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Ryu DW, Yoo SW, Choi KE, Oh YS, Kim JS. Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson's disease. J Neurol 2024; 271:1397-1407. [PMID: 37940708 DOI: 10.1007/s00415-023-12080-8] [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: 08/10/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Hyposmia is a common nonmotor symptom of Parkinson's disease (PD) and reportedly associated with dysautonomia in PD. The smell identification test for measuring olfactory function consists of multiple items to discriminate specific scents. In the present study, factor analysis of the smell identification test was performed, and the correlation of extracted factors with cardiac sympathetic denervation (CSD) in patients with PD was investigated. METHODS The present study included 183 early PD patients who underwent the Cross-Cultural Smell Identification Test (CC-SIT) and 123I-meta-iodobenzylguanidine (123I-MIBG) myocardial scintigraphy. Factor analysis of 12 items on the CC-SIT was performed using the computed correlation matrix for the binary items, and five smell factors were extracted. Multiple linear regression was performed to determine the correlation of olfactory function with late heart-to-mediastinum (H/M) ratio of 123I-MIBG uptake. RESULTS The mean CC-SIT score was 6.1 ± 2.6, and 133 patients (72.7%) had CSD. The CC-SIT score and five smell factors were not associated with dopamine transporter uptake or cognitive functions. However, the CC-SIT score significantly correlated with age (P < 0.001) and late H/M ratio (P < 0.001). Factors 1 and 5 showed an increasing trend with larger H/M ratio, although it was not statistically significant (β = 0.203, P = 0.085 and β = 0.230, P = 0.085, respectively). Factor 5 significantly correlated with the H/M ratio in PD patients with CSD (β = 0.676, P = 0.036). DISCUSSION The results showed olfactory dysfunction to be selectively associated with cardiac sympathetic burden in PD. The correlation of certain factors with CSD indicates the possibility of selective hyposmia in PD patients.
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Affiliation(s)
- Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Ko-Eun Choi
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yoon-Sang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Jacobson PT, Vilarello BJ, Tervo JP, Waring NA, Gudis DA, Goldberg TE, Devanand DP, Overdevest JB. Associations between olfactory dysfunction and cognition: a scoping review. J Neurol 2024; 271:1170-1203. [PMID: 38217708 DOI: 10.1007/s00415-023-12057-7] [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: 07/20/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Strong evidence suggests that olfactory dysfunction (OD) can predict additional neurocognitive decline in neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. However, research exploring olfaction and cognition in younger populations is limited. The aim of this review is to evaluate cognitive changes among non-elderly adults with non-COVID-19-related OD. METHODS We performed a structured comprehensive literature search of PubMed, Ovid Embase, Web of Science, and Cochrane Library in developing this scoping review. The primary outcome of interest was the association between OD and cognitive functioning in adults less than 60 years of age. RESULTS We identified 2878 studies for title and abstract review, with 167 undergoing full text review, and 54 selected for data extraction. Of these, 34 studies reported on populations of individuals restricted to the ages of 18-60, whereas the remaining 20 studies included a more heterogeneous population with the majority of individuals in this target age range in addition to some above the age of 60. The etiologies for smell loss among the included studies were neuropsychiatric disorders (37%), idiopathic cause (25%), type 2 diabetes (7%), trauma (5%), infection (4%), intellectual disability (4%), and other (18%). Some studies reported numerous associations and at times mixed, resulting in a total number of associations greater than the included number of 54 studies. Overall, 21/54 studies demonstrated a positive association between olfaction and cognition, 7/54 demonstrated no association, 25/54 reported mixed results, and only 1/54 demonstrated a negative association. CONCLUSION Most studies demonstrate a positive correlation between OD and cognition, but the data are mixed with associations less robust in this young adult population compared to elderly adults. Despite the heterogeneity in study populations and outcomes, this scoping review serves as a starting point for further investigation on this topic. Notably, as many studies in this review involved disorders that may have confounding effects on both olfaction and cognition, future research should control for these confounders and incorporate non-elderly individuals with non-psychiatric causes of smell loss.
