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Zhu D, Tham T, Georgolios A. Saddle nose deformity: a rare complication of COVID-19 infection. OTOLARYNGOLOGY CASE REPORTS 2022; 23:100428. [PMID: 35368635 PMCID: PMC8957314 DOI: 10.1016/j.xocr.2022.100428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/23/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Although the effects of SARS-CoV-2 (COVID-19) infection in olfaction have been well established, there is relative paucity of information on possible other complications of COVID-19 in the nasal cavities and nasal function. Case report We report the unique case of a young female patient, with a remote history of septoplasty and functional endoscopic sinus surgery who developed severe nasal airway obstruction (NAO) and saddle nose deformity two to three weeks after her recovery from COVID-19. Conclusion This case report illustrates a late septoplasty complication that may be associated with COVID-19. This unusual clinical presentation indicates that structural destabilization of the nose may ensue as a complication of the COVID-19, and requires further investigation of the SARS-CoV-2 effects in vascularity and wound healing in the nasal cavity.
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102
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Scotto G, Fazio V, Lo Muzio E, Lo Muzio L, Spirito F. SARS-CoV-2 Infection and Taste Alteration: An Overview. Life (Basel) 2022; 12:690. [PMID: 35629357 PMCID: PMC9147711 DOI: 10.3390/life12050690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023] Open
Abstract
Since the worldwide spread of SARS-CoV-2 infection, the management of COVID-19 has been a challenge for healthcare professionals. Although the respiratory system has primarily been affected with symptoms ranging from mild pneumonia to acute respiratory distress syndrome, other organs or systems have also been targets of the virus. The mouth represents an important route of entry for SARS-CoV-2. Cells in the oral epithelium, taste buds, and minor and major salivary glands express cellular entry factors for the virus, such as ACE2, TMPRSS2 and Furin. This leads to symptoms such as deterioration of taste, salivary dysfunction, mucosal ulcers, before systemic manifestation of the disease. In this review we report and discuss the prevalence and socio-demographics of taste disturbances in COVID-19 patients, analysing the current international data. Importantly, we also take stock of the various hypothesized pathogenetic mechanisms and their impact on the reported symptoms. The literature indicated that COVID-19 patients frequently present with gustatory dysfunction, whose prevalence varies by country, age and sex. Furthermore, this dysfunction also has a variable duration in relation to the severity of the disease. The pathogenetic action is intricately linked to viral action which can be expressed in several ways. However, in many cases these are only hypotheses that need further confirmation.
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Affiliation(s)
- Gaetano Scotto
- Infectious Diseases Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy;
| | - Vincenzina Fazio
- Department of Prevention, Hygiene and Public Health Unit, University Hospital “OORR” Foggia, 71122 Foggia, Italy;
| | - Eleonora Lo Muzio
- Department of Dental Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
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103
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Pergolizzi JV, Raffa RB, Varrassi G, Magnusson P, LeQuang JA, Paladini A, Taylor R, Wollmuth C, Breve F, Chopra M, Nalamasu R, Christo PJ. Potential neurological manifestations of COVID-19: a narrative review. Postgrad Med 2022; 134:395-405. [PMID: 33089707 PMCID: PMC7799377 DOI: 10.1080/00325481.2020.1837503] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/13/2020] [Indexed: 01/08/2023]
Abstract
Neurological manifestations are increasingly reported in a subset of COVID-19 patients. Previous infections related to coronaviruses, namely Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS) also appeared to have neurological effects on some patients. The viruses associated with COVID-19 like that of SARS enters the body via the ACE-2 receptors in the central nervous system, which causes the body to balance an immune response against potential damage to nonrenewable cells. A few rare cases of neurological sequelae of SARS and MERS have been reported. A growing body of evidence is accumulating that COVID-19, particularly in severe cases, may have neurological consequences although respiratory symptoms nearly always develop prior to neurological ones. Patients with preexisting neurological conditions may be at elevated risk for COVID-19-associated neurological symptoms. Neurological reports in COVID-19 patients have described encephalopathy, Guillain-Barré syndrome, myopathy, neuromuscular disorders, encephalitis, cephalgia, delirium, critical illness polyneuropathy, and others. Treating neurological symptoms can pose clinical challenges as drugs that suppress immune response may be contraindicated in COVID-19 patients. It is possible that in some COVID-19 patients, neurological symptoms are being overlooked or misinterpreted. To date, neurological manifestations of COVID-19 have been described largely within the disease trajectory and the long-term effects of such manifestations remain unknown.
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Affiliation(s)
| | - Robert B. Raffa
- Temple University School of Pharmacy, Temple University, Philadelphia, PA, USA
- University of Arizona College of Pharmacy, Tucson, AZ, USA
| | | | - Peter Magnusson
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
- Department of Medicine, Cardiology Research Unit, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | - Frank Breve
- NEMA Research, Inc., Naples, FL, USA
- Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA, USA
| | | | - Rohit Nalamasu
- Department of Physical Medicine and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paul J. Christo
- Division of Pain Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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104
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Wurth R, Hajdenberg M, Barrera FJ, Shekhar S, Copacino CE, Moreno-Peña PJ, Gharib OAM, Porter F, Hiremath S, Hall JE, Schiffrin EL, Eisenhofer G, Bornstein SR, Brito JP, González-González JG, Stratakis CA, Rodríguez-Gutiérrez R, Hannah-Shmouni F. Scoping review of COVID-19-related systematic reviews and meta-analyses: can we really have confidence in their results? Postgrad Med J 2022; 98:372-379. [PMID: 33637639 PMCID: PMC7918809 DOI: 10.1136/postgradmedj-2020-139392] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study was to systematically appraise the quality of a sample of COVID-19-related systematic reviews (SRs) and discuss internal validity threats affecting the COVID-19 body of evidence. DESIGN We conducted a scoping review of the literature. SRs with or without meta-analysis (MA) that evaluated clinical data, outcomes or treatments for patients with COVID-19 were included. MAIN OUTCOME MEASURES We extracted quality characteristics guided by A Measurement Tool to Assess Systematic Reviews-2 to calculate a qualitative score. Complementary evaluation of the most prominent published limitations affecting the COVID-19 body of evidence was performed. RESULTS A total of 63 SRs were included. The majority were judged as a critically low methodological quality. Most of the studies were not guided by a pre-established protocol (39, 62%). More than half (39, 62%) failed to address risk of bias when interpreting their results. A comprehensive literature search strategy was reported in most SRs (54, 86%). Appropriate use of statistical methods was evident in nearly all SRs with MAs (39, 95%). Only 16 (33%) studies recognised heterogeneity in the definition of severe COVID-19 as a limitation of the study, and 15 (24%) recognised repeated patient populations as a limitation. CONCLUSION The methodological and reporting quality of current COVID-19 SR is far from optimal. In addition, most of the current SRs fail to address relevant threats to their internal validity, including repeated patients and heterogeneity in the definition of severe COVID-19. Adherence to proper study design and peer-review practices must remain to mitigate current limitations.
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Affiliation(s)
- Rachel Wurth
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Hajdenberg
- College of Arts and Sciences, Washington University in St Louis, St Louis, Missouri, USA
| | - Francisco J Barrera
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Skand Shekhar
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pablo J Moreno-Peña
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | - Omar A M Gharib
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Forbes Porter
- NICHD, National Institutes of Health, Bethesda, Maryland, USA
| | - Swapnil Hiremath
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Janet E Hall
- Clinical Research Branch, NIEHS, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Juan P Brito
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
| | - José Gerardo González-González
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
| | | | - René Rodríguez-Gutiérrez
- Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. Jose E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
- Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota, USA
- Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
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Mao Y, Ye B, Fan C, Wu J, Wang B, Shen Y, Shi Z, Xiang M. Correlation Between Coronavirus Disease 2019 and Olfactory Dysfunction. Front Public Health 2022; 10:843850. [PMID: 35392472 PMCID: PMC8980590 DOI: 10.3389/fpubh.2022.843850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 12/20/2022] Open
Abstract
A great number of patients with Coronavirus Disease 2019 (COVID-19) experience olfactory dysfunction, typically of a short duration and with a high incidence rate, during the early stages of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This kind of olfactory dysfunction appears more likely in young people and women. This study presents a review of the clinical features and pathogenic mechanism of the olfactory dysfunction related to SARS-CoV-2 infection, aiming to provide a clinical reference for the diagnosis, differential diagnosis, treatment, and prevention of olfactory dysfunction in COVID-19 patients.
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Affiliation(s)
- Yufeng Mao
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cui Fan
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jichang Wu
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beilei Wang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Shen
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihong Shi
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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106
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Snitz K, Honigstein D, Weissgross R, Ravia A, Mishor E, Perl O, Karagach S, Medhanie A, Harel N, Shushan S, Roth Y, Iravani B, Arshamian A, Ernst G, Okamoto M, Poo C, Bonacchi N, Mainen Z, Monteleone E, Dinnella C, Spinelli S, Mariño-Sánchez F, Ferdenzi C, Smeets M, Touhara K, Bensafi M, Hummel T, Lundström JN, Sobel N. An olfactory self-test effectively screens for COVID-19. COMMUNICATIONS MEDICINE 2022; 2:34. [PMID: 35603293 PMCID: PMC9053292 DOI: 10.1038/s43856-022-00095-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 02/18/2022] [Indexed: 01/05/2023] Open
Abstract
Background Key to curtailing the COVID-19 pandemic are wide-scale screening strategies. An ideal screen is one that would not rely on transporting, distributing, and collecting physical specimens. Given the olfactory impairment associated with COVID-19, we developed a perceptual measure of olfaction that relies on smelling household odorants and rating them online. Methods Each participant was instructed to select 5 household items, and rate their perceived odor pleasantness and intensity using an online visual analogue scale. We used this data to assign an olfactory perceptual fingerprint, a value that reflects the perceived difference between odorants. We tested the performance of this real-time tool in a total of 13,484 participants (462 COVID-19 positive) from 134 countries who provided 178,820 perceptual ratings of 60 different household odorants. Results We observe that olfactory ratings are indicative of COVID-19 status in a country, significantly correlating with national infection rates over time. More importantly, we observe indicative power at the individual level (79% sensitivity and 87% specificity). Critically, this olfactory screen remains effective in participants with COVID-19 but without symptoms, and in participants with symptoms but without COVID-19. Conclusions The current odorant-based olfactory screen adds a component to online symptom-checkers, to potentially provide an added first line of defense that can help fight disease progression at the population level. The data derived from this tool may allow better understanding of the link between COVID-19 and olfaction.
