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Du W, Dang Y, Xu Z, Chen F. Self-Reported Olfactory and Gustatory Dysfunctions in Hospitalized Patients Infected with SARS-CoV-2 Delta Variant. EAR, NOSE & THROAT JOURNAL 2024; 103:85S-90S. [PMID: 35861210 DOI: 10.1177/01455613221116985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to examine the olfactory and gustatory dysfunctions (OGDs) among hospitalized patients with a novel strain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), lineage B.1.617.2, also known as the delta variant, in Xi'an, China through verbal interviews. METHODS Clinical information of 370 hospitalized patients infected with the delta variant in the Aerospace City Branch of Xi'an People's Hospital in Xi'an, China from December 27, 2021 to January 10, 2022 were collected. The prevalence and characteristics of OGDs were collected using a simple questionnaire submitted to all infected patients, including questions about the presence and absence of OGDs. RESULTS Among the 370 patients infected with the delta variant, 28 (7.6%) reported OGDs. A significant proportion of patients with self-reported OGDs were younger than those without (28.9 ± 10.5 vs. 35.3 ± 13.9, P = 0.005) and had significantly higher rates of sore throat and rhinitis (28.6% vs. 12.3%, P = 0.033; 42.9% vs. 9.9%, P = 0.000). Women were significantly more affected by OGDs than men (67.9% vs. 32.1%, P = 0.012). Vaccinated and unvaccinated delta variant-infected patients showed statistically significant differences in terms of disease severity (P = 0.002). CONCLUSIONS The prevalence of OGDs in the delta variant infection was lower than that in wild-type SARS-CoV-2 infection. Meanwhile, young age, female sex, and upper respiratory tract symptoms could be closely related to the occurrence of OGDs in the delta variant infection. In addition, a satisfactory level of efficacy was obtained with coronavirus disease 2019 vaccines against moderate and severe delta variant infections.
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Affiliation(s)
- Weijia Du
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yan Dang
- Nursing Department, Xi'an People's Hospital, Xi'an, China
| | - Zhuo Xu
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Fuquan Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
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Fukuchi T, Oyama-Manabe N, Sugawara H. Fukuchi-Manabe Score for Infection Control Measures During the Very Early COVID-19 Pandemic Period When Access to Reverse Transcription-Polymerase Chain Reaction Testing Was Poor in Japan: A Single-Center Observational Prospective Cohort Study. Cureus 2024; 16:e54748. [PMID: 38523950 PMCID: PMC10960966 DOI: 10.7759/cureus.54748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND During the early stages of the COVID-19 pandemic in Japan, access to reverse transcription-polymerase chain reaction (RT-PCR) testing was limited. All patients with COVID-19 required hospitalization, and isolation of suspected COVID-19 patients had not yet been implemented. With the recently acquired evidence on COVID-19, it is important to develop a risk stratification system for isolation rooms in the context of limited resources for better resource management. OBJECTIVE This study aimed to develop and validate a COVID-19 risk-scoring strategy, the Fukuchi-Manabe score, to safely stratify and manage isolation rooms, personal protective equipment (PPE), and RT-PCR testing in the context of limited RT-PCR testing and a short supply of PPE. METHODS This single-center prospective study consecutively enrolled suspected COVID-19 adult inpatients between March 1 and August 31, 2020. The primary and secondary outcomes were a positive RT-PCR test and the occurrence of nosocomial infections during the study period, respectively. Factors related to patient history, symptoms, chest computed tomography findings, and laboratory data suggestive of COVID-19 were scored, totaled, and divided into four categories ("probable," "possible," "less likely," and "non-suspicious") based on the likelihood of COVID-19. Sensitivity, specificity, and positive and negative predictive values were evaluated for each probability category. FINDINGS Twenty of 224 inpatients were positive on the RT-PCR test, including 18 "probable" patients (90.0%), one "possible" patient, and one "less likely" patient. The area under the curve (AUC) (95% confidence interval: 0.841-0.977), sensitivity, and specificity were 0.909, 90.0%, and 80.4%, respectively. The positive and negative predictive values and accuracy for the "probable" category were 0.90, 0.80, and 0.82, respectively. The mean and standard deviation of AUCs, validated by bootstrap analysis, were 0.910±0.034. No nosocomial infections were observed. CONCLUSION The Fukuchi-Manabe score will be helpful when other novel pathogens emerge in the future before the availability of genetic testing methods.
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Affiliation(s)
- Takahiko Fukuchi
- Department of Comprehensive Medicine, Division of General Medicine, Jichi Medical University, Saitama Medical Center, Saitama, JPN
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University, Saitama Medical Center, Saitama, JPN
| | - Hitoshi Sugawara
- Department of Comprehensive Medicine, Division of General Medicine, Jichi Medical University, Saitama Medical Center, Saitama, JPN
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Wang H, Cheng L, Yu L, Guo Z. Targeting the mammalian target of rapamycin pathway in neurological manifestations of Covid-19. Rev Med Virol 2024; 34:e2503. [PMID: 38282397 DOI: 10.1002/rmv.2503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024]
Abstract
The diverse and severe nature of neurological manifestations associated with coronavirus disease 2019 (Covid-19) has garnered increasing attention. Exploring the potential to decrease neurological complications in Covid-19 patients involves targeting the mammalian target of rapamycin (mTOR) pathway as a therapeutic strategy. The mTOR pathway, widely recognised for its central role in essential cellular processes like synthesising proteins, facilitating autophagy, and modulating immune responses, has implications in various neurological disorders. Drawing parallels between these disorders and the observed neurological complications in Covid-19, we present a comprehensive review on the current understanding of mTOR signalling in the context of severe acute respiratory syndrome coronavirus 2 infection and neuroinflammation.
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Affiliation(s)
- Han Wang
- Department of Clinical Laboratory, The Affiliated Hospital to Changchun, University of Chinese Medicine, Changchun, China
| | - Li Cheng
- Department of Clinical Laboratory, The Affiliated Hospital to Changchun, University of Chinese Medicine, Changchun, China
| | - Lanlan Yu
- Department of Clinical Laboratory, The Affiliated Hospital to Changchun, University of Chinese Medicine, Changchun, China
| | - Zhigang Guo
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, China
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Di Stadio A, Gallina S, Cocuzza S, De Luca P, Ingrassia A, Oliva S, Sireci F, Camaioni A, Ferreli F, Mercante G, Gaino F, Pace GM, La Mantia I, Brenner MJ. Treatment of COVID-19 olfactory dysfunction with olfactory training, palmitoylethanolamide with luteolin, or combined therapy: a blinded controlled multicenter randomized trial. Eur Arch Otorhinolaryngol 2023; 280:4949-4961. [PMID: 37380908 PMCID: PMC10562315 DOI: 10.1007/s00405-023-08085-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE Few evidence-based therapies are available for chronic olfactory dysfunction after COVID-19. This study investigated the relative efficacy of olfactory training alone, co-ultramicronized palmitoylethanolamide with luteolin (um-PEA-LUT, an anti-neuroinflammatory supplement) alone, or combined therapy for treating chronic olfactory dysfunction from COVID-19. METHODS This double-blinded controlled, placebo-controlled multicenter randomized clinical trial was conducted in 202 patients with persistent COVID-19 olfactory dysfunction of > 6 month duration. After a screening nasal endoscopy, patients were randomized to: (1) olfactory training and placebo; (2) once daily um-PEA-LUT alone; (3) twice daily um-PEA-LUT alone; or (4) combination of once daily um-PEA-LUT with olfactory training. Olfactory testing (Sniffin' Sticks odor identification test) was performed at baseline and at 1, 2, and 3 months. The primary outcome was recovery of over three points on olfactory testing, with outcomes compared at T0, T1, T2 and T3 across groups. Statistical analyses included one-way ANOVA for numeric data and chi-square for nominal data. RESULTS All patients completed the study, and there were no adverse events. At 90 days, odor identification scores improved by > 3 points in 89.2% of patients receiving combined therapy vs. 36.8% receiving olfactory training with placebo, 40% receiving twice daily um-PEA-LUT alone, and 41.6% receiving once daily um-PEA-LUT alone (p < 0.00001). Patients receiving treatment with um-PEA-LUT alone demonstrated subclinical improvement (< 3 point odor identification improvement) more often than patients receiving olfactory training with placebo (p < 0.0001.) CONCLUSIONS: Olfactory training plus once daily um-PEA-LUT resulted in greater olfactory recovery than either therapy alone in patients with long-term olfactory function due to COVID-19. TRIAL REGISTRATION 20112020PGFN on clinicaltrials.gov. LEVEL OF EVIDENCE 1b (Individual Randomized Clinical Trial).
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Affiliation(s)
- Arianna Di Stadio
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy.
| | | | - Salvatore Cocuzza
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy
| | - Pietro De Luca
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Angelo Ingrassia
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Simone Oliva
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Federico Sireci
- Otolaryngology Department, University of Palermo, Palermo, Italy
| | - Angelo Camaioni
- Otolaryngology Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Fabio Ferreli
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Giuseppe Mercante
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Francesca Gaino
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Gian Marco Pace
- Otolaryngology Department, Humanitas University Hospital, Milan, Italy
| | - Ignazio La Mantia
- Otolaryngology Unit, GF Ingrassia Department, University of Catania, Catania, Italy
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
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Chen Y, Chen Y, Chen L, Wu H, Liu X, Yan C, Zou L. Smell, taste and chemesthesis disorders in patients with the SARS-CoV-2 during Omicron variant pandemic in China. Heliyon 2023; 9:e20715. [PMID: 37842559 PMCID: PMC10568085 DOI: 10.1016/j.heliyon.2023.e20715] [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: 06/22/2023] [Revised: 09/26/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023] Open
Abstract
Chemosensory disorders (including smell, taste and chemesthesis) are among the established symptoms of COVID-19 infection; however, new data indicate that the changes in chemosensory sensation caused by COVID-19 may differ among populations and COVID-19 variants. To date, few studies have focused on the influence of the SARS-CoV-2 Omicron variant on qualitative changes and quantitative reductions in chemosensory function in China. We conducted a cross-sectional study of patients with COVID-19 caused by the Omicron variant, to investigate the prevalence of chemosensory disorders and chemosensory function before and during infection, using an online questionnaire. A total of 1245 patients with COVID-19 completed the survey. The prevalence rates of smell, taste, and chemesthesis disorders were 69.2%, 67.7%, and 31.4%, respectively. Our data indicate that sex, age, smoking, and COVID-19-related symptoms, such as lack of appetite, dyspnea, and fatigue, may be associated with chemosensory disorders during COVID-19. Self-rating of chemosensory function revealed that patients experienced a general decline in smell, taste, and chemesthesis function. Further longitudinal research studies are needed to generate additional data based on objective assessment and investigate the factors influencing chemosensory function in COVID-19.