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Affiliation(s)
- Patricia T Jacobson
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Brandon J Vilarello
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jeremy P Tervo
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Nicholas A Waring
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Terry E Goldberg
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - D P Devanand
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Jonathan B Overdevest
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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Kumpitsch C, Fischmeister FPS, Lackner S, Holasek S, Madl T, Habisch H, Wolf A, Schöpf V, Moissl-Eichinger C. Reduced olfactory performance is associated with changed microbial diversity, oralization, and accumulation of dead biomaterial in the nasal olfactory area. Microbiol Spectr 2024; 12:e0154923. [PMID: 38193689 PMCID: PMC10846256 DOI: 10.1128/spectrum.01549-23] [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: 04/17/2023] [Accepted: 12/09/2023] [Indexed: 01/10/2024] Open
Abstract
The partial or complete loss of the sense of smell, which affects about 20% of the population, impairs the quality of life in many ways. Dysosmia and anosmia are mainly caused by aging, trauma, infections, or even neurodegenerative disease. Recently, the olfactory area-a site containing the olfactory receptor cells responsible for odor perception-was shown to harbor a complex microbiome that reflects the state of olfactory function. This initially observed correlation between microbiome composition and olfactory performance needed to be confirmed using a larger study cohort and additional analyses. A total of 120 participants (middle-aged, no neurodegenerative disease) were enrolled in the study to further analyze the microbial role in human olfactory function. Olfactory performance was assessed using the Sniffin' Stick battery, and participants were grouped accordingly (normosmia: n = 93, dysosmia: n = 27). The olfactory microbiome was analyzed by 16S rRNA gene amplicon sequencing and supplemented by metatranscriptomics in a subset (Nose 2.0). Propidium monoazide (PMA) treatment was performed to distinguish between intact and non-intact microbiome components. The gastrointestinal microbiome of these participants was also characterized by amplicon sequencing and metabolomics and then correlated with food intake. Our results confirm that normosmics and dysosmics indeed possess a distinguishable olfactory microbiome. Alpha diversity (i.e., richness) was significantly increased in dysosmics, reflected by an increase in the number of specific taxa (e.g., Rickettsia, Spiroplasma, and Brachybacterium). Lower olfactory performance was associated with microbial signatures from the oral cavity and periodontitis (Fusobacterium, Porphyromonas, and Selenomonas). However, PMA treatment revealed a higher accumulation of dead microbial material in dysosmic subjects. The gastrointestinal microbiome partially overlapped with the nasal microbiome but did not show substantial variation with respect to olfactory performance, although the diet of dysosmic individuals was shifted toward a higher meat intake. Dysosmia is associated with a higher burden of dead microbial material in the olfactory area, indicating an impaired clearance mechanism. As the microbial community of dysosmics (hyposmics and anosmics) appears to be influenced by the oral microbiome, further studies should investigate the microbial oral-nasal interplay in individuals with partial or complete olfactory loss.IMPORTANCEThe loss of the sense of smell is an incisive event that is becoming increasingly common in today's world due to infections such as COVID-19. Although this loss usually recovers a few weeks after infection, in some cases, it becomes permanent-why is yet to be answered. Since this condition often represents a psychological burden in the long term, there is a need for therapeutic approaches. However, treatment options are limited or even not existing. Understanding the role of the microbiome in the impairment of olfaction may enable the prediction of olfactory disorders and/or could serve as a possible target for therapeutic interventions.
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Affiliation(s)
- Christina Kumpitsch
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Florian Ph. S. Fischmeister
- Department of Psychology, University of Graz, Graz, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- BioTechMed, Graz, Austria
| | - Sonja Lackner
- Otto Loewi Research Center, Division of Immunology, Medical University of Graz, Graz, Austria
| | - Sandra Holasek
- Otto Loewi Research Center, Division of Immunology, Medical University of Graz, Graz, Austria
| | - Tobias Madl
- BioTechMed, Graz, Austria
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Ageing, Molecular Biology and Biochemistry, Research Unit Integrative Structural Biology, Medical University of Graz, Graz, Austria
| | - Hansjörg Habisch
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Ageing, Molecular Biology and Biochemistry, Research Unit Integrative Structural Biology, Medical University of Graz, Graz, Austria
| | - Axel Wolf
- Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria
| | - Veronika Schöpf
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Christine Moissl-Eichinger
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
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Miyake MM, Valera FCP, Martins RB, Compagnoni IM, Fantucci MZ, Murashima AAB, da Silva LECM, de Lima TM, de Souza MVO, Melo SR, Dolci RLL, Floriano CG, de Campos CAC, Nakanishi M, Freire GSM, Valente AL, Fornazieri MA, da Silva JLB, Anzolin LK, Issa MJA, Souza TV, Lima BA, SantAnna GD, Abreu CB, Sakano E, Cassettari AJ, Avelino MAG, Goncalves MC, de Camargo LA, Romano FR, Alves RD, Roithmann R, Redeker NK, Filho LLB, Dassi CS, Meurer ATO, Garcia DM, Aragon DC, Tepedino MS, Succar ACS, Vianna PM, Dos Santos MCJ, Filho RHR, Kosugi EM, Villa JF, Gregorio LL, Piltcher OB, Meotti CD, Tamashiro E, Arruda E, Anselmo Lima WT. Smell loss associated with SARS-CoV-2 is not clinically different from other viruses: a multicenter cohort study. Rhinology 2024; 62:55-62. [PMID: 37772802 DOI: 10.4193/rhin23.116] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.