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Affiliation(s)
- Kobi Snitz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Reut Weissgross
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Aharon Ravia
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Eva Mishor
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Ofer Perl
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Shiri Karagach
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Abebe Medhanie
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Nir Harel
- Department of Fine Arts, Bezalel Academy of Fine Arts and Design, Jerusalem, Israel
| | - Sagit Shushan
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- Department of Otolaryngology-Head & Neck Surgery, Edith Wolfson Medical Center, Holon, Israel
| | - Yehudah Roth
- Department of Otolaryngology-Head & Neck Surgery, Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Behzad Iravani
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Artin Arshamian
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gernot Ernst
- Psychological institute, Oslo University, Oslo, Norway
| | - Masako Okamoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Cindy Poo
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Niccolò Bonacchi
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Zachary Mainen
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Erminio Monteleone
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Caterina Dinnella
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Sara Spinelli
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Franklin Mariño-Sánchez
- Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, Ramón y Cajal University Hospital, Madrid, Spain
| | - Camille Ferdenzi
- Lyon Neuroscience Research Center, CNRS - INSERM - University Claude Bernard of Lyon, Lyon, France
| | - Monique Smeets
- Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, the Netherlands
| | - Kazushige Touhara
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Moustafa Bensafi
- Lyon Neuroscience Research Center, CNRS - INSERM - University Claude Bernard of Lyon, Lyon, France
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Johan N. Lundström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Monell Chemical Senses Center, Philadelphia, PA USA
| | - Noam Sobel
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
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107
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Long B, Carius BM, Chavez S, Liang SY, Brady WJ, Koyfman A, Gottlieb M. Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation. Am J Emerg Med 2022; 54:46-57. [PMID: 35121478 PMCID: PMC8779861 DOI: 10.1016/j.ajem.2022.01.028] [Citation(s) in RCA: 125] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/01/2022] [Accepted: 01/12/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Coronavirus disease of 2019 (COVID-19) has resulted in millions of cases worldwide. As the pandemic has progressed, the understanding of this disease has evolved. OBJECTIVE This first in a two-part series on COVID-19 updates provides a focused overview of the presentation and evaluation of COVID-19 for emergency clinicians. DISCUSSION COVID-19, caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality worldwide. Several variants exist, including a variant of concern known as Delta (B.1.617.2 lineage) and the Omicron variant (B.1.1.529 lineage). The Delta variant is associated with higher infectivity and poor patient outcomes, and the Omicron variant has resulted in a significant increase in infections. While over 80% of patients experience mild symptoms, a significant proportion can be critically ill, including those who are older and those with comorbidities. Upper respiratory symptoms, fever, and changes in taste/smell remain the most common presenting symptoms. Extrapulmonary complications are numerous and may be severe, including the cardiovascular, neurologic, gastrointestinal, and dermatologic systems. Emergency department evaluation includes focused testing for COVID-19 and assessment of end-organ injury. Imaging may include chest radiography, computed tomography, or ultrasound. Several risk scores may assist in prognostication, including the 4C (Coronavirus Clinical Characterisation Consortium) score, quick COVID Severity Index (qCSI), NEWS2, and the PRIEST score, but these should only supplement and not replace clinical judgment. CONCLUSION This review provides a focused update of the presentation and evaluation of COVID-19 for emergency clinicians.
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Affiliation(s)
- Brit Long
- SAUSHEC, Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| | | | - Summer Chavez
- Department of Emergency Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, United States
| | - Stephen Y Liang
- Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, United States.
| | - William J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, United States
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108
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Ahmad S, Sohail A, Shahid Chishti MA, Aemaz Ur Rehman M, Farooq H. How common are taste and smell abnormalities in COVID-19? A systematic review and meta-analysis. J Taibah Univ Med Sci 2022; 17:174-185. [PMID: 34803567 PMCID: PMC8592522 DOI: 10.1016/j.jtumed.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/16/2021] [Accepted: 10/07/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Olfactory and gustatory dysfunction (OGD) are important early clinical symptoms of COVID-19. We aim to calculate the pooled prevalence of these symptoms and discuss the likely implications on clinical practice such as their use as screening tools and potential prognosis indicators. METHODS Using a combination of keywords and medical subject headings, we searched for observational studies in the following five databases: Medline/PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar. Two authors independently screened and selected the final articles according to the inclusion criteria. Two investigators independently assessed the risk of bias in individual studies using the Newcastle-Ottawa Scale. Heterogeneity and publication bias were also assessed. The reported outcome of the pooled analysis was the prevalence of OGD calculated using a random-effect model. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to report results. RESULTS Seventeen studies with a total sample size of 4149 were included in this meta-analysis. Out of these, 2106 and 2676 patients reported some degree of olfactory and/or gustatory dysfunction with COVID-19, respectively. The reported outcomes were in terms of pooled prevalence, with gustatory dysfunction being 57.33% and olfactory dysfunction being 59.69%, a significantly high occurrence. CONCLUSION There is a high occurrence of smell and taste impairment in COVID-19. Given the lack of objective testing for detecting OGD in most studies, the high prevalence found is likely to be an underestimation of the true prevalence. This implies that physicians must use them as reliable early indicators of COVID-19 and employ them before using expensive tests.
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Affiliation(s)
- Shahzaib Ahmad
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Anum Sohail
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | | | - Hareem Farooq
- Department of Medicine, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
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Byaruhanga R, Kabagenyi F, Kagga DS, Ndoleriire C, Kamulegeya A, Ssemwogerere L, Kiguba R, Kirenga B, Kakande E. Smell and Taste Symptoms Among Patients With Mild and Moderately Severe COVID-19 Infection in Uganda. OTO Open 2022; 6:2473974X221108357. [PMID: 35794964 PMCID: PMC9251986 DOI: 10.1177/2473974x221108357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Patients with coronavirus disease 2019 (COVID-19) may present with smell/taste dysfunctions in addition to the most frequent symptoms (fever, cough, and shortness of breath) or as the first symptom or even the only symptom. There is paucity of documentation of prevalence and characteristics of smell/taste dysfunction in COVID-19 in sub-Saharan Africa. The aim of this study was to determine the prevalence of smell/taste symptoms in our setting to institute local evidence-based practice. Study Design Cross-sectional study. Setting COVID-19 treatment centers in Uganda. Methods Patients hospitalized for COVID-19 at 3 treatment sites from November 2020 to March 2021 were recruited. Following written informed consent, their demographics, comorbidities, and smell/taste symptoms data were collected using a questionnaire. Results Of 614 patients recruited, 409 (63.8%) had mild symptoms and 232 (36.2%) had moderate to severe symptoms; 64.3% were male, and the mean age was 48.6 ± 15.51 years. In total, 23.1% were health responders and 12.2% had contact with a positive case. Smell and taste impairment was seen in 425 (66.3%) patients, second to cough (71.6%). Smell and taste impairment was seen in 162 (38.1%) as the first symptom, in 128 (30%) as the only symptom, and significantly more in those with mild COVID-19 symptoms (P < .001). Conclusion COVID-19 manifests with various symptoms, including impairment of smell and taste. This study shows that smell and taste impairment is common and can be the first and only symptom in less severe COVID-19 infections. Therefore, inclusion in the Ministry of Health guidelines is strongly recommended.
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Affiliation(s)
- Richard Byaruhanga
- Department of Ear Nose and Throat, Uganda Christian University, Mukono, Uganda
| | - Fiona Kabagenyi
- Department of Ear Nose and Throat, Makerere University, Kampala, Uganda
| | | | | | - Adriane Kamulegeya
- Department of Oro-maxillofacial Surgery, Makerere University, Kampala, Uganda
| | | | - Ronald Kiguba
- Department of Pharmacology, Makerere University, Kampala, Uganda
| | - Bruce Kirenga
- Lung Institute, Makerere University, Kampala, Uganda
| | - Emily Kakande
- Department of Ear, Nose and Throat, Mulago National Referral Hospital, Kampala, Uganda
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Hingorani KS, Bhadola S, Cervantes-Arslanian AM. COVID-19 and the Brain. Trends Cardiovasc Med 2022; 32:323-330. [PMID: 35461991 PMCID: PMC9022395 DOI: 10.1016/j.tcm.2022.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 12/11/2022]
Abstract
Entering the third year into the pandemic, overwhelming evidence demonstrates that Coronavirus disease 2019 (COVID-19) infection is a systemic illness, often with involvement of the central nervous system. Multiple mechanisms may underlie the development of neurologic manifestations of illness, including hypoxia, systemic illness, hypercoagulability, endothelial dysfunction, general critical illness, inflammatory response, and neurotropism of the severe acute respiratory syndrome coronavirus 2 (SARS-Co-V2) virus. COVID-19 infection is associated with neurologic involvement in all stages; acute infection, subacute/post-infection, and growing evidence also suggests during a chronic phase, the post-acute sequalae of COVID-19 (PASC). With over 20,000 published articles on COVID and the brain at the time of writing, it is virtually impossible to present an unbiased comprehensive review of how SARS-Co-V2 impacts the nervous system. In this review, we will present an overview of common neurologic manifestations, in particular focusing on the cerebrovascular complications, and proposed pathophysiology.
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Zazhytska M, Kodra A, Hoagland DA, Frere J, Fullard JF, Shayya H, McArthur NG, Moeller R, Uhl S, Omer AD, Gottesman ME, Firestein S, Gong Q, Canoll PD, Goldman JE, Roussos P, tenOever BR, Jonathan B Overdevest, Lomvardas S. Non-cell-autonomous disruption of nuclear architecture as a potential cause of COVID-19-induced anosmia. Cell 2022; 185:1052-1064.e12. [PMID: 35180380 PMCID: PMC8808699 DOI: 10.1016/j.cell.2022.01.024] [Citation(s) in RCA: 146] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/06/2021] [Accepted: 01/26/2022] [Indexed: 12/22/2022]
Abstract
SARS-CoV-2 infects less than 1% of cells in the human body, yet it can cause severe damage in a variety of organs. Thus, deciphering the non-cell-autonomous effects of SARS-CoV-2 infection is imperative for understanding the cellular and molecular disruption it elicits. Neurological and cognitive defects are among the least understood symptoms of COVID-19 patients, with olfactory dysfunction being their most common sensory deficit. Here, we show that both in humans and hamsters, SARS-CoV-2 infection causes widespread downregulation of olfactory receptors (ORs) and of their signaling components. This non-cell-autonomous effect is preceded by a dramatic reorganization of the neuronal nuclear architecture, which results in dissipation of genomic compartments harboring OR genes. Our data provide a potential mechanism by which SARS-CoV-2 infection alters the cellular morphology and the transcriptome of cells it cannot infect, offering insight to its systemic effects in olfaction and beyond.
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Affiliation(s)
- Marianna Zazhytska
- Mortimer B. Zuckerman Mind, and Brain and Behavior Institute, Columbia University, New York, NY 10027, USA
| | - Albana Kodra
- Mortimer B. Zuckerman Mind, and Brain and Behavior Institute, Columbia University, New York, NY 10027, USA; Department of Genetics and Development, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Daisy A Hoagland
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - Justin Frere
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - John F Fullard
- Center for Disease Neurogenomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - Hani Shayya
- Mortimer B. Zuckerman Mind, and Brain and Behavior Institute, Columbia University, New York, NY 10027, USA; Department of Genetics and Development, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Natalie G McArthur
- Department of Biological Sciences, Columbia University New York, NY 10027, USA
| | - Rasmus Moeller
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - Skyler Uhl
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - Arina D Omer
- Baylor Genetics, 2450 Holcombe Blvd, Houston, TX 77021, USA
| | - Max E Gottesman
- Department of Biochemistry and Molecular Biophysics, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Stuart Firestein
- Department of Biological Sciences, Columbia University New York, NY 10027, USA
| | - Qizhi Gong
- Department of Cell Biology and Human Anatomy, School of Medicine, University of California at Davis, Davis, CA 95616, USA
| | - Peter D Canoll
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - James E Goldman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Panos Roussos
- Center for Disease Neurogenomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA
| | - Benjamin R tenOever
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, USA.
| | - Jonathan B Overdevest
- Department of Otolaryngology, Head and Neck Surgery, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Stavros Lomvardas
- Mortimer B. Zuckerman Mind, and Brain and Behavior Institute, Columbia University, New York, NY 10027, USA; Department of Biochemistry and Molecular Biophysics, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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Beigi-Khoozani A, Merajikhah A, Soleimani M. Magnetic Resonance Imaging Findings of Olfactory Bulb in Anosmic Patients with COVID-19: A Systematic Review. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2022; 37:3982. [PMID: 35256044 PMCID: PMC9026950 DOI: 10.24920/003982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/15/2021] [Indexed: 06/14/2023]
Abstract
Background Anosmia is one of the symptoms in individuals with SARS-CoV-2 infection. In anosmic patients, SARS-CoV-2 temporarily alters the signaling process in olfactory nerve cells and olfactory bulb (OB), which eventually damages the structure of the olfactory epithelium, leading to a permanent disorder in the olfactory pathway that this damaged structure is showed in MRI imaging Methods Two investigators independently searched four databases consisting of PubMed, ProQuest, Scopus, and Web of Science for relevant records as of November 11, 2020 with no time, space, and language restrictions. Google Scholar was also searched for the related resources within the time limit of 2020. All the found articles were reviewed based on the PRISMA flow diagram. Qualitative studies, case reports, editorials, letters, and other non-original studies were excluded from this systematic analysis. Results Initial search yielded 434 records. After reviewing the titles and abstracts, we selected 74 articles; finally, 8 articles were depicted to be investigated and read in full text. The obtained results showed an increase in the width and volume of the olfactory cleft (OC), complete or partial destruction of OC, and complete occlusion of OC in COVID-19 patients. Deformation and degeneration as well as a subtle asymmetry were evident in the OBs. Computed tomography (CT), meganetic resonance imaging (MRI), and positron emission tomography (PET) were used to detect the outcomes of anosmia in these studies. Conclusions The changes in OC are greater than those in OB in patients with COVID-19, mainly due to the inflammatory and immune responses in OC. However, fewer changes in OB are due to neurological or vascular disorders. Topical steroid therapy and topical saline can be helpful.
