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Simonini L, Frijia F, Ait Ali L, Foffa I, Vecoli C, De Gori C, De Cori S, Baroni M, Aquaro GD, Maremmani C, Lombardo F. A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings. Diagnostics (Basel) 2024; 14:359. [PMID: 38396398 PMCID: PMC10888385 DOI: 10.3390/diagnostics14040359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Olfactory dysfunction (OD) is one of the most common symptoms in COVID-19 patients and can impact patients' lives significantly. The aim of this review was to investigate the multifaceted impact of COVID-19 on the olfactory system and to provide an overview of magnetic resonance (MRI) findings and neurocognitive disorders in patients with COVID-19-related OD. Extensive searches were conducted across PubMed, Scopus, and Google Scholar until 5 December 2023. The included articles were 12 observational studies and 1 case report that assess structural changes in olfactory structures, highlighted through MRI, and 10 studies correlating the loss of smell with neurocognitive disorders or mood disorders in COVID-19 patients. MRI findings consistently indicate volumetric abnormalities, altered signal intensity of olfactory bulbs (OBs), and anomalies in the olfactory cortex among COVID-19 patients with persistent OD. The correlation between OD and neurocognitive deficits reveals associations with cognitive impairment, memory deficits, and persistent depressive symptoms. Treatment approaches, including olfactory training and pharmacological interventions, are discussed, emphasizing the need for sustained therapeutic interventions. This review points out several limitations in the current literature while exploring the intricate effects of COVID-19 on OD and its connection to cognitive deficits and mood disorders. The lack of objective olfactory measurements in some studies and potential validity issues in self-reports emphasize the need for cautious interpretation. Our research highlights the critical need for extensive studies with larger samples, proper controls, and objective measurements to deepen our understanding of COVID-19's long-term effects on neurological and olfactory dysfunctions.
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Affiliation(s)
- Ludovica Simonini
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy;
| | - Lamia Ait Ali
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
- Pediatric Cardiology and GUCH Unit, Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy
| | - Ilenia Foffa
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Cecilia Vecoli
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Carmelo De Gori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Sara De Cori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Monica Baroni
- Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy;
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy;
| | - Carlo Maremmani
- Unit of Neurology, Ospedale Apuane, Azienda USL Toscana Nord Ovest, 54100 Massa, Italy;
| | - Francesco Lombardo
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
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Modesto DS, Silva Neto HM, Leão FC, Mendes Neto JA, Suzuki FA. Alcohol Sniff Test (AST): An Important Tool for Screening Post-Viral Olfactory Loss in Acute Flu-Like Dysfunction. Indian J Otolaryngol Head Neck Surg 2024; 76:604-610. [PMID: 38440626 PMCID: PMC10909055 DOI: 10.1007/s12070-023-04224-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/07/2023] [Indexed: 03/06/2024] Open
Abstract
Olfactory disorders have a significant impact on patients' quality of life but are often underestimated in clinical practice. Upper respiratory tract infections (URTIs) are a common cause of olfactory loss. While most cases of olfactory loss due to URTIs are conductive and reversible, post-viral olfactory dysfunction (PVOD) persists despite symptom improvement. PVOD is attributed to damage to the olfactory epithelium and nerves or central olfactory pathway lesions. The Alcohol Sniff Test (AST) has been proposed as a tool to assess olfactory function in the acute phase and aid in differentiating PVOD from conductive disorders. This study aims to evaluate the effectiveness of the AST as a predictor of post-viral olfactory loss in patients with flu-like syndrome. An observational cross-sectional study was conducted among employees with flu-like syndrome at a tertiary hospital. Three groups were formed: flu-like syndrome with conductive disorder without COVID-19 (PVOD-), flu-like syndrome with neurosensory and/or central disorder due to COVID-19 (PVOD +), and an asymptomatic control group. The Alcohol Sniff Test was performed to assess olfactory function. Statistical analysis was conducted to evaluate the AST's performance. For a cut off of 10 cm, 88.57% of PVOD + patients and 60.53% of PVOD - patients showed AST alteration, respectively (p = 0.013, OR = 5.05, 95% CI [1.48-17.25]). There was a statistically significant difference in the mean distance between the PVOD + group (4.35 ± 4.1 cm) and the control group (20 ± 4.33 cm) (p < 0.05). This relationship was also observed between the PVOD + and PVOD- groups (9 cm ± 7.5) (p < 0.05) and between the PVOD- and control groups (p < 0.05). For a cut off of 10 cm, the AST showed a sensitivity of 88% and specificity of 41%, resulting in an Odds Ratio of 9.7 (95% CI 3.3-28.1) (p < 0.001) and a Positive Predictive Value of 69.4% for PVOD. PVOD, including cases associated with COVID-19, is a prevalent cause of olfactory loss. The Alcohol Sniff Test demonstrated promising results in identifying PVOD in patients with flu-like syndrome. The test's simplicity and accessibility make it a valuable tool for early screening and identifying individuals who may benefit from prompt treatment. The Alcohol Sniff Test (AST) shows potential as an effective tool for screening post-viral olfactory loss in patients with flu-like syndrome. It can aid in early identification of PVOD cases and facilitate timely interventions to reduce the likelihood of persistent hyposmia.
