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Liu M, Ma R, Cao X, Zhang H, Zhou S, Jiang W, Jiang Y, Sun J, Yang Q, Li X, Sun Y, Shi L, Wang M, Song X, Chen F, Zhang X, Wei H, Yu S, Zhu D, Ba L, Cao Z, Xiao X, Wei X, Lin Z, Chen F, Shan C, Wang G, Ye J, Qu S, Zhao C, Wang Z, Li H, Liu F, Cui X, Ye S, Liu Z, Xu Y, Cai X, Huang W, Zhang R, Zhao Y, Yu G, Shi G, Lu M, Shen Y, Zhao Y, Pei J, Xie S, Yu L, Liu Y, Gu S, Yang Y, Cheng L, liu J. Incidence and prognosis of olfactory and gustatory dysfunctions related to SARS-CoV-2 Omicron strain infection in China: A national multicenter survey of 35,566 individuals. World J Otorhinolaryngol Head Neck Surg 2024; 10:113-120. [PMID: 38855290 PMCID: PMC11156687 DOI: 10.1002/wjo2.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/27/2023] [Accepted: 02/15/2024] [Indexed: 06/11/2024] Open
Abstract
Objective This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.
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Affiliation(s)
- Meng‐Fan Liu
- Graduate School of Beijing University of Chinese MedicineBeijingChina
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
| | - Rui‐Xia Ma
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Xian‐Bao Cao
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Hua Zhang
- Department of OtorhinolaryngologyThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Shui‐Hong Zhou
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Wei‐Hong Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Yan Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jing‐Wu Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of USTCHefeiChina
| | - Qin‐Tai Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Xue‐Zhong Li
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Ya‐Nan Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Li Shi
- Department of Otolaryngology, The Second Hospital of Shandong UniversityShandong UniversityJinanChina
| | - Min Wang
- Department of Otorhinolaryngology Head and Neck SurgeryPeking University People′s HospitalBeijingChina
| | - Xi‐Cheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
| | - Fu‐Quan Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xijing HospitalThe Fourth Military Medical UniversityXi′anChina
| | - Xiao‐Shu Zhang
- Gansu Provincial Center for Disease Control and PreventionLanzhouChina
| | - Hong‐Quan Wei
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of China Medical UniversityShenyangChina
| | - Shao‐Qing Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji HospitalTongji Medical UniversityShanghaiChina
| | - Dong‐Dong Zhu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Luo Ba
- Department of Otorhinolaryngology Head and Neck SurgeryXizang Autonomous Region People′s HospitalLasaChina
| | - Zhi‐Wei Cao
- Department of Otorhinolaryngology Head and Neck SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Xu‐Ping Xiao
- Department of Otorhinolaryngology Head and Neck SurgeryHunan Provincial People′s HospitalChangshaChina
| | - Xin Wei
- Department of Otorhinolaryngology Head and Neck SurgeryHainan General HospitalHaikouChina
| | - Zhi‐Hong Lin
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital, College of MedicineZhejiang UniversityHangzhouChina
| | - Feng‐Hong Chen
- Department of Otorhinolaryngology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Chun‐Guang Shan
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Guang‐Ke Wang
- Department of Otorhinolaryngology Head and Neck SurgeryHenan Provincial People′s HospitalZhengzhouChina
| | - Jing Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Shen‐Hong Qu
- Department of Otorhinolaryngology Head and Neck SurgeryGuangxi Zhuang Autonomous Region People′s HospitalNanningChina
| | - Chang‐Qing Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryShanxi Medical University Affiliated Second HospitalTaiyuanChina
| | - Zhen‐Lin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, XuanWu HospitalCapital Medical UniversityBeijingChina
| | - Hua‐Bin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Feng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China HospitalSichuan UniversityChengduChina
| | - Xiao‐Bo Cui
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | - Sheng‐Nan Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zheng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yu Xu
- Department of Otorhinolaryngology Head and Neck SurgeryRenmin Hospital of Wuhan UniversityWuhanChina
| | - Xiao Cai
- Department of Otorhinolaryngology Head and Neck SurgeryQinghai Provincial People′s HospitalXiningChina
| | - Wei Huang
- Department of Otorhinolaryngology Head and Neck SurgeryTianjin Huanhu HospitalTianjinChina
| | - Ru‐Xin Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryHuadong Hospital Affiliated to Fudan UniversityShanghaiChina
| | - Yu‐Lin Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Guo‐Dong Yu
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Guang‐Gang Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial HospitalAffiliated to Shandong First Medical UniversityJinanChina
| | - Mei‐Ping Lu
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Yang Shen
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yu‐Tong Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Jia‐Hong Pei
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Shao‐Bing Xie
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Long‐Gang Yu
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ye‐Hai Liu
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Shao‐Wei Gu
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Yu‐Cheng Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Jian‐Feng liu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
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Cecchini MP, Pizzini FB, Boschi F, Marcon A, Moro L, Gordon E, Guizard N, Cavedo E, Ricatti MJ, Veronese S, Tamburin S, Tinazzi M, Mansueto G, Sbarbati A. Long-term effects of SARS-CoV-2 infection in patients with and without chemosensory disorders at disease onset: a psychophysical and magnetic resonance imaging exploratory study. Neurol Sci 2024; 45:2409-2418. [PMID: 38441790 PMCID: PMC11082021 DOI: 10.1007/s10072-024-07429-4] [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: 10/27/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
A preserved sense of smell and taste allows us to understand many environmental "messages" and results in meaningfully improvements to quality of life. With the COVID-19 pandemic, it became clear how important these senses are for social and nutritional status and catapulted this niche chemosensory research area towards widespread interest. In the current exploratory work, we assessed two groups of post-COVID-19 patients who reported having had (Group 1) or not (Group 2) a smell/taste impairment at the disease onset. The aim was to compare them using validated smell and taste tests as well as with brain magnetic resonance imaging volumetric analysis. Normative data were used for smell scores comparison and a pool of healthy subjects, recruited before the pandemic, served as controls for taste scores. The majority of patients in both groups showed an olfactory impairment, which was more severe in Group 1 (median UPSIT scores: 24.5 Group 1 vs 31.0 Group 2, p = 0.008), particularly among women (p = 0.014). No significant differences emerged comparing taste scores between Group 1 and Group 2, but dysgeusia was only present in Group 1 patients. However, for taste scores, a significant difference was found between Group 1 and controls (p = 0.005). No MRI anatomical abnormalities emerged in any patients while brain volumetric analysis suggested a significant difference among groups for the right caudate nucleus (p = 0.028), although this was not retained following Benjamini-Hochberg correction. This exploratory study could add new information in COVID-19 chemosensory long-lasting impairment and address future investigations on the post-COVID-19 patients' research.
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Affiliation(s)
- Maria Paola Cecchini
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy.
| | | | - Federico Boschi
- Department of Engineering for Innovation Medicine, Engineering and Physics Section, Verona University, Verona, Italy
| | - Alessandro Marcon
- Department of Diagnostics and Public Heath, Unit of Epidemiology and Medical Statistics, Verona University, Verona, Italy
| | - Lucia Moro
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore, Negrar, Italy
| | | | | | | | - Maria Jimena Ricatti
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Sheila Veronese
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Giancarlo Mansueto
- Department of Engineering for Innovation Medicine, Radiology Unit, Verona University, Verona, Italy
| | - Andrea Sbarbati
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
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Emamzadehashemi YR, Emamzadehashemi KR, Khanghah AG, Paryad E, Sayad Noveiri MJ. Signs and symptoms of covid - 19 in patients with a history of coronary artery bypass grafting surgery. BMC Infect Dis 2024; 24:241. [PMID: 38388892 PMCID: PMC10885614 DOI: 10.1186/s12879-024-09090-w] [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: 09/16/2023] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND People who have coronary artery disease are more likely to develop signs and symptoms of COVID-19 due to their special circumstances. Coronary artery bypass grafting surgery (CABG)does not cure the disease but reduces the signs and symptoms, therefore, there is a possibility of severe complications of Covid-19 after it. MATERIALS AND METHODS This study is a descriptive and cross-sectional study conducted from June to July 2020 on 200 patients who underwent CABG from February 2018 to February 2020. The instrument consisted of socio-demographic variables and COVID's signs and symptoms checklist. Data were collected by census method by telephone. Data were analyzed using descriptive statistics, Fisher's exact test, Mann Whitney U test, and logistic regression model. RESULTS The results showed that the majority of the samples were male (67%). The mean age of them was 62.02 ± 9.06 years and 10% of the m had signs and symptoms of Covid 19. Having the symptoms of COVID-19 is significant in terms of the variables of decreased sense of smell (p < 0.002), decreased sense of taste (p < 0.002), and home quarantine (p < 0.01). The logistic regression model showed decreased sense of taste (OR = 6.071, CI95%: 1.621-29.984, p < 0.009) and non-compliance with home quarantine (OR = 0.061, CI95%: 0.005-0.741, p < 0.028) were the related variables to signs and symptoms of Covid 19. CONCLUSION The results did not indicate the frequency of COVID signs and symptoms among people with a history of Coronary artery bypass grafting surgery more than healthy people in the Iranian community. Extensive studies are suggested in this regard.
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Affiliation(s)
| | | | - Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center (SDHRC), Department of Nursing, Guilan University of Medical Sciences, Rasht, Iran
| | - Ezzat Paryad
- Department of Nursing, GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Marzieh Jahani Sayad Noveiri
- Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Imène K, Mohamed K, Amal G, Mohamed A, Asma C, Asma A, Wael K, Kalboussi H, Olfa EM, Walid N, Maher M, Nejib M. Olfactory Dysfunction in Healthcare Workers with COVID-19: Prevalence and Associated Factors. RECENT ADVANCES IN INFLAMMATION & ALLERGY DRUG DISCOVERY 2024; 18:67-77. [PMID: 37867280 DOI: 10.2174/0127722708249126231006061438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/01/2023] [Accepted: 08/31/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND The COVID-19 pandemic is a real global health crisis. Its clinical presentation has evolved over time with an increasing number of symptoms. Olfactory dysfunction (OD) has recently been recognized as a frequent symptom relevant to screening for COVID-19, especially in pauci-asymptomatic forms. However, the underlying mechanisms of OD are not yet fully understood. AIM To determine the prevalence of OD in healthcare workers with SARS-CoV-2 and to identify its associated factors. METHODS This is a cross-sectional, analytical study, carried out during a period of six months and including all healthcare workers at Farhat Hached Academic Hospital (Tunisia) who were diagnosed with SARS-CoV-2 by PCR, RAT, or chest CT scan. RESULTS A total of 474 healthcare workers were included, representing a participation rate of 85.4%. The mean age was 41.02±10.67 years with a sex ratio of 0.2. The distribution of this population by department noted that it was mainly maternity (13.9%). The most presented workstation was nursing (31.4%). OD represented 39.2% of the reasons for consultation. Hospitalization was indicated in 16 patients (3.4%). The average duration of hospitalization was 8.87 ± 7.8 days. The average time off work was 17.04 ± 11.6 days. OD persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, OD was statistically associated with female gender (p =0.001; OR 95% CI: 2.46 [1.4-4.2]) and blue-collar occupational category (p =0.002; OR IC95%:3.1 [1.5-6.5]). A significant association was also noted between OD and professional seniority and absence from work duration (p =0.019; OR 95% CI: 0.97 [0.95-0.99] and p =0.03; OR 95% CI: 0.97 [0.95-0.99]) respectively. CONCLUSION OD is common in COVID-19 patients. The identification of its associated factors may contribute to enhancing the understanding of its mechanism and drive therapeutic options.