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Affiliation(s)
- Ying Chen
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuying Chen
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Lixin Chen
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Hangying Wu
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiang Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Laiquan Zou
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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Chen YC, Wang X, Teng YS, Jia DS, Li L, Pan HG. Otolaryngology-related symptoms of COVID-19 in children in the post-epidemic era: a cross-sectional web-based survey study. Front Pediatr 2023; 11:1190734. [PMID: 37601127 PMCID: PMC10436526 DOI: 10.3389/fped.2023.1190734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose China adjusted and optimized its prevention and control strategies in December 2022, and it entered a new era of the coronavirus epidemic. Here, we describe the general and otolaryngology-related symptoms of coronavirus disease 2019 (COVID-19) in children during the first pandemic in the post-epidemic era, focusing on the frequency and severity of smell and taste loss, as well as the recovery process and its influencing factors. Patients and methods From 2 January to 7 January 2023, we conducted a cross-sectional online questionnaire survey through Questionnaire Stars in order to collect relevant information about COVID-19 in children in Shenzhen. Results A total of 1,247 valid questionnaires were received, with an effective response rate of 78.72%. All of the diagnoses were confirmed by nucleic acid or antigen test for COVID-19. Among the subjects, the sex ratio of male to female was more inclined to male (1.35:1), and the age was 3-16 years, with an average of 10.13 ± 2.82 years old. The most common symptoms were cough (58.24%), stuffy nose (56.18%), headache (42.09%), fatigue (40.44%), and sore throat (31.63%). Approximately 6.43% of the children reported dysosmia, the mean time of the duration of dysosmia was 5.38 ± 2.92 days, and the mean score of the severity of the dysosmia as assessed by visual analogue scale (VAS) was 4.63 ± 2.29. Approximately 13.34% reported dysgeusia, the mean time of the duration of dysgeusia was 4.77 ± 3.98 days, and the mean score of the severity of the dysgeusia as assessed by VAS was 5.12 ± 2.29. Univariate and multivariate logistic regression analysis showed that the prevalence of taste and olfactory disorders increased with age, mainly in children with severe symptoms and older children. Conclusion In the post-epidemic era, due to weakening of the pathogenicity of the subvariant of Omicron, overall condition of children with COVID-19 was mild, incidence of olfactory and taste disorders was low, recovery was faster, and prognosis was better. In our study, cough, runny nose, and sore throat were the most common symptoms, and the prevalence of taste and olfactory disorders increased with age, mainly in older children with severe symptoms.
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Affiliation(s)
- Yong-chao Chen
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, China Medical University, Shenzhen, China
| | - Xin Wang
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, China Medical University, Shenzhen, China
| | - Yi-shu Teng
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
| | - De-sheng Jia
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, China Medical University, Shenzhen, China
| | - Lan Li
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Hong-guang Pan
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
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Winn PZ, Hlaing T, Tun KM, Lei SL. Effect of any form of steroids in comparison with that of other medications on the duration of olfactory dysfunction in patients with COVID-19: A systematic review of randomized trials and quasi-experimental studies. PLoS One 2023; 18:e0288285. [PMID: 37531338 PMCID: PMC10395913 DOI: 10.1371/journal.pone.0288285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 06/25/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the decreased pleasure of eating to impaired quality of life. This research aimed to provide a comprehensive understanding of the effects of corticosteroid treatments by comparing that to other currently available treatments and interventions. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist's 27-point checklist was used to conduct this review. PubMed (Public/Publisher MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently selected and Boolean search commands were used for a comprehensive literature search. Five core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", "corticosteroids", "treatments" and "interventions". The reporting qualities of the included studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The characteristics of the 21 experimental studies with a total sample (of 130,550) were aggregated using frequencies and percentages and presented descriptively. The main interventions and their effects on the duration of the COVID-19-related olfactory dysfunction were narratively analyzed. RESULTS Among patients with COVID-19, the normal functions of the olfactory lobe were about 23 days earlier to gain with the treatments of fluticasone and triamcinolone acetonide nasal spray compared with that of mometasone furoate nasal spray and oral corticosteroid. The smell loss duration was reduced by fluticasone and triamcinolone acetonide nasal spray 9 days earlier than the inflawell syrup and 16 days earlier than the lavender syrup. The nasal spray of corticosteroids ended the COVID-19-related smell loss symptoms 2 days earlier than the zinc supplementation, about 47 days earlier than carbamazepine treatment and was more effective than palmitoylethanolamide (PEA) and luteolin and omega-3 supplementations and olfactory training. Treatment with oral corticosteroid plus olfactory training significantly improved Threshold, Discrimination and Identification (TDI) scores compared with olfactory training alone. A full dose of the COVID-19 vaccination was not uncertain to reduce the COVID-19-related smell loss duration. CONCLUSION Corticosteroid treatment is effective in reducing the duration of COVID-19-related smell loss and olfactory training, the basic, essential and effective intervention, should be used as a combination therapy.
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Affiliation(s)
- Phyo Zin Winn
- Community-initiated COVID-19 Response Project, Myanmar Health Assistant Association, Magway Region, Myanmar
| | - Thein Hlaing
- District Public Health Department (Ministry of Health), Pyay District, Pyay, Bago Region, Myanmar
| | - Kyaw Myo Tun
- Department of Health and Social Sciences, STI Myanmar University, Yangon, Myanmar
| | - Seim Lei Lei
- Community Initiative COVID-19 Response Project, Myanmar Health Assistant Association, Sagaing Region, Myanmar
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Ramillon J, de Lamballerie X, Robineau O, Blanché H, Severi G, Touvier M, Zins M, Carrat F, Lapidus N. Antibody response, associated symptoms and profile of patients presumably infected by SARS-CoV-2 with taste or smell disorders in the SAPRIS multicohort study. BMC Infect Dis 2023; 23:228. [PMID: 37060075 PMCID: PMC10103027 DOI: 10.1186/s12879-023-08162-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/14/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Taste or smell disorders have been reported as strongly associated with COVID-19 diagnosis. We aimed to identify subject characteristics, symptom associations, and antibody response intensity associated with taste or smell disorders. METHODS We used data from SAPRIS, a study based on a consortium of five prospective cohorts gathering 279,478 participants in the French general population. In the analysis, we selected participants who were presumably infected by SARS-CoV-2 during the first epidemic wave. RESULTS The analysis included 3,439 patients with a positive ELISA-Spike. Sex (OR = 1.28 [95% CI 1.05-1.58] for women), smoking (OR = 1.54 [95% CI 1.13-2.07]), consumption of more than 2 drinks of alcohol a day (OR = 1.37 [95% CI 1.06-1.76]) were associated with a higher probability of taste or smell disorders. The relationship between age and taste or smell disorders was non-linear. Serological titers were associated with taste or smell disorders: OR = 1.31 [95% CI 1.26-1.36], OR = 1.37 [95% CI 1.33-1.42] and OR = 1.34 [95% CI 1.29-1.39] for ELISA-Spike, ELISA-Nucleocapsid and seroneutralization, respectively. Among participants with taste or smell disorders, 90% reported a wide variety of other symptoms whereas 10% reported no other symptom or only rhinorrhea. CONCLUSIONS Among patients with a positive ELISA-Spike test, women, smokers and people drinking more than 2 drinks a day were more likely to develop taste or smell disorders. This symptom was strongly associated with an antibody response. The overwhelming majority of patients with taste or smell disorders experienced a wide variety of symptoms.
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Affiliation(s)
- Julien Ramillon
- Département de Santé Publique, Hôpital Saint-Antoine, AP-HP.Sorbonne Université, F75012, Paris, France
| | - Xavier de Lamballerie
- Unité Des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, 13005, France
| | - Olivier Robineau
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP.Sorbonne Université, F75012, Paris, France
- EA2694, Univ Lille, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Hélène Blanché
- Fondation Jean Dausset-CEPH (Centre d'Etude du Polymorphisme Humain), CEPH-Biobank, Paris, France
| | - Gianluca Severi
- CESP UMR1018, Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science and Applications, University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Marie Zins
- Population-Based Epidemiological Cohorts, UMS 11, Paris-Saclay University, Versailles St Quentin University, Université de Paris, Inserm, Villejuif, France
| | - Fabrice Carrat
- Département de Santé Publique, Hôpital Saint-Antoine, AP-HP.Sorbonne Université, F75012, Paris, France
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP.Sorbonne Université, F75012, Paris, France
| | - Nathanaël Lapidus
- Département de Santé Publique, Hôpital Saint-Antoine, AP-HP.Sorbonne Université, F75012, Paris, France.
- Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP.Sorbonne Université, F75012, Paris, France.
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Almaamuri AM, Mohammed MM. COVID-19 olfactory dysfunction, evaluation of onset, and persistence. J Adv Pharm Technol Res 2023; 14:137-141. [PMID: 37255874 PMCID: PMC10226702 DOI: 10.4103/japtr.japtr_48_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 06/01/2023] Open
Abstract
Olfactory dysfunction (OD) is a common feature of COVID-19. The goal of the study was to define the modes of onset of OD in the clinical course of the disease and to follow the cases for 12-18 months in order to estimate the differences in the recovery time from OD over the course of the disease. We managed to follow a total of 325 patients (females: 198, males: 127) in the Babylon governorate in Iraq. All were COVID-19 patients who should have OD during the course of the disease. COVID-19 infection was established in all patients by swab test, i.e. polymerase chain reaction (PCR) and/or chest computed tomography findings of pneumonia compatible with COVID-19. Detailed medical records were obtained directly from the patients or their relatives. The patients were then followed up by telephone and questioned with structured questionnaires concentrating upon general clinical features and the sense of olfaction. Information about the presence of olfactory disorders, their occurrence, and development was recorded. Based on the onset of OD, the patients were categorized into three groups. Olfactory functions were assessed primarily by face-to-face interview and then (if necessary) by a telephone questionnaire assessing self-reported olfactory function and olfactory-related quality of life, which measures the subjective olfactory capability (SOC). In the first 2 weeks, 148 (45.5%) patients reported complete recovery from OD, of which 90 (73.2%) patients joined at the end of the 1st month. OD persistence was observed in 11 (3.3%) patients toward the end of the 1st year, in 5 (1.5%) patients at the end of the 15th month, and only in two (0.6%) patients at the end of the 18th month. We found no significant correlation between the type of onset of OD and the duration and persistence of OD. Most sufferers of COVID-associated OD recover their sense of smell within the 1st month.