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Affiliation(s)
| | - Amirmohammad Merajikhah
- Department of Operating Room, Sabzevar University of Medical Sciences, Razavi Khorasan, Iran
| | - Mahdieh Soleimani
- Department of Operating Room, Maragheh University of Medical Sciences, East Azerbaijan, Iran
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113
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Jafari Z, Kolb BE, Mohajerani MH. Hearing Loss, Tinnitus, and Dizziness in COVID-19: A Systematic Review and Meta-Analysis. Can J Neurol Sci 2022; 49:184-195. [PMID: 33843530 PMCID: PMC8267343 DOI: 10.1017/cjn.2021.63] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Extensive studies indicate that severe acute respiratory syndrome coronavirus (SARS-CoV-2) involves human sensory systems. A lack of discussion, however, exists given the auditory-vestibular system involvement in CoV disease 2019 (COVID-19). The present systematic review and meta-analysis were performed to determine the event rate (ER) of hearing loss, tinnitus, and dizziness caused by SARS-CoV-2. METHODS Databases (PubMed, ScienceDirect, Wiley) and World Health Organization updates were searched using combined keywords: 'COVID-19,' 'SARS-CoV-2,' 'pandemic,' 'auditory dysfunction,' 'hearing loss,' 'tinnitus,' 'vestibular dysfunction,' 'dizziness,' 'vertigo,' and 'otologic symptoms.' RESULTS Twelve papers met the eligibility criteria and were included in the study. These papers were single group prospective, cross-sectional, or retrospective studies on otolaryngologic, neurologic, or general clinical symptoms of COVID-19 and had used subjective assessments for data collection (case histories/medical records). The results of the meta-analysis demonstrate that the ER of hearing loss (3.1%, CIs: 0.01-0.09), tinnitus (4.5%, CIs: 0.012-0.153), and dizziness (12.2%, CIs: 0.070-0.204) is statistically significant in patients with COVID-19 (Z ≤ -4.469, p ≤ 0.001). CONCLUSIONS COVID-19 can cause hearing loss, tinnitus, and dizziness. These findings, however, should be interpreted with caution given insufficient evidence and heterogeneity among studies. Well-designed studies and follow-up assessments on otologic symptoms of SARS-CoV-2 using standard objective tests are recommended.
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Affiliation(s)
- Zahra Jafari
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
| | - Bryan E. Kolb
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
| | - Majid H. Mohajerani
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, Canada
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Helman SN, Adler J, Jafari A, Bennett S, Vuncannon JR, Cozart AC, Wise SK, Kuruvilla ME, Levy JM. Treatment strategies for postviral olfactory dysfunction: A systematic review. Allergy Asthma Proc 2022; 43:96-105. [PMID: 35317886 DOI: 10.2500/aap.2022.43.210107] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has been associated with a dramatic increase in postviral olfactory dysfunction (PVOD) among patients who are infected. A contemporary evidence-based review of current treatment options for PVOD is both timely and relevant to improve patient care. Objective: This review seeks to impact patient care by qualitatively reviewing available evidence in support of medical and procedural treatment options for PVOD. Systematic evaluation of data quality and of the level of evidence was completed to generate current treatment recommendations. Methods: A systematic review was conducted to identify primary studies that evaluated treatment outcomes for PVOD. A number of medical literature data bases were queried from January 1998 to May 2020, with completion of subsequent reference searches of retrieved articles to identify all relevant studies. Validated tools for the assessment of bias among both interventional and observational studies were used to complete quality assessment. The summary level of evidence and associated outcomes were used to generate treatment recommendations. Results: Twenty-two publications were identified for qualitative review. Outcomes of alpha-lipoic acid, intranasal and systemic corticosteroids, minocycline, zinc sulfate, vitamin A, sodium citrate, caroverine, intranasal insulin, theophylline, and Gingko biloba are reported. In addition, outcomes of traditional Chinese acupuncture and olfactory training are reviewed. Conclusion: Several medical and procedural treatments may expedite the return of olfactory function after PVOD. Current evidence supports olfactory training as a first-line intervention. Additional study is required to define specific treatment recommendations and expected outcomes for PVOD in the setting of COVID-19.
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Affiliation(s)
- Samuel N. Helman
- From the Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College, New York, New York
| | - Jonah Adler
- School of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Aria Jafari
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, Washington
| | - Sasha Bennett
- School of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jackson R. Vuncannon
- Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Ashley C. Cozart
- College of Medicine, University of Central Florida College of Medicine, Orlando, Florida; and
| | - Sarah K. Wise
- Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Merin E. Kuruvilla
- Division of Pulmonary, Allergy, Critical Care, and Sleep, Emory University School of Medicine, Atlanta, Georgia
| | - Joshua M. Levy
- Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia
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Othman BA, Maulud SQ, Jalal PJ, Abdulkareem SM, Ahmed JQ, Dhawan M, Priyanka, Choudhary OP. Olfactory dysfunction as a post-infectious symptom of SARS-CoV-2 infection. Ann Med Surg (Lond) 2022; 75:103352. [PMID: 35169465 PMCID: PMC8830927 DOI: 10.1016/j.amsu.2022.103352] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/25/2022] [Accepted: 02/01/2022] [Indexed: 01/08/2023] Open
Abstract
The unexpected onset smell and taste disability was being recognized as a COVID-19 related symptom. Loss of smell might occur alone or be followed by other COVID-19 symptoms, such as a dry cough, fever, headache, and shortness of breath. Other virus infections have been linked to anosmia (parainfluenza, rhinovirus, SARS, and others), affecting up to 20% of the adult population, which is much less common than SARS-CoV-2 infection. A hypothesis about the pathophysiology of post-infectious olfactory loss is that viruses could make an inflammatory response of the nasal mucosa or directly damage the olfactory neuroepithelium. However, in patients with COVID-19, loss of smell may occur without other rhino logic symptoms or suggestive nasal inflammation. According to evidence, anosmia-related SARS-CoV-2 could be a new viral syndrome unique to COVID-19. Furthermore, through experimental intranasal inoculation in mice, SARS-CoV-2 can be inoculated into the olfactory neural circuitry. This disease has not had the required focus, most likely because it is not life-threatening in and of itself. Though patients' quality of living is significantly reduced as their olfactory ability is lost, resulting in lowering and inadequate appetite, excessive or unbalanced food consumption, as well as an overall sense of insecurity. This review aims to give a quick overview of the latest epidemiological research, pathological mechanisms for the dysfunction of smell, and taste in patients infected with SARS-CoV-2. In addition, the initial diagnosis and treatment options for dysfunction are also discussed. The pathological mechanism of SARS-CoV-2 infection in olfactory dysfunction. Pathognomonic symptoms of sinonasal impairment in COVID-19 patients. Treatment of olfactory dysfunction after SARS-CoV-2 infection.
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McKendry R, Lemm NM, Papargyris L, Chiu C. Human Challenge Studies with Coronaviruses Old and New. Curr Top Microbiol Immunol 2022. [PMID: 35181805 DOI: 10.1007/82_2021_247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Coronavirus infections have been known to cause disease in animals since as early as the 1920s. However, only seven coronaviruses capable of causing human disease have been identified thus far. These Human Coronaviruses (HCoVs) include the causes of the common cold, but more recent coronaviruses that have emerged (i.e. SARS-CoV, MERS-CoV and SARS-CoV-2) are associated with much greater morbidity and mortality. HCoVs have been relatively under-studied compared to other common respiratory infections, as historically they have presented with mild symptoms. This has led to a relatively limited understanding of their animal reservoirs, transmission and determinants of immune protection. To address this, human infection challenge studies with HCoVs have been performed that enable a detailed clinical and immunological analysis of the host response at specific time points under controlled conditions with standardised viral inocula. Until recently, all such human challenge studies were conducted with common cold HCoVs, with the study of SARS-CoV and MERS-CoV unacceptable due to their greater pathogenicity. However, with the emergence of SARS-CoV-2 and the COVID-19 pandemic during which severe outcomes in young healthy adults have been rare, human challenge studies with SARS-CoV-2 are now being developed. Two SARS-CoV-2 human challenge studies in the UK studying individuals with and without pre-existing immunity are underway. As well as providing a platform for testing of antivirals and vaccines, such studies will be critical for understanding the factors associated with susceptibility to SARS-CoV-2 infection and thus developing improved strategies to tackle the current as well as future HCoV pandemics. Here, we summarise the major questions about protection and pathogenesis in HCoV infection that human infection challenge studies have attempted to answer historically, as well as the knowledge gaps that aim to be addressed with contemporary models.
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Affiliation(s)
- Richard McKendry
- Department of Infectious Disease, Imperial College London, London, UK
| | - Nana-Marie Lemm
- Department of Infectious Disease, Imperial College London, London, UK
| | - Loukas Papargyris
- Department of Infectious Disease, Imperial College London, London, UK
| | - Christopher Chiu
- Department of Infectious Disease, Imperial College London, London, UK.
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Khan AM, Lee J, Rammaha T, Gupta S, Smith H, Kannampallil T, Farrell N, Kallogjeri D, Piccirillo JF. Natural Trajectory of Recovery of COVID-19 Associated Olfactory Loss. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.17.22270551. [PMID: 35194618 PMCID: PMC8863162 DOI: 10.1101/2022.02.17.22270551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
IMPORTANCE Prevalence of post-viral olfactory loss has increased dramatically due to the frequency and severity of olfactory dysfunction associated with infection by the SARS-CoV-2 virus. OBJECTIVE To determine the trajectory of COVID-19 olfactory loss over a six-month period. A key secondary objective is to assess predictive factors associated with the recovery of olfaction. DESIGN Longitudinal repeated-measures study that enrolled from May 5, 2020 to February 2, 2021, with the last date of data collection on June 15, 2021. SETTING Barnes-Jewish HealthCare/Washington University School of Medicine facilities (Saint Louis, Missouri, USA). PARTICIPANTS Individuals who tested positive for SARS-CoV-2 by real-time polymerase chain reaction on nasopharyngeal swab and indicated olfactory loss on COVID-19 screening questionnaire. Individuals were excluded if they had previously diagnosed history of olfactory loss, neurodegenerative disorders, less than 18 years of age, admitted to hospital service, unable to read, write, and understand English, or lacked computer or internet access. INTERVENTIONS/EXPOSURES Watch and wait for spontaneous recovery. MAIN OUTCOMES AND MEASURES Participants completed olfactory assessments every 30 days for six months. Each assessment consisted of the University of Pennsylvania Smell Identification Test (UPSIT), an objective "scratch-and-sniff" test, and Clinical Global Impressions (CGI), a subjective Likert rating scale. RESULTS The mean age was 41 years old (SD = 16). 39 (80%) were female and 42 (86%) white. At baseline assessment of objective olfaction, 18 (36%) participants had anosmia or severe hyposmia. Subjective, complete recovery at six months was 81% (95% CI 74% to 88%). Likelihood of recovery was associated with age less than 50 years (aHR = 8.1 (95% CI 1.1 to 64.1)) and mild olfactory loss at baseline (UPSIT = 30-33 for males and 31-34 for females) (aHR 6.2 (95% CI 1.2 to 33.0)). CONCLUSIONS AND RELEVANCE The trajectory of olfactory recovery among adults with COVID-19 olfactory loss illustrated rapid recovery within 2-3 weeks of infection, and by six months 81% had recovered based on self-report. Age less than 50 years old and mild severity of olfactory loss at baseline were associated with increased likelihood of recovery of olfaction. These findings can be used to inform shared decision-making with patients.