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Affiliation(s)
- Kacem Imène
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Kahloul Mohamed
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Anesthesia and Intensive Care, University Hospital Sahloul, Sousse, Tunisia
| | - Ghenim Amal
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Ajmi Mohamed
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Anesthesia and Intensive Care, University Hospital Sahloul, Sousse, Tunisia
| | - Chouchane Asma
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Aloui Asma
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Khalefa Wael
- Family and Community Medicine Department, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - H Kalboussi
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - El Maalel Olfa
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Naija Walid
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Anesthesia and Intensive Care, University Hospital Sahloul, Sousse, Tunisia
| | - Maoua Maher
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
| | - Mrizak Nejib
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
- Department of Occupational Medicine, University Hospital Farhat Hached, Sousse, Tunisia
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5
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Hu B, Gong M, Xiang Y, Qu S, Zhu H, Ye D. Mechanism and treatment of olfactory dysfunction caused by coronavirus disease 2019. J Transl Med 2023; 21:829. [PMID: 37978386 PMCID: PMC10657033 DOI: 10.1186/s12967-023-04719-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the start of the pandemic, olfactory dysfunction (OD) has been reported as a common symptom of COVID-19. In some asymptomatic carriers, OD is often the first and even the only symptom. At the same time, persistent OD is also a long-term sequela seen after COVID-19 that can have a serious impact on the quality of life of patients. However, the pathogenesis of post-COVID-19 OD is still unclear, and there is no specific treatment for its patients. The aim of this paper was to review the research on OD caused by SARS-CoV-2 infection and to summarize the mechanism of action, the pathogenesis, and current treatments.
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Affiliation(s)
- Bian Hu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
- Department of Otorhinolaryngology-Head and Neck Surgery, Ninghai First Hospital, Ningbo, 315600, Zhejiang, China
| | - Mengdan Gong
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Yizhen Xiang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Siyuan Qu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Hai Zhu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Dong Ye
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China.
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Li J, Wang J, Wang H. Emerging Landscape of Preclinical Models for Studying COVID-19 Neurologic Diseases. ACS Pharmacol Transl Sci 2023; 6:1323-1339. [PMID: 37854617 PMCID: PMC10580392 DOI: 10.1021/acsptsci.3c00127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Indexed: 10/20/2023]
Abstract
COVID-19 (Coronavirus Disease 2019) is an infectious disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and has globally infected 768 million people and caused over 6 million deaths. COVID-19 primarily affects the respiratory system but increasing reports of neurologic symptoms associated with COVID-19 have been reported in the literature. The exact mechanism behind COVID-19 neurologic pathophysiology remains poorly understood due to difficulty quantifying clinical neurologic symptoms in humans and correlating them to findings in human post-mortem samples and animal models. Thus, robust preclinical experimental models for COVID-19 neurologic manifestations are urgently needed. Here, we review recent advances in in vitro, in vivo, and other models and technologies for studying COVID-19 including primary cell cultures, pluripotent stem cell-derived neurons and organoids, rodents, nonhuman primates, 3D bioprinting, artificial intelligence, and multiomics. We specifically focus our discussion on the contribution, recent advancements, and limitations these preclinical models have on furthering our understanding of COVID-19's neuropathic physiology. We also discuss these models' roles in the screening and development of therapeutics, vaccines, antiviral drugs, and herbal medicine, and on future opportunities for COVID-19 neurologic research and clinical management.
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Affiliation(s)
- Jason Li
- Department
of Neurology, Indiana University School
of Medicine, Indianapolis, Indiana 46202, United States
| | - Jing Wang
- Department
of Cellular and Molecular Medicine, University
of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, United States
| | - Hu Wang
- Institute
of Cell Engineering, School of Medicine, Johns Hopkins University, Baltimore 21215, United States
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7
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Mitchell MB, Workman AD, Rathi VK, Bhattacharyya N. Smell and Taste Loss Associated with COVID-19 Infection. Laryngoscope 2023; 133:2357-2361. [PMID: 37265267 DOI: 10.1002/lary.30802] [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: 01/25/2023] [Revised: 03/31/2023] [Accepted: 05/12/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to quantify the impact of COVID-19 on olfactory and gustatory function in US adults. METHODS From the 2021 Adult National Health Interview Survey, demographic and survey-specific module data concerning COVID-19 diagnoses, testing and disease severity, and data quantifying disturbances and eventual recovery of smell and taste were extracted. Sample weights were applied to obtain nationally representative statistics. The overall rate of COVID-19 infection was determined, and those diagnosed with COVID-19 were analyzed with respect to disease severity, smell and taste disturbance, and respective recoveries. RESULTS In 2021, 35.8 million or 14% of the adult population (95% CI 13.5-14.7%; mean age, 43.9 years; 53.8% female) had been diagnosed with COVID-19. Among those, 60.5% (58.6-62.5%) and 58.2% (56.2-60.1%) reported accompanying losses in smell or taste, respectively; there was a significant association between overall COVID-19 symptom severity and smell (p < 0.001) and taste disturbance (p < 0.001). Following infection, 72.2% (69.9-74.3%), 24.1% (22.2-26.2%), and 3.7% (3.0-4.6%) of the patients experienced complete, partial, and no smell recovery, respectively. Recovery rates for gustatory function paralleled olfaction, with 76.8% (74.6-78.9%), 20.6% (18.7-22.7%), and 2.6 (1.9-3.4%) reporting complete, partial, and no recovery of taste, respectively. When sensory disturbance was present, severity of overall symptomatology was negatively associated with smell and taste recovery (p < 0.001 for each). CONCLUSION The majority of adults infected with COVID-19 in 2021 experienced olfactory or gustatory dysfunction with a non-negligible population reporting incomplete or no near-term sensory recovery. Our results are useful for providers counseling patients and suggest that interventions lessening overall COVID-19 symptom burden may prevent prolonged sensory dysfunction. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2357-2361, 2023.
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Affiliation(s)
- Margaret B Mitchell
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Alan D Workman
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Vinay K Rathi
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
| | - Neil Bhattacharyya
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
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8
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Verro B, Vivoli G, Saraniti C. Hyposmia in COVID-19: Temporal Recovery of Smell: A Preliminary Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1511. [PMID: 37763630 PMCID: PMC10535790 DOI: 10.3390/medicina59091511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Hypo/anosmia is a characteristic symptom of COVID-19 infection. The aim of this study is to investigate the time of smell recovery and to identify a possible order of perception recovery of different odors in COVID-19 patients. Materials and Methods: A prospective observational study was conducted on not hospitalized COVID-19 patients, selected according to eligible criteria. The study was approved by the Ethical Committee. A questionnaire formulated by our team was submitted to patients in order to know the duration of the hypo/anosmia and hypo/ageusia and the order of odor recovery: vanillin (mixed olfactory/gustatory substances), phenyl ethyl alcohol (rosewater) (pure olfactory substances), eucalyptol (mixed olfactory/trigeminal substances), and eugenol (mixed olfactory/trigeminal/gustatory substances). Results: 181 patients were included. Hypo/ageusia and hypo/anosmia lasted on average 10.25 (±8.26) and 12.8 (±8.80) days, respectively. The most frequent odor recovery sequence was: (1) phenyl ethyl alcohol; (2) eucalyptol; (3) vanillin; and (4) eugenol. In COVID-19 patients, hypo/anosmia occurs more often in women and at a young age. Conclusions: This preliminary investigation highlighted novel data: there is a chronological order in perception recovery of different olfactory substances and, therefore, in the restoration of the various sensitive nerve pathways involved in the sense of smell.
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Affiliation(s)
- Barbara Verro
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy;
| | - Giulia Vivoli
- Division of Plastic, Reconstructive, Microvascular and Aesthetic Surgery, Department of Maternal-Infant and Adult Surgical Medical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Carmelo Saraniti
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy;
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Landis BN, Hsieh JW, Konstantinidis I, Holbrook EH, Huart C, Mori E, Hummel T. What Is Different in COVID-19-Associated Olfactory Loss from Classical Postinfectious Olfactory Impairment? ORL J Otorhinolaryngol Relat Spec 2023; 85:245-247. [PMID: 37591225 PMCID: PMC10614460 DOI: 10.1159/000533228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Basile Nicolas Landis
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Julien Wen Hsieh
- Rhinology-Olfactory Unit, Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Iordanis Konstantinidis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Eric H. Holbrook
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear/Harvard Medical School, Boston, MA, USA
| | - Caroline Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Machado C, Gutiérrez-Gil J, González-Quevedo A. It is necessary to assess olfactory and gustatory function in post covid-19 patients, due to the omicron variant infection. Int Forum Allergy Rhinol 2023; 13:1564-1566. [PMID: 36965119 DOI: 10.1002/alr.23160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Calixto Machado
- Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba
| | - Joel Gutiérrez-Gil
- Department of Clinical Neurophysiology, Institute of Neurology and Neurosurgery, Havana, Cuba
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11
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Klimek L, Hagemann J, Huppertz T, Bärhold F, Albrecht T, Klimek F, Casper I, Cuevas M, Bergmann C, Becker S. COVID-19 and chronic rhinosinusitis: management and comorbidity - what have we learned? Expert Rev Clin Immunol 2023; 19:1399-1406. [PMID: 37551742 DOI: 10.1080/1744666x.2023.2244673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION Approximately 5%-12% of the population worldwide suffer from chronic rhinosinusitis (CRS). CRS is defined as a chronic respiratory disease and is considered to be a risk factor for COVID-19 patients. AREAS COVERED A non-systematic literature research was conducted on COVID-19 and treatment options for CRSwNP. The latest international publications in medical databases, international guidelines, and the internet were reviewed. Since there were no publications on all aspects of this topic during the pandemic, we included our own experience in this report. Based on the conducted literature research in addition to our previously reported experience, we discuss the treatment of CRSwNP during the COVID-19 pandemic and what can be taken for future pandemics. EXPERT OPINION Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Indications for surgical treatment of CRS should be critically evaluated and reserved for patients with complications and those with no other treatment options. For this purpose, COVID-19 status should be known if possible and, in case of unclear status (emergency), using appropriate personal protective equipment. Systemic corticosteroids should be avoided were possible. Biological treatment should be continued under careful monitoring in uninfected patients and should be temporarily interrupted during COVID-19 infection.
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Affiliation(s)
- L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - J Hagemann
- Department of Otorhinolaryngology, Mainz University Medical Center, Mainz, Germany
| | - T Huppertz
- Department of Otorhinolaryngology, Mainz University Medical Center, Mainz, Germany
| | - F Bärhold
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
| | - T Albrecht
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
| | - F Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - I Casper
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - M Cuevas
- Clinic and Polyclinic for Otorhinolaryngology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Bergmann
- Practice for Ear, Nose and Throat Medicine, Clinic RKM 740, Düsseldorf, Germany
| | - S Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University, Tübingen, Germany
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12
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Hummel T, Power Guerra N, Gunder N, Hähner A, Menzel S. Olfactory Function and Olfactory Disorders. Laryngorhinootologie 2023; 102:S67-S92. [PMID: 37130532 PMCID: PMC10184680 DOI: 10.1055/a-1957-3267] [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] [Indexed: 05/04/2023]
Abstract
The sense of smell is important. This became especially clear to patients with infection-related olfactory loss during the SARS-CoV-2 pandemic. We react, for example, to the body odors of other humans. The sense of smell warns us of danger, and it allows us to perceive flavors when eating and drinking. In essence, this means quality of life. Therefore, anosmia must be taken seriously. Although olfactory receptor neurons are characterized by regenerative capacity, anosmia is relatively common with about 5 % of anosmic people in the general population. Olfactory disorders are classified according to their causes (e. g., infections of the upper respiratory tract, traumatic brain injury, chronic rhinosinusitis, age) with the resulting different therapeutic options and prognoses. Thorough history taking is therefore important. A wide variety of tools are available for diagnosis, ranging from short screening tests and detailed multidimensional test procedures to electrophysiological and imaging methods. Thus, quantitative olfactory disorders are easily assessable and traceable. For qualitative olfactory disorders such as parosmia, however, no objectifying diagnostic procedures are currently available. Therapeutic options for olfactory disorders are limited. Nevertheless, there are effective options consisting of olfactory training as well as various additive drug therapies. The consultation and the competent discussion with the patients are of major importance.