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Affiliation(s)
| | - Mohammed M. Mohammed
- Department of Pediatric, Al-Tarmia General Hospital, Al-Karkh Health Directorate, Baghdad, Iraq
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10
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 DOI: 10.1093/chemse/bjad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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11
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Mozaffar B, Ardavani A, Muzafar H, Idris I. The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr Metab 2023; 2023:6711071. [PMID: 36937245 PMCID: PMC10017214 DOI: 10.1155/2023/6711071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction Food taste and flavour affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect the taste, but the efficacy of zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. Methods We searched four electronic bibliographical databases: Ovid MEDLINE, Ovid Embase, Ovid AMAD, and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. There were no restrictions on the publication date to facilitate the collection and identification of all available and relevant articles published before 7 February 2021. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. Results In total, we included 12 randomized controlled trials with 938 subjects. The intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc, and acetate), and the pooled results of the meta-analysis of subjects with idiopathic and zinc-deficient taste disorder indicate that improvements in taste disorder occurred more frequently in the experimental group compared to the control group (RR = 1.38; 95% CI: 1.16, 1.64, p=0.0002). Zinc supplementation appears to confer a greater improvement in taste perception amongst those with chronic renal disease using zinc acetate (overall RR = 26.69, 95% CI = 5.52-129.06, p < 0.0001). The doses are equivalent to 17 mg-86.7 mg of elemental zinc for three to six months. Conclusion Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency, idiopathic taste disorders, and in patients with taste disorders induced by chronic renal failure when given in high doses ranging from 68 to 86.7 mg/d for up to six months.
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Affiliation(s)
- Boshra Mozaffar
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
- 2Clinical Nutrition Department, Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Arash Ardavani
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - Hisham Muzafar
- 3Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Iskandar Idris
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
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12
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Pirola F, Giombi F, Ferreli F, Costantino A, Mercante G, Paoletti G, Heffler E, Canonica GW, Settimi S, De Corso E, Spriano G, Malvezzi L. Cross-Cultural Validation of the Short Version of the Questionnaire of Olfactory Disorders-Negative Statements into Italian: Towards Personalized Patient Care. J Pers Med 2022; 12:jpm12122010. [PMID: 36556231 PMCID: PMC9782898 DOI: 10.3390/jpm12122010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/21/2022] [Accepted: 12/02/2022] [Indexed: 12/07/2022] Open
Abstract
Given the high burden of olfactory dysfunction worldwide, recently increased due to the COVID-19 pandemic, it is mandatory to adopt a specific questionnaire to assess the impact of olfactory impairment on quality of life, to be used in clinical practice. The aim of this study is to adapt and validate the short version of the Questionnaire of Olfactory Disorders-Negative Statements (svQOD-NS) for Italian. In the pilot phase, the Italian version of the questionnaire (ITA-svQOD-NS) was produced following recommended guidelines. It was then given to 50 healthy subjects and 50 patients (affected by either nasal polyposis or septal deviation), and results were compared to those of other widely used questionnaires. Test-retest reliability was assessed on a sample of 25 patients. All 50 patients repeated the questionnaires at one and nine months after surgery. The internal consistency of ITA-svQOD-NS measured with Cronbach α was excellent (α = 0.92). The intraclass correlation coefficient for test-retest reliability was also optimal (0.93; 95%CI: 0.90-0.96). Concurrent validity tested with the Pearson coefficient was significant with all other tests administered; also, concerning responsiveness, statistically significant differences were obtained between pre- and post-operative conditions. ITA-svQOD-NS showed high internal consistency, test-retest reliability, and significant correlation with all most-used clinical questionnaires; thus, it can be efficiently applied to assess olfaction-related QoL in the Italian population.
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Affiliation(s)
- Francesca Pirola
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Francesco Giombi
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Fabio Ferreli
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Andrea Costantino
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Giuseppe Mercante
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Giovanni Paoletti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Enrico Heffler
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Stefano Settimi
- Department of Head and Neck and Sensory Organs, Catholic University of the Sacred Hearth, 00168 Rome, Italy
| | - Eugenio De Corso
- Unit of Otorhinolaryngology-Head and Neck Surgery, A. Gemelli Hospital Foundation IRCCS, 00168 Rome, Italy
| | - Giuseppe Spriano
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Luca Malvezzi
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
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13
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Sabbagh HJ, Abdelaziz W, Quritum M, Alamoudi RA, AlKhateeb NAB, Abourdan J, Qureshi N, Qureshi S, Hamoud AHN, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Alade O, Gomaa N, Alnahdi R, Mahmoud NA, El Wazziki H, Alnaas M, Samodien B, Mahmoud RA, Assab NA, Saad S, Alsayad MM, Alhachim SG, El Tantawi M. A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults. BMC Oral Health 2022; 22:513. [PMID: 36402969 PMCID: PMC9675238 DOI: 10.1186/s12903-022-02515-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/18/2022] [Indexed: 11/21/2022] Open
Abstract
Background Oral diseases are features of COVID-19 infection. There is, however, little known about oral diseases associated with COVID-19 in adolescents and young adults (AYA). Therefore, the aim of this study was to assess oral lesions’ association with COVID-19 infection in AYA; and to identify if sex and age will modify these associations. Methodology Data was collected for this cross-sectional study between August 2020 and January 2021 from 11-to-23 years old participants in 43-countries using an electronic validated questionnaire developed in five languages. Data collected included information on the dependent variables (the presence of oral conditions- gingival inflammation, dry mouth, change in taste and oral ulcers), independent variable (COVID-19 infection) and confounders (age, sex, history of medical problems and parents’ educational level). Multilevel binary logistic regression was used for analysis. Results Complete data were available for 7164 AYA, with 7.5% reporting a history of COVID-19 infection. A significantly higher percentage of participants with a history of COVID-19 infection than those without COVID-19 infection reported having dry mouth (10.6% vs 7.3%, AOR = 1.31) and taste changes (11.1% vs 2.7%, AOR = 4.11). There was a significant effect modification in the association between COVID-19 infection and the presence of dry mouth and change in taste by age and sex (P = 0.02 and < 0.001). Conclusion COVID-19 infection was associated with dry mouth and change in taste among AYA and the strength of this association differed by age and sex. These oral conditions may help serve as an index for suspicion of COVID-19 infection in AYA. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02515-5.
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Affiliation(s)
- Heba Jafar Sabbagh
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589 Saudi Arabia
| | - Wafaa Abdelaziz
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Maryam Quritum
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Rana Abdullah Alamoudi
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Nada Abu Bakr AlKhateeb
- grid.412125.10000 0001 0619 1117Faculty of Medicine, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Joud Abourdan
- grid.411781.a0000 0004 0471 9346Medical Faculty, Istanbul Medipol University, 34230 Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, DD1 3JA UK
| | - Shabnum Qureshi
- grid.412997.00000 0001 2294 5433Department of Education, University of Kashmir, Srinagar, 190006 India
| | - Ahmed H. N. Hamoud
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
| | - Nada Mahmoud
- grid.449328.00000 0000 8955 8908Faculty of Dentistry, National Ribat University, 1111 Khartoum, Sudan
| | - Ruba Odeh
- grid.444470.70000 0000 8672 9927College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, 386 Syria
| | - Rawiah Jaber
- grid.412125.10000 0001 0619 1117General Courses, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Abdulrahman Loaie Balkhoyor
- grid.412125.10000 0001 0619 1117Faculty of Engineering, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Mohammed Shabi
- grid.460099.2University of Jeddah, Jeddah, 23218 Saudi Arabia
| | - Morenike Oluwatoyin Folayan
- grid.10824.3f0000 0001 2183 9444Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State Nigeria
| | - Omolola Alade
- grid.10824.3f0000 0001 2183 9444Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Noha Gomaa
- grid.39381.300000 0004 1936 8884Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
| | - Raqiya Alnahdi
- Department of Dental Surgery, Oman Dental College, 116 Muscat, Oman
| | - Nawal A. Mahmoud
- grid.444472.50000 0004 1756 3061Institute of Creative Art and Design (ICAD), Kuala Lumpur Campus, UCSI University, 56000 Kuala Lumpur, Malaysia
| | - Hanane El Wazziki
- Department of Cereal Plant Pathology, National Institute of Agricultural Research, 10090 Rabat, Morocco
| | - Manal Alnaas
- grid.8241.f0000 0004 0397 2876Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, DD1 4HN UK
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, 8001 South Africa
| | - Rawa A. Mahmoud
- Musculoskeletal Center, International Medical Centre, Jeddah, 21451 Saudi Arabia
| | - Nour Abu Assab
- Schools of Awqaf, Directorate of Education, Jerusalem, Israel
| | - Sherin Saad
- grid.8761.80000 0000 9919 9582Department of Pharmacology, Institute of Neuroscience and Physiology, University of Gothenburg, Box 431, 40530 Gothenburg, Sweden
| | | | | | - Maha El Tantawi
- grid.7155.60000 0001 2260 6941Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21561 Egypt
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14
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Kolawole OM, Tomori O, Agbonlahor D, Ekanem E, Bakare R, Abdulsalam N, Okojie O, Braide E, Uzochukwu B, Rafindadi A, Bello S, Shehu S, Gureje O, Lecky M, Onwujekwe O, Onyedum C, Ezike A, Bukbuk D, Ashir G, Anyaehie B, Amazigo U, Habib A, Ufere J, Azodoh N. SARS CoV-2 Seroprevalence in Selected States of High and Low Disease Burden in Nigeria. JAMA Netw Open 2022; 5:e2236053. [PMID: 36219441 PMCID: PMC9554701 DOI: 10.1001/jamanetworkopen.2022.36053] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The global impact of COVID-19 has led to an increased need to continuously assess disease surveillance tools. The utility of SARS-CoV-2 serologic tools in determining immunity levels across different age groups and locations in helping to quickly assess the burden of COVID-19 with significant health policy implications is unknown. OBJECTIVE To determine the prevalence of SARS-CoV-2 antibodies with respect to the age group and sex of participants. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional survey of 4904 individuals across 12 states with high and low COVID-19 disease burden in Nigeria was carried out between June 29 and August 21, 2021. MAIN OUTCOMES AND MEASURES Enzyme-linked immunosorbent assay was used for the detection of specific SARS-CoV-2 immunoglobulin G and immunoglobulin M antibodies, such as the nucleocapsid protein-NCP and spike protein S1. Interviewer-administered questionnaires provided information on participants' history of disease and associated risk factors. RESULTS A total of 4904 individuals participated in the study (3033 were female [61.8%]; mean [SD] age, 26.7 [6.51] years). A high seroprevalence of SARS-CoV-2 (78.9%) was obtained. Seropositivity was consistent across the states surveyed, ranging from 69.8% in Lagos to 87.7% in Borno. There was no association between sex and seropositivity (female, 2414 [79.6%]; male, 1456 [77.8%]; P = .61); however, an association was noted between age and seropositivity, with the peak prevalence observed in participants aged 15 to 19 years (616 [83.6%]; P = .001). Similarly, loss of appetite (751 [82.3%]; P = .04) and smell (309 [84.4%]; P = .01) were associated with seropositivity. CONCLUSIONS AND RELEVANCE In this cross-sectional study, a high SARS-CoV-2 seroprevalence was obtained among the study population during the low level of vaccination at the time of the survey. Thus, there is a need for both an efficacy and antibody neutralization test study to ascertain the efficacy of the antibody detected and the potential for herd immunity in Nigeria.