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Affiliation(s)
- M M Miyake
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil and Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - F C P Valera
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R B Martins
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - I M Compagnoni
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M Z Fantucci
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - A A B Murashima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - L E C M da Silva
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - T M de Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M V O de Souza
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - S R Melo
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - R L L Dolci
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C G Floriano
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - C A C de Campos
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil
| | - M Nakanishi
- University of Brasilia, Brasilia, DF, Brazil
| | | | - A L Valente
- University of Brasilia, Brasilia, DF, Brazil
| | | | | | - L K Anzolin
- State University of Londrina, Londrina, PR, Brazil
| | - M J A Issa
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - T V Souza
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - B A Lima
- Mater Dei Hospital, Belo Horizonte, MG, Brazil
| | - G D SantAnna
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - C B Abreu
- Santa Casa de Misericordia Hospital de Porto Alegre, Porto Alegre, RS, Brazil
| | - E Sakano
- State University of Campinas. Campinas, SP, Brazil
| | | | | | | | | | | | - R D Alves
- Hospital Moriah, Sao Paulo, SP, Brazil
| | - R Roithmann
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - N K Redeker
- Lutheran University of Brazil, Canoas, RS, Brazil
| | - L L B Filho
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - C S Dassi
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - A T O Meurer
- Hospital Edmundo Vasconcelos, Sao Paulo, SP, Brazil
| | - D M Garcia
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - D C Aragon
- Ribeirio Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - M S Tepedino
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - A C S Succar
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P M Vianna
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - E M Kosugi
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - J F Villa
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - L L Gregorio
- Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - C D Meotti
- Hospital de Clinicas Porto Alegre, RS, Brazil
| | - E Tamashiro
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - E Arruda
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
| | - W T Anselmo Lima
- Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil
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Haas M, Raninger J, Kaiser J, Mueller CA, Liu DT. Treatment adherence to olfactory training: a real-world observational study. Rhinology 2024; 62:35-45. [PMID: 37838940 DOI: 10.4193/rhin23.207] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
BACKGROUND Olfactory training (OT) is considered an effective intervention for most causes of smell loss and is recommended as a long-term treatment. However, the treatment adherence of OT remains unclear. This study aims to identify the frequency and causalities for lack of adherence to OT. METHODS In this prospective study, 53 patients previously diagnosed with olfactory dysfunction (OD), who were recommended to perform OT, were enrolled. Patients underwent olfactory testing using Sniffin' Sticks for threshold, discrimination, and identification (TDI) and a subjective numeric rating scale (NRS) at a baseline and follow-up visit. In addition, patients answered a six-item treatment adherence questionnaire. The primary outcome measures were clinically relevant improvements according to the TDI (>=5.5) and NRS (>=5.5) scores. RESULTS Out of 53 patients, 45 performed OT. Among patients who performed OT, 31% discontinued the use of OT on their own due to a self-perceived improvement, while 51% discontinued use due to lack of improvements in olfaction. In these patients, the average duration of OT use was five months. After controlling for baseline duration of OD, baseline TDI score and smell loss aetiologies, discontinuing OT due to a lack of self-perceived improvement remained significantly associated with worse TDI and NRS outcomes at follow-up. CONCLUSIONS Our data show that therapeutical adherence to OT is low, regardless of patients' perception of olfactory function. Olfactory improvement leads to decreased training due to satisfaction, while lack of improvement leads to non-adherence based on disappointing subjective outcome. Patients should be advised to perform OT consistently.
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Affiliation(s)
- M Haas
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - J Raninger
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - J Kaiser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - C A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - D T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Grote H, Hoffmann A, Kerzel S, Lukasik H, Maier C, Mallon C, Schlegtendal A, Schwarzbach M, van Ackeren K, Volkenstein S, Brinkmann F. Subjective Smell Disturbances in Children with Sars-Cov-2 or Other Viral Infections do not Correspond with Olfactory Test Results. Klin Padiatr 2024; 236:129-138. [PMID: 38262421 DOI: 10.1055/a-2208-6245] [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] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Olfactory dysfunction associated with SARS-CoV-2 infection in children has not been verified by a validated olfactory test. We aimed to determine whether these complaints are objectifiable (test-based hyposmia), how often they occur during acute SARS-CoV-2 infection compared to other upper respiratory tract infections (URTI), as well as in children recovered from COVID-19 compared to children with long COVID. METHODS Olfactory testing (U-sniff test; hyposmia<8 points) and survey-based symptom assessments were performed in 434 children (5-17 years; 04/2021-06/2022). 186 symptom-free children served as controls. Of the children with symptoms of acute respiratory tract infection, SARS-CoV-2 PCR test results were positive in 45 and negative in 107 children (URTI group). Additionally, 96 children were recruited at least 4 weeks (17.6±15.2 weeks) after COVID-19, of whom 66 had recovered and 30 had developed long COVID. RESULTS Compared to controls (2.7%), hyposmia frequency was increased in all other groups (11-17%, p<0.05), but no between-group differences were observed. Only 3/41 children with hyposmia reported complaints, whereas 13/16 children with complaints were normosmic, with the largest proportion being in the long-COVID group (23%, p<0.05). CONCLUSION Questionnaires are unsuitable for assessing hyposmia frequency in children. Olfactory complaints and hyposmia are not specific for SARS-CoV-2 infection. The number of complaints in the long-COVID group could result from aversive olfactory perception, which is undetectable with the U-sniff test.
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Affiliation(s)
- Hanna Grote
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Anna Hoffmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Sebastian Kerzel
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Hannah Lukasik
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Christoph Maier
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Claire Mallon
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Anne Schlegtendal
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Michaela Schwarzbach
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Konstantin van Ackeren
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Stefan Volkenstein
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Paediatric Pneumology, University Hospital Schleswig Holstein Campus Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), German Center for Lung Research, Lübeck, Germany
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7
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Lobova OV, Avramenko IV, Shpak II. COVID-19 associated anosmia in pediatric patients: subject publications review. Wiad Lek 2024; 77:114-119. [PMID: 38431815 DOI: 10.36740/wlek202401114] [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] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment and recovery. The peculiarity of pediatric COVID-19 anosmia is due to children accounting for very low percentage of COVID-19 patients (comparing to one in adults), mostly with milder course of the disease. Awareness of anosmia and its proper diagnostics is crucial in children and adolescents, considering it can be the only manifestation in COVID-19 positive pediatric patients. PATIENTS AND METHODS Materials and Methods: In order to achieve this goal a meta-analysis of information from databases followed by statistical processing and generalisation of the obtained data was carried out. CONCLUSION Conclusions: Publications on COVID-19 anosmia in children and adolescents are less numerous than those concerning adult patients, so it is important to use every single trustworthy one. Anosmia/ageusia may be the only symptom, early identifier and the strongest predictor of COVID-19 infection in pediatric patients. Prospects for further scientific researches. Further researches regarding differential diagnostics of COVID-19 and other infections, including seasonal influenza, manifesting with both olfactory and taste dysfunction as well as anosmia diagnostics in children and adolescents with autistic spectrum and different types of mental disorders are possible.