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Affiliation(s)
- Domenico Seabra Modesto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Hugo Machado Silva Neto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Felipe Carvalho Leão
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - José Arruda Mendes Neto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Fábio Akira Suzuki
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
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Chan KH, Thomas BJ, Gilbert DD, Tong S, Teynor NJ, Friedman NR, Herrmann BW, Gitomer SA. Olfactory dysfunction and training in children with COVID-19 infection: A prospective study Post-COVID pediatric olfactory training. Int J Pediatr Otorhinolaryngol 2024; 176:111799. [PMID: 38081110 DOI: 10.1016/j.ijporl.2023.111799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/19/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Postviral olfactory dysfunction (OD) including corona 2019 viral disease (COVID-19) OD occurs in both adults and children. Despite limited reports of efficacy in treating adult postviral including COVID-19 OD with olfactory training (OT), its effects on children in general, and post-COVID-19 in specific, is unknown. The study aimed at evaluating the effects of OT in a COVID-19 OD pediatric cohort. METHODS A single-arm prospective study of pediatric COVID-19 OD subjects confirmed by the University of Pennsylvania Smell Identification Test (UPSIT), was conducted. All subjects underwent OT by sniffing 4 odorants (lavender, orange, peppermint, and eucalyptus) for 1 min twice a day for 3 months. Subjects underwent an odorant identification test (OIT) of the 4 odorants each visit. A repeat UPSIT was administered at the 4th visit. RESULTS The study enrolled a total of 37 subjects [11 males/26 females with mean age/standard deviation (std) of 15.6(2.1) years]. The time interval between COVID-19 and entry was 5.3(2.4) months. The mean pre/post study UPSIT score improvement was 2.3(4.7), p = .09. OIT scores between entry and 3 subsequent visits showed a mean improvement of 1.8(1.5), 1.8(1.9) and 2.3(1.9) odorants, respectively, with P < .001 for all 3 comparisons. CONCLUSIONS OT subjects were predominantly female teens with substantial OD lasting greater than 5 months. OT did not affect OD as measured by UPSIT but OIT scores improved during OT. We postulate that OT likely has a role in pediatric post-COVID OD recovery, but UPSIT likely is too rigid to detect disparate odorant improvement.
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Affiliation(s)
- Kenny H Chan
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA.
| | - Bethany J Thomas
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Deborah D Gilbert
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Suhong Tong
- Department of Pediatrics, School of Medicine and Department of Biostatistics and Informatics, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nathan J Teynor
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Norman R Friedman
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Brian W Herrmann
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Sarah A Gitomer
- Department of Otolaryngology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA; Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
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Paris D, Palomba L, Albertini MC, Tramice A, Motta L, Giammattei E, Ambrosino P, Maniscalco M, Motta A. The biomarkers' landscape of post-COVID-19 patients can suggest selective clinical interventions. Sci Rep 2023; 13:22496. [PMID: 38110483 PMCID: PMC10728085 DOI: 10.1038/s41598-023-49601-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/10/2023] [Indexed: 12/20/2023] Open
Abstract
In COVID-19 clinical symptoms can persist even after negativization also in individuals who have had mild or moderate disease. We here investigated the biomarkers that define the post-COVID-19 clinical state analyzing the exhaled breath condensate (EBC) of 38 post COVID-19 patients and 38 sex and age-matched healthy controls via nuclear magnetic resonance (NMR)-based metabolomics. Predicted gene-modulated microRNAs (miRNAs) related to COVID-19 were quantified from EBC of 10 patients and 10 controls. Finally, clinical parameters from all post-COVID-19 patients were correlated with metabolomic data. Post-COVID-19 patients and controls showed different metabolic phenotype ("metabotype"). From the metabolites, by using enrichment analysis we identified miRNAs that resulted up-regulated (hsa-miR146a-5p) and down-regulated (hsa-miR-126-3p and hsa-miR-223-3p) in post-COVID-19. Taken together, our multiomics data indicate that post-COVID-19 patients before rehabilitation are characterized by persistent inflammation, dysregulation of liver, endovascular thrombotic and pulmonary processes, and physical impairment, which should be the primary clinical targets to contrast the post-acute sequelae of COVID-19.
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Affiliation(s)
- Debora Paris
- Institute of Biomolecular Chemistry, National Research Council, 80078, Pozzuoli (Naples), Italy
| | - Letizia Palomba
- Department of Biomolecular Sciences, "Carlo Bo" University, 61029, Urbino, Italy
| | | | - Annabella Tramice
- Institute of Biomolecular Chemistry, National Research Council, 80078, Pozzuoli (Naples), Italy
| | - Lorenzo Motta
- Neuroradiology Unit, Ospedale Santa Maria Della Misericordia, 45100, Rovigo, Italy
- IRCCS Istituto Delle Scienze Neurologiche (Padiglione G), via Altura 3, 40139, Bologna, Italy
| | - Eleonora Giammattei
- Department of Biomolecular Sciences, "Carlo Bo" University, 61029, Urbino, Italy
| | - Pasquale Ambrosino
- Directorate of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037, Telese Terme (Benevento), Italy
| | - Mauro Maniscalco
- Pulmonary Rehabilitation Unit of the Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, 82037, Telese Terme (Benevento), Italy.
- Department of Clinical Medicine and Surgery, Section of Respiratory Disease, University of Naples Federico II, 80131, Naples, Italy.
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, 80078, Pozzuoli (Naples), Italy.
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Cardoso Soares P, de Freitas PM, Eduardo CDP, Azevedo LH. Photobiomodulation, Transmucosal Laser Irradiation of Blood, or B complex as alternatives to treat Covid-19 Related Long-Term Taste Impairment: double-blind randomized clinical trial. Lasers Med Sci 2023; 38:261. [PMID: 37947919 DOI: 10.1007/s10103-023-03917-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
COVID-19 Related Long-Term Taste Impairment (CRLTTI) is a condition that can be expressed after COVID-19 contagion, lasting for months or even years, affecting the routine and quality of life of individuals. Participants expressing CRLTTI, with a minimum of 2 months, attested by PCR-RT test were assessed for taste and smell, and underwent experimental treatments in 6 distinct groups: Photobiomodulation (PBM) in tongue dorsum and lateral (660 nm, 808 nm, association of 660 and 808 nm), Transmucosal Laser Irradiation of Blood (TLIB)-ventral surface of tongue (660 nm), B complex supplementation, and Sham laser. No intergroup statistical differences were observed at the final evaluation, despite the tendencies of better results with PBM and TLIB observed. PBM, TLIB, and B complex might be treatment options in the management of CRLTTI, despite the lack of total remission of taste and smell perception after 8 sessions (PBM and TLIB) or 30 days of B complex supplementation.