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Affiliation(s)
- T Hummel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - N Power Guerra
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Medizinische Universität Rostock, Rostock
| | - N Gunder
- Universitäts-HNO Klinik Dresden, Dresden
| | - A Hähner
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
| | - S Menzel
- Interdisziplinäres Zentrum Riechen und Schmecken, HNO Klinik, TU Dresden
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13
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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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14
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Heller M, Henrici C, Büttner J, Leube S, Treske I, Pospischil P, Doll M, Schanz I, Hallier A, Herrmann E, Schmidt M, Sarrazin C. SARS-CoV-2 neutralizing antibody therapies: an early retrospective cohort study of 26 hospitalized patients treated with bamlanivimab or casirivimab/imdevimab. Int J Infect Dis 2023; 129:260-265. [PMID: 36690138 PMCID: PMC9859643 DOI: 10.1016/j.ijid.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES In this early retrospective cohort study, a total of 26 patients with SARS-CoV-2 were treated with bamlanivimab or casirivimab/imdevimab, and the reduction of the viral load associated with the developed clinical symptoms was analyzed. METHODS Patients in the intervention groups received bamlanivimab or casirivimab/imdevimab. Patients without treatment served as control. Outcomes were assessed by clinical symptoms and change in log viral load from baseline based on the cycle threshold over a period of 18 days. RESULTS Median log viral load decline was higher in both intervention groups after 3 and 6 days compared to control. However, at later time points, the decline of the viral load was more distinct in the control group. Mild symptoms of COVID-19 were observed in 6.3% of the intervention groups and in no patient of the control. No patients treated with bamlanivimab, 18.8% treated with casirivimab/imdevimab, and 14.2% in the control group developed moderate symptoms. Severe symptoms were recorded only in the control group (14.2%), including one related death. CONCLUSION Treatment with monoclonal SARS-CoV-2 antibodies seems to accelerate decline of virus loads, especially in the first 6 days after administration, compared to control. This may be associated with a reduced likeliness of a severe course of COVID-19.
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Affiliation(s)
- Martin Heller
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany.
| | - Clara Henrici
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Judith Büttner
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Sebastian Leube
- Department of Cardiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Isabelle Treske
- Department of Cardiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Petra Pospischil
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Michael Doll
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Ilka Schanz
- Department of Interdisciplinary Intensive Care, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Agnes Hallier
- Department of Emergency Medicine, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Eva Herrmann
- Institute for Biostatistics and Mathematical Modeling, Universitätsklinikum der Goethe-Universität Frankfurt, Frankfurt am Main, Germany
| | - Michael Schmidt
- Blutspendedienst, DRK Baden-Württemberg - Hessen Gesellschaft mit beschränkter Haftung, Frankfurt Germany
| | - Christoph Sarrazin
- Department of Gastroenterology and Infectiology, Medical Clinic, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
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15
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Hatter M, Abdelwahab M, Holsinger FC, Capasso R, Nayak JV, Hwang PH, Patel ZM, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The burden of olfactory dysfunction during the COVID-19 pandemic in the United Kingdom. Rhinology 2023; 61:93-96. [PMID: 36286227 DOI: 10.4193/rhin22.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK; UCL Cancer Institute, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | - D Chandrasekharan
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- Division of Surgery and Interventional Science, University College London, London, UK
| | - R Gupta
- Division of Surgery and Interventional Science, University College London, London, UK
| | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - M Hatter
- Medical University of South Carolina, Charleston, SC, USA
| | - M Abdelwahab
- Medical University of South Carolina, Charleston, SC, USA
| | - F C Holsinger
- Medical University of South Carolina, Charleston, SC, USA
| | - R Capasso
- Medical University of South Carolina, Charleston, SC, USA
| | - J V Nayak
- Medical University of South Carolina, Charleston, SC, USA
| | - P H Hwang
- Medical University of South Carolina, Charleston, SC, USA
| | - Z M Patel
- Medical University of South Carolina, Charleston, SC, USA
| | - S Paun
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N Eynon-Lewis
- Division of Surgery and Interventional Science, University College London, London, UK
| | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- Division of Surgery and Interventional Science, University College London, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospitals NHS Trust, London, UK
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16
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Anwar F, Altayeb H, Alhayyani S, Kumar V, Al-Abbasi FA, Ashraf GM. Analysis of Interaction Between Odorant Receptors and Flexible Spike of SARS CoV-2- Key to Loss of Smell. Curr Neuropharmacol 2023; 21:151-159. [PMID: 35761501 PMCID: PMC10193757 DOI: 10.2174/1570159x20666220627165846] [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: 12/09/2021] [Revised: 04/06/2022] [Accepted: 06/13/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The development of a vaccine for SARS-CoV-2 is primarily focused on the structure of the spike (S) protein. The heavy glycosylation of S with flexible hinges at the stalk shields from antibody attachment. OBJECTIVE This study deciphers the flexible nature of hinges responsible for binding the odorant receptor on neurons responsible for the loss of smell in COVID-19 patients. METHODS The 3D structure via EPIK in Maestro, protein docking with ligands via Maestro protein analysis tool, and molecular dynamic simulation at 30 ns run using DESMOND was prepared. RESULTS The data of the study strongly suggest that strong and stable bond formation results from the reaction between R:14: Trp and Phe at the residue, targeting the flexible hinges of SARS-CoV-2. The difference in the conformational structure of the S protein and its binding with the odorant receptor in COVID-19 is the prime factor for the loss of smell and taste in patients, as supported by the concept of Antigen (epitope) Antibody interaction by the stable formation of a hydrogen bond among odorant receptor and the S protein. The flexibility of structural proteins determines the binding potential of antibodies or other defense proteins produced to participate in the antigen-antibody reaction. CONCLUSION Molecular and atomic details potentiate the design and screening of small molecules that can inhibit the fusion at entry level or odorant receptors and potentially be used in the prevention and treatment of infection, particularly when formulated as nasal drops, paving a new approach for pharmacologists in the treatment of COVID-19 infection.
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Affiliation(s)
- Firoz Anwar
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Hisham Altayeb
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Sultan Alhayyani
- Department of Chemistry, College of Sciences & Arts, King Abdulaziz University, Rabigh King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Vikas Kumar
- Department of Pharmaceutical Sciences, Natural Product Discovery Laboratory, Shalom Institute of Health and Allied Sciences. SHUATS, Naini, Prayagraj, India
| | - Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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17
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Naidu SAG, Wallace TC, Davies KJA, Naidu AS. Lactoferrin for Mental Health: Neuro-Redox Regulation and Neuroprotective Effects across the Blood-Brain Barrier with Special Reference to Neuro-COVID-19. J Diet Suppl 2023; 20:218-253. [PMID: 33977807 DOI: 10.1080/19390211.2021.1922567] [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] [Indexed: 10/21/2022]
Abstract
Overall mental health depends in part on the blood-brain barrier, which regulates nutrient transfer in-and-out of the brain and its central nervous system. Lactoferrin, an innate metal-transport protein, synthesized in the substantia nigra, particularly in dopaminergic neurons and activated microglia is vital for brain physiology. Lactoferrin rapidly crosses the blood-brain barrier via receptor-mediated transcytosis and accumulates in the brain capillary endothelial cells. Lactoferrin receptors are additionally present on glioma cells, brain micro-vessels, and neurons. As a regulator of neuro-redox, microglial lactoferrin is critical for protection/repair of neurons and healthy brain function. Iron imbalance and oxidative stress are common among patients with neurodegenerative disorders such as Parkinson's disease, Alzheimer's disease, dementia, depression, and multiple sclerosis. As an endogenous iron-chelator, lactoferrin prevents iron accumulation and dopamine depletion in Parkinson's disease patients. Oral lactoferrin supplementation could modulate the p-Akt/PTEN pathway, reduce Aβ deposition, and ameliorate cognitive decline in Alzheimer's disease. Novel lactoferrin-based nano-therapeutics have emerged as effective drug-delivery systems for clinical management of neurodegenerative disorders. Recent emergence of the Coronavirus disease-2019 (COVID-19) pandemic, initially considered a respiratory illness, demonstrated a broader virulence spectrum with the ability to cross the blood-brain barrier and inflict a plethora of neuropathological manifestations in the brain - the Neuro-COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are widely reported in Parkinson's disease, Alzheimer's disease, dementia, and multiple sclerosis patients with aggravated clinical outcomes. Lactoferrin, credited with several neuroprotective benefits in the brain could serve as a potential adjuvant in the clinical management of Neuro-COVID-19.
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Affiliation(s)
- Sreus A G Naidu
- N-terminus Research Laboratory, Yorba Linda, California, USA
| | - Taylor C Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia, USA
- Think Healthy Group, Washington, District of Columbia, USA
| | - Kelvin J A Davies
- Division of Biogerontology, Leonard Davis School of Gerontology, The University of Southern California, Los Angeles, California, USA
- Division of Molecular & Computational Biology, Dornsife College of Letters, Arts, and Sciences, The University of Southern California, Los Angeles, California, USA
- Department Biochemistry & Molecular Medicine, Keck School of Medicine of USC, The University of Southern California, Los Angeles, California, USA
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18
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Klarendic M, Zupanic E, Zalaznik M, Georgiev D, Tomazic J, Kojovic M. Olfactory evaluation in hospitalised and self-isolated patients with COVID-19: a single-centre experience on 55 cases. Postgrad Med J 2022; 98:902-905. [PMID: 34772796 PMCID: PMC8594974 DOI: 10.1136/postgradmedj-2021-140315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/08/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Smell loss is a common symptom of COVID-19 infection. Majority of the studies that evaluated olfactory impairment in COVID-19 used questionnaires (subjective smell evaluations) and did not compare the results with objective or semiobjective measures of smell. We performed smell testing in hospitalised and self-isolated patients with COVID-19 and control participants. METHODS Fifty-five COVID-19 and 44 control participants underwent smell testing, using Burghart Sniffin' Sticks 'Screening 12 Test'. Participants also rated their smelling capability on the numerical scale. Differences between groups and correlation between smell loss and time from acute onset of symptoms were tested, as well as correlation between results of smell test and subjective assessment of smell. RESULTS Hospitalised patients with COVID-19 correctly determined 6.5/12 odorants compared with 10/12 in the self-isolated and 11/12 in the control group (p<0.001). Hyposmia or anosmia were present in 87.5% of hospitalised and 29.0% of self-isolated patients (p<0.001). The correlation between subjective self-assessment and results of smell testing was non-significant in both groups of patients with COVID-19, while there was a moderate positive correlation (p=0.001, Spearman's correlation coefficient=0.499) in control participants. CONCLUSION Contrary to some previous reports suggesting that the presence of olfactory loss may predict milder course of disease, our study found that a vast majority of hospitalised patients with COVID-19 had prominent olfactory impairment. The absence of correlation between self-rated and objective smell evaluation in patients with COVID-19 indicates that subjective smell assessment is unreliable.