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Affiliation(s)
| | - Iryna V Avramenko
- KYIV MEDICAL UNIVERSITY, KYIV, UKRAINE; DNIPRO STATE MEDICAL UNIVERSITY, DNIPRO, UKRAINE
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Mohamed R, Alsuhibani R, Almasaoud H, Alsubhi S, Alabdulazeem L, Alzahrani N, Alsaif S, Al Ghamdi K, Al-Asoom L. Assessment of anosmia/hyposmia in post-COVID-19 patients: a cross-sectional study in an eastern province of Saudi Arabia. Acta Biomed 2023; 94:e2023259. [PMID: 38054673 PMCID: PMC10734232 DOI: 10.23750/abm.v94i6.15130] [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] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/02/2023] [Indexed: 12/07/2023]
Abstract
Background and aim It has been shown that olfactory dysfunction is one of Coronavirus disease-2019 (COVID-19)common and puzzling symptoms that may persist weeks after the infection. This study aimed for the objective assessment of persisting olfactory dysfunction in post-COVID-19 patients. It also investigated the factors associated with the development of such symptoms in the Eastern Province of Saudi Arabia. METHODS A cross-sectional study that was conducted in the Department of Physiology, College of Medicine, Imam Abdulrahman bin Faisal University, Khobar, Saudi Arabia. One hundred and forty-seven participants were included in this study, and sixty of them agreed to participate in the objective testing using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfaction test. RESULTS There was a significant correlation between the following factors: (1) Persistence of anosmia/hyposmia and the time of onset of anosmia/hyposmia (P=0.015). (2) Persistence of anosmia/hyposmia and the duration of anosmia/hyposmia (P=0.012). (3) Duration of anosmia/hyposmia and the duration of COVID-19 symptoms (P=0.010). Interestingly, there was a significant association between the subjective participants' claim of anosmia/hyposmia and the score of their objective assessment (P=0.026). CONCLUSION The current study demonstrated that post-COVID-19 participants with delayed onset of anosmia/hyposmia and/or longer duration of either anosmia/hyposmia or COVID-19 symptoms were prone to have persistent olfactory dysfunction. Further studies are necessary to uncover the underlying pathophysiology and management of this olfactory dysfunction in COVID-19 patients.
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Affiliation(s)
- Reem Mohamed
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Reem Alsuhibani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Heba Almasaoud
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Shahad Alsubhi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Lama Alabdulazeem
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Nora Alzahrani
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Seham Alsaif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Kholoud Al Ghamdi
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Lubna Al-Asoom
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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El Otmani H, Daghi M, Maghfour M, Haddouali K, Bellakhdar S, El Moutawakil B, Tahiri Jouti N, Rafai MA. RBD and hyposmia in Moroccan patients with a synucleinopathy: prevalence and the timing of occurrence in a large cohort. Acta Neurol Belg 2023; 123:2229-2233. [PMID: 37046132 PMCID: PMC10096100 DOI: 10.1007/s13760-023-02262-6] [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: 01/27/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Rapid Eye Movement Sleep Behavior Disorder (RBD) and hyposmia are common in synucleinopathies and they tend to occur in connection to the prodromal development of these disorders. In this study, we sought to determine the prevalence of RBD and hyposmia and the timeline of their occurrence in a large cohort of Moroccan patients. METHODS We recruited 774 consecutive patients with synucleinopathy and tauopathy at Ibn Rochd University Hospital of Casablanca. A group of 100 healthy controls was also recruited. We relied on a questionnaire to collect general characteristics and clinical data filled by the patient and his companion under the supervision of a qualified health professional. RESULTS The study included 697 patients with PD, 37 with DLB and 40 had a tauopathy disorder (PSP or CBD). The proportion of patients who have RBD was 52% in PD, 100% in DLB, 0% in tauopathies and 12% among healthy controls. Hyposmia symptom was found in 47% of patients with PD, 68% in patients with DLB, 0% in tauopathy patients and in 10% of healthy controls. Moreover, 46% of PD patients and 75% of DLB patients developed RBD during the prodromal phase. Meanwhile, hyposmia occurred in association with the prodromal phase among 67% of PD cases and 85% of DLB patients. CONCLUSION RBD and hyposmia are both prevalent among Moroccan patients with synucleinopathy and they occur frequently during the prodromal phase. Identifying these premotor signs will improve early and differential diagnosis and enhance our understanding of how a specific synucleinopathy progresses.
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Affiliation(s)
- Hicham El Otmani
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Manal Maghfour
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Kamal Haddouali
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Salma Bellakhdar
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Bouchra El Moutawakil
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Nadia Tahiri Jouti
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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10
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Payandeh JE, Motamed M, Kirubalingam K, Chadha NK. Olfactory Dysfunction in Children: A Scoping Review. Otolaryngol Head Neck Surg 2023; 169:1399-1408. [PMID: 37449420 DOI: 10.1002/ohn.415] [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: 03/20/2023] [Revised: 06/03/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Olfactory disorders are well-studied in the adult population, however, there is a paucity of literature characterizing olfactory dysfunction in pediatric patients. The purpose of this scoping review was to identify known causes of olfactory loss in pediatric populations, clarify the extent of use and validity of smell tests, and summarize current therapies for olfactory loss. DATA SOURCES PubMed, Ovid MEDLINE, and Web of Science. REVIEW METHODS Databases were systematically searched in September 2020. Two independent reviewers conducted the title and abstract screen, followed by review of full-texts for inclusion based on preset inclusion and exclusion criteria. Extracted data included study type, age/age-range of participants, gender, radiological evidence of olfactory dysfunction, types and results of smell tests used, etiology of olfactory loss, and therapies employed for olfactory loss. RESULTS A total of 103 articles (n = 1654) were eligible for final data extraction. The University of Pennsylvania Smell Identification Test was used most frequently for smell testing (21% of studies). In total, 45 causes of olfactory dysfunction have been elucidated by this study: 22 congenital and 23 acquired. Few therapies were described, and all were specific to the etiology of olfactory loss. CONCLUSION Olfactory dysfunction has a wide range of etiologies in the pediatric population, and clinicians should have a diagnostic algorithm for how to identify a cause should they encounter it in practice. If no etiology can be identified, education around safety should be provided to both the patient and their caregivers.