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Affiliation(s)
- Pedro Cardoso Soares
- Special Laboratory of Lasers in Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil.
| | - Patrícia Moreira de Freitas
- Special Laboratory of Lasers in Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos de Paula Eduardo
- Special Laboratory of Lasers in Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Luciane Hiramatsu Azevedo
- Special Laboratory of Lasers in Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
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Di Stadio A, Gallina S, Cocuzza S, De Luca P, Ingrassia A, Oliva S, Sireci F, Camaioni A, Ferreli F, Mercante G, Gaino F, Pace GM, La Mantia I, Brenner MJ. Treatment of COVID-19 olfactory dysfunction with olfactory training, palmitoylethanolamide with luteolin, or combined therapy: a blinded controlled multicenter randomized trial. Eur Arch Otorhinolaryngol 2023; 280:4949-4961. [PMID: 37380908 PMCID: PMC10562315 DOI: 10.1007/s00405-023-08085-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE Few evidence-based therapies are available for chronic olfactory dysfunction after COVID-19. This study investigated the relative efficacy of olfactory training alone, co-ultramicronized palmitoylethanolamide with luteolin (um-PEA-LUT, an anti-neuroinflammatory supplement) alone, or combined therapy for treating chronic olfactory dysfunction from COVID-19. METHODS This double-blinded controlled, placebo-controlled multicenter randomized clinical trial was conducted in 202 patients with persistent COVID-19 olfactory dysfunction of > 6 month duration. After a screening nasal endoscopy, patients were randomized to: (1) olfactory training and placebo; (2) once daily um-PEA-LUT alone; (3) twice daily um-PEA-LUT alone; or (4) combination of once daily um-PEA-LUT with olfactory training. Olfactory testing (Sniffin' Sticks odor identification test) was performed at baseline and at 1, 2, and 3 months. The primary outcome was recovery of over three points on olfactory testing, with outcomes compared at T0, T1, T2 and T3 across groups. Statistical analyses included one-way ANOVA for numeric data and chi-square for nominal data. RESULTS All patients completed the study, and there were no adverse events. At 90 days, odor identification scores improved by > 3 points in 89.2% of patients receiving combined therapy vs. 36.8% receiving olfactory training with placebo, 40% receiving twice daily um-PEA-LUT alone, and 41.6% receiving once daily um-PEA-LUT alone (p < 0.00001). Patients receiving treatment with um-PEA-LUT alone demonstrated subclinical improvement (< 3 point odor identification improvement) more often than patients receiving olfactory training with placebo (p < 0.0001.) CONCLUSIONS: Olfactory training plus once daily um-PEA-LUT resulted in greater olfactory recovery than either therapy alone in patients with long-term olfactory function due to COVID-19. TRIAL REGISTRATION 20112020PGFN on clinicaltrials.gov. LEVEL OF EVIDENCE 1b (Individual Randomized Clinical Trial).
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Affiliation(s)
- Arianna Di Stadio
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy.
| | | | - Salvatore Cocuzza
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy
| | - Pietro De Luca
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Angelo Ingrassia
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Simone Oliva
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Federico Sireci
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Fabio Ferreli
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Giuseppe Mercante
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Francesca Gaino
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Gian Marco Pace
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Ignazio La Mantia
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
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AlBilasi TM, Alanazi RM, AlDhawi LF, Albathi AA. Outcome and Safety of Insulin in the Management of Smell Loss: A Systematic Review. Ear Nose Throat J 2023:1455613231201028. [PMID: 37776014 DOI: 10.1177/01455613231201028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Abstract
Background: Olfactory dysfunction can negatively impact the quality of life and increase the risk of danger from warning odors. Various factors can cause olfactory dysfunction, including COVID-19 infection, which has increased anosmia cases. No medications are approved; however, recent studies have suggested that intranasal insulin could effectively treat olfactory dysfunction. Aim: To comprehensively evaluate the effectiveness and safety of intranasal insulin in treating olfactory dysfunction. Materials and Methods: PubMed, Google Scholar, and CENTRAL databases were searched using specific keywords, and the outputs were screened using the Rayyan AI system. Original research articles published without time frame limitations that reported the relevant outcomes were included. The reviewers performed the screening and data extraction, and any disagreements were resolved by a third senior author. Results: This systematic review identified 66 references from 3 databases, with 45 articles meeting the criteria for review after duplicates were removed. Six articles met the inclusion criteria and were selected, including 177 subjects. The selected studies consisted of various study designs, including pilot studies, placebo-controlled trials, crossover studies, and randomized clinical trials. The findings showed that intranasal insulin therapy had beneficial effects on olfactory function. Specifically, improvements were observed in olfactory detection and discrimination in patients with post-COVID-19 anosmia, olfactory threshold performance in healthy participants, and odor identification in hyposmic patients. However, there were variations in the observed effects based on different doses of insulin administered and gender differences. It also shows that using insulin provides good outcomes. Using it intranasally was safe and did not cause any complications. Conclusion: Intranasal insulin has shown promising results as a potentially safe treatment for olfactory dysfunction. Studies suggest that it can improve olfactory thresholds. Further studies are needed to investigate optimal doses and potential gender differences in response.
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Affiliation(s)
- Thamer M AlBilasi
- Department of Otolaryngology - Head & Neck Surgery (ORL-H&N), Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Rawan Mahmoud Alanazi
- A Medical Student College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Lama F AlDhawi
- A Medical Student at Al-Maarefa University College of Medicine, Riyadh, Saudi Arabia
| | - Abeer Ali Albathi
- Department of Otolaryngology - Head & Neck Surgery (ORL-H&N), Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
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Cherobin GB, Guimarães RES, de Paula Gomes MC, Vasconcelos LOG, de Abreu LAN. Intranasal Insulin for the Treatment of Persistent Post-COVID-19 Olfactory Dysfunction. Otolaryngol Head Neck Surg 2023; 169:719-724. [PMID: 37078341 DOI: 10.1002/ohn.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To investigate if intranasal insulin could be a treatment option for those suffering from recalcitrant olfactory dysfunction due to COVID-19. STUDY DESIGN Prospective interventional cohort with a single group. SETTING Sixteen volunteers with anosmia, severe hyposmia, or moderate hyposmia for more than 60 days as sequelae of severe acute respiratory syndrome coronavirus 2 infections were selected for the study. All volunteers reported that standard therapies, such as corticosteroids, have failed to improve their olfactory function. METHODS Olfactory function was assessed by the Chemosensory Clinical Research Center test of olfaction (COT) before and after the intervention. Changes in qualitative, quantitative, and global COT scores were investigated. The insulin therapy session consisted of placing into each olfactory cleft 2 pieces of gelatin sponge soaked with neutral protamine Hagedorn (NPH) insulin, 40 IU on each side. The procedure was repeated twice a week for 1 month. Glycaemic blood level was measured before and after each session. RESULTS The qualitative COT score rose 1.53 points, p = .0001, 95% confidence interval (CI) (-2.12 to -0.94). The quantitative COT score increased by 2.00 points, p = .0002, 95% CI (-3.59 to -1.41). Global COT score had an improvement of 2.01 points, p = .00003, 95% CI (-2.7 to -1.3). Glycaemic blood level dropped on average 10.4 mg/dL, p < .00003, 95% CI (8.1-12.8). CONCLUSION Our results suggest that the administration of NPH insulin into the olfactory cleft yields a rapid improvement in the sense of smell of patients suffering from persistent post-COVID-19 olfactory dysfunction. Moreover, the procedure seems to be safe and tolerable.