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Rha MS, Cho HJ, Yoon JH, Kim CH. Gustatory dysfunction in patients with olfactory dysfunction and the associated factors. Rhinology 2022; 60:200-206. [PMID: 35174812 DOI: 10.4193/rhin21.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Little is known about the occurrence of gustatory dysfunction (GD) in relation to different aetiologies of olfactory dysfunction (OD) as assessed by psychophysical chemosensory tests. The aim of this study was to analyse gustatory function in patients with OD and to investigate clinical factors associated with GD. METHODS A total of 742 individuals who underwent both olfactory and gustatory function tests at a tertiary medical centre from November 2019 to March 2021 were retrospectively enrolled. Olfactory and gustatory function were assessed by the YSK olfactory and gustatory function tests, respectively. Patients with OD were classified into four groups according to the aetiology: sinonasal disease, post-infection OD (PIOD), post-traumatic OD (PTOD), and others. Secondary outcomes included age, sex, smoking history, and alcohol history. RESULTS Among the 488 patients with OD, 93 (19.1%) showed GD and 395 (80.9%) had normal gustatory function. Only 25 (9.8%) among 254 individuals with normosmia showed GD. Analyses of these frequencies revealed a significant association between OD and GD. In addition, the taste score was significantly lower in patients with OD than individuals with normosmia. The frequency of GD was significantly higher in patients with PTOD (53.6%) than in those with OD of other aetiologies (sinonasal disease, 6.7%; PIOD, 13.0%; others, 24.4%). In the multivariate analysis, age ≥55 years and PTOD were associated with a high frequency of GD among patients with OD. CONCLUSIONS The current study show that GD is significantly associated with OD. In particular, GD is more common in patients with PTOD than in those with OD of other aetiologies.
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Affiliation(s)
- M-S Rha
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - H-J Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Korea Mouse Phenotyping Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - J-H Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Korea Mouse Phenotyping Center, Yonsei University College of Medicine, Seoul, Republic of Korea.,Global Research Laboratory for Allergic Airway Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - C-H Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Korea Mouse Phenotyping Center, Yonsei University College of Medicine, Seoul, Republic of Korea.,Medical Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
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Systematic review and meta-analysis of olfactory and gustatory dysfunction in COVID-19. Int J Infect Dis 2022; 117:155-161. [PMID: 35134561 PMCID: PMC8817419 DOI: 10.1016/j.ijid.2022.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/20/2022] Open
Abstract
Background Chemosensory disorders associated with COVID-19 have been widely discussed during the pandemic. We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19. Methods Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 1, 2019, and August 31, 2021. We selected random-effects model or fixed-effects model to pool data based on heterogeneity. The results were reported as odds ratios (ORs) or standardized mean differences (SMDs) and the corresponding 95% confidence intervals (CIs). Heterogeneity was reported as I2. Results Twenty-six studies with a total of 13,813 patients were included. The pooled data indicated that sex (OR 1.47; 95% CI 0.93–2.31), age (SMD −5.80; 95% CI −13.35 to 1.75), smoking (OR 2.04; 95% CI 0.72–5.79), and comorbidity (OR 1.21; 95% CI 0.58–2.53) of patients with COVID-19 had no effect on gustatory dysfunction. Olfactory dysfunction was more likely to occur in older patients with COVID-19 (SMD, −5.22; 95% CI, −8.28 to −2.16). Patients with COVID-19 with nasal congestion (OR 3.41; 95% CI 2.30–5.06) and rhinorrhea (OR 2.35; 95% CI 1.60–3.45) were more prone to olfactory dysfunction. Conclusion These findings emphasize that older patients with COVID-19 are more likely to experience olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction.
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Pitak-Arnnop P, Meningaud JP, Sirintawat N, Subbalekha K, Auychai P, Iamaroon A, O-Charoenrat P, Suntorntham S, Messer-Peti R, Neff A. A German AWMF's S2e/realist synthesis and meta-narrative snapshot of craniomaxillofacial manifestations in COVID-19 patients: Rapid living update on 1 January 2021. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:64-73. [PMID: 33524604 PMCID: PMC9767311 DOI: 10.1016/j.jormas.2021.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 12/24/2022]
Abstract
PURPOSES To execute a review answering the following question: "Among novel coronavirus disease (COVID19) patients, what are craniomaxillofacial (CMF) manifestations?" based on the RAMESES and the German Association of Scientific Medical Societies (AWMF)'s S2e guidelines. METHODS We performed a realist synthesis and meta-narrative review extracting data in English, French, German and Thai from PubMed/Medline, Embase, Biomed Central, Cochrane Library, and Thai Journals Online, until 1 January 2021. The primary outcome variable was CMF manifestations grouped into 5 categories: (1) mouth and throat, (2) nose, paranasal sinus, and skull base (3) ocular/orbital and periorbital tissue, (4) ear, and (5) craniofacial skin. Appropriate statistics was computed. RESULTS Thirty-seven original articles meeting the inclusion criteria were analysed; all were in English and indexed in PubMed/Medline. Hand searches of their references yielded a total of 101 articles for the review. Most data were in low level of evidence and focused on smell and taste disturbances and non-specific orofacial lesions. Iatrogenic complications may occur in this body region. Conservative measures remained effective and were usually enough for patient care. CONCLUSION Because SARS-CoV-2 infection is new and becomes the stringent worldwide pandemic within a short time period, most of the data on CMF symptoms are of low level evidence. Apart from taste and smell dysfunctions, non-specific CMF lesions can be found and treated conservatively. Treatment complications are possible. Dentists and CMF surgeons are privileged to examine the orofacial region and work closely with colleagues in other specialities to combat this pandemic.
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Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany,Corresponding author at: Klinik für MKG-Chirurgie, Universitätsklinikum Marburg, UKGM, Baldingerstr., 35043 Marburg, Germany
| | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor University Hospital, AP-HP, Faculty of Medicine, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France
| | - Nattapong Sirintawat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Prim Auychai
- Department of Paediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Anak Iamaroon
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chaing Mai, Thailand,Excellence Center in Osteology Research and Training Center (ORTC), Chiang Mai University, Chaing Mai, Thailand
| | | | - Surajit Suntorntham
- HRH Princess Chulabhorn College of Medical Science, Chulaborn Royal Academy, Bangkok, Thailand
| | - Robert Messer-Peti
- Department of Urology, Medius Klinik Ostfildern‐Ruit – Academic Teaching Hospital of University Tübingen, Ostfildern, Germany
| | - Andreas Neff
- Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany
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Arabkhazaeli A, Maghsudlu M, Mohammadi S, Eshghi P. Positive anti-SARS-CoV-2 rapid serological test results among asymptomatic blood donors. Transfus Clin Biol 2022; 29:24-30. [PMID: 34428567 PMCID: PMC8379815 DOI: 10.1016/j.tracli.2021.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The world is fighting with a COVID-19 pandemic, some of the uncertainties have been revealed. To figure out an estimation of asymptomatic patients and seropositive SARS-COV-2 blood donors in Iran, a national survey was conducted to find the prevalence of asymptomatic blood donors with positive SARS-COV-2 IgM/IgG test results at the end of May 2020. MATERIAL AND METHODS From all 31 provinces, 1339 blood donors were included. At first, data was collected with an interview containing demographic data, risk factors and possible signs and symptoms held for each donor by a trained medical expert. Then, SARS-COV-2 serologic rapid tests were conducted. Subsequently, the test results were observed and recorded; all of their photos were checked by one single expert. We corrected the prevalence rates for sensitivity and weighted them by the last year rate of blood donation of each province. RESULTS The corrected prevalence rates of positive serological test results for sensitivity in provinces were between zero and 38.24%. The national prevalence was calculated 14.45% after weighting. Out of 161 positive donors, only 43 cases reported related signs or symptoms during the defined period of time, while 118 (73.29%) seropositive cases had not reported any related signs or symptoms. Some signs or symptoms were reported more frequent in the SARS-COV-2 serologic rapid test positives. The highest OR (10.19) was linked to ageusia. CONCLUSIONS This study has shown the prevalence of seropositive results to be around 14% in target population in which around ¾ had not reported any signs or symptoms.
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Affiliation(s)
- Ali Arabkhazaeli
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Mahtab Maghsudlu
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Saeed Mohammadi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Eshghi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran; Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Ojha P, Dixit A. Olfactory training for Olfactory dysfunction in COVID-19: A promising mitigation amidst looming neurocognitive sequelae of the pandemic. Clin Exp Pharmacol Physiol 2022; 49:462-473. [PMID: 35090056 DOI: 10.1111/1440-1681.13626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/15/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
Olfactory dysfunction (OD) is a recognized symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is independently associated with neurodegenerative disorders. Moreover, the central nervous system manifestations in patients infected with the coronavirus -2019 (COVID-19) have demonstrated cognitive decline and neuropsychiatric manifestations. Hence, OD in COVID -19 necessitates perusal of its' mechanism and available treatment options to avert possible development of neurocognitive sequelae of the pandemic. The article presents a literature review organized from the published information about olfactory training (OT) for OD during COVID-19. The methodology comprised retrieval of available literature from database searches and subsequent scrutinization of relevant information. Inferentially, Injury to the sustentacular cells, possessing angiotensin-converting enzyme 2 (ACE-2) receptors, is an important mechanism causing OD in COVID-19. OD may be prolonged in severe cases of anosmia predisposing to neurodegenerative and cognitive impairment in COVID-19 infection. OT demonstrates an effective treatment for OD based on human and animal-derived evidence through recent studies. It curtails the progression of OD, besides inducing neural rearrangement and changes in functional connectivity in patients receiving OT. Additionally, contemporary reports support that the administration of OT for COVID-induced anosmia is effective and encompasses no significant adverse effects. The present review highlights the prominence of olfactory training as a recommended intervention for OD in COVID-19. This review can guide the clinicians in curbing neurological repercussions of COVID besides enhancing cognitive rehabilitation through olfactory training.
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Affiliation(s)
- Pooja Ojha
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Abhinav Dixit
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Esmaeili M, Abdi F, Shafiee G, Asayesh H, Abdar ZE, Baygi F, Qorbani M. Olfactory and Gustatory Dysfunction in 2019 Novel Coronavirus: An Updated Systematic Review and Meta-analysis. Int J Prev Med 2022; 12:170. [PMID: 35070203 PMCID: PMC8724794 DOI: 10.4103/ijpvm.ijpvm_484_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/21/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Evidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients. Methods: In this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method. Results: Among 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively. Conclusions: Olfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.