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Affiliation(s)
| | - Mehras Motamed
- Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Neil K Chadha
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Department of Surgery, B.C. Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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11
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Shiraishi T, Yoshimaru D, Umehara T, Ozawa M, Omoto S, Okumura M, Kokubu T, Takahashi J, Sato T, Onda A, Komatsu T, Sakai K, Mitsumura H, Murakami H, Okano HJ, Iguchi Y. Interactive effect of orthostatic hypotension on gray matter atrophy associated with hyposmia and RBD in de novo Parkinson's disease. J Neurol 2023; 270:5924-5934. [PMID: 37626243 DOI: 10.1007/s00415-023-11934-5] [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: 04/25/2023] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Orthostatic hypotension (OH) is a potential modifiable risk factor for cognitive impairment in patients with Parkinson's disease (PD). Although other risk factors for dementia, hyposmia and REM sleep behavior disorder (RBD), are closely associated with autonomic dysfunction in PD, little is known about how these risk factors influence cognitive function and cerebral pathology. OBJECTIVE We investigated how these three factors contribute to gray matter atrophy by considering the interaction of OH with hyposmia and RBD. METHODS We analyzed cortical thickness, subcortical gray matter volume, and cognitive measures from 78 patients with de novo PD who underwent the head-up tilt test for the diagnosis of OH. RESULTS Whole-brain analyses with Monte Carlo corrections revealed that hyposmia was associated with decreased cortical thickness in a marginal branch of the cingulate sulcus among patients with OH, and cortical thickness in this area correlated with cognitive functioning only in patients with OH. Subcortical gray matter volume analysis indicated that severe RBD was associated with decreased volume in the left hippocampus and bilateral amygdala among patients with OH. CONCLUSION Even in early PD, OH exerts effects on gray matter atrophy and cognitive dysfunction by interacting with RBD and hyposmia. OH might exacerbate cerebral pathology induced by hyposmia or RBD.
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Affiliation(s)
- Tomotaka Shiraishi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
- Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Daisuke Yoshimaru
- Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masakazu Ozawa
- Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | - Shusaku Omoto
- Department of Neurology, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Motohiro Okumura
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tatsushi Kokubu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Junichiro Takahashi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Asako Onda
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hidetomo Murakami
- Department of Neurology, Showa University East Hospital, Tokyo, Japan
| | - Hirotaka James Okano
- Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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12
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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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Karpishchenko SA, Lavrenova GV, Baranskaya SV, Zhamakochan KC. [Olfactory impairment in patients of the older age group with COVID-19 in the acute period and in the period of convalescence.]. Adv Gerontol 2023; 36:339-345. [PMID: 37782640] [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] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Complete or partial loss of sense of smell significantly reduces the quality of life and in some cases is life-threatening. A new coronavirus infection in some cases leads to hypo- or anosmia. The defeat of the olfactory epithelium, swelling of the mucous membrane, the presence of discharge in the nasal cavity complicate the effect of odorants on the neuroepithelium. With COVID-19, anosmia may be the first and leading symptom. The restoration of the sense of smell occurs more often during the first weeks, but in some cases it is persistent. A special group of patients are older patients, older than 60 years. The course of a new coronavirus infection due to concomitant pathology proceeds in a more severe form. We present the experience of olfactory training with a set of essential oils (juniper, turmeric, eucalyptus and rose). Aromatherapy was preceded by irrigation of the nasal cavity with isotonic saline solution. In the absence of a clear clinical effect for 3 weeks, the set of oils was changed to fir oil, rosemary oil, monarda and lavender. The course of treatment continued for an average of 2 months. The technique included physiotherapy (endonasal electrophoresis with 0,25% zinc sulfate solution № 10), zinc preparations, pumpkin seeds 20-30 g per day, B vitamins (B6 and B12).