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Affiliation(s)
- Olatunji Matthew Kolawole
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Oyewale Tomori
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Dennis Agbonlahor
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Ekanem Ekanem
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Rasheed Bakare
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Nasidi Abdulsalam
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Obehi Okojie
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Eka Braide
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Benjamin Uzochukwu
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Abdulmumini Rafindadi
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Shaibu Bello
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Sule Shehu
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Oye Gureje
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Muhammed Lecky
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Obinna Onwujekwe
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Cajetan Onyedum
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Adaobi Ezike
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - David Bukbuk
- Department of Microbiology, Faculty of Science, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Garba Ashir
- Department of Microbiology, Faculty of Science, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Bond Anyaehie
- Department of Physiology, College of Medicine, University of Nigeria, Enugu
| | - Uche Amazigo
- Pan-African Community Initiative on Education and Health, Enugu, Enugu State, Nigeria
| | - Abdulrajak Habib
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
| | - Joy Ufere
- World Health Organization Country Office, Federal Capital Territory, Abuja, Nigeria
| | - Ngozi Azodoh
- Ministerial Expert Advisory Committee on COVID-19-Health Sector Response, Federal Ministry of Health, Abuja, Nigeria
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15
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Chen CH, Chang KC, Lin YN, Ho MW, Cheng MY, Shih WH, Chou CH, Lin PC, Chi CY, Lu MC, Tien N, Wu MY, Chang SS, Hsu WH, Shyu WC, Cho DY, Jeng LB. Mesenchymal stem cell therapy on top of triple therapy with remdesivir, dexamethasone, and tocilizumab improves PaO2/FiO2 in severe COVID-19 pneumonia. Front Med (Lausanne) 2022; 9:1001979. [PMID: 36213639 PMCID: PMC9537613 DOI: 10.3389/fmed.2022.1001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Despite patients with severe coronavirus disease (COVID-19) receiving standard triple therapy, including steroids, antiviral agents, and anticytokine therapy, health condition of certain patients continue to deteriorate. In Taiwan, the COVID-19 mortality has been high since the emergence of previous variants of this disease (such as alpha, beta, or delta). We aimed to evaluate whether adjunctive infusion of human umbilical cord mesenchymal stem cells (MSCs) (hUC-MSCs) on top of dexamethasone, remdesivir, and tocilizumab improves pulmonary oxygenation and suppresses inflammatory cytokines in patients with severe COVID-19. Methods Hospitalized patients with severe or critical COVID-19 pneumonia under standard triple therapy were separated into adjuvant hUC-MSC and non-hUC-MSC groups to compare the changes in the arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio and biological variables. Results Four out of eight patients with severe or critical COVID-19 received either one (n = 2) or two (n = 2) doses of intravenous infusions of hUC-MSCs using a uniform cell dose of 1.0 × 108. Both high-sensitivity C-reactive protein (hs-CRP) level and monocyte distribution width (MDW) were significantly reduced, with a reduction in the levels of interleukin (IL)-6, IL-13, IL-12p70 and vascular endothelial growth factor following hUC-MSC transplantation. The PaO2/FiO2 ratio increased from 83.68 (64.34–126.75) to 227.50 (185.25–237.50) and then 349.56 (293.03–367.92) within 7 days after hUC-MSC infusion (P < 0.001), while the change of PaO2/FiO2 ratio was insignificant in non-hUC-MSC patients (admission day: 165.00 [102.50–237.61]; day 3: 100.00 [72.00–232.68]; day 7: 250.00 [71.00–251.43], P = 0.923). Conclusion Transplantation of hUC-MSCs as adjunctive therapy improves pulmonary oxygenation in patients with severe or critical COVID-19. The beneficial effects of hUC-MSCs were presumably mediated by the mitigation of inflammatory cytokines, characterized by the reduction in both hs-CRP and MDW.
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Affiliation(s)
- Chih-Hao Chen
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Kuan-Cheng Chang,
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Meng-Yu Cheng
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Hsin Shih
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Huei Chou
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lin
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chi
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Min-Chi Lu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan
| | - Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wu-Huei Hsu
- School of Medicine, China Medical University, Taichung, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Woei-Cheang Shyu
- School of Medicine, China Medical University, Taichung, Taiwan
- Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Woei-Cheang Shyu,
| | - Der-Yang Cho
- School of Medicine, China Medical University, Taichung, Taiwan
- Stroke Center, China Medical University Hospital, Taichung, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
| | - Long-Bin Jeng
- School of Medicine, China Medical University, Taichung, Taiwan
- Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
- Long-Bin Jeng,
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16
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Luo X, Lv M, Zhang X, Estill J, Yang B, Lei R, Ren M, Liu Y, Wang L, Liu X, Wang Q, Meng M, Chen Y. Clinical manifestations of COVID-19: An overview of 102 systematic reviews with evidence mapping. J Evid Based Med 2022; 15:201-215. [PMID: 35909298 PMCID: PMC9353366 DOI: 10.1111/jebm.12483] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but there is so far no comprehensive analysis of all known symptoms of the disease. Our study aimed to present a comprehensive picture of the clinical symptoms of COVID-19 using an evidence map. METHODS We systematically searched MEDLINE via PubMed, Web of Science, Embase, and Cochrane library from their inception to March 16, 2021. We included systematic reviews reporting the clinical manifestations of COVID-19 patients. We followed the PRISMA guidelines, and the study selection, data extraction, and quality assessment were done by two individuals independently. We assessed the methodological quality of the studies using AMSTAR. We visually presented the clinical symptoms of COVID-19 and their prevalence. RESULTS A total of 102 systematic reviews were included, of which, 68 studies (66.7%) were of high quality, 19 studies (18.6%) of medium quality, and 15 studies (14.7%) of low quality. We identified a total of 74 symptoms including 17 symptoms of the respiratory system, 21 symptoms of the neurological system, 10 symptoms of the gastrointestinal system, 16 cutaneous symptoms, and 10 ocular symptoms. The most common symptoms were fever (67 studies, ranging 16.3%-91.0%, pooled prevalence: 64.6%, 95%CI, 61.3%-67.9%), cough (68 studies, ranging 30.0%-72.2%, pooled prevalence: 53.6%, 95%CI, 52.1%-55.1%), muscle soreness (56 studies, ranging 3.0%-44.0%, pooled prevalence: 18.7%, 95%CI, 16.3%-21.3%), and fatigue (52 studies, ranging 3.3%-58.5%, pooled prevalence: 29.4%, 95%CI, 27.5%-31.3%). The prevalence estimates for COVID-19 symptoms were generally lower in neonates, children and adolescents, and pregnant women than in the general populations. CONCLUSION At least 74 different clinical manifestations are associated with COVID-19. Fever, cough, muscle soreness, and fatigue are the most common, but attention should also be paid to the rare symptoms that can help in the early diagnosis of the disease.
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Affiliation(s)
- Xufei Luo
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Meng Lv
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Xianzhuo Zhang
- The First School of Clinical MedicineLanzhou UniversityLanzhouChina
| | - Janne Estill
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Institute of Mathematical Statistics and Actuarial ScienceUniversity of BernBernSwitzerland
| | - Bo Yang
- Department of Immune Programming and ManagementShapingba District Center for Disease Control and Prevention of ChongqingChongqingChina
| | - Ruobing Lei
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Mengjuan Ren
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Yunlan Liu
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Ling Wang
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Xiao Liu
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Qi Wang
- Faculty of Health SciencesDepartment of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonCanada
- McMaster Health ForumMcMaster UniversityHamiltonCanada
| | - Min Meng
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
- Department of PharmacyGansu Provincial HospitalLanzhouChina
| | - Yaolong Chen
- School of Public HealthLanzhou UniversityLanzhouChina
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Research Unit of Evidence‐Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical SciencesLanzhou UniversityLanzhouChina
- Institute of Health Data ScienceLanzhou UniversityLanzhouChina
- Evidence‐Based Medicine Center, School of Basic Medical SciencesLanzhou UniversityLanzhouChina
- WHO Collaborating Centre for Guideline Implementation and Knowledge TranslationLanzhou UniversityLanzhouChina
- Guideline International Network AsiaLanzhouChina
- Key Laboratory of Evidence‐Based Medicine and Knowledge Translation of Gansu ProvinceLanzhou UniversityLanzhouChina
- Lanzhou University GRADE CenterLanzhouChina
- Lanzhou UniversityAffiliate of the Cochrane China NetworkLanzhouChina
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17
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Di Stadio A, D’Ascanio L, Vaira LA, Cantone E, De Luca P, Cingolani C, Motta G, De Riu G, Vitelli F, Spriano G, De Vincentiis M, Camaioni A, La Mantia I, Ferreli F, Brenner MJ. Ultramicronized Palmitoylethanolamide and Luteolin Supplement Combined with Olfactory Training to Treat Post-COVID-19 Olfactory Impairment: A Multi-Center Double-Blinded Randomized Placebo- Controlled Clinical Trial. Curr Neuropharmacol 2022; 20:2001-2012. [PMID: 35450527 PMCID: PMC9886808 DOI: 10.2174/1570159x20666220420113513] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/23/2022] [Accepted: 04/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Olfactory training is the only evidence-based treatment for post-viral olfactory dysfunction. Smell disorders after SARS-CoV-2 infection have been attributed to neuroinflammatory events within the olfactory bulb and the central nervous system. Therefore, targeting neuroinflammation is one potential strategy for promoting recovery from post-COVID-19 chronic olfactory dysfunction. Palmitoylethanolamide and luteolin (PEA-LUT) are candidate antiinflammatory/ neuroprotective agents. OBJECTIVE To investigate recovery of olfactory function in patients treated with PEA-LUT oral supplements plus olfactory training versus olfactory training plus placebo. METHODS Multicenter double-blinded randomized placebo-controlled clinical trial was held. Eligible subjects had prior COVID-19 and persistent olfactory impairment >6 months after follow-up SARS-CoV-2 negative testing, without prior history of olfactory dysfunction or other sinonasal disorders. Participants were randomized to daily oral supplementation with ultramicronized PEA-LUT 770 mg plus olfactory training (intervention group) or olfactory training with placebo (control). Sniffin' Sticks assessments were used to test the patients at baseline and 90 days. RESULTS A total of 185 patients, including intervention (130) and control (55) were enrolled. The intervention group showed significantly greater improvement in olfactory threshold, discrimination, and identification scores compared to controls (p=0.0001). Overall, 92% of patients in the intervention group improved versus 42% of controls. Magnitude of recovery was significantly greater in the intervention group versus control (12.8 + 8.2 versus mean 3.2 + 3), with >10-fold higher prevalence of anosmia in control versus intervention groups at the 90-day endpoint. CONCLUSION Among individuals with olfactory dysfunction post-COVID-19, combining PEA-LUT with olfactory training resulted in greater recovery of smell than olfactory training alone.