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Affiliation(s)
- Giancarlo B Cherobin
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Roberto E S Guimarães
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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10
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Li C, Verduzco-Gutierrez M. Neurologic and Neuromuscular Sequelae of COVID-19. Phys Med Rehabil Clin N Am 2023; 34:539-549. [PMID: 37419530 DOI: 10.1016/j.pmr.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
It is known that there can be neurologic complications related to acute infection with SARS-CoV-2, the virus that causes COVID-19. Currently, there is a growing body of evidence that postacute sequelae of SARS-CoV-2 infection can manifest as neurologic sequelae as a result of direct neuroinvasion, autoimmunity, and possibly lead to chronic neurodegenerative processes. Certain complications can be associated with worse prognosis, lower functional outcome, and higher mortality. This article provides an overview of the known pathophysiology, symptoms presentation, complications and treatment approaches of the post-acute neurologic and neuromuscular sequelae of SARS-CoV-2 infection.
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Affiliation(s)
- Carol Li
- Department of Rehabilitation Medicine, Long School of Medicine at University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7798, San Antonio, TX 78229, USA; Polytrauma Outpatient Neurorehabilitation Services, Audie L. Murphy VA Medical Center; Polytrauma Rehabilitation Center, P168, 7400 Merton Minter, San Antonio, TX 78229, USA.
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, Long School of Medicine at University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7798, San Antonio, TX 78229, USA
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11
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Hamed SA, Ahmed MAAR. The effectiveness of cerebrolysin, a multi-modal neurotrophic factor, for treatment of post-covid-19 persistent olfactory, gustatory and trigeminal chemosensory dysfunctions: a randomized clinical trial. Expert Rev Clin Pharmacol 2023; 16:1261-1276. [PMID: 37950370 DOI: 10.1080/17512433.2023.2282715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND This trial aimed to monitor the outcomes of persistent post-covid-19 smell and taste disorders after cerebrolysin therapy, a NTF, and olfactory and gustatory trainings. RESEARCH DESIGN AND METHODS This was a prospective randomized trial. It included 250 patients (male = 93, female = 157; age: 31.3 ± 8.9 years). Patients were randomized into group 1 (n = 150): received cerebrolysin [5 ml/d (IM), 5d/week] and practiced olfactory and gustatory trainings, and group 2 (n = 100): practiced olfactory and gustatory trainings only, for ≥ 8-24 weeks. Measures of outcomes were: a clinical questionnaire; sniffin' odor, taste and flavor identification tests; and global rating scales for smell and taste. RESULTS The duration of disorders was 11.7 ± 3.7mo (range: 6-24mo). The majority (n = 167; 66.8%) developed parosmia within months (3.6 ± 2.7mo) after anosmia. Objective testing showed anosmia in all and taste, flavor, and trigeminal sensory losses in 18% (n = 45). Analyses for secondary outcome were done on 202 patients (group 1 = 130; group 2 = 72). Recovery was complete in 61.5% (n = 80) with cerebrolysin therapy and partial in 17% (n = 22). There was no recovery with trainings only. There were no predictors for recovery. CONCLUSIONS Cerebrolysin had fast, promising, and constant effect, with cure rate of > 60%. This might be due to its ability to initiate and enhance neuronal regeneration and reorganization of sensory epithelia. TRIAL REGISTRATION NCT04830943.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
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12
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Lerner DK, Garvey KL, Arrighi-Allisan A, Kominsky E, Filimonov A, Al-Awady A, Filip P, Liu K, Ninan S, Spock T, Tweel B, van Gerwen M, Schaberg M, Colley P, Del Signore A, Govindaraj S, Iloreta AM. Omega-3 Fatty Acid Supplementation for the Treatment of Persistent COVID-Related Olfactory Dysfunction. Am J Rhinol Allergy 2023:19458924231174799. [PMID: 37261995 DOI: 10.1177/19458924231174799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the efficacy of omega-3 fatty acid (O3FA) supplementation in the treatment of COVID-related olfactory dysfunction (OD). METHODS Patients with laboratory-confirmed or clinically-suspected COVID-19 infection and new-onset OD from August 2020 to November 2021 were prospectively recruited. Patients with quantitative OD, defined as a brief smell identification test (BSIT) score of 9 or less, were eligible for study inclusion. The experimental group received 2 g of O3FA supplementation, while the control group received an identical placebo to be taken daily for 6 weeks. The primary outcome was a change in BSIT score between the initial and 6-week follow-up tests. RESULTS One hundred and seventeen patients were included in the analysis, including 57 patients in the O3FA group and 60 in the placebo group. O3FA group patients demonstrated a mean BSIT improvement of 1.12 ± 1.99 compared to 0.68 ± 1.86 in the placebo group (p = 0.221). Seventy-seven patients, 42 within the O3FA group and 35 in the placebo group, completed a follow-up BSIT survey at an average of 717.8 days from study onset. At long-term follow-up, there was an average BSIT score improvement of 1.72 within the O3FA group compared to 1.76 within the placebo group (p = 0.948). CONCLUSION Among patients with persistent COVID-related OD, our study showed no clear evidence of relative short-term or long-term olfactory recovery among patients receiving high doses of O3FA supplementation.