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Affiliation(s)
- S A Karpishchenko
- I.P.Pavlov First Saint-Petersburg State Medical University, 6-8 Lev Tolstoy str., St. Petersburg 197022, Russian Federation, e-mail:
| | - G V Lavrenova
- I.P.Pavlov First Saint-Petersburg State Medical University, 6-8 Lev Tolstoy str., St. Petersburg 197022, Russian Federation, e-mail:
| | - S V Baranskaya
- I.P.Pavlov First Saint-Petersburg State Medical University, 6-8 Lev Tolstoy str., St. Petersburg 197022, Russian Federation, e-mail:
| | - K C Zhamakochan
- I.P.Pavlov First Saint-Petersburg State Medical University, 6-8 Lev Tolstoy str., St. Petersburg 197022, Russian Federation, e-mail:
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Zhang Y, Dong B, Xue Y, Wang Y, Yan J, Xu L. Case report: A case of Culler-Jones syndrome caused by a novel mutation of GLI2 gene and literature review. Front Endocrinol (Lausanne) 2023; 14:1133492. [PMID: 36936162 PMCID: PMC10020625 DOI: 10.3389/fendo.2023.1133492] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Culler-Jones syndrome is a rare clinical phenomenon with diverse manifestations and is prone to misdiagnosis. We report one patient who presented with a 10-year history of anosmia and a 1-year history of epididymal pain. Kallmann syndrome was suspected initially. The results of his laboratory tests, imaging, and genetic testing, however, combined to provide a conclusive diagnosis of Culler-Jones syndrome. With the aid of high-throughput sequencing technology, the GLI2 gene c.527A>G (p.Tyr176Cys) heterozygous mutation in the child was identified. No published works have yet described this mutation site. We described Culler-Jones syndrome in a child at length. We recommend that Culler-Jones syndrome be taken into account when considering the spectrum of disorders associated with abnormal growth and development in children. Once diagnosed, individualized hormone replacement treatment is required for each patient.
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Affiliation(s)
- Yiwen Zhang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bingzi Dong
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Xue
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yunyang Wang
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jing Yan
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Xu
- Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Lili Xu,
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15
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Chen Y, Xu Q, Wu L, Zhou M, Lin Y, Jiang Y, He Q, Zhao L, Dong Y, Liu J, Chen W. REM sleep behavior disorder correlates with constipation in de novo Chinese Parkinson's disease patients. Neurol Sci 2023; 44:191-197. [PMID: 36098886 DOI: 10.1007/s10072-022-06381-5] [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: 04/14/2022] [Accepted: 09/04/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Constipation, rapid eye movement sleep behavior disorder (RBD) and hyposmia are common prodromal symptoms of Parkinson's disease (PD), and they may represent two distinct types of disease origin, from the body or the brain. Our study aimed to compare the clinical characteristics of de novo PD patients with and without constipation and identify which prodromal symptoms were associated with constipation. METHODS A total of 111 de novo, drug-naïve Chinese PD patients were consecutively enrolled from Jan 2017 to Sept 2021. Patients were classified into PD with and without constipation based on item 5 of the Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT). The demographic data, motor, and non-motor symptoms were compared between the two groups. The associated factors of constipation were analyzed by the multivariate logistic regression analysis. RESULTS In total, 44.1% (n = 49) of de novo PD patients had constipation. PD patients with constipation were older (p = 0.028), had higher proportions of Hoehn and Yahr (H-Y) stage [Formula: see text] 2 (p = 0.002), clinical possible RBD (cpRBD) (p = 0.002) and depression (p = 0.023), as well as marginal increase of hyposmia (p = 0.058) and freezing of gait (p = 0.069). After adjusting for H-Y stage and other confounding factors, cpRBD (OR = 3.508, p = 0.009), rather than hyposmia or depression, was closely related to constipation in de novo Chinese PD patients. CONCLUSIONS RBD is closely associated with constipation in de novo Chinese PD patients. Our results support the theory that prodromal symptoms that represent the same pathological origin are closely related to each other.
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Affiliation(s)
- Yajing Chen
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Xu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengxi Zhou
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yin Lin
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhan Jiang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing He
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yourong Dong
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Chen
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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16
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Abstract
In recent months it has emerged that the novel coronavirus-responsible for the COVID-19 pandemic-causes reduction of smell and taste in a large fraction of patients. The chemosensory deficits are often the earliest, and sometimes the only signs in otherwise asymptomatic carriers of the SARS-CoV-2 virus. The reasons for the surprisingly early and specific chemosensory dysfunction in COVID-19 are now beginning to be elucidated. In this hypothesis review, we discuss implications of the recent finding that the prevalence of smell and taste dysfunction in COVID-19 patients differs between populations, possibly because of differences in the spike protein of different virus strains or because of differences in the host proteins that enable virus entry, thus modifying infectivity. We review recent progress in defining underlying cellular and molecular mechanisms of the virus-induced anosmia, with a focus on the emerging crucial role of sustentacular cells in the olfactory epithelium. We critically examine the current evidence whether and how the SARS-CoV-2 virus can follow a route from the olfactory epithelium in the nose to the brain to achieve brain infection, and we discuss the prospects for using the smell and taste dysfunctions seen in COVID-19 as an early and rapid diagnostic screening tool.
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Affiliation(s)
- Rafal Butowt
- Department of Molecular Cell Genetics, L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- Department of Anatomy, L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Christopher S. von Bartheld
- Center of Biomedical Research Excellence in Cell Biology, Reno School of Medicine, University of Nevada, Reno, NV, USA
- Department of Physiology and Cell Biology, Reno School of Medicine, University of Nevada, Reno, NV, USA
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Brandini DA, Takamiya AS, Thakkar P, Schaller S, Rahat R, Naqvi AR. Covid-19 and oral diseases: Crosstalk, synergy or association? Rev Med Virol 2021; 31:e2226. [PMID: 33646645 PMCID: PMC8014590 DOI: 10.1002/rmv.2226] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Abstract
The coronavirus disease 2019 (Covid-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that clinically affects multiple organs of the human body. Cells in the oral cavity express viral entry receptor angiotensin-converting enzyme 2 that allows viral replication and may cause tissue inflammation and destruction. Recent studies have reported that Covid-19 patients present oral manifestations with multiple clinical aspects. In this review, we aim to summarise main signs and symptoms of Covid-19 in the oral cavity, its possible association with oral diseases, and the plausible underlying mechanisms of hyperinflammation reflecting crosstalk between Covid-19 and oral diseases. Ulcers, blisters, necrotising gingivitis, opportunistic coinfections, salivary gland alterations, white and erythematous plaques and gustatory dysfunction were the most reported clinical oral manifestations in patients with Covid-19. In general, the lesions appear concomitant with the loss of smell and taste. Multiple reports show evidences of necrotic/ulcerative gingiva, oral blisters and hypergrowth of opportunistic oral pathogens. SARS-CoV-2 exhibits tropism for endothelial cells and Covid-19-mediated endotheliitis can not only promote inflammation in oral tissues but can also facilitate virus spread. In addition, elevated levels of proinflammatory mediators in patients with Covid-19 and oral infectious disease can impair tissue homeostasis and cause delayed disease resolution. This suggests potential crosstalk of immune-mediated pathways underlying pathogenesis. Interestingly, few reports suggest recurrent herpetic lesions and higher bacterial growth in Covid-19 subjects, indicating SARS-CoV-2 and oral virus/bacteria interaction. Larger cohort studies comparing SARS-CoV-2 negative and positive subjects will reveal oral manifestation of the virus on oral health and its role in exacerbating oral infection.