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Affiliation(s)
- Maja Klarendic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Zupanic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Zalaznik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department for Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Dejan Georgiev
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Janez Tomazic
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department for Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Maja Kojovic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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19
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Elsayad OA, Abdou SM. Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients. Int Arch Otorhinolaryngol 2022; 26:e533-e537. [PMCID: PMC9668420 DOI: 10.1055/s-0042-1755311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
Olfactory and gustative alterations are frequent in the initial stages of the COVID-19 infection. Vitamin B12 deficiency has been linked to olfactory dysfunction.
Objective
The present study aimed to assess the relationship between vitamin B12 levels and smell affection in COVID-19 patients.
Methods
The present study included 201 laboratory-confirmed COVID-19 patients. Smell affection was assessed using self-rated olfactory function. Serum vitamin B12 levels were assessed using commercial enzyme-linked immunosorbent assay (ELISA) kits.
Results
According to the smell function assessment, the patients were classified into three categories: normal osmesis (
n
= 77), hyposmia (
n
= 49), and anosmia (
n
= 75) (
Fig. 1
). Four weeks later, 195 patients (97.0%) had their normal smell function restored. The remainder 6 patients included 4 anosmic and 2 hyposmic patients. Patients with hyposmia or anosmia had significantly lower vitamin B12 levels when compared with patients with normal osmesis (median [IQR]: 363.0 [198.0–539.0] versus 337.0 [175.0–467.0] and 491.0 [364.5–584.5] pg/ml, respectively,
p
< 0.001).
Conclusion
Vitamin B12 appears to have some contribution to smell affection in patients with COVID-19 infection.
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Affiliation(s)
- Osama A. Elsayad
- Benha University Faculty of Medicine, Tanta University Faculty of Medicine, Tanta, Egypt,Address for correspondence Osama A. Elsayad Benha University Faculty of Medicine, Tanta University Faculty of MedicineEl Bahr St.، Tanta Qism 2, Tanta, Gharbia Governorate 31111Egypt
| | - Said Mohammed Abdou
- Benha University Faculty of Medicine, Tanta University Faculty of Medicine, Tanta, Egypt
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20
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Karimian A, Behjati M, Karimian M. Molecular mechanisms involved in anosmia induced by SARS-CoV-2, with a focus on the transmembrane serine protease TMPRSS2. Arch Virol 2022; 167:1931-1946. [PMID: 35939103 PMCID: PMC9358639 DOI: 10.1007/s00705-022-05545-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
Since 2020, SARS-CoV-2 has caused a pandemic virus that has posed many challenges worldwide. Infection with this virus can result in a number of symptoms, one of which is anosmia. Olfactory dysfunction can be a temporary or long-term viral complication caused by a disorder of the olfactory neuroepithelium. Processes such as inflammation, apoptosis, and neuronal damage are involved in the development of SARS-CoV-2-induced anosmia. One of the receptors that play a key role in the entry of SARS-CoV-2 into the host cell is the transmembrane serine protease TMPRSS2, which facilitates this process by cleaving the viral S protein. The gene encoding TMPRSS2 is located on chromosome 21. It contains 15 exons and has many genetic variations, some of which increase the risk of disease. Delta strains have been shown to be more dependent on TMPRSS2 for cell entry than Omicron strains. Blockade of this receptor by serine protease inhibitors such as camostat and nafamostat can be helpful for treating SARS-CoV-2 symptoms, including anosmia. Proper understanding of the different functional aspects of this serine protease can help to overcome the therapeutic challenges of SARS-CoV-2 symptoms, including anosmia. In this review, we describe the cellular and molecular events involved in anosmia induced by SARS-CoV-2 with a focus on the function of the TMPRSS2 receptor.
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Affiliation(s)
- Ali Karimian
- Department of Otorhinolaryngology, School of Medicine, Kashan University of Medical Science, Kashan, Iran
| | - Mohaddeseh Behjati
- Cellular, Molecular and Genetics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, 47416-95447, Iran.
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21
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Aref ZF, Bazeed SEES, Hassan MH, Hassan AS, Ghweil AA, Sayed MAA, Rashad A, Mansour H, Abdelmaksoud AA. Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia. Infect Drug Resist 2022; 15:5483-5494. [PMID: 36164334 PMCID: PMC9508858 DOI: 10.2147/idr.s381715] [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: 07/10/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Anosmia or hyposmia, with or without taste changes, are common symptoms that occur in SARS-CoV-2 infection and frequently persist as post-COVID-19 manifestations. This is the first trial to assess the potential value of using local ivermectin in the form of a mucoadhesive nanosuspension nasal spray to treat post-COVID-19 anosmia. Methods It is a controlled, randomized trial. Participants were recruited from South Valley University Hospitals in Qena, Upper Egypt, from the ENT and Chest Diseases Departments and outpatient clinics. Patients with persistent post COVID-19 anosmia were randomly divided into two groups, the first group "ivermectin group" included 49 patients treated by ivermectin nanosuspension mucoadhesive nasal spray (two puffs per day). The second group included 47 patients "placebo group" who received saline nasal spray. Follow- up of anosmia [using Visual analogue scale (VAS)] in all patients for three months or appearance of any drug related side effects was done. Results The mean duration of pre-treatment post COVID-19 anosmia was 19.5± 5.8 days in the ivermectin group and 19.1± 5.9 days in the placebo group,p˃0.05. Regarding the median duration of anosmia recovery, the ivermectin group recovered from post COVID-19 anosmia in 13 days compared to 50 days in the placebo group, p˂ 0.001. Following the first week of ivermectin nanosuspension mucoadhesive nasal spray therapy, the ivermectin group had a significantly higher percentage of anosmia recovery (59.2%) than the placebo group (27.7%), p˂ 0.01, with no significant differences in recovery rates between the two groups at 1, 2, and 3 months of follow up, p˃0.05. Conclusion In the small number of patients treated, local Ivermectin exhibited no side effects. In persistent post-COVID-19 anosmia, it could be used for one week at the most as the treatment was extended to one, two and three months, with no difference in recovery compared to the placebo treatment. Trial Registration No NCT04951362.
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Affiliation(s)
- Zaki F Aref
- ENT Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | | | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Abeer S Hassan
- Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, Egypt
| | - Ali A Ghweil
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | | | - Alaa Rashad
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Haggagy Mansour
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, South Valley University, Qena, Egypt
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22
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Shahbaz MA, De Bernardi F, Alatalo A, Sachana M, Clerbaux LA, Muñoz A, Parvatam S, Landesmann B, Kanninen KM, Coecke S. Mechanistic Understanding of the Olfactory Neuroepithelium Involvement Leading to Short-Term Anosmia in COVID-19 Using the Adverse Outcome Pathway Framework. Cells 2022; 11:3027. [PMID: 36230989 PMCID: PMC9563945 DOI: 10.3390/cells11193027] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 12/23/2022] Open
Abstract
Loss of the sense of smell (anosmia) has been included as a COVID-19 symptom by the World Health Organization. The majority of patients recover the sense of smell within a few weeks postinfection (short-term anosmia), while others report persistent anosmia. Several studies have investigated the mechanisms leading to anosmia in COVID-19; however, the evidence is scattered, and the mechanisms remain poorly understood. Based on a comprehensive review of the literature, we aim here to evaluate the current knowledge and uncertainties regarding the mechanisms leading to short-term anosmia following SARS-CoV-2 infection. We applied an adverse outcome pathway (AOP) framework, well established in toxicology, to propose a sequence of measurable key events (KEs) leading to short-term anosmia in COVID-19. Those KEs are (1) SARS-CoV-2 Spike proteins binding to ACE-2 expressed by the sustentacular (SUS) cells in the olfactory epithelium (OE); (2) viral entry into SUS cells; (3) viral replication in the SUS cells; (4) SUS cell death; (5) damage to the olfactory sensory neurons and the olfactory epithelium (OE). This AOP-aligned approach allows for the identification of gaps where more research should be conducted and where therapeutic intervention could act. Finally, this AOP gives a frame to explain several disease features and can be linked to specific factors that lead to interindividual differences in response to SARS-CoV-2 infection.
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Affiliation(s)
- Muhammad Ali Shahbaz
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Francesca De Bernardi
- Division of Otorhinolaryngology, Department of Biotechnologies and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
| | - Arto Alatalo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Magdalini Sachana
- Environment Health and Safety Division, Environment Directorate, Organisation for Economic Cooperation and Development (OECD), 75775 Paris, France
| | | | - Amalia Muñoz
- European Commission, Joint Research Centre (JRC), 2440 Geel, Belgium
| | - Surat Parvatam
- Centre for Predictive Human Model Systems, Atal Incubation Centre-Centre for Cellular and Molecular Biology (AIC-CCMB), Habsiguda, Hyderabad 500039, India
| | | | - Katja M. Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Sandra Coecke
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy
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23
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Pavlidis P, Schittek GA, Fouka E, Spyridonidis E, Gouveris H. [Functional and morphological disorders of taste and olfaction in COVID-19 patients]. HNO 2022; 70:828-836. [PMID: 36040511 PMCID: PMC9425785 DOI: 10.1007/s00106-022-01218-1] [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] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
Ziele Testen der Prävalenz und Entwicklung akuter olfaktorischer und gustatorischer Funktionsstörungen und ihrer morphologischen Korrelate bei COVID-19-Patienten, die aufgrund von COVID-19-bedingten Atemwegserkrankungen einen Krankenhausaufenthalt benötigen. Methoden Eingeschlossen wurden 53 Krankenhauspatienten (23 Männer, 30 Frauen, Alter 42,54 ± 10,95 Jahre) mit RT-PCR-bestätigter COVID-19-Diagnose. Die Patienten wurden zweimal untersucht: direkt nach der Entlassung aus dem Krankenhaus und 4–6 Wochen später. Elektrogustometrische (EGM-)Schwellen im von der Chorda tympani versorgten Zungenbereich, am weichen Gaumen und im Bereich der Papillae vallatae wurden beidseitig erfasst. Der Geruchssinn wurde mit Riechstäbchen untersucht (Sniffin’ Sticks, Burghart GmbH, Wedel, Deutschland). Mittels Kontaktendoskopie wurden die Nasen- und Mundschleimhäute (fungiforme Papillen, fPap) der Patienten untersucht. Die Ergebnisse wurden mit denen von 53 gesunden Personen verglichen (23 Männer, 30 Frauen, Alter 42,90 ± 10,64 Jahre). Ergebnisse Die EGM-Schwellenwerte der Patienten waren in beiden Fällen signifikant höher als die der gesunden Probanden. Die EGM-Schwellenwerte bei der 2. Messung waren signifikant niedriger als bei der 1. Messung. Dementsprechend waren die vom Patienten berichteten gustatorischen Ergebnisse bei der 2. Messung verbessert. Dasselbe Muster wurde bei der Verwendung von Sniffin’ Sticks gefunden. Signifikante Veränderungen in Form und Vaskularisierung von fPap wurden bei Patienten festgestellt, insbesondere beim 1. Mal. Bemerkenswert ist, dass keine signifikanten Unterschiede in der Vaskularisation der Nasenschleimhaut der Patienten beobachtet wurden. Schlussfolgerung COVID-19 beeinträchtigt sowohl die Geschmacks- als auch die Geruchsfunktion. Es beeinflusst auch parallel die Struktur und Vaskularisierung der Mundschleimhaut, wenn auch die Nasenschleimhaut in einem viel geringeren, nicht signifikanten Ausmaß. Unsere Ergebnisse deuten darauf hin, dass COVID-19 eine leichte bis schwere Neuropathie mehrerer Hirnnerven verursachen kann.