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Affiliation(s)
- Marzieh Esmaeili
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Esmaeili Abdar
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Fortunato F, Martinelli D, Iannelli G, Milazzo M, Farina U, Di Matteo G, De Nittis R, Ascatigno L, Cassano M, Lopalco PL, Prato R. Self-reported olfactory and gustatory dysfunctions in COVID-19 patients: a 1-year follow-up study in Foggia district, Italy. BMC Infect Dis 2022; 22:77. [PMID: 35065619 PMCID: PMC8783175 DOI: 10.1186/s12879-022-07052-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/12/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND From the initial stages of the pandemic in early 2020, COVID-19-related olfactory and gustatory dysfunctions have been widely reported and are emerging as one of the most frequent long-term sequelae of SARS-CoV-2 infection. However, data regarding the long-term recovery of the sense of smell and taste are lacking. This study aimed to characterize the evolution up to one year after the diagnosis of self-reported olfactory and gustatory dysfunctions in COVID-19 cases. METHODS Based on the data of the active surveillance platform of the Apulia region, Italy, we selected the residents of Foggia district who were confirmed positive for SARS-CoV-2 from March 1st to June 16th, 2020, and home-quarantined with paucisymptomatic-to-mild clinical presentation. Self-reported olfactory and gustatory dysfunctions were recorded at baseline through a survey of dichotomous questions. The evolution of these symptoms at approximately one year was prospectively assessed via telephone by the validated sino-nasal outcome test 22 (SNOT-22, Italian version). RESULTS Among the 1,175 COVID-19 cases notified in the Foggia district during the first epidemic wave, 488 had paucisymptomatic-to-mild clinical presentation. Of these, 41.2% (n = 201, 95% confidence interval [CI] 36.8-45.7%) reported at least one sensory dysfunction. A total of 178 to 201 (88.5%) patients agreed to participate in the follow-up survey. According to the SNOT-22 results, the persistence of a sensory dysfunction was observed in the 29.8% (n = 53, 95% CI 23.2-37.1%) of them. Particularly, loss of smell persisted in 25.8% (n = 46, 95% CI 19.6-32.9%), loss of taste in 21.3% (n = 38, 95% CI 15.6-28.1%), loss of both in 17.4% (n = 31, 95% CI 12.2-23.8%) of participants in the follow-up. The rates of full recovery increased over time: from 59% at 30 days to 71.9% at 90 days for the sense of smell; from 61.3% at 30 days to 74.7% at 90 days for the sense of taste. CONCLUSIONS The persistence of COVID-19-related olfactory and gustatory dysfunctions up to 12 months after the disease onset in a noteworthy proportion (approximately 3 out of 10) of patients with paucisymptomatic-to-mild clinical presentation deserves further investigations due to its possible pathophysiological implications and impact on the quality of life.
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Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Giuseppina Iannelli
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Marica Milazzo
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Umberto Farina
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Gabriella Di Matteo
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Rosella De Nittis
- Microbiology and Virology Section, Policlinico Riuniti Foggia Hospital, Foggia, Italy
| | - Leonardo Ascatigno
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy
| | - Michele Cassano
- Otolaryngology - Head and Neck Surgery Unit, Policlinico Riuniti Foggia Hospital, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Rosa Prato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Ospedale Colonnello D'Avanzo, Viale degli Aviatori 2, 71122, Foggia, Italy.
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Wei G, Gu J, Gu Z, Du C, Huang X, Xing H, Li L, Zhang A, Hu X, Huo J. Olfactory Dysfunction in Patients With Coronavirus Disease 2019: A Review. Front Neurol 2022; 12:783249. [PMID: 35115994 PMCID: PMC8805677 DOI: 10.3389/fneur.2021.783249] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/14/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is wreaking havoc on public-health and economic systems worldwide. Among the several neurological symptoms of patients with COVID-19 reported in clinical practice, olfactory dysfunction (OD) is the most common. OD occurs as the earliest or the only clinical manifestation in some patients. Increasing research attention has focused on OD, which is listed as one of the main diagnostic symptoms of severe acute respiratory syndrome-coronavirus-2 infection. Multiple clinical and basic-science studies on COVID-19-induced OD are underway to clarify the underlying mechanism of action. In this review, we summarize the clinical characteristics, mechanisms, evaluation methods, prognosis, and treatment options of COVID-19-induced OD. In this way, we hope to improve the understanding of COVID-19-induced OD to aid early identification and precise intervention.
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Affiliation(s)
- Guoli Wei
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
- Department of Oncology, Yangzhou University Medical College, Yangzhou, China
| | - Jialin Gu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- The Third Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhancheng Gu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- The Third Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Du
- Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaofei Huang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- The Third Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haiyan Xing
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lingchang Li
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Aiping Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Xingxing Hu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
- Department of Oncology, Yangzhou University Medical College, Yangzhou, China
- *Correspondence: Xingxing Hu
| | - Jiege Huo
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Jiege Huo
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COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3918980. [PMID: 35047633 PMCID: PMC8763038 DOI: 10.1155/2022/3918980] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.
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Kalyuzhner Z, Agdarov S, Orr I, Beiderman Y, Bennett A, Zalevsky Z. Remote photonic detection of human senses using secondary speckle patterns. Sci Rep 2022; 12:519. [PMID: 35017632 PMCID: PMC8752628 DOI: 10.1038/s41598-021-04558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/23/2021] [Indexed: 11/09/2022] Open
Abstract
Neural activity research has recently gained significant attention due to its association with sensory information and behavior control. However, the current methods of brain activity sensing require expensive equipment and physical contact with the tested subject. We propose a novel photonic-based method for remote detection of human senses. Physiological processes associated with hemodynamic activity due to activation of the cerebral cortex affected by different senses have been detected by remote monitoring of nano-vibrations generated by the transient blood flow to the specific regions of the human brain. We have found that a combination of defocused, self-interference random speckle patterns with a spatiotemporal analysis, using Deep Neural Network, allows associating between the activated sense and the seemingly random speckle patterns.
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Affiliation(s)
- Zeev Kalyuzhner
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel.
| | - Sergey Agdarov
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
| | - Itai Orr
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
| | - Yafim Beiderman
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
| | - Aviya Bennett
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
| | - Zeev Zalevsky
- Faculty of Engineering and the Nano-Technology Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
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Sampaio Rocha-Filho PA, Albuquerque PM, Carvalho LCLS, Dandara Pereira Gama M, Magalhães JE. Headache, anosmia, ageusia and other neurological symptoms in COVID-19: a cross-sectional study. J Headache Pain 2022; 23:2. [PMID: 34979899 PMCID: PMC8721484 DOI: 10.1186/s10194-021-01367-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022] Open
Abstract
Background Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms are related to one another. Objectives To determine whether there is an association between the neurological symptoms in patients with COVID-19, and to characterize the headache. Method This was a cross-sectional study. All hospital inpatients and health workers at the Hospital Universitario Oswaldo Cruz with a PCR-confirmed COVID-19 infection between March and June 2020 were considered for the study and were interviewed by telephone at least 2-months after the acute phase of the disease. These patients were identified by the hospital epidemiological surveillance department. A semi-structured questionnaire was used containing sociodemographic and clinical data and the ID-Migraine. Results A total of 288 patients was interviewed; 53.1% were male; with a median age of 49.9 (41.5–60.5) years; 91.7% presented some neurological symptom; 22.2% reported some neurological symptom as the symptom that troubled them most during COVID-19. Neurological symptoms were: ageusia (69.8%), headache (69.1%), anosmia (67%), myalgia (44.4%), drowsiness (37.2%), agitation (20.8%); mental confusion (14.9%), syncope (4.9%) and epileptic seizures (2.8%). Females, those who presented with fever, sore throat, anosmia/ageusia and myalgia also presented significantly more with headache (logistic regression). The most frequent headache phenotype was a non-migraine phenotype, was of severe intensity and differed from previous headaches. This persisted for more than 30 days in 18% and for more than 90 days in 10% of patients. Thirteen percent of those with anosmia and 11% with ageusia continued with these complaints after more than 90 days of the acute phase of the disease. Aged over 50 years, agitation and epileptic seizures were significantly associated with mental confusion (logistic regression). Conclusion Headache is frequent in COVID-19, is associated with other symptoms such as fever, sore throat, anosmia, ageusia, and myalgia, and may persist beyond the acute phase of the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01367-8.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Av. da Engenharia, 531-611, Recife, PE, 50730-120, Brazil. .,Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil.
| | - Pedro Mota Albuquerque
- Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Av. da Engenharia, 531-611, Recife, PE, 50730-120, Brazil
| | | | - Mylana Dandara Pereira Gama
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil
| | - João Eudes Magalhães
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco, Tv. Jackson Pollock - Santo Amaro, Recife, PE, 52171-011, Brazil
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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Hans V, Hans M, Kahlon N, Sagar M, Pandey A, Das A. Gustatory dysfunction and oral ulceration in COVID-19 patients: A cross sectional study. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.346401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cavallieri F, Sellner J, Zedde M, Moro E. Neurologic complications of coronavirus and other respiratory viral infections. HANDBOOK OF CLINICAL NEUROLOGY 2022; 189:331-358. [PMID: 36031313 PMCID: PMC9418023 DOI: 10.1016/b978-0-323-91532-8.00004-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In humans, several respiratory viruses can have neurologic implications affecting both central and peripheral nervous system. Neurologic manifestations can be linked to viral neurotropism and/or indirect effects of the infection due to endothelitis with vascular damage and ischemia, hypercoagulation state with thrombosis and hemorrhages, systemic inflammatory response, autoimmune reactions, and other damages. Among these respiratory viruses, recent and huge attention has been given to the coronaviruses, especially the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in 2020. Besides the common respiratory symptoms and the lung tropism of SARS-CoV-2 (COVID-19), neurologic manifestations are not rare and often present in the severe forms of the infection. The most common acute and subacute symptoms and signs include headache, fatigue, myalgia, anosmia, ageusia, sleep disturbances, whereas clinical syndromes include mainly encephalopathy, ischemic stroke, seizures, and autoimmune peripheral neuropathies. Although the pathogenetic mechanisms of COVID-19 in the various acute neurologic manifestations are partially understood, little is known about long-term consequences of the infection. These consequences concern both the so-called long-COVID (characterized by the persistence of neurological manifestations after the resolution of the acute viral phase), and the onset of new neurological symptoms that may be linked to the previous infection.
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Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria,Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elena Moro
- Division of Neurology, CHU of Grenoble, Grenoble Alpes University, Grenoble Institute of Neurosciences, Grenoble, France,Correspondence to: Elena Moro, Service de neurologie, CHU de Grenoble (Hôpital Nord), Boulevard de la Chantourne, 38043 La Tronche, France. Tel: + 33-4-76-76-94-52, Fax: +33-4-76-76-56-31
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133
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Coelho DH, Reiter ER, Budd SG, Shin Y, Kons ZA, Costanzo RM. Predictors of smell recovery in a nationwide prospective cohort of patients with COVID-19. Am J Otolaryngol 2022; 43:103239. [PMID: 34547716 PMCID: PMC8443532 DOI: 10.1016/j.amjoto.2021.103239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine which factors (demographic, symptoms, comorbidities, and treatments) are associated with recovery of smell in patients with COVID-19 associated olfactory loss. STUDY DESIGN Prospective, longitudinal questionnaires. SETTING National survey. METHODS A longitudinal web-based nationwide survey of adults with COVID-19 associated smell and taste loss was launched April 10, 2020. After completing an initial entry survey, participants received detailed follow-up questionnaires 14 days, and 1, 3 and 6 months later. RESULTS As of June 25, 2021, 798 participants met study inclusion criteria and completed 6-month questionnaires. Of demographic characteristics only age <40 years was positively associated with smell recovery (p < .003). Of symptoms, difficulty breathing was negatively associated with smell recovery (p < .004), and nasal congestion positively associated with smell recovery (p < .03). Of pre-existing comorbidities only previous head injury (p < .017) was negatively associated with smell recovery. None of the queried medications used to treat COVID were associated with better rates of smell recovery. CONCLUSIONS Age <40 and presence of nasal congestion at time of COVID-19 infection were predictive of improved rates of smell recovery, while difficulty breathing at time of COVID-19 infection, and prior head trauma predicted worsened rates of recovery. Further study will be required to identify potential mechanisms for the other observed associations. Such information can be used by clinicians to counsel patients suffering COVID-19 associated smell loss as to prognosis for recovery.