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Affiliation(s)
- Arianna Di Stadio
- Address correspondence to this author at the University of Catania, Otolaryngology Department, Catania, Italy; E-mail:
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18
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Ferreli F, Gaino F, Russo E, Di Bari M, Rossi V, De Virgilio A, Malvezzi L, Colombo G, Cristalli G, Spriano G, Mercante G. Long-standing gustatory and olfactory dysfunction in COVID-19 patients: a prospective study. Eur Arch Otorhinolaryngol 2022; 279:4633-4640. [PMID: 35767055 PMCID: PMC9244308 DOI: 10.1007/s00405-022-07428-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunction (OD) in COVID-19 patients, and to analyze variables associated with early or late recovery. Methods Telephone surveys were administered during an 18-month follow-up after COVID-19 diagnosis. One hundred and thirty-two included patients rated olfactory and gustatory function at each follow-up. Results One hundred and twenty-nine patients reported GD, of whom 91 (70.5%) reported severe GD, and 99 patients reported OD, of whom 84 (84.9%) reported severe OD. Seventy-two/129 (55.8%) and 52/99 (52.5%) patients reported an improvement in GD and in OD during the first 7 days from the onset, respectively. At 3-month follow-up, 110/120 patients (85.3%) recovered from GD, while 80/99 patients (80.8%) recovered from OD. At 18-month follow-up, a total of 120/129 patients (93.0%) recovered from GD and 86/99 patients (86.9%) recovered from OD; while 10 patients (7.0%) still reported GD and 13 patients (13.1%) still reported OD. Severe GD/OD at presentation were associated with late complete recovery of taste/smell (p = 0.019 and p = 0.034, respectively). Improvement over the first 7 days from onset was significantly associated with faster recovery (p < 0.001). Conclusions More than 80% of patients reported complete recovery of olfactory/gustatory function in the first 3 months after symptom onset. At 18-month follow-up, patients reporting complete recovery of gustatory and olfactory function were 93% and 87%, respectively. Severity of chemosensory dysfunction at the onset was negatively correlated to recovery, and improvement of taste and/or smell function within the first 7 days from symptom onset was significantly associated with early resolution.
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Affiliation(s)
- Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Francesca Gaino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy. .,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy.
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Matteo Di Bari
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vanessa Rossi
- Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giovanni Colombo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giovanni Cristalli
- Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta", Padua, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
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19
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Awwad AA, Abd Elhay OMM, Rabie MM, Awad EA, Kotb FM, Maghraby HM, Eldamarawy RH, Dawood YMA, Balat MIEI, Hasan AIM, Elsheshiny AH, El Sayed SSMM, Fouda AAB, Alkot AMF. Impact of Systemic Diseases on Olfactory Function in COVID-19 Infected Patients. Int J Gen Med 2022; 15:5681-5691. [PMID: 35747780 PMCID: PMC9212789 DOI: 10.2147/ijgm.s355974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background COVID-19 (SARS-CoV-2/2019-nCoV) is now a major public health threat to the world. Olfactory dysfunctions (ODs) are considered potential indicating symptoms and early case identification triaging for coronavirus disease 2019 (COVID-19). The most common reported comorbidities are diabetes mellitus, chronic lung disease, and cardiovascular disease. The objective of this study was to evaluate prevalence of different types of smell disorders in patients with laboratory-confirmed COVID-19 infection and impact of involved systemic diseases. Methodology A cross-sectional retrospective study has been done for patients with laboratory-confirmed COVID-19 infection (mild-to-moderate). The data collected from patient's files and developed online electronic questionnaire (WhatsApp) based on the patients most common and recurrent reported data including: a) symptoms of olfactory dysfunction and associated covid19 symptoms fever and headache, cough, sore throat, pneumonia, nausea, vomiting and diarrhea, arthralgia and myalgia and taste dysfunction. b) Associated systemic diseases including: diabetes, hypertension, asthma, chronic renal disease, chorionic liver disease and hypothyroidism. Results Of 308 patients confirmed with Covid-19 infection, (72.4%) developed OD distributed as follows; complete anosmia (57.8%), troposmia (8.4%), hyposmia (2.9%), partial anosmia (2.6%) and euosmia (0.6%). Significantly increased prevalence of diabetes, hypertension asthma in the group with olfactory dysfunction (p < 0.001), chronic liver disease (p = 0.005), and hypothyroidism (p = 0.03). Conclusion The development of ODs after Covid-19 infection was associated with mild disease form and lower hospitalization. In addition, it showed significant relationship with preexisting systemic diseases. Anosmia is the common modality of ODs.
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Affiliation(s)
- Ayat A Awwad
- Otorhinolaryngology department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Osama M M Abd Elhay
- Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Moustafa M Rabie
- Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Eman A Awad
- Internal medicine department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Fatma M Kotb
- Internal medicine department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hend M Maghraby
- Internal medicine department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Rmadan H Eldamarawy
- Internal medicine department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Yahia M A Dawood
- Otorhinolaryngology department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mostafa I E I Balat
- Otorhinolaryngology department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed I M Hasan
- Pediatric Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed H Elsheshiny
- Neurology department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Said S M M El Sayed
- Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Albayoumi A B Fouda
- Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmad M F Alkot
- Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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20
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Hans M, Hans VM, Kahlon N, Sagar M, Pandey AK, Das A. Gustatory dysfunction and oral ulceration in COVID-19 patients: A cross sectional study. Dent Res J (Isfahan) 2022; 19:43. [PMID: 35915715 PMCID: PMC9338349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 11/16/2021] [Accepted: 01/24/2022] [Indexed: 11/05/2022] Open
Abstract
Background Over the past year, patients infected by severe acute respiratory syndrome coronavirus-2 presented with severe gustatory dysfunction, the prevalence of which varies among different populations. Furthermore, there have been sporadic reports of oral ulceration observed in coronavirus disease-19 (COVID-19) patients due to varied reasons. The aim of this study was to investigate and characterize the presence of gustatory disorders, oral ulceration, and other oral changes in patients with laboratory-confirmed COVID-19 infection. Materials and Methods In this cross-sectional observational study, a total of 402 participants who were detected COVID-19 positive by reverse transcription-polymerase chain reaction were included. Their demographic and clinical data were recorded through hospital records. The participants were interviewed either in person or on the telephone to record any change in taste and/or changes within the oral cavity. t-test for independent means was used to compare mean age, while other characteristics were compared by Chi-square test and Z-score test. P < 0.05 was taken as significant. Results Out of the total sample of 402 individuals, 262 were male and 140 were female. The prevalence of gustatory dysfunction and oral ulceration was 43.53% and 15.67%, respectively, in the studied sample. Significantly more females had gustatory dysfunction than males and older subjects more commonly than younger. The symptom of loss/change of taste and oral ulceration were more probable to occur together. In addition, the tongue was the most common site for ulceration in our studied sample. Conclusion Loss of taste is a common symptom of COVID-19 patients, whereas oral ulceration is not so commonly reported. However, the presence of both these symptoms could impair the quality of life of patients and hamper adequate nutritional uptake.
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Affiliation(s)
- Mayank Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Veenu Madaan Hans
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India,Address for correspondence: Dr. Veenu Madaan Hans, Department of Dentistry, ESIC Medical College and Hospital, NIT-3, Faridabad, Haryana, India. E-mail:
| | - Namrata Kahlon
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Mayank Sagar
- Department of Dentistry, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Anil Kumar Pandey
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Asim Das
- Department of Physiology, ESIC Medical College and Hospital, Faridabad, Haryana, India
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21
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Vasconcelos CCF, Hammerle MB, Sales DS, Rueda Lopes FC, Pinheiro PG, Gouvea EG, Alves MCDF, Pereira TV, Schmidt SL, Alvarenga RMP, Pires KL. Post-COVID-19 olfactory dysfunction: carbamazepine as a treatment option in a series of cases. J Neurovirol 2022; 28:312-318. [PMID: 35366736 PMCID: PMC8976535 DOI: 10.1007/s13365-022-01066-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/24/2022]
Abstract
Olfactory dysfunction is reported frequently in patients with coronavirus disease 2019. However, an effective treatment for this dysfunction is unknown. The present study evaluated carbamazepine as a treatment option for olfactory dysfunction based on its use in cases of neuralgia, especially of the V cranial nerve. The study included 10 patients with coronavirus disease with olfactory complaints who were part of a cohort of 172 coronavirus disease patients monitored for late neurological manifestations. Carbamazepine was administered for 11 weeks. The adverse effects reported were drowsiness (9/10) and dizziness (2/10); 9 of the 10 patients reported improved olfactory function after carbamazepine treatment. While the role of carbamazepine in the control of post-coronavirus disease olfactory dysfunction could not be confirmed in this study, the satisfactory response observed in most patients in this series suggests that further studies are warranted.