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Affiliation(s)
- Pavlos Pavlidis
- HNO-Klinik, Universitätsklinikikum, Mainz, Deutschland. .,, Badralexistr. 3, 59132, Veria, Griechenland.
| | | | - Evangelia Fouka
- Klinik für Pulmologie, Aristotle Universität Thessaloniki, Thessaloniki, Griechenland
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24
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Mazzatenta A, Berardi A, Novarria GA, Neri G. Unmasking the 'Asymptomatic' COVID-19: A Nose Question. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081248. [PMID: 36013428 PMCID: PMC9410152 DOI: 10.3390/life12081248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/22/2022]
Abstract
The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has high infectivity, often masked by asymptomatic carriers, which allows it to spread rapidly and become a pandemic. Attempts to slow the pandemic at this stage depend on the ability to unmask asymptomatic carriers. The rapid diagnosis of active coronavirus disease 2019 (COVID-19) infection is one of the cornerstones of pandemic control, as the nasal cavity is the main gateway for SARS-CoV-2 entry and altered sense of smell is a feature of the current virus. In the present study, we therefore tested the olfactory threshold coupled with heart–lung parameters in subjects undergoing traditional molecular testing, resulting in a significantly different score between asymptomatic subjects and healthy controls. In total, 82% of asymptomatic positives showed olfactory impairment; of these, 46% had severe hyposmia and 7% had anosmia, while in the control 9% had severe hyposmia and 0% had anosmia, respectively, which agrees with heart rate, breathing rate, and blood pressure parameter variations. The olfactory test coupled with physiological parameters may help to identify asymptomatic people. In conclusion, our results suggest that most asymptomatic individuals could be unmasked by mass olfactory rapid threshold screening and then referred to traditional slower diagnostic tests.
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Affiliation(s)
- Andrea Mazzatenta
- Dipartimento di Neuroscienze, Imaging and Clinical Science, ‘G. d’Annunzio’ Chieti-Pescara University, Via dei Vestini 31, 66100 Chieti, Italy
- Correspondence:
| | - Anna Berardi
- ENT Department, Istituto Clinico Città Studi, Via Jommelli 17, 20131 Milano, Italy
| | | | - Giampiero Neri
- Dipartimento di Neuroscienze, Imaging and Clinical Science, ‘G. d’Annunzio’ Chieti-Pescara University, Via dei Vestini 31, 66100 Chieti, Italy
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25
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SARS-CoV-2 Infection (COVID-19) and Rhinologic Manifestation: Narrative Review. J Pers Med 2022; 12:jpm12081234. [PMID: 36013183 PMCID: PMC9409980 DOI: 10.3390/jpm12081234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 01/08/2023] Open
Abstract
Patients with severe pneumonia of unknown etiology presented in December 2019 in Wuhan, China. A novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was isolated from the respiratory tracts of these patients. The World Health Organization (WHO) defined respiratory diseases due to SARS-CoV-2 infection as coronavirus disease 2019 (COVID-19). Many researchers have reported that the nasal cavity is an important initial route for SARS-CoV-2 infection and that the spike protein of this virus binds to angiotensin-converting enzyme 2 (ACE2) on epithelial cell surfaces. Therefore, COVID-19 is thought to significantly affect nasal symptoms and various rhinological diseases. In this review, we summarize the association between COVID-19 and various rhinological diseases, such as olfactory dysfunction, rhinosinusitis, and allergic rhinitis.
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26
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Mohammadian M, Golchoobian R. Potential autonomic nervous system dysfunction in COVID-19 patients detected by heart rate variability is a sign of SARS-CoV-2 neurotropic features. Mol Biol Rep 2022; 49:8131-8137. [PMID: 35810238 DOI: 10.1007/s11033-022-07486-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022]
Abstract
Increasing evidence strongly support that the newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to the development of COVID-19-associated central nervous system (CNS) manifestations. The presence of SARS-CoV-2 viral protein in the brainstem, which includes cardiovascular control centers, has been documented previously. Given the changes in autonomic nervous system function evaluated by heart rate variability (HRV) metrics, which are observed even prior to clinical signs, the potential effect of SARS-CoV-2 on the autonomic nervous system (ANS) center is likely. The integral parts of the brain renin-angiotensin system, as ACE2 enzyme, are highly expressed in the brainstem, which may also be involved in baroreflex sensitivity, playing an important role in HRV. SARS-CoV-2 may bind to ACE2 in order to enter the host brainstem cell and change baroreflex sensitivity due to the altered ratio of the concentration of angiotensin II (Ag II) to angiotensin (1-7). In this article, we discussed the information on the possibility that the SARS-CoV-2 viral particle by disrupting the homeostasis of the brain renin-angiotensin system even without brainstem neuropathological changes, may affect the function of the ANS center in the brainstem. SARS-CoV-2 could influence ANS function before affecting the immune system. It is possible that the altered HRV parameters imply the potential neurotropic characteristics of SARS-CoV-2. Therefore, this potential feature should be taken into account in diagnostic and therapeutic approaches for COVID-19 patients.
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Affiliation(s)
- Maryame Mohammadian
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ravieh Golchoobian
- Department of Physiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
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27
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Assessment of Neurocognitive Functions, Olfaction, Taste, Mental, and Psychosocial Health in COVID-19 in Adults: Recommendations for Harmonization of Research and Implications for Clinical Practice. J Int Neuropsychol Soc 2022; 28:642-660. [PMID: 34365990 PMCID: PMC8825876 DOI: 10.1017/s1355617721000862] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To propose a set of internationally harmonized procedures and methods for assessing neurocognitive functions, smell, taste, mental, and psychosocial health, and other factors in adults formally diagnosed with COVID-19 (confirmed as SARS-CoV-2 + WHO definition). METHODS We formed an international and cross-disciplinary NeuroCOVID Neuropsychology Taskforce in April 2020. Seven criteria were used to guide the selection of the recommendations' methods and procedures: (i) Relevance to all COVID-19 illness stages and longitudinal study design; (ii) Standard, cross-culturally valid or widely available instruments; (iii) Coverage of both direct and indirect causes of COVID-19-associated neurological and psychiatric symptoms; (iv) Control of factors specifically pertinent to COVID-19 that may affect neuropsychological performance; (v) Flexibility of administration (telehealth, computerized, remote/online, face to face); (vi) Harmonization for facilitating international research; (vii) Ease of translation to clinical practice. RESULTS The three proposed levels of harmonization include a screening strategy with telehealth option, a medium-size computerized assessment with an online/remote option, and a comprehensive evaluation with flexible administration. The context in which each harmonization level might be used is described. Issues of assessment timelines, guidance for home/remote assessment to support data fidelity and telehealth considerations, cross-cultural adequacy, norms, and impairment definitions are also described. CONCLUSIONS The proposed recommendations provide rationale and methodological guidance for neuropsychological research studies and clinical assessment in adults with COVID-19. We expect that the use of the recommendations will facilitate data harmonization and global research. Research implementing the recommendations will be crucial to determine their acceptability, usability, and validity.
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28
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Ganesh A, Reis IR, Varma M, Patry DG, Cooke LJ. Neurological and Head/Eyes/Ears/Nose/Throat Manifestations of COVID-19: A Systematic Review and Meta-Analysis. Can J Neurol Sci 2022; 49:514-531. [PMID: 34287109 PMCID: PMC8460425 DOI: 10.1017/cjn.2021.180] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVE Coronavirus disease 2019 (COVID-19) has been associated with various neurological and atypical head/eyes/ears/nose/throat (HEENT) manifestations. We sought to review the evidence for these manifestations. METHODS In this systematic review and meta-analysis, we compiled studies published until March 31, 2021 that examined non-respiratory HEENT, central, and peripheral nervous system presentations in COVID-19 patients. We included 477 studies for qualitative synthesis and 59 studies for meta-analyses. RESULTS Anosmia, ageusia, and conjunctivitis may precede typical upper/lower respiratory symptoms. Central nervous system (CNS) manifestations include stroke and encephalopathy, potentially with brainstem or cranial nerve involvement. MRI studies support CNS para-/postinfectious etiologies, but direct neuroinvasion seems very rare, with few cases detecting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the CNS. Peripheral nervous system (PNS) manifestations include muscle damage, Guillain-Barre syndrome (GBS), and its variants. There was moderate-to-high study heterogeneity and risk of bias. In random-effects meta-analyses, anosmia/ageusia was estimated to occur in 56% of COVID-19 patients (95% CI: 0.41-0.71, I2:99.9%), more commonly than in patients without COVID-19 (OR: 14.28, 95% CI: 8.39-24.29, I2: 49.0%). Neurological symptoms were estimated to occur in 36% of hospitalized patients (95% CI: 0.31-0.42, I2: 99.8%); ischemic stroke in 3% (95% CI: 0.03-0.04, I2: 99.2%), and GBS in 0.04% (0.033%-0.047%), more commonly than in patients without COVID-19 (OR[stroke]: 2.53, 95% CI: 1.16-5.50, I2: 76.4%; OR[GBS]: 3.43,1.15-10.25, I2: 89.1%). CONCLUSIONS Current evidence is mostly from retrospective cohorts or series, largely in hospitalized or critically ill patients, not representative of typical community-dwelling patients. There remains a paucity of systematically gathered prospective data on neurological manifestations. Nevertheless, these findings support a high index of suspicion to identify HEENT/neurological presentations in patients with known COVID-19, and to test for COVID-19 in patients with such presentations at risk of infection.
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Affiliation(s)
- Aravind Ganesh
- Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Isabella R. Reis
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Malavika Varma
- Department of Emergency Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - David G. Patry
- Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Lara J. Cooke
- Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
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ERDOĞMUŞ KÜÇÜKCAN N, KÜÇÜKCAN A. COVID-19 ile enfekte hastalarda koku ve tat disfonksiyonu prevalansı. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1093938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Amaç: Bu çalışma, COVID-19 ile enfekte kişilerin hastaneye başvuru şekline ve olası risk faktörlerine göre koku ve tat alma disfonksiyonunu (KTD) değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Çalışmaya Ocak ve Eylül 2021 arasında COVID-19 tanısı konan toplam 200 hasta dahil edildi. Hastalar iki gruba ayrıldı. İlk grupta; kliniği daha hafif seyreden, evde izole olan 100 hasta, ikinci grupta; kliniği daha ağır seyreden pandemi servisinde yatan 100 hasta bulunmaktaydı. Hastalar hastaneye başvuru sırasında koku ve tat fonksiyonları ve çeşitli klinik bilgileri hakkında veri formu doldurdu. Hastalardan ayrıca görsel analog skalası (GAS) kullanarak koku ve tat bozukluklarını derecelendirmeleri istendi.
Bulgular: Evde izole olarak takip edilen hastaların, %72’ si kadın olup, yaş ortalaması 39,6±13,2’dır. Pandemi servisinde takip edilen hastaların ise %50’ si kadın ve ortalama yaş 52.4±11,0. Tüm hastalarda en sık görülen semptom tat (%41) ve koku (45,5) kaybıydı. Kadın cinsiyette ve gençlerde KTD daha yüksek bulundu. Ayaktan hastalarda KTD daha sıktı. Tat ve koku VAS skorları ayakta takip edilen hastalarda daha düşüktü.
Sonuç: KTD; COVID-19 ile enfekte kişilerde çeşitli mekanizmalar aracılığıyla artmış inflamatuar yanıta bağlı oluşur. KTD, anahtar semptom ve tanı göstergesi olarak görülmeli ve sorgulanmalıdır. KTD sıklığının yaş gruplarında ve cinsiyete göre farklılıklar gösterebileceği akılda tutulmalıdır.