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Affiliation(s)
- Daniel H Coelho
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - Evan R Reiter
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Serenity G Budd
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Yongyun Shin
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Zachary A Kons
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Richard M Costanzo
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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134
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Kremer S, Gerevini S, Ramos A, Lersy F, Yousry T, Vernooij MW, Anzalone N, Jäger HR. Neuroimaging in patients with COVID-19: a neuroradiology expert group consensus. Eur Radiol 2022; 32:3716-3725. [PMID: 35044509 PMCID: PMC8766353 DOI: 10.1007/s00330-021-08499-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023]
Abstract
Neurological and neuroradiological manifestations in patients with COVID-19 have been extensively reported. Available imaging data are, however, very heterogeneous. Hence, there is a growing need to standardise clinical indications for neuroimaging, MRI acquisition protocols, and necessity of follow-up examinations. A NeuroCovid working group with experts in the field of neuroimaging in COVID-19 has been constituted under the aegis of the Subspecialty Committee on Diagnostic Neuroradiology of the European Society of Neuroradiology (ESNR). The initial objectives of this NeuroCovid working group are to address the standardisation of the imaging in patients with neurological manifestations of COVID-19 and to give advice based on expert opinion with the aim of improving the quality of patient care and ensure high quality of any future clinical studies. KEY POINTS: • In patients with COVID-19 and neurological manifestations, neuroimaging should be performed in order to detect underlying causal pathology. • The basic MRI recommended protocol includes T2-weighted, FLAIR (preferably 3D), and diffusion-weighted images, as well as haemorrhage-sensitive sequence (preferably SWI), and at least for the initial investigation pre and post-contrast T1 weighted-images. • 3D FLAIR should be acquired after gadolinium administration in order to optimise the detection of leptomeningeal contrast enhancement.
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Affiliation(s)
- Stéphane Kremer
- Hôpitaux Universitaires de Strasbourg, Service d'imagerie 2, Hôpital de Hautepierre, Strasbourg, France.
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France.
| | | | - Ana Ramos
- Sección de Neurorradiología, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - François Lersy
- Hôpitaux Universitaires de Strasbourg, Service d'imagerie 2, Hôpital de Hautepierre, Strasbourg, France
| | - Tarek Yousry
- Neuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, Great Britain
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, Great Britain
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Nicoletta Anzalone
- Department of Neuroradiology, IRCCS San Raffaele, Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Hans Rolf Jäger
- Neuroradiological Academic Unit, Queen Square UCL Institute of Neurology, London, Great Britain
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, Great Britain
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135
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Wang E, Ulualp SO, Liu C, Veling M. Sudden anosmia and ageusia in a child: A COVID-19 case report. OTOLARYNGOLOGY CASE REPORTS 2021; 18:100267. [PMID: 34957358 PMCID: PMC7825856 DOI: 10.1016/j.xocr.2021.100267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022] Open
Abstract
Objective COVID-19 in children has a spectrum of clinical presentations ranging from asymptomatic infection to severe illness and death. The recognition of COVID-19 in children has been challenging due to overlap with symptoms of common respiratory and gastrointestinal tract infections. We describe isolated sudden anosmia and ageusia as an uncommon clinical presentation of a child with COVID-19. Methods Chart of a 17-year-old male referred to a tertiary care pediatric hospital for assessment of anosmia and ageusia was reviewed. Data included relevant history and physical examination, diagnostic work up, and management. Results The child presented with sudden anosmia and ageusia for 3 months. The patient did not have symptoms of upper respiratory tract infection or gastrointestinal infection. There was no history of trauma. Examination of the ears, nose, and throat were all unremarkable. Magnetic resonance imaging documented the presence of both olfactory bulbs and olfactory sulci. SARS-CoV-2 IgG test was positive. Anosmia was confirmed by The University of Pennsylvania Smell Identification Test with a score of 27.5%. Conclusions The clinical picture of our patient represents a non-classical presentation of COVID-19 in a child. Clinicians should be cognizant about uncommon presentations of COVID-19 in previously asymptomatic children.
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Affiliation(s)
- Ellen Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Children's Health, Dallas, TX, USA
| | - Seckin O Ulualp
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Children's Health, Dallas, TX, USA.,Division of Pediatric Otolaryngology, Children's Health, Dallas, TX, USA
| | - Christopher Liu
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Children's Health, Dallas, TX, USA.,Division of Pediatric Otolaryngology, Children's Health, Dallas, TX, USA
| | - Maria Veling
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Children's Health, Dallas, TX, USA.,Division of Pediatric Otolaryngology, Children's Health, Dallas, TX, USA
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136
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High prevalence of long-term olfactory dysfunction confirmed by olfactory testing after a community COVID-19 outbreak. HNO 2021; 70:224-231. [PMID: 34940903 PMCID: PMC8697538 DOI: 10.1007/s00106-021-01129-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/29/2022]
Abstract
Purpose The prevalence of long-term olfactory and gustatory dysfunction in participants suffering from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19) is unknown. Furthermore, evaluations of the reliability of participants’ self-reporting of olfactory function (SOF) and gustatory function (SGF) using extended objective psychophysical testing are missing. Methods In this population-based cohort study in a PCR-tested community in Thuringia, Germany, olfactory function was extensively examined 4 months after a COVID-19 outbreak using the “Sniffin Sticks” test battery to determine the TDIa score, i.e., the sum of results obtained for threshold, discrimination, and identification scores averaged for both nasal sides. Gustatory function was assessed using the three-drop test resulting in the gustatory composite score (CSg). The data were compared with SOF and SGF. Results Of 43 adult convalescents (median age: 68 years; 58% female) after SARS-CoV‑2 infection, 18 participants (42%) had olfactory complaints due to SOF, one participant (2%) complained of taste disturbance due to SGF. The TDIa was 22.0 ± 5.9. Normosmia, hyposmia, and anosmia were seen in 17, 18, and eight participants, respectively. TDIa correlated with SOF (rs = −0.434, p = 0.004); CSg was 23.5 ± 2.7. Normogeusia and hypogeusia were objectified in 39 and four participants, respectively. The prevalence of long-term olfactory dysfunction and gustatory dysfunction in the study group was 60.5 and 9.3%, respectively. Conclusion The SOF was reliable, especially for participants who felt a sudden chemosensory dysfunction during the outbreak. At 4 months after SARS-CoV‑2 infection, a high proportion of participants were dysosmic, whereas nearly all of them had normal taste function.
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137
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Eyheramendy S, Saa PA, Undurraga EA, Valencia C, López C, Méndez L, Pizarro-Berdichevsky J, Finkelstein-Kulka A, Solari S, Salas N, Bahamondes P, Ugarte M, Barceló P, Arenas M, Agosin E. Screening of COVID-19 cases through a Bayesian network symptoms model and psychophysical olfactory test. iScience 2021; 24:103419. [PMID: 34786538 PMCID: PMC8580551 DOI: 10.1016/j.isci.2021.103419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/12/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
The sudden loss of smell is among the earliest and most prevalent symptoms of COVID-19 when measured with a clinical psychophysical test. Research has shown the potential impact of frequent screening for olfactory dysfunction, but existing tests are expensive and time consuming. We developed a low-cost ($0.50/test) rapid psychophysical olfactory test (KOR) for frequent testing and a model-based COVID-19 screening framework using a Bayes Network symptoms model. We trained and validated the model on two samples: suspected COVID-19 cases in five healthcare centers (n = 926; 33% prevalence, 309 RT-PCR confirmed) and healthy miners (n = 1,365; 1.1% prevalence, 15 RT-PCR confirmed). The model predicted COVID-19 status with 76% and 96% accuracy in the healthcare and miners samples, respectively (healthcare: AUC = 0.79 [0.75-0.82], sensitivity: 59%, specificity: 87%; miners: AUC = 0.71 [0.63-0.79], sensitivity: 40%, specificity: 97%, at 0.50 infection probability threshold). Our results highlight the potential for low-cost, frequent, accessible, routine COVID-19 testing to support society's reopening.
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Affiliation(s)
- Susana Eyheramendy
- Faculty of Engineering and Science, Universidad Adolfo Ibáñez, Santiago, Chile
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pedro A. Saa
- Department of Chemical and Bioprocess Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo A. Undurraga
- School of Government, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile
- CIFAR Azrieli Global Scholars Program, Toronto, Canada
| | | | - Carolina López
- Center for Aromas and Flavors, DICTUC SA., Santiago, Chile
| | - Luis Méndez
- Endoscopy Unit, Hospital Padre Hurtado, Santiago, Chile
- Department of Gastroenterology, Clínica Alemana de Santiago, Santiago, Chile
| | - Javier Pizarro-Berdichevsky
- Center for Innovation in Pelvic Floor, Hospital Sótero del Río, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Finkelstein-Kulka
- Department of Otolaryngology, Clínica Alemana de Santiago, Santiago, Chile
- Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Sandra Solari
- Department of Clinical Laboratory, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Salas
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pedro Bahamondes
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Martín Ugarte
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
| | - Pablo Barceló
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo Arenas
- Millennium Institute for Foundational Research on Data (IMFD), Santiago, Chile
- Institute for Mathematical and Computational Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Computer Science, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Agosin
- Department of Chemical and Bioprocess Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
- Center for Aromas and Flavors, DICTUC SA., Santiago, Chile
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138
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Richard SA, Epsi NJ, Pollett S, Lindholm DA, Malloy AMW, Maves R, Utz GC, Lalani T, Smith AG, Mody RM, Ganesan A, Colombo RE, Colombo CJ, Chi SW, Huprikar N, Larson DT, Bazan S, Madar C, Lanteri C, Rozman JS, English C, Mende K, Tribble DR, Agan BK, Burgess TH, Powers JH. Performance of the inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus) Instrument in Patients With Coronavirus Disease 2019. Open Forum Infect Dis 2021; 8:ofab517. [PMID: 34901299 DOI: 10.1093/ofid/ofab517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/07/2021] [Indexed: 01/10/2023] Open
Abstract
Background The inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus) is a patient-reported outcome data collection instrument assessing symptoms of viral respiratory tract infections across 8 body systems. This study evaluated the measurement properties of FLU-PRO Plus in a study enrolling individuals with coronavirus disease 2019 (COVID-19). Methods Data from a prospective cohort study (EPICC) in US Military Health System beneficiaries evaluated for COVID-19 was utilized. Adults with symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with FLU-PRO Plus survey information within 1 week of symptom onset were included. Reliability of FLU-PRO Plus was estimated using intraclass correlation coefficient (ICC; 2 days' reproducibility). Known-groups validity was assessed using patient global assessment (PGA) of disease severity. Patient report of return to usual health was used to assess responsiveness (day 1-6/7). Results Two hundred twenty-six SARS-CoV-2-positive participants were included in the analysis. Reliability among those who reported no change in their symptoms from one day to the next was high for most domains (ICC range, 0.68-0.94 for day 1 to day 2). Construct validity was demonstrated by moderate to high correlation between the PGA rating of disease severity and domain and total scores (eg, total scores correlation: 0.69 [influenza-like illness severity], 0.69 [interference in daily activities], and -0.58 [physical health]). In addition, FLU-PRO Plus demonstrated good known-groups validity, with increasing domain and total scores observed with increasing severity ratings. Conclusions FLU-PRO Plus performs well in measuring signs and symptoms in SARS-CoV-2 infection with excellent construct validity, known-groups validity, and responsiveness to change. Standardized data collection instruments facilitate meta-analyses, vaccine effectiveness studies, and other COVID-19 research activities.