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Affiliation(s)
- David K Lerner
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine L Garvey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Annie Arrighi-Allisan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Evan Kominsky
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrey Filimonov
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Abdurrahman Al-Awady
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter Filip
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine Liu
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sen Ninan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Todd Spock
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Tweel
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maaike van Gerwen
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Madeleine Schaberg
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrick Colley
- Department of Otolaryngology, Albert Einstein College of Medicine, New York, NY, USA
| | - Anthony Del Signore
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alfred Marc Iloreta
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Martins AF, de Souza DRV, de Rezende Neto JM, Santos AA, da Invenção GB, Matos ILS, dos Santos KA, de Jesus PC, da Silva FA, de Almeida FHO, do Vale FYN, Fonseca DLM, Schimke LF, Matos SS, Oliveira BM, Ferreira CS, de Paula Dias B, dos Santos SMSA, Barbosa CC, de Carvalho Barreto ID, Moreno AKM, Gonçalves RL, de Mello Silva B, Cabral-Marques O, Borges LP. A higher number of SARS-COV-2 infections in quilombola communities than in the local population in Brazil. Front Public Health 2023; 11:1095162. [PMID: 37304100 PMCID: PMC10253171 DOI: 10.3389/fpubh.2023.1095162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
The historical and social vulnerability of quilombola communities in Brazil can make them especially fragile in the face of COVID-19, considering that several individuals have precarious health systems and inadequate access to water. This work aimed to characterize the frequency of SARS-COV-2 infections and the presence of IgM and IgG SARS-CoV-2 antibodies in quilombola populations and their relationship with the presence of risk factors or preexisting chronic diseases in the quilombola communities. We analyzed the sociodemographic and clinical characteristics, serological status, comorbidities, and symptoms of 1,994 individuals (478 males and 1,536 females) from 18 Brazilian municipalities in the State of Sergipe of quilombola communities, which were evaluated at different epidemiological weeks, starting at the 32nd (August 6th) and ending at the 40th (October 3rd) epidemiological week. More than 70% of studied families live in rural areas and they have an extreme poverty social status. Although we found a higher number of SARS-COV-2 infections in quilombola communities than in the local population, their SARS-CoV-2 reactivity and IgM and IgG positivity varied across the communities investigated. Arterial hypertension was the most risk factor, being found in 27.8% of the individuals (9.5% in stage 1, 10.8% in stage 2, and 7.5% in stage 3). The most common COVID-19 symptoms and comorbidities were headache, runny nose, flu, and dyslipidemia. However, most individuals were asymptomatic (79.9%). Our data indicate that mass testing must be incorporated into public policy to improve the health care system available to quilombola populations during a future pandemic or epidemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Fernando Yuri Nery do Vale
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences University of São Paulo, São Paulo, Brazil
| | - Dennyson Leandro M. Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Lena F. Schimke
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Saulo Santos Matos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | | | - Cyntia Silva Ferreira
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Bruna de Paula Dias
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Camila Cavadas Barbosa
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Ana Karolina Mendes Moreno
- Postgraduate Program in Animal Biodiversity, Institute of Biological Sciences, Federal University of Goiás, Goiânia, Brazil
| | - Ricardo Lemes Gonçalves
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Breno de Mello Silva
- Department of Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Otavio Cabral-Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences University of São Paulo, São Paulo, Brazil
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of São Paulo (USP), São Paulo, SP, Brazil
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Department of Pharmacy and Postgraduate Program of Health and Science, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
- Laboratory of Medical Investigation 29, University of São Paulo School of Medicine, São Paulo, Brazil
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14
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Tsuchiya H. Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders. Dent J (Basel) 2023; 11:140. [PMID: 37366663 DOI: 10.3390/dj11060140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become a critical issue. The aim of the present study was to update information on treatments applicable to such oral symptoms and discuss their pathogenic mechanisms. The literature search indicated that different treatments using tetracycline, corticosteroids, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drugs, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion have potential effects on COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. These treatments have multiple modes of action on viral cellular entry and replication, cell proliferation and differentiation, immunity, and/or SARS-CoV-2 infection-induced pathological conditions such as inflammation, cytokine storm, pyroptosis, neuropathy, zinc dyshomeostasis, and dysautonomia. An understanding of currently available treatment options is required for dental professionals because they may treat patients who were infected with SARS-CoV-2 or who recovered from COVID-19, and become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists could play a crucial role in managing COVID-19 oral symptoms and contribute to improving the oral health-related quality of life of the relevant patients.