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Hafez W, Abdelshakor M, Gador M, Abdelli I, Ahmed S. The Prevalence and Implications of Olfactory/Gustatory Dysfunctions among Adult COVID-19 Patients: A Retrospective Cohort Multiethnic Populations Study. Trop Med Infect Dis 2022; 7:tropicalmed7070115. [PMID: 35878127 PMCID: PMC9320986 DOI: 10.3390/tropicalmed7070115] [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: 05/29/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Olfactory and gustatory dysfunctions (OGDs) was found in COVID-19 patients. Only a few studies looked into the prevalence of OGDs in the United Arab Emirates (UAE). The purpose of this study was to estimate the prevalence OGDs among multiethnic COVID-19 patients in the UAE, and its association to patients’ characteristics and disease outcomes; (2) Methods: There were 1785 COVID-19 patients included in our cohort; (3) Results: Males made up most of the study participants (86.3%). A total of 11.7% of the participants reported OGDs. Female gender and ethnicity had significantly higher symptom prevalence (p < 0.001). COVID-19 severity had a strong inverse association with OGDs (p = 0.007). Other illness outcomes, such as ICU admission, pneumonia development, and mortality, showed no correlation. Males, Asians, and patients with comorbidities all had statistically significantly lower prevalence odds. On the other hand, Emirati, Arab, and Iranian patients had a higher prevalence. COVID-19 patients with OGDs had a considerably shorter time until viral clearance than those without the symptom; (4) Conclusions: in nonsevere COVID-19, olfactory/gustatory dysfunction is common. As a result, it could be applied as a predictive sign for early disease diagnosis and prognosis.
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Affiliation(s)
- Wael Hafez
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
- The Medical Research Division, Department of Internal Medicine, The National Research Center, El Buhouth Street, Ad Doqi, Cairo 12622, Egypt
- Correspondence:
| | - Mahmoud Abdelshakor
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Muneir Gador
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Ikram Abdelli
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
| | - Shougyat Ahmed
- NMC Royal Hospital, 16th Street, Khalifa City P.O. Box 35233, Abu Dhabi, United Arab Emirates; (M.A.); (M.G.); (I.A.); (S.A.)
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Chronic Rhinosinusitis and COVID-19. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1423-1432. [PMID: 35307579 PMCID: PMC8926942 DOI: 10.1016/j.jaip.2022.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/03/2022] [Accepted: 03/03/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has raised awareness about olfactory dysfunction, although a loss of smell was present in the general population before COVID-19. Chronic rhinosinusitis (CRS) is a common upper airway chronic inflammatory disease that is also one of the most common causes of olfactory dysfunction. It can be classified into different phenotypes (ie, with and without nasal polyps) and endotypes (ie, type 2 and non-type 2 inflammation). However, scientific information regarding CRS within the context of COVID-19 is still scarce. This review focuses on (1) the potential effects of severe acute respiratory syndrome coronavirus 2 infection on CRS symptoms, including a loss of smell, and comorbidities; (2) the pathophysiologic mechanisms involved in the olfactory dysfunction; (3) CRS diagnosis in the context of COVID-19, including telemedicine; (4) the protective hypothesis of CRS in COVID-19; and (5) the efficacy and safety of therapeutic options for CRS within the context of COVID-19.
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Elvan-Tuz A, Karadag-Oncel E, Kiran S, Kanik-Yuksek S, Gulhan B, Hacimustafaoglu M, Ozdem-Alatas S, Kuyucu N, Ozdemir H, Egil O, Elmas-Bozdemir S, Polat M, Bursal-Duramaz B, Cem E, Apaydin G, Teksam O. Prevalence of Anosmia in 10.157 Pediatric COVID-19 Cases: Multicenter Study from Turkey. Pediatr Infect Dis J 2022; 41:473-477. [PMID: 35349499 PMCID: PMC9083317 DOI: 10.1097/inf.0000000000003526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire. MATERIAL AND METHODS This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10-18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness. RESULTS Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001). DISCUSSION With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia.
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Affiliation(s)
- Aysegul Elvan-Tuz
- From the Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Eda Karadag-Oncel
- From the Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Sibel Kiran
- Hacettepe University Hospital, Ankara, Turkey
| | | | | | | | | | | | | | - Oguz Egil
- Gaziantep CG Obstetrics and Children’s Hospital, Gaziantep, Turkey
| | | | - Meltem Polat
- Health Sciences University Dr Sami Ulus Training and Research Hospital, Ankara, Turkey
| | | | - Ela Cem
- Health Sciences University Behcet Uz Training and Research Hospital, Izmir, Turkey
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Insights into the molecular triggers of parosmia based on gas chromatography olfactometry. COMMUNICATIONS MEDICINE 2022; 2:58. [PMID: 35647609 PMCID: PMC9130211 DOI: 10.1038/s43856-022-00112-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 04/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Parosmia is a debilitating condition in which familiar smells become distorted and disgusting, with consequences for diet and mental health. It is a feature of post-infectious olfactory loss, particularly resulting from COVID-19. There is currently little understanding of its pathophysiology, and the prevailing hypothesis for the underlying mechanism is aberrant growth of regenerating olfactory sensory neurons after damage. Methods We use gas-chromatograph olfactometry to individually present components of a complex olfactory mixture as a rapid screening tool for assessment of both quantitative and qualitative olfactory dysfunction in those with and without parosmia. This allows them to report the associated sensory effects and to identify those molecules which are altered or parosmic in nature. Results Here we show 15 different molecular triggers of this symptom. These trigger molecules are common to many in the parosmic volunteer group and share certain characteristics such as extremely low olfactory threshold and common molecular structure Conclusions We posit that specific highly odour-active molecules are the cause of the parosmic symptom in most cases and initiate the sense of disgust, suggesting that parosmia is, at least in part, a receptor-level phenomenon. Parker et al. determine the aroma compounds responsible for the distortions experienced by those with the olfactory disorder parosmia, by applying a technique normally used in flavour chemistry, GC-Olfactometry. The authors show that a group of 15 highly odour-active compounds are common triggers of distortion and individually elicit the perception of disgust. During the recovery from smell loss, caused by infection or injury, sometimes certain smells can become revolting – a condition called parosmia. We used a technique that separates out the chemicals that make up the smell of instant coffee and let several people with parosmia after infection smell them one at a time. Most of these people picked out the same chemicals as smelling disgusting and setting off their parosmia. These chemicals are known to have strong smells to humans and can be grouped into four classes based on their chemical shape and the elements they contain. These findings help in the understanding of what chemical compounds trigger parosmia, which may help in developing diagnostics and therapies for this condition in the future.
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Arora RD, Krishna Sasanka KSBS, Thangaraju P, Tanguturi Yella SS, Nagarkar NM. Proportion of New Onset of Anosmia and Its Diagnostic Significance in COVID-19. Cureus 2022; 14:e24983. [PMID: 35719805 PMCID: PMC9191271 DOI: 10.7759/cureus.24983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 01/08/2023] Open
Abstract
Objective: This study aimed to know the proportion of new-onset of anosmia and to find its diagnostic significance in coronavirus disease 2019 (COVID-19) patients attending the hospital. Study design and duration: The Indian smell test in COVID-19 by AIIMS Raipur (ISCA-R) was developed for evaluating olfaction in the Indian population. The olfactory function was assessed using the corona scale on anosmia AIIMS Raipur (COSANAr). Results: Out of 256 patients, 171 were males and 85 were females. In the majority of the patients, 75 (29.29%), the COSANAr score “0” was higher on the day of admission compared to the score “3” on the day of discharge with 61 (23.82%) patients. There was no improvement in 134 (52.34%) patients with loss of smell at the time of discharge. Conclusion: This study is a step forward in identifying anosmia by ISCA-R at the early stages of the COVID phase. The COSANAr is affordable for the Indian population. It is noticed that most of the patients have mild hyposmia at the time of discharge and anosmia at the admission time.
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Tomasino B, Pellitteri G, Bax F, Marini A, Surcinelli A, Gigli GL, Valente M. Multisensory mental representation in covid-19 patients and the possibility of long-lasting gustatory and olfactory dysfunction in the CNS. Sci Rep 2022; 12:7340. [PMID: 35513422 PMCID: PMC9069215 DOI: 10.1038/s41598-022-11119-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/06/2022] [Indexed: 12/19/2022] Open
Abstract
Gustatory (GD) and olfactory (OD) dysfunctions are the most frequent neurological manifestations of COVID-19. We used mental imagery as an experimental psychological paradigm to access olfactory and gustatory brain representations in 80 Italian COVID-19 adult patients (68.75% reported both OD and GD). COVID-19 patients with OD + GD have a significantly and selectively decreased vividness of odor and taste imagery, indicating that COVID-19 has an effect on their chemosensory mental representations. OD + GD length and type influenced the status of mental chemosensory representations. OD + GD were become all COVID-19 negative at the time of testing. Data suggest that patients are not explicitly aware of long-term altered chemosensory processing. However, differences emerge when their chemosensory function is implicitly assessed using self-ratings. Among patients developing OD + GD, self-ratings of chemosensory function (taste, flavor) were significantly lower as compared to those who did not. At the level of mental representation, such differences can be further detected, in terms of a reduced ability to mentally activate an odor or taste mental image. Our study shows that COVID-19 infection not only frequently causes hyposmia and dysgeusia, but that may also alter the mental representations responsible for olfactory and gustatory perception.
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Affiliation(s)
- Barbara Tomasino
- Scientific Institute IRCCS "Eugenio Medea", Polo Regionale del Friuli Venezia Giulia, Via della Bontà, 7, 33078, San Vito Al Tagliamento, PN, Italy.
| | - Gaia Pellitteri
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Francesco Bax
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Alessandro Marini
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Andrea Surcinelli
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Neurology Unit, Department of Medicine (DAME), University of Udine, Udine, Italy
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Cortes-Altamirano JL, Yáñes-Pizaña A, Reyes-Long S, Angélica GM, Bandala C, Bonilla-Jaime H, Alfaro-Rodríguez A. Potential Neuroprotective Effect of Cannabinoids in Covid-19 Patients. Curr Top Med Chem 2022; 22:1326-1345. [PMID: 35382723 DOI: 10.2174/1568026622666220405143003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/29/2022] [Accepted: 02/08/2022] [Indexed: 11/22/2022]
Abstract
The global pandemic caused by the SARS-CoV-2 virus began in early 2020 and is still present. The respiratory symptoms caused by COVID-19 are well established, however, neurological manifestations that may result from direct or indirect neurological damage after SARS-CoV-2 infection have been reported frequently. The main proposed pathophysiological processes leading to neurological damage in COVID-19 are cerebrovascular disease, and indirect mechanisms of inflammatory / autoimmune origin. A growing number of studies confirm that neuroprotective measures should be maintained in COVID-19 patients. On the other hand, cannabinoids have been the subject of various studies that propose them as potential promising drugs in chronic neurodegenerative diseases due to their powerful neuroprotective potential. In this review we address the possible mechanism of action of cannabinoids as a neuroprotective treatment in patients infected by SARS-CoV-2. The endocannabinoid system is found in multiple systems within the body, including the immune system. Its activation can lead to beneficial results, such as a decrease in viral entry, a decrease in viral replication, and a decrease in pro-inflammatory cytokines such as IL-2, IL-4, IL-6, IL-12, TNF-α or IFN-c through CB2R expression induced during inflammation by SARS-CoV-2 infection in the central nervous system.