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Affiliation(s)
- Daniela A. Brandini
- Department of Diagnosis and SurgerySchool of DentistrySão Paulo State University (UNESP)AraçatubaSão PauloBrazil
| | - Aline S. Takamiya
- Department of Diagnosis and SurgerySchool of DentistrySão Paulo State University (UNESP)AraçatubaSão PauloBrazil
| | - Pari Thakkar
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Samantha Schaller
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Rani Rahat
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Afsar R. Naqvi
- Mucosal Immunology LabCollege of DentistryUniversity of Illinois at ChicagoChicagoIllinoisUSA
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18
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Abstract
This cohort study examines the clinical course and prognosis of patients with COVID-19–related anosmia for 1 year after diagnosis.
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Affiliation(s)
- Marion Renaud
- Otorhinolaryngology Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Claire Thibault
- Otorhinolaryngology Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Floriane Le Normand
- Otorhinolaryngology Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Emily G. Mcdonald
- Clinical Practice Assessment Unit, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Benoît Gallix
- Institut Hospitalo-Universitaire-Strasbourg, Strasbourg, France
- Department of Radiology, McGill University, Montreal, Quebec, Canada
- Faculte de Medecine, Universite de Strasbourg, Strasbourg, France
| | - Christian Debry
- Otorhinolaryngology Department, University Hospitals of Strasbourg, Strasbourg, France
| | - Aina Venkatasamy
- Institut Hospitalo-Universitaire-Strasbourg, Strasbourg, France
- Streinth Laboratory (Stress Response and Innovative Therapies), Inserm UMR_S 1113, Interface Recherche Fondamental et Appliquee à la Cancerologie, Strasbourg, France
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Trachootham D, Thongyen S, Lam-Ubol A, Chotechuang N, Pongpirul W, Prasithsirikul W. Simultaneously complete but not partial taste and smell losses were associated with SARS-CoV-2 infection. Int J Infect Dis 2021; 106:329-337. [PMID: 33819604 PMCID: PMC8080514 DOI: 10.1016/j.ijid.2021.03.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives The aim of this study was to investigate the association between taste and smell losses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and to elucidate whether taste preference influences such taste loss. Methods A matched case–control study was conducted in 366 Thai participants, including 122 who were confirmed SARS-CoV-2-positive by RT-PCR (case group) and 244 who were SARS-CoV-2-negative (control group). Taste, smell, and appetite changes were assessed by self-reported visual analog scale. Preference for sweet, salty, umami, sour, bitter, and spicy were judged using the validated TASTE-26 questionnaire. Results Partial taste and smell losses were observed in both groups, while complete losses (ageusia and anosmia) were detected only in the case group. Moreover, only ageusia and anosmia were associated with SARS-CoV-2 positivity (P < 0.001, odds ratio of 14.5 and 27.5, respectively). Taste, smell, and appetite scores were more severely reduced in the case group (P < 0.0001). Multivariate analysis showed that anosmia and ageusia were the best predictors of SARS-CoV-2 positivity, followed by appetite loss and fever. Simultaneous losses of taste and smell but not taste preferences were associated with SARS-CoV-2 positivity (P < 0.01, odds ratio 2.28). Conclusions Complete, but not partial, losses of taste and smell were the best predictors of SARS-CoV-2 infection. During the current COVID-19 pandemic, healthy persons with sudden simultaneous complete loss of taste and smell should be screened for COVID-19.