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Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Gifu 501-0296, Japan
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15
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Hamed SA. Post-COVID-19 persistent olfactory, gustatory, and trigeminal chemosensory disorders: Definitions, mechanisms, and potential treatments. World J Otorhinolaryngol 2023; 10:4-22. [DOI: 10.5319/wjo.v10.i2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/28/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry into the body. Smell and taste deficits are the most common acute viral manifestations. Persistent smell disorders are the most common and bothersome complications after SARS-CoV-2 infection, lasting for months to years. The mechanisms and treatment of persistent post-coronavirus disease 2019 (COVID-19) smell and taste disorders are still challenges. Information sources for the review are PubMed, Centers for Disease Control and Prevention, Ovid Medline, Embase, Scopus, Web of Science, International Prospective Register of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Elton Bryson Stephens Company, Cochrane Effective Practice and Organization of Care, Cooperation in Science and Technology, International Clinical Trials Registry Platform, World Health Organization, Randomized Controlled Trial Number Registry, and MediFind. This review summarizes the up-to-date information about the prevalence, patterns at onset, and prognoses of post-COVID-19 smell and taste disorders, evidence for the neurotropism of SARS-CoV-2 and the overlap between SARS-CoV-1, Middle East respiratory syndrome coronavirus, and SARS-CoV-2 in structure, molecular biology, mode of replication, and host pathogenicity, the suggested cellular and molecular mechanisms for these post-COVID19 chemosensory disorders, and the applied pharmacotherapies and interventions as trials to treat these disorders, and the recommendations for future research to improve understanding of predictors and mechanisms of these disorders. These are crucial for hopeful proper treatment strategies.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University, Faculty of Medicine, Assiut 71516, Egypt
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16
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Ren J, Zhang Y, Guo W, Feng K, Yuan Y, Huang T, Cai YD. Identification of Genes Associated with the Impairment of Olfactory and Gustatory Functions in COVID-19 via Machine-Learning Methods. Life (Basel) 2023; 13:798. [PMID: 36983953 PMCID: PMC10051382 DOI: 10.3390/life13030798] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), as a severe respiratory disease, affects many parts of the body, and approximately 20-85% of patients exhibit functional impairment of the senses of smell and taste, some of whom even experience the permanent loss of these senses. These symptoms are not life-threatening but severely affect patients' quality of life and increase the risk of depression and anxiety. The pathological mechanisms of these symptoms have not been fully identified. In the current study, we aimed to identify the important biomarkers at the expression level associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-mediated loss of taste or olfactory ability, and we have suggested the potential pathogenetic mechanisms of COVID-19 complications. We designed a machine-learning-based approach to analyze the transcriptome of 577 COVID-19 patient samples, including 84 COVID-19 samples with a decreased ability to taste or smell and 493 COVID-19 samples without impairment. Each sample was represented by 58,929 gene expression levels. The features were analyzed and sorted by three feature selection methods (least absolute shrinkage and selection operator, light gradient boosting machine, and Monte Carlo feature selection). The optimal feature sets were obtained through incremental feature selection using two classification algorithms: decision tree (DT) and random forest (RF). The top genes identified by these multiple methods (H3-5, NUDT5, and AOC1) are involved in olfactory and gustatory impairments. Meanwhile, a high-performance RF classifier was developed in this study, and three sets of quantitative rules that describe the impairment of olfactory and gustatory functions were obtained based on the optimal DT classifiers. In summary, this study provides a new computation analysis and suggests the latent biomarkers (genes and rules) for predicting olfactory and gustatory impairment caused by COVID-19 complications.
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Affiliation(s)
- Jingxin Ren
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Yuhang Zhang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Wei Guo
- Key Laboratory of Stem Cell Biology, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai 200030, China
| | - Kaiyan Feng
- Department of Computer Science, Guangdong AIB Polytechnic College, Guangzhou 510507, China
| | - Ye Yuan
- Institute of Image Processing and Pattern Recognition, Shanghai Jiao Tong University, and Key Laboratory of System Control and Information Processing, Ministry of Education of China, Shanghai 200240, China
| | - Tao Huang
- Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yu-Dong Cai
- School of Life Sciences, Shanghai University, Shanghai 200444, China
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17
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Leng A, Shah M, Ahmad SA, Premraj L, Wildi K, Li Bassi G, Pardo CA, Choi A, Cho SM. Pathogenesis Underlying Neurological Manifestations of Long COVID Syndrome and Potential Therapeutics. Cells 2023; 12:816. [PMID: 36899952 PMCID: PMC10001044 DOI: 10.3390/cells12050816] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
The development of long-term symptoms of coronavirus disease 2019 (COVID-19) more than four weeks after primary infection, termed "long COVID" or post-acute sequela of COVID-19 (PASC), can implicate persistent neurological complications in up to one third of patients and present as fatigue, "brain fog", headaches, cognitive impairment, dysautonomia, neuropsychiatric symptoms, anosmia, hypogeusia, and peripheral neuropathy. Pathogenic mechanisms of these symptoms of long COVID remain largely unclear; however, several hypotheses implicate both nervous system and systemic pathogenic mechanisms such as SARS-CoV2 viral persistence and neuroinvasion, abnormal immunological response, autoimmunity, coagulopathies, and endotheliopathy. Outside of the CNS, SARS-CoV-2 can invade the support and stem cells of the olfactory epithelium leading to persistent alterations to olfactory function. SARS-CoV-2 infection may induce abnormalities in innate and adaptive immunity including monocyte expansion, T-cell exhaustion, and prolonged cytokine release, which may cause neuroinflammatory responses and microglia activation, white matter abnormalities, and microvascular changes. Additionally, microvascular clot formation can occlude capillaries and endotheliopathy, due to SARS-CoV-2 protease activity and complement activation, can contribute to hypoxic neuronal injury and blood-brain barrier dysfunction, respectively. Current therapeutics target pathological mechanisms by employing antivirals, decreasing inflammation, and promoting olfactory epithelium regeneration. Thus, from laboratory evidence and clinical trials in the literature, we sought to synthesize the pathophysiological pathways underlying neurological symptoms of long COVID and potential therapeutics.
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Affiliation(s)
- Albert Leng
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Manuj Shah
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Syed Ameen Ahmad
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Lavienraj Premraj
- Department of Neurology, Griffith University School of Medicine, Gold Coast, Brisbane, QLD 4215, Australia
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD 4032, Australia
| | - Karin Wildi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD 4032, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD 4032, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4000, Australia
- Intensive Care Unit, St Andrew’s War Memorial Hospital and the Wesley Hospital, Uniting Care Hospitals, Brisbane, QLD 4000, Australia
- Wesley Medical Research, Auchenflower, QLD 4066, Australia
| | - Carlos A. Pardo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Alex Choi
- Division of Neurosciences Critical Care, Department of Neurosurgery, UT Houston, Houston, TX 77030, USA
| | - Sung-Min Cho
- Divisions of Neurosciences Critical Care and Cardiac Surgery, Departments of Neurology, Surgery, Anesthesiology and Critical Care Medicine and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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18
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Cappell MS, Tobi M, Friedel DM. The Impact of COVID-19 Infection on Miscellaneous Inflammatory Disorders of the Gastrointestinal Tract. Gastroenterol Clin North Am 2023; 52:115-138. [PMID: 36813420 PMCID: PMC9537253 DOI: 10.1016/j.gtc.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The novel coronavirus pandemic of COVID-19 has emerged as a highly significant recent threat to global health with about 600,000,000 known infections and more than 6,450,000 deaths worldwide since its emergence in late 2019. COVID-19 symptoms are predominantly respiratory, with mortality largely related to pulmonary manifestations, but the virus also potentially infects all parts of the gastrointestinal tract with related symptoms and manifestations that affect patient treatment and outcome. COVID-19 can directly infect the gastrointestinal tract because of the presence of widespread angiotensin-converting enzyme 2 receptors in the stomach and small intestine that can cause local COVID-19 infection and associated inflammation. This work reviews the pathopysiology, clinical manifestations, workup, and treatment of miscellaneous inflammatory disorders of the gastrointestinal tract other than inflammatory bowel disease.