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Affiliation(s)
- Claudia Cristina Ferreira Vasconcelos
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Mariana Beiral Hammerle
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil.
| | - Deborah Santos Sales
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Fernanda Cristina Rueda Lopes
- Departamento de Radiologia, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil
- Diagnósticos da América S/A (DASA), São Paulo, Brazil
| | - Patricia Gomes Pinheiro
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Elisa Gutman Gouvea
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Manuella Caroline Dutra Frazão Alves
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Tayane Vasconcellos Pereira
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Sergio Luis Schmidt
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Regina Maria Papais Alvarenga
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
| | - Karina Lebeis Pires
- Departamento de Neurologia, Hospital Universitário Gaffrée E Guinle/HUGG Programa de Pós Graduação Em Neurologia da Universidade Federal Do Estado Do Rio de Janeiro (UNIRIO), 775 Mariz e Barros St, Tijuca, Rio de Janeiro, RJ, 22.270-004, Brazil
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22
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Sharma R, Rana A, Sharma V, Mehrotra A, Babu H, Gupta S, Singh R, Tyagi A, Sethi N, Bhatt P, Yadav V, Chopra P, Upadhyay D. Clinical correlation and assessment of olfactory dysfunction with n-butanol in COVID-19 patients: our experience. RHINOLOGY ONLINE 2022. [DOI: 10.4193/rhinol/21.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Studies showed olfactory disturbances in COVID patients. This has attracted focus of clinicians as an easy clinical screening tool in suspected population. Material and methods: 70 mild and moderate category COVID-19 RT-PCR positive patients, more than 10 years of age were tested on day of admission for olfaction with serial dilution of n-butanol and asked to grade severity of their olfactory dysfunction according to visual analogue score from 1-10. Results: Fatigue 42 (93.33%), sore throat 37 (82.22%), fever 36 (80%) and dyspnea 23 (51.11%) were the most common symptoms in moderate patients. Diabetes, hypertension and allergy were the three prominent risk factors. At time of admission, n-butanol diagnosed 20 patients having olfactory dysfunction compared to 11 by VAS. Patients tend to grade their dysfunction higher on VAS whereas the n-butanol test classified their olfactory dysfunction lower. Viral load and high CRP were not found to be significantly related with olfactory dysfunction. d-Dimer and LDH levels were found statistically associated with higher grading of olfactory dysfunction detected by n-butanol. Conclusion: The majority of cases developed hyposmia before they were admitted to hospital even before they realized that they were having hyposmia as revealed by n-butanol testing. We should go for objective tests of olfaction.
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23
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Bansal R, Gubbi S, Koch CA. COVID-19 and chronic fatigue syndrome: An endocrine perspective. J Clin Transl Endocrinol 2022; 27:100284. [PMID: 34877261 PMCID: PMC8641402 DOI: 10.1016/j.jcte.2021.100284] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/13/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022] Open
Abstract
Patients recovering from COVID-19 may have persistent debilitating symptoms requiring long term support through individually tailored cardiopulmonary and psychological rehabilitation programs. Clinicians need to be aware about the likely long-term complications and their diagnostic assessments to help identify any occult problems requiring additional help. Endocrinological evaluations should be considered as part of the armamentarium in the management of such individuals with diligent cognizance about the involvement of the hypothalamo-pituitary-adrenal (HPA) axis, adrenal and thyroid function. We here review the literature and potential pathophysiological mechanisms involved in and related to post COVID-19 symptoms with an emphasis on endocrine function.
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Affiliation(s)
- Rashika Bansal
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Sriram Gubbi
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Christian A. Koch
- Department of Medicine, Fox Chase Cancer Center, Philadelphia, PA, United States
- Dept of Medicine/Endocrinology, The University of Tennessee Health Science Center, Memphis, TN, United States
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Gupta S, Kallogjeri D, Farrell NF, Lee JJ, Smith HJ, Khan AM, Piccirillo JF. Development and Validation of a Novel At-home Smell Assessment. JAMA Otolaryngol Head Neck Surg 2022; 148:252-258. [PMID: 35024772 PMCID: PMC8759030 DOI: 10.1001/jamaoto.2021.3994] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/15/2021] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Current tools for diagnosis of olfactory dysfunction (OD) are costly, time-consuming, and often require clinician administration. OBJECTIVE To develop and validate a simple screening assessment for OD using common household items. DESIGN, SETTING, AND PARTICIPANTS This fully virtual diagnostic study included adults with self-reported OD from any cause throughout the US. Data were collected from December 2020 to April 2021 and analyzed from May 2021 to July 2021. MAIN OUTCOMES AND MEASURES Participants with self-reported olfactory dysfunction took a survey assessing smell perception of 45 household items and completed the Clinical Global Impression-Severity (CGI-S) smell questionnaire, the University of Pennsylvania Smell Identification Test (UPSIT), and the 36-item Short Form Survey (SF-36). Psychometric and clinimetric analyses were used to consolidate 45 household items into 2 short Novel Anosmia Screening at Leisure (NASAL) assessments, NASAL-7 (range, 0-14; lower score indicating greater anosmia) and NASAL-3 (range, 0-6; lower score indicating greater anosmia). RESULTS A total of 115 participants were included in the study, with a median (range) age of 42 (19-70) years, 92 (80%) women, and 97 (84%) White individuals. There was a moderate correlation between the UPSIT and NASAL-7 scores and NASAL-3 scores (NASAL-7: ρ = 0.484; NASAL-3: ρ = 0.404). Both NASAL-7 and NASAL-3 had moderate accuracy in identifying participants with anosmia as defined by UPSIT (NASAL-7 area under the receiver operating curve [AUC], 0.706; 95% CI, 0.551-0.862; NASAL-3 AUC, 0.658; 95% CI, 0.503-0.814). Scoring 7 or less on the NASAL-7 had 70% (95% CI, 48%-86%) sensitivity and 53% (95% CI, 43%-63%) specificity in discriminating participants with anosmia from participants without. Scoring 2 or less on the NASAL-3 had 57% (95% CI, 36%-76%) sensitivity and 78% (95% CI, 69%-85%) specificity in discriminating participants with anosmia from participants without. There was moderate agreement between UPSIT-defined OD categories and those defined by NASAL-7 (weighted κ = 0.496; 95% CI, 0.343-0.649) and those defined by NASAL-3 (weighted κ = 0.365; 95% CI, 0.187-0.543). The agreement with self-reported severity of olfactory dysfunction as measured by CGI-S and the NASAL-7 and NASAL-3 was moderate, with a weighted κ of 0.590 (95% CI, 0.474-0.707) for the NASAL-7 and 0.597 (95% CI, 0.481-0.712) for the NASAL-3. CONCLUSION AND RELEVANCE The findings of this diagnostic study suggest that NASAL-7 and NASAL-3, inexpensive and brief patient-reported assessments, can be used to identify individuals with OD. As the burden of COVID-19-associated OD increases, these assessments may prove beneficial as screening and diagnostic tools. Future work will explore whether the NASAL assessments are sensitive to change and how much of a change is clinically important.
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Affiliation(s)
- Shruti Gupta
- Medical College of Georgia, Augusta
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Statistical Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Nyssa F. Farrell
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jake J. Lee
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Harrison J. Smith
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- New York Medical College, Valhalla
| | - Amish M. Khan
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor, JAMA Otolaryngology–Head & Neck Surgery
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Tsuchiya H. Gustatory and Saliva Secretory Dysfunctions in COVID-19 Patients with Zinc Deficiency. Life (Basel) 2022; 12:life12030353. [PMID: 35330104 PMCID: PMC8950751 DOI: 10.3390/life12030353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/22/2022] Open
Abstract
Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients.
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Ferreli F, Gaino F, Russo E, Di Bari M, Rossi V, De Virgilio A, Di Stadio A, Spriano G, Mercante G. Long-term olfactory dysfunction in COVID-19 patients: 18-month follow-up study. Int Forum Allergy Rhinol 2022; 12:1078-1080. [PMID: 35199476 PMCID: PMC9082048 DOI: 10.1002/alr.22990] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/26/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Francesca Gaino
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Matteo Di Bari
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Vanessa Rossi
- Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Arianna Di Stadio
- Dipartimento GF Ingrassia, Otorinolaringoiatria, Università di Catania, Sicilia, Catania, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Otorhinolaryngology-Head and Neck Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
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Relationship between Recovery from COVID-19-Induced Smell Loss and General and Oral Health Factors. Medicina (B Aires) 2022; 58:medicina58020283. [PMID: 35208609 PMCID: PMC8877343 DOI: 10.3390/medicina58020283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 01/22/2023] Open
Abstract
Background and Objectives: Loss of smell is one of the strongest predictors of coronavirus disease 2019 (COVID-19) and can persist long after other symptoms have resolved. “Long” cases (>28 days) of smell dysfunction present future challenges to medical and dental professionals, as there is a lack of evidence on the causes and any exacerbating or relieving factors. This study aimed to explore the persistence of COVID-19-induced smell loss and association with physical, lifestyle and oral health factors. Materials and Methods: This study was a cross-sectional survey of 235 participants. Recovery of smell was explored, comparing rapid recovery (≤28 days) with prolonged recovery (>28 days). Associative factors included age, sex, illness severity, diet, BMI, vitamin D supplementation, antidepressants, alcohol use, smoking, brushing frequency, flossing, missing teeth, appliances and number of dental restorations. Results: Smell loss showed 87% resolution within 30 days. Prolonged smell loss was significantly associated with older age (mean ± 95%, CI = 31.53 ± 1.36 years for rapid recovery vs. mean ± 95%, CI = 36.0 ± 3 years for prolonged recovery, p = 0.003) and increased self-reported illness severity (mean ± 95%, CI = 4.39 ± 0.27 for rapid recovery vs. 5.01 ± 0.54 for prolonged recovery, p = 0.016). Fisher’s exact test revealed flossing was associated with rapid recovery, with flossers comprising 75% of the rapid-recovery group, compared to 56% in the prolonged-recovery group (odds ratio ± 95%, CI = 2.26 (1.23–4.15), p = 0.01). All other factors were not significantly associated (p > 0.05). Conclusions: Increased age and illness severity were associated with prolonged smell recovery. Use of floss was the only modifiable factor associated with rapid recovery of smell loss. As 87% of cases resolve within 30 days, future studies may benefit from targeted recruitment of individuals experiencing prolonged sense loss. This would increase statistical confidence when declaring no association with the other factors assessed, avoiding type II errors.
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Baiardini I, Paoletti G, Mariani A, Malvezzi L, Pirola F, Spriano G, Mercante G, Puggioni F, Racca F, Melone G, Malipiero G, Ferri S, Canonica GW, Heffler E. Nasal Polyposis Quality of Life (NPQ): Development and Validation of the First Specific Quality of Life Questionnaire for Chronic Rhinosinusitis with Nasal Polyps. Healthcare (Basel) 2022; 10:healthcare10020253. [PMID: 35206869 PMCID: PMC8871881 DOI: 10.3390/healthcare10020253] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
To date, no disease-specific tool has been available to assess the impact of chronic rhinosinusitis with nasal polyps (CRSwNP) on health-related quality of life (HRQoL). Therefore, the purpose of this study was to develop and validate a questionnaire specifically designed to this aim: the Nasal Polyposis Quality of Life (NPQ) questionnaire. As indicated in the current guidelines, the development and validation of the NPQ occurred in two separate steps involving different groups of patients. The questionnaire was validated by assessing internal structure, consistency, and validity. Responsiveness and sensitivity to changes were also evaluated. In the development process of NPQ an initial list of 40 items was given to 60 patients with CRSwNP; the 27 most significant items were selected and converted into questions. The validation procedure involved 107 patients (mean age 52.9 ± 12.4). NPQ revealed a five-dimensional structure and high levels of internal consistency (Cronbach’s alpha 0.95). Convergent validity (Spearman’ coefficient r = 0.75; p < 0.01), discriminant validity (sensitivity to VAS score), and reliability in a sample of patients with a stable health status (Interclass Coefficient 0.882) were satisfactory. Responsiveness to clinical changes was accomplished. The minimal important difference was 7. NPQ is the first questionnaire for the assessment of HRQoL in CRSwNP. Our results demonstrate that the new tool is valid, reliable, and sensitive to individual changes.