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Affiliation(s)
- Stephanie A Richard
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - Nusrat J Epsi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - Simon Pollett
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - David A Lindholm
- Brooke Army Medical Center, Fort Sam Houston, Texas, USA.,Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Allison M W Malloy
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Ryan Maves
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Naval Medical Center San Diego, San Diego, California, USA
| | - Gregory C Utz
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Naval Medical Center San Diego, San Diego, California, USA
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Alfred G Smith
- Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - Rupal M Mody
- William Beaumont Army Medical Center, El Paso, Texas, USA
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Rhonda E Colombo
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Madigan Army Medical Center, Joint Base Lewis McChord, Washington, USA
| | - Christopher J Colombo
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Madigan Army Medical Center, Joint Base Lewis McChord, Washington, USA
| | - Sharon W Chi
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Tripler Army Medical Center, Honolulu, Hawaii, USA
| | - Nikhil Huprikar
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Derek T Larson
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA
| | - Samantha Bazan
- Carl R. Darnall Army Medical Center, Fort Hood, Texas, USA
| | | | - Charlotte Lanteri
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Julia S Rozman
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - Caroline English
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - Katrin Mende
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.,Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - David R Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Brian K Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA
| | - Timothy H Burgess
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - John H Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
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Partinen M, Holzinger B, Morin CM, Espie C, Chung F, Penzel T, Benedict C, Bolstad CJ, Cedernaes J, Chan RNY, Dauvilliers Y, De Gennaro L, Han F, Inoue Y, Matsui K, Leger D, Cunha AS, Merikanto I, Mota-Rolim S, Nadorff M, Plazzi G, Schneider J, Sieminski M, Wing YK, Bjorvatn B. Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire. BMJ Open 2021; 11:e050672. [PMID: 34903540 PMCID: PMC8671846 DOI: 10.1136/bmjopen-2021-050672] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Sleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe. METHODS This large-scale international survey used a harmonised questionnaire. Fourteen countries participated during the period of May-August 2020. Sleep and daytime problems (poor sleep quality, sleep onset and maintenance problems, nightmares, hypnotic use, fatigue and excessive sleepiness) occurring 'before' and 'during' the pandemic were investigated. In total, 25 484 people participated and 22 151 (86.9%) responded to the key parameters and were included. Effects of COVID-19, confinement and financial suffering were considered. In the fully adjusted logistic regression models, results (weighted and stratified by country) were adjusted for gender, age, marital status, educational level, ethnicity, presence of sleep problems before COVID-19 and severity of the COVID-19 pandemic in each country at the time of the survey. RESULTS The responders were mostly women (64%) with a mean age 41.8 (SD 15.9) years (median 39, range 18-95). Altogether, 3.0% reported having had COVID-19; 42.2% reported having been in confinement; and 55.9% had suffered financially. All sleep and daytime problems worsened during the pandemic by about 10% or more. Also, some participants reported improvements in sleep and daytime function. For example, sleep quality worsened in about 20% of subjects and improved in about 5%. COVID-19 was particularly associated with poor sleep quality, early morning awakening and daytime sleepiness. Confinement was associated with poor sleep quality, problems falling asleep and decreased use of hypnotics. Financial suffering was associated with all sleep and daytime problems, including nightmares and fatigue, even in the fully adjusted logistic regression models. CONCLUSIONS Sleep problems, fatigue and excessive sleepiness increased significantly worldwide during the first phase of the COVID-19 pandemic. Problems were associated with confinement and especially with financial suffering.
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Affiliation(s)
- Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland
- Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Brigitte Holzinger
- Institute for Dream and Consciousness Research, Medical University of Vienna, Wien, Austria
| | - Charles M Morin
- Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval École de psychologie, Quebec, Quebec, Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, Toronto, Ontario, Canada
| | - Thomas Penzel
- Sleep Medicine Center, Charite University Hospital Berlin, Berlin, Germany
| | - Christian Benedict
- Department of Neuroscience, Sleep Science (BMC), Uppsala University, Uppsala, Sweden
| | - Courtney J Bolstad
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jonathan Cedernaes
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep and Wake Unit, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Centre Montpellier, Montpellier, France
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Roma, Lazio, Italy
- IRCCS Fondazione Santa Lucia, Roma, Italy
| | - Fang Han
- Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, China
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Shinjuku-ku, Japan
- Neuropsychiatric Research Institute, Japan Somnology Center, Tokyo, Japan
| | - Kentaro Matsui
- Department of Clinical Laboratory and Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry National Institute of Mental Health, Kodaira, Japan
- Department of Psychiatry, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Damien Leger
- Sleep and Vigilance Center, Hopital Hotel-Dieu de Paris, Paris, France
- VIFASOM (EA 7331 Vigilance Fatigue Sommeil et Santé Publique), Universite de Paris, Paris, France
| | - Ana Suely Cunha
- Production Engineering Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ilona Merikanto
- Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sergio Mota-Rolim
- Brain Institute, Onofre Lopes University Hospital, Petropolis, Brazil
- Physiology and Behavior Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jules Schneider
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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140
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Lerner DK, Garvey KL, Arrighi-Allisan AE, Filimonov A, Filip P, Shah J, Tweel B, Del Signore A, Schaberg M, Colley P, Govindaraj S, Iloreta AM. Clinical Features of Parosmia Associated With COVID-19 Infection. Laryngoscope 2021; 132:633-639. [PMID: 34870334 PMCID: PMC9015517 DOI: 10.1002/lary.29982] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
Objective To characterize the clinical features, risk factors, symptom time‐course, and quality of life implications for parosmia among coronavirus disease (COVID)‐related olfactory dysfunction patients. Methods Individuals with olfactory dysfunction associated with laboratory‐confirmed or clinically suspected COVID‐19 infection were recruited from otolaryngology and primary care practices over a period from August 2020 to March 2021. Participants completed olfactory dysfunction and quality of life surveys. Results A total of 148 (64.1%) of 231 respondents reported parosmia at some point. Parosmia developed within 1 week of any COVID‐19 symptom onset in 25.4% of respondents, but more than 1 month after symptom onset in 43.4% of respondents. Parosmia was associated with significantly better quantitative olfactory scores on Brief Smell Identification Test (8.7 vs. 7.5, P = .006), but demonstrated worse quality of life scores, including modified brief Questionnaire of Olfactory Dysfunction—Negative Statements and Sino‐Nasal Outcome Test‐22 scores (12.1 vs. 8.5, P < .001; 26.2 vs. 23.2, P = .113). Participants who developed parosmia at any point were significantly younger and less likely to have history of chronic sinusitis than those who did not develop parosmia (40.2 vs. 44.9 years, P = .007; 7.2% vs. 0.7%, P = .006). Conclusion COVID‐19‐associated olfactory dysfunction is frequently linked with development of parosmia, which often presents either at onset of smell loss or in a delayed fashion. Despite better quantitative olfactory scores, respondents with parosmia report decreased quality of life. A majority of respondents with persistent parosmia have sought treatment. Level of Evidence 3 Laryngoscope, 132:633–639, 2022
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Affiliation(s)
- David K Lerner
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katherine L Garvey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Annie E Arrighi-Allisan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrey Filimonov
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter Filip
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janki Shah
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Tweel
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anthony Del Signore
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madeleine Schaberg
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Patrick Colley
- Department of Otolaryngology, Albert Einstein College of Medicine, New York, New York, USA
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alfred Marc Iloreta
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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141
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Sheen F, Tan V, Lim AJ, Haldar S, Sengupta S, Allen D, Somani J, Chen HY, Tambyah P, Forde CG. The COVOSMIA-19 trial: Preliminary application of the Singapore smell and taste test to objectively measure smell and taste function with COVID-19. Food Qual Prefer 2021; 97:104482. [PMID: 34848929 PMCID: PMC8612753 DOI: 10.1016/j.foodqual.2021.104482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 11/21/2021] [Indexed: 12/05/2022]
Abstract
Sudden loss of smell and/or taste has been identified as an early symptom of SARS-CoV-2 2019 (COVID-19) infection, and presents an effective target for prompt self-isolation and reducing community spread. The current study sought to develop and test a novel, rapid, self-administered test to objectively measure smell and taste losses associated with COVID-19, and administered self-report questionnaires to characterise symptoms associated with COVID-19 in Singapore. Participants (N = 99) completed questionnaires to record recent changes in smell and taste ability. This was followed by the ‘Singapore Smell and Taste Test’ (SSTT), a personal, objective testing kit for daily self-assessment of smell and taste function at their place of residence. Seventy-two recruited participants were confirmed as COVID-19 positive at baseline, of which 58 completed the SSTT at home. Of these, 36.2% had objectively measured smell and/or taste loss. The SSTT measures of smell and taste function were positively associated with participants’ self-reported smell and taste acuity, and rated smell intensity of 6 common household items. This study presents the first application of the SSTT as a rapid, cost-effective, objective tool to self-monitor smell and taste function in a residential setting, and ensures comparability across individuals through the use of standardised stimuli. The SSTT has potential for future application in populations with limited access to formal COVID-19 testing as a self-administered objective method to monitor sudden changes in smell and taste, and to prompt early self-isolation, in order to reduce community transmission of COVID-19.
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Affiliation(s)
- Florence Sheen
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Vicki Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Amanda JiaYing Lim
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Sumanto Haldar
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore
| | - Sharmila Sengupta
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - David Allen
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Jyoti Somani
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Hui Yee Chen
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - Paul Tambyah
- Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.,Yong Loo Lin School of Medicine, National University Singapore
| | - Ciarán G Forde
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science and Research (ASTAR), Singapore.,Wageningen University, Sensory Science and Eating Behaviour, Division of Human Nutrition, the Netherlands
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142
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Recent evidence for the impacts of olfactory disorders on food enjoyment and ingestive behavior. Curr Opin Food Sci 2021. [DOI: 10.1016/j.cofs.2021.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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143
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Butowt R, von Bartheld CS. Anosmia in COVID-19: Underlying Mechanisms and Assessment of an Olfactory Route to Brain Infection. Neuroscientist 2021; 27:582-603. [PMID: 32914699 PMCID: PMC7488171 DOI: 10.1177/1073858420956905] [Citation(s) in RCA: 192] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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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144
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Dean A, Said A, Marri K, Chelius D. Stridor Due to Cranial Nerve X Palsy Progressing to Polyneuropathy in a Teenager With COVID-19. Pediatrics 2021; 148:183397. [PMID: 34851417 DOI: 10.1542/peds.2021-051534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/24/2022] Open
Abstract
The neurologic manifestations of coronavirus disease 2019 (COVID-19) are wide-ranging, including various cranial neuropathies, beyond anosmia and dysgeusia, the exact neuropathological mechanism of which are yet unknown. Acute cranial nerve (CN) X neuritis with vocal cord paralysis has not been reported in COVID-19 and is a rare presentation of neuropathy in general. A girl aged 14 years was admitted with stridor. She was diagnosed with symptomatic COVID-19 8 days before. By presentation, fever had resolved, but she had developed stridor; sore throat with dysphagia; chest, shoulder, and back pain; and generalized weakness. Neurologic examination and laryngoscopy were consistent with isolated left CN X palsy. Steroids were started, but neurologic disease progressed with subjective pain, right lower face numbness, and eye fatigability. Respiratory distress increased, and she was intubated for airway protection. MRI revealed abnormal enhancement of CNs III, V, XII, and X. Cerebrospinal fluid studies were normal. Nasopharyngeal severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test result was positive. She was treated with intravenous immunoglobulin, a total of 2 g/kg, and steroids were continued. She made a full neurologic recovery and was discharged after 9 days of hospitalization. This is a case of a teenager who presented with an acute, life-threatening CN X palsy and development of a progressive polyneuropathy in the setting of COVID-19. Although there was concern for Guillain-Barre syndrome, a definitive diagnosis could not be made, and the unusual features of this case, including presentation with stridor and predominate CN involvement seem to indicate a separate symptomatic COVID-19-associated polyneuritis.