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Affiliation(s)
- Mitchell S Cappell
- Division of Gastroenterology, Department of Medicine, Aleda E. Lutz Veterans Hospital, Gastroenterology Service, Main Building, Room 3212, 1500 Weiss Street, Saginaw, MI 48602, USA.
| | - Martin Tobi
- Department of Research and Development, John D. Dingell Veterans Affairs Medical Center, 4747 John R. Street, Detroit, MI 48201, USA
| | - David M Friedel
- Division of Therapeutic Endoscopy, Division of Gastroenterology, Department of Medicine, NY of New York University Langone Hospital, 259 1st Street, Mineola, NY 11501, USA
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19
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Garcia JAP, Miller E, Norwood TG, Dorin NA, Grayson J, Woodworth B, Cho D. Gabapentin improves parosmia after COVID-19 infection. Int Forum Allergy Rhinol 2022; 13:1034-1036. [PMID: 36484400 PMCID: PMC9877759 DOI: 10.1002/alr.23117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Jaime A. Pena Garcia
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Emily Miller
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Timothy G. Norwood
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Natalie A. Dorin
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jessica Grayson
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Bradford Woodworth
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA,Gregory Fleming James Cystic Fibrosis Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Do‐Yeon Cho
- Department of Otolaryngology Head & Neck SurgeryUniversity of Alabama at BirminghamBirminghamAlabamaUSA,Gregory Fleming James Cystic Fibrosis Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA,Division of OtolaryngologyDepartment of SurgeryVeterans AffairsBirminghamAlabamaUSA
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20
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Khurana K, Singh CV. Management of Anosmia in COVID-19: A Comprehensive Review. Cureus 2022; 14:e30425. [PMID: 36407192 PMCID: PMC9670825 DOI: 10.7759/cureus.30425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022] Open
Abstract
With the evolving understanding of COVID-19, a thorough analysis of the effects of this unique coronavirus on the affected people's olfactory abilities could highlight the disease's specific course of treatment. Researchers have discovered that the neurological side effects of SARS-CoV-2 infection include acute anosmia and ageusia. This work aims to review the relevant mechanisms, provide information on COVID-19-related anosmia, and suggest a novel approach to treating long-term anosmia brought on by coronavirus disease. For that, we did a thorough literature assessment of the subject from various online resources, including PubMed, Scopus, and Google Scholar. We evaluated the publications that described anosmia in COVID-19 and its management. In patients with SARS-CoV-2 infections, the angiotensin-converting enzyme two receptor plays a crucial role in the anosmia process. Olfactory systems are directly harmed by new coronaviruses when they connect with sustentacular cells' ACE-2 (Angiotensin converting enzyme-2) receptors. Other suggested processes include the virus's infiltration of the olfactory nerve and the ensuing local inflammation. Therefore, neuroprotective, anti-inflammatory, or depolarizing medications may be helpful for COVID-19 individuals who have lost their sense of smell. According to the available data, we found out olfactory training, topical or oral corticosteroids, caffeine, insulin, or minocycline may effectively treat COVID-19 odor loss. A novel method of treating long-term COVID-19 with persistent anosmia can be suggested based on recent investigations. The path to effective anosmia management is still somewhat hazy, but there is hope that we can find the right treatment plan with the right clinical trials and additional research. People who lost their sense of smell during COVID-19 can be reassured that recovery is typically possible.
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Di Stadio A, D’Ascanio L, Vaira LA, Cantone E, De Luca P, Cingolani C, Motta G, De Riu G, Vitelli F, Spriano G, De Vincentiis M, Camaioni A, La Mantia I, Ferreli F, Brenner MJ. Ultramicronized Palmitoylethanolamide and Luteolin Supplement Combined with Olfactory Training to Treat Post-COVID-19 Olfactory Impairment: A Multi-Center Double-Blinded Randomized Placebo- Controlled Clinical Trial. Curr Neuropharmacol 2022; 20:2001-2012. [PMID: 35450527 PMCID: PMC9886808 DOI: 10.2174/1570159x20666220420113513] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/23/2022] [Accepted: 04/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Olfactory training is the only evidence-based treatment for post-viral olfactory dysfunction. Smell disorders after SARS-CoV-2 infection have been attributed to neuroinflammatory events within the olfactory bulb and the central nervous system. Therefore, targeting neuroinflammation is one potential strategy for promoting recovery from post-COVID-19 chronic olfactory dysfunction. Palmitoylethanolamide and luteolin (PEA-LUT) are candidate antiinflammatory/ neuroprotective agents. OBJECTIVE To investigate recovery of olfactory function in patients treated with PEA-LUT oral supplements plus olfactory training versus olfactory training plus placebo. METHODS Multicenter double-blinded randomized placebo-controlled clinical trial was held. Eligible subjects had prior COVID-19 and persistent olfactory impairment >6 months after follow-up SARS-CoV-2 negative testing, without prior history of olfactory dysfunction or other sinonasal disorders. Participants were randomized to daily oral supplementation with ultramicronized PEA-LUT 770 mg plus olfactory training (intervention group) or olfactory training with placebo (control). Sniffin' Sticks assessments were used to test the patients at baseline and 90 days. RESULTS A total of 185 patients, including intervention (130) and control (55) were enrolled. The intervention group showed significantly greater improvement in olfactory threshold, discrimination, and identification scores compared to controls (p=0.0001). Overall, 92% of patients in the intervention group improved versus 42% of controls. Magnitude of recovery was significantly greater in the intervention group versus control (12.8 + 8.2 versus mean 3.2 + 3), with >10-fold higher prevalence of anosmia in control versus intervention groups at the 90-day endpoint. CONCLUSION Among individuals with olfactory dysfunction post-COVID-19, combining PEA-LUT with olfactory training resulted in greater recovery of smell than olfactory training alone.