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Affiliation(s)
- Ilaria Baiardini
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Giovanni Paoletti
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
- Correspondence: ; Tel.: +39-02-2440-1821; Fax: +39-02-3440-6684
| | - Alessia Mariani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Luca Malvezzi
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (L.M.); (F.P.)
| | - Francesca Pirola
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (L.M.); (F.P.)
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (L.M.); (F.P.)
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (L.M.); (F.P.)
| | - Francesca Puggioni
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Francesca Racca
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
| | - Giulio Melone
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Giacomo Malipiero
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
| | - Sebastian Ferri
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Giorgio Walter Canonica
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
| | - Enrico Heffler
- Personalized Medicine Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, 20089 Milan, Italy; (I.B.); (F.P.); (F.R.); (G.M.); (S.F.); (G.W.C.); (E.H.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy; (A.M.); (G.S.); (G.M.); (G.M.)
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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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Park GC, Bang SY, Lee HW, Choi KU, Kim JM, Shin SC, Cheon YI, Sung ES, Lee M, Lee JC, Kim HS, Lee BJ. ACE2 and TMPRSS2 immunolocalization and oral manifestations of COVID-19. Oral Dis 2022; 28 Suppl 2:2456-2464. [PMID: 35000261 DOI: 10.1111/odi.14126] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/07/2021] [Accepted: 01/04/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry into the host cells depends on the expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2). We investigated the distribution of ACE2- and TMPRSS2-expressing cells in various oral tissues to identify the underlying mechanism of oral manifestations in patients with coronavirus disease 2019. Subjects We analysed the expression patterns of ACE2 and TMPRSS2 in the oral mucosa (tongue, palate, and buccal mucosa), trigeminal ganglion, vessels, and salivary glands of 9 Sprague-Dawley rats using immunohistochemistry and immunofluorescence. RESULTS ACE2 and TMPRSS2 were strongly expressed in the intermediate layer of the squamous epithelia of tongue papillae and buccal mucosa. ACE2- and TMPRSS2-positive cells were observed in the taste buds of the tongue. Additionally, ACE2 and TMPRSS2 were co-expressed in the ductal epithelium and acinar cells of salivary glands. Furthermore, both ACE2 and TMPRSS2 were stained in the neuronal cell body of trigeminal ganglia, but not in Schwann cells. Moreover, ACE2 and TMPRSS2 were expressed in capillaries, but not in venules/arterioles. CONCLUSIONS SARS-CoV-2 can spread the suprabasal area of squamous epithelia of the oral mucosa, invades taste bud, trigeminal nerve, parotid gland, and microvessel, resulting in oral manifestations.
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Affiliation(s)
- Gi Cheol Park
- Department of Otolaryngology - Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Soo-Young Bang
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyoun Wook Lee
- Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Kyung Un Choi
- Department of Pathology, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Min Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Yong-Il Cheon
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Eui-Suk Sung
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Minhyung Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jin-Choon Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National University and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyung-Sik Kim
- Department of Life Science in Dentistry, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Byung-Joo Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Pusan National Universtiy and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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García-Escobar A, Vera-Vera S, Jurado-Román A, Jiménez-Valero S, Galeote G, Moreno R. Calcium Signaling Pathway Is Involved in the Shedding of ACE2 Catalytic Ectodomain: New Insights for Clinical and Therapeutic Applications of ACE2 for COVID-19. Biomolecules 2022; 12:biom12010076. [PMID: 35053224 PMCID: PMC8774087 DOI: 10.3390/biom12010076] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 02/04/2023] Open
Abstract
The angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that exists in two forms: the first is a transmembrane protein; the second is a soluble catalytic ectodomain of ACE2. The catalytic ectodomain of ACE2 undergoes shedding by a disintegrin and metalloproteinase domain-containing protein 17 (ADAM17), in which calmodulin mediates the calcium signaling pathway that is involved in ACE2 release, resulting in a soluble catalytic ectodomain of ACE2 that can be measured as soluble ACE2 plasma activity. The shedding of the ACE2 catalytic ectodomain plays a role in cardiac remodeling and endothelial dysfunction and is a predictor of all-cause mortality, including cardiovascular mortality. Moreover, considerable evidence supports that the ACE2 catalytic ectodomain is an essential entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Additionally, endotoxins and the pro-inflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNFα) all enhanced soluble catalytic ectodomain ACE2 shedding from the airway epithelia, suggesting that the shedding of ACE2 may represent a mechanism by which viral entry and infection may be controlled such as some types of betacoronavirus. In this regard, ACE2 plays an important role in inflammation and thrombotic response, and its down-regulation may aggravate COVID-19 via the renin-angiotensin system, including by promoting pathological changes in lung injury. Soluble forms of ACE2 have recently been shown to inhibit SARS-CoV-2 infection. Furthermore, given that vitamin D enhanced the shedding of ACE2, some studies reported that vitamin D treatment is associated with prognosis improvement in COVID-19. This is an updated review on the evidence, clinical, and therapeutic applications of ACE2 for COVID-19.
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Affiliation(s)
- Artemio García-Escobar
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-917-27-70-00
| | - Silvio Vera-Vera
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfonso Jurado-Román
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Santiago Jiménez-Valero
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Guillermo Galeote
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Raúl Moreno
- Cardiology Department, Interventional Cardiology Section, University Hospital La Paz, 28046 Madrid, Spain; (S.V.-V.); (A.J.-R.); (S.J.-V.); (G.G.); (R.M.)
- Instituto de Investigación Hospital La Paz (IDIPAZ), 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
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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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34
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Zhukova NG, Kicherov NA, Semykin ME. [Gustatory disorders in COVID-19]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:23-31. [PMID: 36537627 DOI: 10.17116/jnevro202212212123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Taste disturbances are present in 20.3-88.0% of COVID-19 cases and are the first signs of infection in 11.0-18.1% of cases. They often manifested 3-7 days after the onset of general respiratory symptoms and last 2 to 16 days, followed by recovery. There are also prolonged disturbances of taste sensation (up to 61-76 days or more), which is associated with damage to various types of receptor cells of the mucous membrane of the tongue. More severe taste disturbances are recorded in the elderly. In women, changes in taste sensation are noted more often than in men, and with a longer recovery period. Severe and critical forms of taste disorders predominate in COVID-19; dysgeusia, as a rule, prevails over hypogeusia and ageusia. Taste disturbance is a common clinical symptom in COVID-19, which can and should be considered as a marker of early manifestation of coronavirus infection.
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Affiliation(s)
- N G Zhukova
- Siberian State Medical University» Ministry of Health of Russia, Tomsk, Russia
| | - N A Kicherov
- Siberian State Medical University» Ministry of Health of Russia, Tomsk, Russia
| | - M E Semykin
- Siberian State Medical University» Ministry of Health of Russia, Tomsk, Russia
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35
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Maiorano E, Calastri A, Robotti C, Cassaniti I, Baldanti F, Zuccaro V, Stellin E, Ferretti VV, Klersy C, Benazzo M. Clinical, virological and immunological evolution of the olfactory and gustatory dysfunction in COVID-19. Am J Otolaryngol 2022; 43:103170. [PMID: 34391165 PMCID: PMC8349441 DOI: 10.1016/j.amjoto.2021.103170] [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: 06/22/2021] [Accepted: 08/01/2021] [Indexed: 02/07/2023]
Abstract
Purpose New-onset olfactory and gustatory dysfunction (OGD) represents a well-acknowledged COVID-19 red flag. Nevertheless, its clinical, virological and serological features are still a matter of debate. Materials and methods For this cohort study, 170 consecutive subjects with new-onset OGD were consecutively recruited. Otolaryngological examination, OGD subjective grading, nasopharyngeal swabs (NS) for SARS-CoV-2 RNA detection and serum samples (SS) collection for SARS-CoV-2 IgG quantification were conducted at baseline and after one (T1), two (T2) and four weeks (T3). Results SARS-CoV-2 infection was confirmed in 79% of patients. Specifically, 43% of positive patients were detected only by SS analysis. The OGD was the only clinical complaint in 10% of cases. Concurrent sinonasal symptoms were reported by 45% of patients. Subjective improvement at T3 was reported by 97% of patients, with 40% recovering completely. Hormonal disorders and RNA detectability in NS were the only variables associated with OGD severity. Recovery rate was higher in case of seasonal influenza vaccination, lower in patients with systemic involvement and severe OGD. Not RNA levels nor IgG titers were correlated with recovery. Conclusion Clinical, virological and serological features of COVID-19 related OGD were monitored longitudinally, offering valuable hints for future research on the relationship between host characteristics and chemosensory dysfunctions.
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36
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du Preez HN, Aldous C, Hayden MR, Kruger HG, Lin J. Pathogenesis of COVID-19 described through the lens of an undersulfated and degraded epithelial and endothelial glycocalyx. FASEB J 2021; 36:e22052. [PMID: 34862979 DOI: 10.1096/fj.202101100rr] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022]
Abstract
The glycocalyx surrounds every eukaryotic cell and is a complex mesh of proteins and carbohydrates. It consists of proteoglycans with glycosaminoglycan side chains, which are highly sulfated under normal physiological conditions. The degree of sulfation and the position of the sulfate groups mainly determine biological function. The intact highly sulfated glycocalyx of the epithelium may repel severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) through electrostatic forces. However, if the glycocalyx is undersulfated and 3-O-sulfotransferase 3B (3OST-3B) is overexpressed, as is the case during chronic inflammatory conditions, SARS-CoV-2 entry may be facilitated by the glycocalyx. The degree of sulfation and position of the sulfate groups will also affect functions such as immune modulation, the inflammatory response, vascular permeability and tone, coagulation, mediation of sheer stress, and protection against oxidative stress. The rate-limiting factor to sulfation is the availability of inorganic sulfate. Various genetic and epigenetic factors will affect sulfur metabolism and inorganic sulfate availability, such as various dietary factors, and exposure to drugs, environmental toxins, and biotoxins, which will deplete inorganic sulfate. The role that undersulfation plays in the various comorbid conditions that predispose to coronavirus disease 2019 (COVID-19), is also considered. The undersulfated glycocalyx may not only increase susceptibility to SARS-CoV-2 infection, but would also result in a hyperinflammatory response, vascular permeability, and shedding of the glycocalyx components, giving rise to a procoagulant and antifibrinolytic state and eventual multiple organ failure. These symptoms relate to a diagnosis of systemic septic shock seen in almost all COVID-19 deaths. The focus of prevention and treatment protocols proposed is the preservation of epithelial and endothelial glycocalyx integrity.