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Affiliation(s)
- José Luis Cortes-Altamirano
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico.,Departamento de Quiropráctica, Universidad Estatal del Valle de Ecatepec, Estado de Mexico, 55210, Mexico
| | - Ariadna Yáñes-Pizaña
- Escuela de Ciencias de la Salud, Medicina Veterinaria y Zootecnia, Universidad del Valle de Mexico, Mexico City, 04910, México.,Escuela de Medicina Veterinaria y Zootecnia en Pequeñas Especies, Federación Canofila Mexicana, Mexico City, 14430, México
| | - Samuel Reyes-Long
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico.,Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, 07738, México
| | - González-Maciel Angélica
- Laboratory of Cell and Tissue Morphology, Instituto Nacional de Pediatría, Secretaría de Salud, Insurgentes Sur No. 3700-C, Mexico City, C. P. 04530, Mexico
| | - Cindy Bandala
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico.,Escuela de Medicina Veterinaria y Zootecnia en Pequeñas Especies, Federación Canofila Mexicana, Mexico City, 14430, México
| | - Herlinda Bonilla-Jaime
- Departamento de Biología de la reproducción, Universidad Autónoma Metropolitana, Mexico City, 09340, Mexico
| | - Alfonso Alfaro-Rodríguez
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico
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Bhutani S, Coppin G, Veldhuizen MG, Parma V, Joseph PV. COVID-19 related chemosensory changes in individuals with self-reported obesity. Rhinology 2022; 60:128-138. [PMID: 35191431 PMCID: PMC11036347 DOI: 10.4193/rhin21.351] [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: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Self-reported smell loss is a prominent symptom of COVID-19 infection and a potentially useful clinical tool for remote pre-screening of this disease. However, pre-existing chemosensory dysfunction with obesity may diminish the usefulness of self-reported smell loss in this vulnerable group. Here we aim to compare COVID-19 related chemosensory alterations in participants with and without obesity and determine if self-reported smell loss is predictive of lab-based COVID-19 diagnosis in both groups in the context of restrictive clinical data collection. SUBJECTS/METHODS In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to have obesity (C19+; n = 433, C19-; n = 86) or not. RESULTS Participants with obesity and without obesity reported a similar decline in smell, taste, and chemesthesis during illness. In C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory and GI symptoms. Critically, we found that the model previously proposed also predicts C19+ diagnosis in participants with obesity. CONCLUSIONS We conclude that COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity. In both groups self-reported chemosensory symptoms are similarly predictive of COVID-19 infection, thus highlighting the potential of collecting self-report of symptoms and comorbidities remotely when clinical observations are restrictive.
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Affiliation(s)
- S Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - G Coppin
- Department of Psychology, Formation Universitaire Distance (UniDistance), Brig, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - M G Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - V Parma
- Department of Psychology, Temple University, Monell Chemical Senses Center, Philadelphia, PA, USA
| | - P V Joseph
- National Institutes of Alcohol Abuse and Alcoholism and National Institute of Nursing Research, Bethesda, MD, USA
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Parker JK, Methven L, Pellegrino R, Smith BC, Gane S, Kelly CE. Emerging Pattern of Post-COVID-19 Parosmia and Its Effect on Food Perception. Foods 2022; 11:967. [PMID: 35407054 PMCID: PMC8997629 DOI: 10.3390/foods11070967] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 01/05/2023] Open
Abstract
Olfactory dysfunction is amongst the many symptoms of Long COVID. Whilst most people that experience smell loss post COVID-19 recover their sense of smell and taste within a few weeks, about 10% of cases experience long-term problems, and their smell recovery journey often begins a few months later when everyday items start to smell distorted. This is known as parosmia. The aim of this study was to identify the key food triggers of parosmic distortions and investigate the relationship between distortion and disgust in order to establish the impact of parosmia on diet and quality of life. In this cross-sectional study (n = 727), respondents experiencing smell distortions completed a questionnaire covering aspects of smell loss, parosmia and the associated change in valence of everyday items. There was a significant correlation between strength and disgust (p < 0.0001), and when the selected items were reported as distorted, they were described as either unpleasant or gag-inducing 84% of the time. This change in valence associated with loss of expected pleasure and the presence of strange tastes and burning sensations must certainly lead to changes in eating behaviours and serious longer-term consequences for mental health and quality of life.
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Affiliation(s)
- Jane K. Parker
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
| | | | - Barry C. Smith
- Centre for the Study of the Senses, Institute of Philosophy, School of Advanced Study, University of London, London WC1E 7HU, UK;
| | - Simon Gane
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, University College London Hospital, 47-49 Huntley St., London WC1E 6DG, UK;
| | - Christine E. Kelly
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (L.M.); (C.E.K.)
- AbScent, 14 London Road, Andover SP10 2PA, UK
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SARS-CoV-2 Leads to Significantly More Severe Olfactory Loss than Other Seasonal Cold Viruses. Life (Basel) 2022; 12:life12030461. [PMID: 35330212 PMCID: PMC8955706 DOI: 10.3390/life12030461] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 01/05/2023] Open
Abstract
The aim of this study was to investigate whether COVID-associated olfactory impairment differs from olfactory disorders due to other upper respiratory tract infections. We investigated the frequency of a SARS-CoV-2 infection among subjects presenting with a subjective olfactory impairment to a corona outpatient clinic between October 2020 and March 2021. Olfactory and gustatory loss were tested psychophysically, and the type of infection, SARS-CoV-2 versus 14 other common cold viruses, was assessed with nasopharyngeal swabs. Differences between the smell impairment caused by the pathogens were compared. Out of the 2120 patients, 314 reported sudden smell and/or taste loss (14%). In 68.9% of them, olfactory and in 25.6%, gustatory dysfunction could be confirmed by psychophysical testing. Of those with a psychophysically determined loss of smell, 61% were tested positive for SARS-CoV-2. SARS-CoV-2 led to a significantly more severe loss of smell and more qualitative olfactory disorders than other pathogens. Apart from rhinorrhea, shortness of breath and sore throat accompanying cold symptoms do not differ significantly between the viruses indicating the particular importance of smell loss in the differential diagnosis of seasonal colds. Multiplex-PCR in non-COVID patients revealed that only 27% of them had rhinoviruses, whereas the remainder were no further identified pathogens. Olfactory screening significantly increases diagnostic accuracy in COVID-19 patients compared to subjective assessment of olfactory loss.
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Kokorina VE, Bykov IA. [The optimization in the rehabilitation of anosmia after SARS-CoV-2 infection]. Vestn Otorinolaringol 2022; 87:33-38. [PMID: 35274890 DOI: 10.17116/otorino20228701133] [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: 11/17/2022]
Abstract
During SARS-CoV-2 pandemic number of patients with olfactory disorders caused by new coronavirus infection substantially increased, making their rehabilitation an issue of the day. We analyzed influence of the drug Sinupret on the restoration dynamic of the olfactory dysfunction associated with SARS-CoV-2 infection. 187 patients with impaired sense of smell associated with SARS-CoV-2 infection were included in this study: test group consisted of 104 cases in which olfactory training methods were combined with the prescription of the drug Sinupret. Control group consisted of 84 patients those undergone olfactory training alone. During study period in 26 patients restoration of the olfactory disorders have not been achieved, due to the virus induced neurodegenerative nature of the lesion. It was observed that in test group odor detection threshold restoration was on average 3.6 days faster than in control group. At the same time, the use of Sinupret was associated with a statistically significant 29.4% decrease of antibiotic prescription frequency for bacterial complications of SARS-CoV-2. Therefore, we assume that the positive effect of Sinupret on SARS-CoV-2 associated anosmia is caused by its antiviral, secretolytic, anti-inflammatory, decongestant and moderately antibacterial effects in the olfactory epithelium.
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Affiliation(s)
- V E Kokorina
- Postgraduate Institute for Public Health Workers, Surgical Department, Khabarovsk, Russia
| | - I A Bykov
- Far Eastern State Medical University Public Health and Healthcare Department, Khabarovsk, Russia.,Harbin Medical University School of Public Health Social Medicine Department, Harbin, People's Republic of China
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Beigi-Khoozani A, Merajikhah A, Soleimani M. Magnetic Resonance Imaging Findings of Olfactory Bulb in Anosmic Patients with COVID-19: A Systematic Review. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2022; 37:3982. [PMID: 35256044 PMCID: PMC9026950 DOI: 10.24920/003982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/15/2021] [Indexed: 06/14/2023]
Abstract
Background Anosmia is one of the symptoms in individuals with SARS-CoV-2 infection. In anosmic patients, SARS-CoV-2 temporarily alters the signaling process in olfactory nerve cells and olfactory bulb (OB), which eventually damages the structure of the olfactory epithelium, leading to a permanent disorder in the olfactory pathway that this damaged structure is showed in MRI imaging Methods Two investigators independently searched four databases consisting of PubMed, ProQuest, Scopus, and Web of Science for relevant records as of November 11, 2020 with no time, space, and language restrictions. Google Scholar was also searched for the related resources within the time limit of 2020. All the found articles were reviewed based on the PRISMA flow diagram. Qualitative studies, case reports, editorials, letters, and other non-original studies were excluded from this systematic analysis. Results Initial search yielded 434 records. After reviewing the titles and abstracts, we selected 74 articles; finally, 8 articles were depicted to be investigated and read in full text. The obtained results showed an increase in the width and volume of the olfactory cleft (OC), complete or partial destruction of OC, and complete occlusion of OC in COVID-19 patients. Deformation and degeneration as well as a subtle asymmetry were evident in the OBs. Computed tomography (CT), meganetic resonance imaging (MRI), and positron emission tomography (PET) were used to detect the outcomes of anosmia in these studies. Conclusions The changes in OC are greater than those in OB in patients with COVID-19, mainly due to the inflammatory and immune responses in OC. However, fewer changes in OB are due to neurological or vascular disorders. Topical steroid therapy and topical saline can be helpful.
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Affiliation(s)
| | - Amirmohammad Merajikhah
- Department of Operating Room, Sabzevar University of Medical Sciences, Razavi Khorasan, Iran
| | - Mahdieh Soleimani
- Department of Operating Room, Maragheh University of Medical Sciences, East Azerbaijan, Iran
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Abstract
The worldwide pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected an estimated 200 million people with over 4 million deaths. Although COVID-19, the disease caused by the SARS-CoV-2 virus, is primarily a respiratory disease, an increasing number of neurologic symptoms have been reported. Some of these symptoms, such as loss of smell or taste, are mild and non-life threatening, while others, such as stroke or seizure, are more critical. Many of these symptoms remain long after the acute illness has passed, a phenomenon known as "long COVID" or postacute sequelae of SARS-CoV-2 infection (PASC). Neurological symptoms can be difficult to study due to the complexity of the central and peripheral nervous system. These neurologic symptoms can be difficult to identify and quantitate. This narrative review will describe approaches for assessing neurologic manifestations of COVID-19, with examples of the data they provide, as well as some directions for future research to aid in understanding the pathophysiology of COVID-19-related neurological implications.
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Key Words
- ace2, angiotensin converting enzyme 2
- ards, acute respiratory distress syndrome
- cfs, cerebral spinal fluid
- cns, central nervous system
- gbs, guillain-barre syndrome
- gfap, glial fibrillary acidic protein
- nfl, neurofilament light chain
- me/cfs, myalgic encephalomyelitis/chronic fatigue syndrome
- pasc, postacute sequelae of covid-19
- pcr, polymerase chain reaction
- pns, peripheral nervous system
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
- uch-l1, ubiquitin carboxyl-terminal esterase l1
- ykl-40, chitinase 3-like 1.