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Affiliation(s)
| | | | | | - Daniel Chelius
- Otolaryngology, Baylor College of Medicine, Houston, Texas
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145
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Dharmarajan S, Bharathi MB, Sivapuram K, Prakash BG, Madhan S, Madhu A, Devi GN, Aliya SA, Ramya SB. Hearing Loss-a Camouflaged Manifestation of COVID 19 Infection. Indian J Otolaryngol Head Neck Surg 2021; 73:494-498. [PMID: 33996529 PMCID: PMC8109216 DOI: 10.1007/s12070-021-02581-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/17/2021] [Indexed: 11/28/2022] Open
Abstract
The symptomatology of novel Severe Acute Respiratory Syndrome Corona virus type 2 infection runs the entire gamut of mild to moderate and serious illness among the affected individuals. As listed in recent literature, respiratory, cardiovascular, gastrointestinal, olfactory and gustatory systems are commonly involved. With the growing knowledge about the disease, varied manifestations have been identified and lately, otorhinolaryngology dysfunctions in COVID 19 have been described. Hearing loss in COVID era is one of the emerging areas of concern and calls for further research in the field for the better understanding and treatment of this entity. This study was designed to assess the audiological profile among 100 mild to moderately affected COVID-19 individuals, so as to make a contribution to the emerging literature on otologic manifestations in COVID 19. In our case series, high frequency hearing loss and referred OAE was noted among significant number of COVID 19 positive patients. This was even observed in patients without any otologic symptoms. Hence, early identification and intervention if required helps to give a better quality of life to the patient.
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Affiliation(s)
- Sandhya Dharmarajan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - M. B. Bharathi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Kavya Sivapuram
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - B. G. Prakash
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Sriram Madhan
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Ashima Madhu
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - G. Nivetha Devi
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - Shaik Ayesha Aliya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
| | - S. B. Ramya
- Department of ENT, Head and Neck Surgery, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, Karnataka 570004 India
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146
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Terrier O, Si-Tahar M, Ducatez M, Chevalier C, Pizzorno A, Le Goffic R, Crépin T, Simon G, Naffakh N. Influenza viruses and coronaviruses: Knowns, unknowns, and common research challenges. PLoS Pathog 2021; 17:e1010106. [PMID: 34969061 PMCID: PMC8718010 DOI: 10.1371/journal.ppat.1010106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The development of safe and effective vaccines in a record time after the emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a remarkable achievement, partly based on the experience gained from multiple viral outbreaks in the past decades. However, the Coronavirus Disease 2019 (COVID-19) crisis also revealed weaknesses in the global pandemic response and large gaps that remain in our knowledge of the biology of coronaviruses (CoVs) and influenza viruses, the 2 major respiratory viruses with pandemic potential. Here, we review current knowns and unknowns of influenza viruses and CoVs, and we highlight common research challenges they pose in 3 areas: the mechanisms of viral emergence and adaptation to humans, the physiological and molecular determinants of disease severity, and the development of control strategies. We outline multidisciplinary approaches and technological innovations that need to be harnessed in order to improve preparedeness to the next pandemic.
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Affiliation(s)
- Olivier Terrier
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- CIRI, Centre International de Recherche en Infectiologie (Team VirPath), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Mustapha Si-Tahar
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- Inserm U1100, Research Center for Respiratory Diseases (CEPR), Université de Tours, Tours, France
| | - Mariette Ducatez
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- IHAP, UMR1225, Université de Toulouse, ENVT, INRAE, Toulouse, France
| | - Christophe Chevalier
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- Université Paris-Saclay, UVSQ, INRAE, VIM, Equipe Virus Influenza, Jouy-en-Josas, France
| | - Andrés Pizzorno
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- CIRI, Centre International de Recherche en Infectiologie (Team VirPath), Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Ronan Le Goffic
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- Université Paris-Saclay, UVSQ, INRAE, VIM, Equipe Virus Influenza, Jouy-en-Josas, France
| | - Thibaut Crépin
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- Institut de Biologie Structurale (IBS), Université Grenoble Alpes, CEA, CNRS, Grenoble, France
| | - Gaëlle Simon
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- Swine Virology Immunology Unit, Ploufragan-Plouzané-Niort Laboratory, ANSES, Ploufragan, France
| | - Nadia Naffakh
- CNRS GDR2073 ResaFlu, Groupement de Recherche sur les Virus Influenza, France
- RNA Biology and Influenza Virus Unit, Institut Pasteur, CNRS UMR3569, Université de Paris, Paris, France
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147
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Pang KW, Tham SL, Ng LS. Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review. Life (Basel) 2021; 11:1315. [PMID: 34947846 PMCID: PMC8706269 DOI: 10.3390/life11121315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The diagnosis of COVID-19 is made using reverse transcription polymerase chain reaction (RT-PCR) but its sensitivity varies from 20 to 100%. The presence of gustatory dysfunction (GD) in a patient with upper respiratory tract symptoms might increase the clinical suspicion of COVID-19. AIMS To perform a systematic review and meta-analysis to determine the pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR) of using GD as a triage symptom prior to RT-PCR. METHODS PubMed and Embase were searched up to 20 June 2021. Studies published in English were included if they compared the frequency of GD in COVID-19 adult patients (proven by RT-PCR) to COVID-19 negative controls in case control or cross-sectional studies. The Newcastle-Ottawa scale was used to assess the methodological quality of the included studies. RESULTS 21,272 COVID-19 patients and 52,298 COVID-19 negative patients were included across 44 studies from 21 countries. All studies were of moderate to high risk of bias. Patients with GD were more likely to test positive for COVID-19: DOR 6.39 (4.86-8.40), LR+ 3.84 (3.04-4.84), LR- 0.67 (0.64-0.70), pooled sensitivity 0.37 (0.29-0.47) and pooled specificity 0.92 (0.89-0.94). While history/questionnaire-based assessments were predictive of RT-PCR positivity (DOR 6.62 (4.95-8.85)), gustatory testing was not (DOR 3.53 (0.98-12.7)). There was significant heterogeneity among the 44 studies (I2 = 92%, p < 0.01). CONCLUSIONS GD is useful as a symptom to determine if a patient should undergo further testing, especially in resource-poor regions where COVID-19 testing is scarce. Patients with GD may be advised to quarantine while repeated testing is performed if the initial RT-PCR is negative. FUNDING None.
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Affiliation(s)
- Khang Wen Pang
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore 119228, Singapore; (S.-L.T.); (L.S.N.)
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148
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Orilisi G, Mascitti M, Togni L, Monterubbianesi R, Tosco V, Vitiello F, Santarelli A, Putignano A, Orsini G. Oral Manifestations of COVID-19 in Hospitalized Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312511. [PMID: 34886241 PMCID: PMC8656958 DOI: 10.3390/ijerph182312511] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/21/2022]
Abstract
Background: COVID-19 disease first appeared in 2019 and quickly spread worldwide, causing a global pandemic. The oral cavity represents a target of SARS-CoV-2, and oral lesions are observed in both non-hospitalized and hospitalized patients. This systematic review aims to investigate the frequency of oral manifestations in COVID-19 hospitalized patients. Methods: An electronic search was conducted in PubMed, Scopus, and Web of Science databases, including articles published up to September 2021. The review protocol was based on PRISMA-P. The risk of bias of the studies was assessed using the Joana Briggs Institute. The certainty of evidence was assessed using the GRADE instrument. Results: Fifty-nine articles were included: 19 case reports, 17 case series, 2 case-control studies, 13 cross-sectional studies, 4 observational studies, and 4 retrospective studies. Oral ulcers, cheilitis, and tongue lesions were more common in patients before hospitalization, while perioral pressure ulcers, macroglossia, blisters, and oral candidiasis were more recurrent in patients during hospitalization. The first could be related directly to COVID-19, while the latter could be caused by medical devices, treatments, prone position, and immunological impairment. Conclusions: An accurate oral examination during the hospital admission of all confirmed COVID-19 cases is encouraged to recognize oral early manifestations and to apply appropriate treatments.
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Affiliation(s)
- Giulia Orilisi
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Marco Mascitti
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Lucrezia Togni
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Riccardo Monterubbianesi
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Vincenzo Tosco
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Flavia Vitiello
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Andrea Santarelli
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
- Dentistry Clinic, National Institute of Health and Science of Aging, IRCCS INRCA, Via Tronto 10, 60126 Ancona, Italy
| | - Angelo Putignano
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
| | - Giovanna Orsini
- Department of Clinical, Specialistic and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy; (G.O.); (M.M.); (L.T.); (R.M.); (V.T.); (F.V.); (A.S.); (A.P.)
- Correspondence: ; Tel.: +39-34-7248-3290
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149
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Sharma S, Jagadeesh H, Saxena A, Chakravarthy H, Devanathan V. Central nervous system as a target of novel coronavirus infections: Potential routes of entry and pathogenic mechanisms. J Biosci 2021. [PMID: 34840148 PMCID: PMC8612883 DOI: 10.1007/s12038-021-00232-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Since the COVID-19 pandemic started in December 2019, there have been several reports of patients succumbing to neurological complications. Early reports were suggestive of a possibility, while by early 2020 it was clearly evident that although SARS-CoV-2 primarily attacks the respiratory system, the brain is one of the most affected organs post-recovery. Although it may be premature to comment on the long-term effects of COVID-19 in brain, some reliable predictions can be made based on the data currently available. Further, exploring the CNS connections of SARS-CoV-2 is of keen interest for neuroscience researchers. As soon as the virus enters the nasal region, it is exposed to the olfactory nervous system which is interlinked with the visual system, and hence we explore the mechanism of entry of this virus into CNS, including brain, olfactory and retinal nervous systems. In this review, we have thoroughly reviewed reports about both SARS-CoV-1 and SARS-CoV-2 with respect to their ability to breach the blood-brain and blood-retinal barriers. We have compiled different neurological conditions resulting from COVID-19 and looked into viral infections related to COVID-19 to understand how the virus may gain control of the olfactory and visual systems. Once the dust settles on the pandemic, it would be interesting to explore the extent of viral infection in the CNS. The long-term effects of this virus in the CNS are not yet known, and several scientific research papers evolving in this field will throw light on the same.
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150
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Khan AM, Kallogjeri D, Piccirillo JF. Growing Public Health Concern of COVID-19 Chronic Olfactory Dysfunction. JAMA Otolaryngol Head Neck Surg 2021; 148:81-82. [PMID: 34792577 DOI: 10.1001/jamaoto.2021.3379] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Amish M Khan
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.,Statistics Editor, JAMA Otolaryngology-Head & Neck Surgery
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.,Editor, JAMA Otolaryngology-Head & Neck Surgery
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