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Affiliation(s)
| | - Supeda Thongyen
- Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Nonthaburi, Thailand
| | - Aroonwan Lam-Ubol
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Nattida Chotechuang
- Department of Food Technology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Wannarat Pongpirul
- Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Nonthaburi, Thailand
| | - Wisit Prasithsirikul
- Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Nonthaburi, Thailand
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20
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Ghaffari M, Ansari H, Beladimoghadam N, Aghamiri SH, Haghighi M, Nabavi M, Mansouri B, Mehrpour M, Assarzadegan F, Hesami O, Sedaghat M, Farahbakhsh M, Lima BS. Neurological features and outcome in COVID-19: dementia can predict severe disease. J Neurovirol 2021; 27:86-93. [PMID: 33417193 PMCID: PMC7792552 DOI: 10.1007/s13365-020-00918-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Received: 08/24/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic has infected more than 22 million people worldwide. Although much has been learned about COVID-19, we do not know much about its neurological features and their outcome. This observational study was conducted on the patients of Imam Hossein Hospital, and 361 adult patients (214 males) with confirmed diagnosis of COVID-19 from March 5, 2020 to April 3, 2020, were enrolled. Data was gathered on age, sex, comorbidities, initial symptoms, symptoms during the disease course, neurological symptoms, and outcome. The mean age of the patients was 61.90 ± 16.76 years. The most common initial symptoms were cough, fever, and dyspnea. In 21 patients (5.8%), the initial symptom was neurological. History of dementia was associated with severe COVID-19 disease (odds ratio = 1.28). During the course of the disease, 186 patients (51.52%) had at least one neurological symptom, the most common being headache (109 [30.2%]), followed by anosmia/ageusia (69, [19.1%]), and dizziness (54, [15%]). Also, 31 patients had neurological complications (8.58%). Anosmia, ageusia, dizziness, and headache were associated with favorable outcome (P < 0.001), while altered mental status and hemiparesis were associated with poor outcome. The mortality rate of patients who had neurological complications was more than twice than that of patients without neurological complication (P = 0.008). Almost half of the patients experienced at least one neurological symptom, which may be the initial presentation of COVID-19. Dementia appears to be associated with severe COVID-19. Mortality was higher in patients with neurological complications, and these patients needed more intensive care.
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Affiliation(s)
- Mehran Ghaffari
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Ansari
- Headache and Facial Pain Clinic, Kaizen Brain Center, San Diego, USA
- Department of Neurology, University of California, San Diego, USA
| | - Nahid Beladimoghadam
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehrdad Haghighi
- Department of Infectious Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Nabavi
- Department of Infectious Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnam Mansouri
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mehrpour
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Assarzadegan
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Hesami
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meghdad Sedaghat
- Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Farahbakhsh
- Department of Infectious Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnam Safarpour Lima
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Imam Hossein Medical and Educational Center , Madani Street, Tehran, Iran.
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21
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Abstract
This paper suggests that ATP release induced by the SARS-CoV-2 virus plays a key role in the genesis of the major symptoms and complications of COVID-19. Infection of specific cells which contain the Angiotensin-Converting Enzyme 2 (ACE2) receptor results in a loss of protection of the Mineralocorticoid Receptor (MR). Local activation by cortisol stimulates the release of ATP initially into the basolateral compartment and then by lysosomal exocytosis from the cell surface. This then acts on adjacent cells. In the nose ATP acts as a nociceptive stimulus which results in anosmia. It is suggested that a similar paracrine mechanism is responsible for the loss of taste. In the lung ATP release from type 2 alveolar cells produces the non-productive cough by acting on purinergic receptors on adjacent neuroepithelial cells and activating, via the vagus, the cough reflex. Infection of endothelial cells results in the exocytosis of WeibelPalade bodies. These contain the Von Willebrand Factor responsible for micro-clotting and angiopoietin-2 which increases vascular permeability and plays a key role in the Acute Respiratory Distress Syndrome. To test this hypothesis this paper reports proof of concept studies in which MR blockade using spironolactone and low dose dexamethasone (SpiDex) was given to PCR-confirmed COVID-19 patients. In 80 patients with moderate to severe respiratory failure 40 were given SpiDex and 40 conventional treatment with high dose dexamethasone (HiDex). There was 1 death in the HiDex group and none in the SpiDex. As judged by clinical, biochemical and radiological parameters there were clear statistically significant benefits of SpiDex in comparison to HiDex. A further 20 outpatients with COVID-19 were given SpiDex. There was no control group and the aim was to demonstrate safety. No adverse effects were noted and no patient became hyperkalaemic. 90% were asymptomatic at 10 days. The very positive results suggest that blockade of the MR can produce major benefit in COVID19 patients. Further larger controlled studies of inpatients and outpatients are required not only for SARS-CoV-2 infection per se but also to determine if this treatment affects the incidence of Long COVID.
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Affiliation(s)
- Christopher Edwards
- Hammersmith Hospital, Imperial College, London, United Kingdom
- *Correspondence: Christopher Edwards, ; orcid.org/0000-0003-1025-2095
| | - Oleksandra Klekot
- Clinical Pharmacology Department, Vinnytsia National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Larisa Halugan
- Infection Department, Vinnytsia State Clinical Hospital #3, Vinnytsia, Ukraine
| | - Yuri Korchev
- Hammersmith Hospital, Imperial College, London, United Kingdom
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22
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Klein H, Karni N, Israel S, Gross M, Muszkat M, Niv MY. Reversible Taste Loss in a COVID-19 Patient With Preexisting Chronic Smell Impairment. J Investig Med High Impact Case Rep 2021; 9:2324709621990765. [PMID: 33535814 PMCID: PMC7868492 DOI: 10.1177/2324709621990765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/21/2020] [Accepted: 01/01/2021] [Indexed: 01/06/2023] Open
Abstract
Smell loss is important for coronavirus disease-2019 (COVID-19) screening and diagnosis. Particular attention should be paid to individuals with pre-COVID-19 chronic hyposmia or anosmia. We report a case of reversible taste impairment in a COVID-19 patient with chronically impaired sense of smell. This case emphasizes the importance of COVID-19-related taste assessment.
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Affiliation(s)
| | - Noam Karni
- Hadassah University Hospital, Mt. Scopus Campus, Jerusalem, Israel
| | - Sarah Israel
- Hadassah University Hospital, Mt. Scopus Campus, Jerusalem, Israel
| | - Menachem Gross
- Hadassah Hebrew-University Medical Center, Jerusalem, Israel
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