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Affiliation(s)
- Arianna Di Stadio
- Address correspondence to this author at the University of Catania, Otolaryngology Department, Catania, Italy; E-mail:
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22
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Tabbiche A, Bouchama A, Chafai N, Zaidi F, Chiter C, Yahiaoui M, Abiza A. New bis hydrazone: Synthesis, X-ray crystal structure, DFT computations, conformational study and in silico study of the inhibition activity of SARS-CoV-2. J Mol Struct 2022; 1261:132865. [PMID: 35345533 PMCID: PMC8934244 DOI: 10.1016/j.molstruc.2022.132865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/16/2022]
Abstract
The aim of this work was to synthesize new bis hydrazone derived from benzil in good yield, namely: (1Z,2Z)-1,2-bis (3-Chlorophenyl Hydrazino) Benzil, encoded by 3-Cl BHB. The benzil (or 1,2-diphenyl ethanedione) reacts with 3-Cl phenyl hydrazine by reflux method using ethanol as solvent to obtain the target compound. The obtained product is depicted by UV-Vis, IR spectroscopy and XRD-crystals analysis. All various contacts intra and intermolecular found in 3-Cl BHB were determined by the X-ray diffraction technique performed on single crystals. On the other hand, the optimized geometric structure of 3-Cl BHB was computed by the DFT/B3LYP method with 6-31 G (d, p) level. So, the bond lengths and angles, frontier molecular orbitals (FMO), surface electrostatic potential of the molecule (MEP), global reactivity descriptors, Mulliken atomic charges, computed vibrational analysis and electronic absorption spectrum were determined to get a good understanding of the electronic properties and the active sites of 3-Cl BHB, then to compare them with experimental data. Additionally, a conformational study was carried out using the same method (DFT). The structure-activity relationships established through molecular docking studies showed that 3-Cl BHB structure strongly binds to the receptors Mpro (-8.90 Kcal/mol) and RdRp (-8.60 Kcal/mol) which confirm its inhibition activity against COVID-19.
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Affiliation(s)
- Abdelkader Tabbiche
- Laboratoire de Chimie, Ingénierie Moléculaire et Nanostructures, Université Ferhat Abbas Sétif 1, Sétif 19000, Algeria,Département de chimie, Faculté des sciences, Université Ferhat Abbas-Sétif-1, Algeria
| | - Abdelaziz Bouchama
- Département de chimie, Faculté des sciences, Université Ferhat Abbas-Sétif-1, Algeria
| | - Nadjib Chafai
- Department of Process Engineering, Faculty of Technology, Laboratory of Electrochemistry of Molecular Materials and Complex (LEMMC). University of Ferhat ABBAS Setif-1, El-Mabouda campus, Sétif 19000, Algeria,Corresponding author
| | - Farouk Zaidi
- Département de chimie, Faculté des sciences, Université Ferhat Abbas-Sétif-1, Algeria
| | - Chaabane Chiter
- Department of Process Engineering, Faculty of Technology, Laboratory of Electrochemistry of Molecular Materials and Complex (LEMMC). University of Ferhat ABBAS Setif-1, El-Mabouda campus, Sétif 19000, Algeria
| | - Messaoud Yahiaoui
- Department of Process Engineering, Faculty of Technology, Laboratory of Electrochemistry of Molecular Materials and Complex (LEMMC). University of Ferhat ABBAS Setif-1, El-Mabouda campus, Sétif 19000, Algeria
| | - Abdellah Abiza
- Laboratoire de Chimie, Ingénierie Moléculaire et Nanostructures, Université Ferhat Abbas Sétif 1, Sétif 19000, Algeria
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Xu W, Sunavala‐Dossabhoy G, Spielman AI. Chemosensory loss in
COVID
‐19. Oral Dis 2022; 28 Suppl 2:2337-2346. [PMID: 35790059 PMCID: PMC9349612 DOI: 10.1111/odi.14300] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 01/08/2023]
Abstract
The COVID‐19 pandemic caused by SARS‐CoV‐2 virus quickly spread globally, infecting over half a billion individuals, and killing over 6 million*. One of the more unusual symptoms was patients' complaints of sudden loss of smell and/or taste, a symptom that has become more apparent as the virus mutated into different variants. Anosmia and ageusia, the loss of smell and taste, respectively, seem to be transient for some individuals, but for others persists even after recovery from the infection. Causes for COVID‐19‐associated chemosensory loss have undergone several hypotheses. These include non‐functional or destroyed olfactory neurons and gustatory receptors or of their supporting cells, disruption of the signaling protein Neuropilin‐1, and disruption in the interaction with semaphorins, key molecules in the gustatory and olfactory axon guidance. The current paper will review these hypotheses and chart out potential therapeutic avenues.
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Affiliation(s)
- Winnie Xu
- Department of Molecular Pathobiology New York University College of Dentistry New York NY
| | - Gulshan Sunavala‐Dossabhoy
- Department of Biochemistry and Molecular Biology, LSU Health Shreveport and Feist Weiller Cancer Center Shreveport LA
| | - Andrew I. Spielman
- Department of Molecular Pathobiology New York University College of Dentistry New York NY
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Abstract
Article Title and Bibliographic Information J. Amorim dos Santos, A.G.C. Normando, R.L.Carvalho da Silva, A.C. Acevedo G. De Luca Canto, N. Sugaya, A.R. Santos-Silva , E.N.S. Guerra (2021). ``Oral Manifestations in Patients with COVID-19: A Living Systematic Review.'' J Dent Res 100(2): 141-154. Source of Funding Non-profit, Foundations, etc.? National Council for Scientific and Technological Development, Ministry of Education, Brazil and the Department of Research and Innovation, University of Brasilia, Brazil. Type of Study/Design Systematic review with meta-analysis of data.
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Affiliation(s)
- Lauren L Patton
- Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
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