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Saceleanu V, Moreanu MS, Covache-Busuioc RA, Mohan AG, Ciurea AV. SARS-COV-2 - the pandemic of the XXI century, clinical manifestations - neurological implications. J Med Life 2022; 15:319-327. [PMID: 35450003 PMCID: PMC9015186 DOI: 10.25122/jml-2020-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/02/2022] [Indexed: 11/21/2022] Open
Abstract
In December 2019, in Wuhan, China, the first cases of infection with SARS-CoV 2 responsible for COVID-19 disease were identified. SARS-CoV 2 was declared a pandemic on March 11, 2020, and since then has attracted the medical world's attention. The threat to humans' health that this emerging pandemic could leave raises awareness on the importance of understanding the mechanisms that underlie the developing conditions. The epidemiology, clinical picture, and pathogenesis of COVID-19 show that this virus presents new strategies to overcome the past defensive medicine. While all the current data has focused on the pulmonary and cardiovascular manifestations, little has been written about the neurological implications of the disease. This review updates new clinical aspects that SARS-CoV 2 expresses in humans by focusing primarily on neurological manifestations. The damage to the nervous system became more apparent - anosmia, ageusia, polyneuritis, meningitis, meningoencephalitis, stroke, acute necrotizing encephalopathy. Oxygen therapy is vital for those in critical health situations. Finally, prevention is the most important element in breaking the epidemiological chain.
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Affiliation(s)
- Vicentiu Saceleanu
- Department of Neurosurgery, Faculty of Medicine, Lucian Blaga University, Sibiu, Romania
- Department of Neurosurgery, County Emergency Hospital, Sibiu, Romania
| | - Mihai-Stelian Moreanu
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Aurel George Mohan
- Department of Neurosurgery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Department of Neurosurgery, County Emergency Hospital, Oradea, Romania
| | - Alexandru-Vlad Ciurea
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Neurosurgery, Sanador Clinical Hospital, Bucharest, Romania
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Alharbi H, You S, Katz J. Should anosmia and dysgeusia be a concern for oral and maxillofacial surgeons during the COVID-19 pandemic? Oral Maxillofac Surg 2022; 26:105-111. [PMID: 33954852 PMCID: PMC8099141 DOI: 10.1007/s10006-021-00965-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/18/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. METHODS This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients' registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant. RESULTS Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. CONCLUSION Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.
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Affiliation(s)
- Hamad Alharbi
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, FL 32603 USA
| | - Sijia You
- Department of Biostatistics, College of Public Health and Health Professionals, University of Florida, Gainesville, FL USA
| | - Joseph Katz
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
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Ghods K, Alaee A. Olfactory and Taste Disorders in Patients Suffering from Covid-19, a Review of Literature. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:1-6. [PMID: 35291682 PMCID: PMC8918638 DOI: 10.30476/dentjods.2021.87800.1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/22/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
Corona virus epidemic has caused a widespread disaster around the world. In studies, there are pieces of evidence of olfactory and taste dysfunction in patients with Covid-19. These symptoms occur independently or can be associated with other symptoms such as dry cough. The mechanism of the above-mentioned disorders and their clinical features in patients are not yet known. The rate of incidence of olfactory dysfunction in patients has been varied from 29.64% to 75.23% and the rate of incidence of taste dysfunction among the people can be different from 20.46% to 68.95%. Therefore, clinicians including ENT specialists and dentists should pay attention to the symptoms of anosmia and ageusia in these patients to prevent delayed diagnosis and inappropriate treatments. In this review article, data have been collected by searching the available articles in the domestic and foreign journals using databases such as PubMed, PubMed Central, Medline, EBSCO, Google Scholar, and Embase with key words of Anosmia, Ageusia, Dysgeusia, Covid-19, and Coronavirus from 2019 to 2020. Among the relevant references, 38 authoritative articles were chosen. The data showed that it seems olfactory and taste function disorders are the obvious symptoms of Covid-19, which can occur independently or with other symptoms, but the pathogenesis is not well specified yet. Therefore, further studies are required to achieve a reliable result in this area.
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Affiliation(s)
- Kimia Ghods
- Student of Dentistry, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arezoo Alaee
- Dept. of Oral Medicine, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Esmaeili M, Abdi F, Shafiee G, Asayesh H, Abdar ZE, Baygi F, Qorbani M. Olfactory and Gustatory Dysfunction in 2019 Novel Coronavirus: An Updated Systematic Review and Meta-analysis. Int J Prev Med 2022; 12:170. [PMID: 35070203 PMCID: PMC8724794 DOI: 10.4103/ijpvm.ijpvm_484_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/21/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Evidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients. Methods: In this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method. Results: Among 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively. Conclusions: Olfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.
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Affiliation(s)
- Marzieh Esmaeili
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Esmaeili Abdar
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Bruno A, Ferrante G, Di Vincenzo S, Pace E, La Grutta S. Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection? Front Physiol 2022; 12:776963. [PMID: 35002761 PMCID: PMC8727443 DOI: 10.3389/fphys.2021.776963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/26/2021] [Indexed: 12/23/2022] Open
Abstract
Leptin is a pleiotropic adipocytokine involved in several physiologic functions, with a known role in innate and adaptive immunity as well as in tissue homeostasis. Long- and short-isoforms of leptin receptors are widely expressed in many peripheral tissues and organs, such as the respiratory tract. Similar to leptin, microbiota affects the immune system and may interfere with lung health through the bidirectional crosstalk called the “gut-lung axis.” Obesity leads to impaired protective immunity and altered susceptibility to pulmonary infections, as those by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it is known that leptin and microbiota link metabolism and lung health, their role within the SARS-CoV2 coronavirus disease 2019 (COVID-19) deserves further investigations. This review aimed to summarize the available evidence about: (i) the role of leptin in immune modulation; (ii) the role of gut microbiota within the gut-lung axis in modulating leptin sensitivity; and (iii) the role of leptin in the pathophysiology of COVID-19.
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Affiliation(s)
- Andreina Bruno
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Giuliana Ferrante
- Pediatric Division, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Serena Di Vincenzo
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Elisabetta Pace
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, Palermo, Italy
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Abstract
Coronavirus disease (COVID-19) arising from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection has caused a worldwide pandemic, mainly owing to its highly virulent nature stemming from a very strong and highly efficacious binding to the angiotensin converting enzyme-2 (ACE2) receptor. As the pandemic developed, increasing numbers of COVID-19 patients with neurological manifestations were reported, strongly suggesting a causal relationship. Indeed, direct invasion of SARS-CoV-2 viral particles into the brain can occur through the cribriform plate via olfactory nerves, passage through a damaged blood-brain-barrier, or via haematogenic infiltration of infected leukocytes. Neurological complications range from potentially fatal encephalopathy and stroke, to the onset of headaches and dizziness, which despite their apparent innocuous presentation may still imply a more sinister pathology. Here, we summarize the most recent knowledge on the neurological presentations typically being associated with COVID-19, whilst providing potential pathophysiological mechanisms. The latter are centered upon hypoxic brain injury, generation of a cytokine storm with attendant immune-mediated damage, and a prothrombotic state. A better understanding of both the neuroinvasive properties of SARS-CoV-2 and the neurological complications of COVID-19 will be important to improve patient outcomes.
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Affiliation(s)
- Matteo Galea
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Michaela Agius
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Neville Vassallo
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
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Guekht AB, Kryukov AI, Kazakova AA, Akzhigitov RG, Gulyaeva NV, Druzhkova TA. [Olfactory disorders as a multidisciplinary problem]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:32-38. [PMID: 36537628 DOI: 10.17116/jnevro202212212132] [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] [Indexed: 06/17/2023]
Abstract
Olfactory dysfunction is a serious symptom that requires careful differential diagnosis. The article presents convincing evidence that dysosmia is not only a symptom of rinological pathology, but also a manifestation of various neurodegenerative diseases. Some patients with SARS-CoV-2 have neurological symptoms. Modern studies show that olfactory and gustatory dysfunctions are significant symptoms in the clinical presentation of the COVID-19 infection. The importance of olfactory diagnostics in relatives of patients with hereditary neurodegenerative diseases for the purpose of early detection of pathology is noted. We consider the possibility of introducing new methods for the diagnosis of olfactory dysfunction, which is a promising task both in the field of neurology and otorhinolaryngology, in order to prevent the development of neurodegenerative diseases at an early stage, improve the quality of life and social adaptation of patients.
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Affiliation(s)
- A B Guekht
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - A I Kryukov
- Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow, Russia
| | - A A Kazakova
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - R G Akzhigitov
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
| | - N V Gulyaeva
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - T A Druzhkova
- Solov'ev Scientific-Applied Psychoneurology Center, Moscow, Russia
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50
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Eyheramendy S, Saa PA, Undurraga EA, Valencia C, López C, Méndez L, Pizarro-Berdichevsky J, Finkelstein-Kulka A, Solari S, Salas N, Bahamondes P, Ugarte M, Barceló P, Arenas M, Agosin E. Screening of COVID-19 cases through a Bayesian network symptoms model and psychophysical olfactory test. iScience 2021; 24:103419. [PMID: 34786538 PMCID: PMC8580551 DOI: 10.1016/j.isci.2021.103419] [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: 08/12/2021] [Revised: 10/12/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
The sudden loss of smell is among the earliest and most prevalent symptoms of COVID-19 when measured with a clinical psychophysical test. Research has shown the potential impact of frequent screening for olfactory dysfunction, but existing tests are expensive and time consuming. We developed a low-cost ($0.50/test) rapid psychophysical olfactory test (KOR) for frequent testing and a model-based COVID-19 screening framework using a Bayes Network symptoms model. We trained and validated the model on two samples: suspected COVID-19 cases in five healthcare centers (n = 926; 33% prevalence, 309 RT-PCR confirmed) and healthy miners (n = 1,365; 1.1% prevalence, 15 RT-PCR confirmed). The model predicted COVID-19 status with 76% and 96% accuracy in the healthcare and miners samples, respectively (healthcare: AUC = 0.79 [0.75-0.82], sensitivity: 59%, specificity: 87%; miners: AUC = 0.71 [0.63-0.79], sensitivity: 40%, specificity: 97%, at 0.50 infection probability threshold). Our results highlight the potential for low-cost, frequent, accessible, routine COVID-19 testing to support society's reopening.
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Affiliation(s)
- Susana Eyheramendy
- Faculty of Engineering and Science, Universidad Adolfo Ibáñez, Santiago, Chile
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pedro A. Saa
- Department of Chemical and Bioprocess Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo A. Undurraga
- School of Government, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile
- CIFAR Azrieli Global Scholars Program, Toronto, Canada
| | | | - Carolina López
- Center for Aromas and Flavors, DICTUC SA., Santiago, Chile
| | - Luis Méndez
- Endoscopy Unit, Hospital Padre Hurtado, Santiago, Chile
- Department of Gastroenterology, Clínica Alemana de Santiago, Santiago, Chile
| | - Javier Pizarro-Berdichevsky
- Center for Innovation in Pelvic Floor, Hospital Sótero del Río, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Finkelstein-Kulka
- Department of Otolaryngology, Clínica Alemana de Santiago, Santiago, Chile
- Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Sandra Solari
- Department of Clinical Laboratory, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Salas
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pedro Bahamondes
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Martín Ugarte
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pablo Barceló
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo Arenas
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Computer Science, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Agosin
- Department of Chemical and Bioprocess Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Center for Aromas and Flavors, DICTUC SA., Santiago, Chile
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