Rhinol 2021; 11:1504-1507. [PMID: 34013654 PMCID: PMC8222876 DOI: 10.1002/alr.22815] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 02/06/2023]
Affiliation(s)
| | - Léa Payen
- Department of Otorhinolaryngology, epiCURA, Mons, Belgium
| | - Léa Prunier
- Department of Otorhinolaryngology, CHU Saint-Pierre, Brussels, Belgium
| | - Younès Steffens
- Department of Otorhinolaryngology, CHU Saint-Pierre, Brussels, Belgium
| | - Mihaela Horoi
- Department of Otorhinolaryngology, CHU Saint-Pierre, Brussels, Belgium
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science PhD School, Biomedical Science Department, University of Sassari, Sassari, Italy
| | | | - Jérôme R Lechien
- Department of Otorhinolaryngology, CHU Saint-Pierre, Brussels, Belgium
| | - Sven Saussez
- Department of Otorhinolaryngology, epiCURA, Mons, Belgium
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Prem B, Liu DT, Besser G, Renner B, Mueller CA. Retronasal olfactory testing in early diagnosed and suspected COVID-19 patients: a 7-week follow-up study. Eur Arch Otorhinolaryngol 2021; 279:257-265. [PMID: 33987699 PMCID: PMC8118104 DOI: 10.1007/s00405-021-06826-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Olfactory dysfunction (OD) constitutes a major symptom in Coronavirus Disease 2019 (COVID-19). Yet, most data on smell loss rely on the evaluation of orthonasal olfactory performance. Therefore, we aimed to assess retronasal olfactory function (ROF) over a period of several weeks in proven and suspected COVID-19 patients. METHODS One hundred and one subjects with suspected or laboratory-proven COVID-19 participated in this study. In patients with OD no longer than 4 weeks after initial symptom onset, ROF was measured with the 7-item Candy Smell Test ten times over 7 weeks. RESULTS Olfactory function was decreased in the investigated patients and remained decreased over the course of 7 weeks. One-way repeated-measures ANOVA revealed no significant difference of ROF between different measurement time points. However, self-assessment of smell and flavour improved significantly (p = 0.013 and p = 0.043), but did not show complete recovery. CONCLUSION The current investigation revealed significant improvements in subjective smell and flavour perception over the course of 7 weeks in proven and suspected COVID-19 patients suffering from acute OD. However, objectively measured ROF based on a screening test revealed no improvements within the same time period.
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Affiliation(s)
- Bernhard Prem
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - David Tianxiang Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.,Medical Faculty Carl Gustav Carus, Institute of Clinical Pharmacology, Technische Universität Dresden, Dresden, Germany
| | - Christian Albert Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria.
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Maltezou HC, Pavli A, Tsakris A. Post-COVID Syndrome: An Insight on Its Pathogenesis. Vaccines (Basel) 2021; 9:497. [PMID: 34066007 PMCID: PMC8151752 DOI: 10.3390/vaccines9050497] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/22/2022] Open
Abstract
Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome.
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Affiliation(s)
- Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, 11523 Athens, Greece
| | - Androula Pavli
- Department of Travel Medicine, National Public Health Organization, 11523 Athens, Greece;
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
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