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Affiliation(s)
- Heidi N du Preez
- Catalysis and Peptide Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Colleen Aldous
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Melvin R Hayden
- Division of Endocrinology Diabetes and Metabolism, Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA.,Diabetes and Cardiovascular Disease Center, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA
| | - Hendrik G Kruger
- Catalysis and Peptide Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Johnson Lin
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
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Higo H, Taguchi Y, Suzaki N, Nagata T, Marukawa M. Indications for SARS-CoV-2 nucleic acid amplification test for areas with low endemicity. J Infect Chemother 2021; 28:238-241. [PMID: 34776347 PMCID: PMC8576171 DOI: 10.1016/j.jiac.2021.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/11/2021] [Accepted: 10/30/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The optimal indication for the nucleic acid amplification test (NAAT) in areas with low endemicity for coronavirus disease 2019 (COVID-19) is unclear. This study aimed to identify patients who should undergo the NAAT for COVID-19 diagnosis. METHODS We retrospectively analyzed the clinical data of patients with suspected COVID-19 who underwent NAAT between October 5, 2020, and May 31, 2021 in our institution. RESULTS A total of 1238 patients were enrolled and NAAT positive results were observed in 40 patients (3.2%). The NAAT positivity rate was 34.3% (23/67) in patients with a history of close contact and 1.5% (17/1171) in patients without a history of close contact. Olfactory/gustatory dysfunction and a history of stay in other prefectures were independent risk factors of COVID-19 in patients without a history of close contact. On the other hand, the NAAT positivity rate was only 0.7% (8/1073) in patients without olfactory/gustatory dysfunction and a history of stay in other prefectures. Among them, the group without respiratory symptoms/sign had only one NAAT-positive case (0.1%: 1/1073). CONCLUSIONS This study revealed that a history of close contact, olfactory/gustatory dysfunction, and a history of stay in other prefectures are key eligibility criteria for NAAT in areas with relatively few patients with COVID-19. On the other hand, NAAT may not be necessary in cases without all of these factors and respiratory symptoms/sign.
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Affiliation(s)
- Hisao Higo
- Department of Internal Medicine, Kagawa Rosai Hospital, Kagawa, Japan.
| | - Yoshinori Taguchi
- Department of Internal Medicine, Kagawa Rosai Hospital, Kagawa, Japan
| | - Noriyuki Suzaki
- Department of Internal Medicine, Kagawa Rosai Hospital, Kagawa, Japan
| | - Takuya Nagata
- Department of Internal Medicine, Kagawa Rosai Hospital, Kagawa, Japan
| | - Masaomi Marukawa
- Department of Internal Medicine, Kagawa Rosai Hospital, Kagawa, Japan
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38
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Kavaz E, Tahir E, Kurnaz SÇ, Deveci A, Tanyel EA. Clinical, Prognostic, and Predictive Value of Olfactory Dysfunction for COVID-19: A Prospective Controlled Study. Otolaryngol Head Neck Surg 2021; 167:187-196. [PMID: 34726987 DOI: 10.1177/01945998211057024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the effect of olfactory dysfunction on the course and severity of COVID-19 and its prognostic and predictive significance for COVID-19. STUDY DESIGN Prospective case-control study. SETTING Ondokuz Mayıs University School of Medicine. METHODS Reverse transcription polymerase chain reaction (PCR)-positive patients, patients with COVID-19-related symptoms who had a negative PCR result, and healthy controls were included in the study. Clinicodemographic characteristics, inflammatory markers, and computed tomography stages were recorded. Disease progression and intensive care unit admission were registered. The visual analog scale (0, worst; 10, best) was used to evaluate subjective olfactory, taste, and nasal breathing ability, and the Sniffin' Sticks identification (SS-ID) test was used for psychophysical olfactory assessment. RESULTS Mean SS-ID scores were significantly lower in the positive group (8.77) than in the negative (10.43) and healthy control (12.17) groups. VAS-smell scores were significantly lower and anosmia was more prevalent in PCR-positive patients (P < .01). SS-ID and VAS-smell scores were significantly correlated (r = 0.681, P < .001). The inflammatory parameters, pulmonary infiltration stage, disease progression, and ICU admission were not associated with SS-ID scores. A cutoff SS-ID score <9 resulted in 55.56% sensitivity in predicting COVID-19 positivity, and a cutoff VAS-smell score <8 yielded 72.22% sensitivity. CONCLUSION Olfactory dysfunction was detected objectively and subjectively in the PCR-positive group, and no difference was found in terms of taste function and nasal breathing. The severity and prognosis of COVID-19 are not exclusively dependent on olfactory dysfunction. The degree of olfactory dysfunction can be useful in predicting PCR positivity.
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Affiliation(s)
- Esra Kavaz
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Emel Tahir
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Senem Çengel Kurnaz
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Aydın Deveci
- Department of Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Esra Aksakal Tanyel
- Department of Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.09.21264771. [PMID: 34671775 PMCID: PMC8528083 DOI: 10.1101/2021.10.09.21264771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 35.34-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
- Department of Public Health, University of California Merced, Merced, CA 95348
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
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Piccirillo JF. JAMA Otolaryngology-Head & Neck Surgery-The Year in Review, 2020. JAMA Otolaryngol Head Neck Surg 2021; 147:415-417. [PMID: 33764390 DOI: 10.1001/jamaoto.2021.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
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41
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Goyal R, Kapoor A, Goyal MK, Singh R. Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India. Indian J Otolaryngol Head Neck Surg 2021; 73:371-377. [PMID: 34123736 PMCID: PMC8185497 DOI: 10.1007/s12070-021-02670-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September-November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.
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Affiliation(s)
- Rashmi Goyal
- Department of ENT, Jaipuria Hospital, RUHS-CMS, Jaipur, Rajasthan India
| | - Anju Kapoor
- Department of Paediatrics, Peoples College of Medical Sciences, Bhopal, MP India
| | | | - Rekha Singh
- RDBP Jaipuria Hospital, Jaipur, Rajasthan India
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Marino L, Suppa M, Rosa A, Servello A, Coppola A, Palladino M, Mazzocchitti AM, Bresciani E, Petramala L, Bertazzoni G, Pastori D. Time to hospitalisation, CT pulmonary involvement and in-hospital death in COVID-19 patients in an Emergency Medicine Unit. Int J Clin Pract 2021; 75:e14426. [PMID: 34076933 PMCID: PMC8236995 DOI: 10.1111/ijcp.14426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with coronavirus disease 2019 (COVID-19) are often treated at home given the limited healthcare resources. Many patients may have sudden clinical worsening and may be already compromised at hospitalisation. We investigated the burden of lung involvement according to the time to hospitalisation. METHODS In this observational cohort study, 55 consecutive COVID-19-related pneumonia patients were admitted to the Emergency Medicine Unit. Groups of lung involvement at computed tomography were classified as follows: 0 (<5%), 1 (5%-25%), 2 (26%-50%), 3 (51%-75%) and 4 (>75%). We also investigated in-hospital death and the predictive value of Yan-XGBoost model and PREDI-CO scores for death. RESULTS The median age was 74 years and 34 were men. Time to admission increased from 2 days in group 0 to 8.5-9 days in groups 3 and 4. A progressive increase in LDH, CRP and d-dimer was found across groups, while a decrease of lymphocytes paO2 /FiO2 ratio and SpO2 was found. Ten (18.2%) patients died during the in-hospital staying. Patients who died were older, with a trend to lower lymphocytes, a higher d-dimer, creatine phosphokinase and troponin T. The Yan-XGBoost model did not accurately predict in-hospital death with an AUC of 0.57 (95% confidence interval [CI] 0.37-0.76), which improved after the addition of the lung involvement groups (AUC 0.68, 95%CI 0.45-0.90). Conversely, a good predictive value was found for the original PREDI-CO score with an AUC of 0.76 (95% CI 0.58-0.93) which remained similar after the addition of the lung involvement (AUC 0.76, 95% CI 0.57-0.94). CONCLUSION We found that delayed hospital admission is associated with higher lung involvement. Hence, our data suggest that patients at risk for more severe disease, such as those with high LDH, CRP and d-dimer, should be promptly referred to hospital care.
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Affiliation(s)
- Luca Marino
- Department of Mechanical and Aerospace EngineeringSapienza University of RomeRomaItaly
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Marianna Suppa
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Antonello Rosa
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Adriana Servello
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Alessandro Coppola
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Mariangela Palladino
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Anna Maria Mazzocchitti
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Emanuela Bresciani
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Luigi Petramala
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Giuliano Bertazzoni
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
| | - Daniele Pastori
- Emergency Medicine UnitDepartment of Clinical, Internal, Anesthesiological and Cardiovascular SciencesSapienza University of RomeRomaItaly
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Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [Citation(s) in RCA: 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: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
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Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
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Cirillo N, Bizzoca ME, Lo Muzio E, Cazzolla AP, Lo Muzio L. Gustatory dysfunction in COVID-19 patients: a rapid systematic review on 27,687 cases. Acta Odontol Scand 2021; 79:418-425. [PMID: 33450165 DOI: 10.1080/00016357.2020.1869828] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: This is a rapid systematic review concerning taste alterations in 27,687 individuals infected with SARS-CoV-2, published in the worldwide literature.Material and methods: Of the 485 articles recovered, 67 eligible studies (27,687 confirmed COVID-19 cases) were included in this analysis. We analysed the prevalence of the taste alterations in patients considering the country of origin of the studies.Results: The results show strong important differences in the overall reported prevalence of taste alterations among the different countries (from 11% of Korea to 88.8% of Belgium).Conclusions: These data highlight that there is a different geographical distribution of taste alterations in COVID-19 patients. Gustatory dysfunction seems to be an understudied symptom of COVID-19 and this may explain the inconsistencies of diagnostic criteria for COVID-19 case definition. Furthermore, this diagnostic underestimation can lead to an increased risk of contagion for the whole population and for the working classes most at risk, including the dental one.
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Affiliation(s)
- Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
| | | | - Eleonora Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), Chieti, Italy
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Pyne JD, Brickman AM. The Impact of the COVID-19 Pandemic on Dementia Risk: Potential Pathways to Cognitive Decline. NEURODEGENER DIS 2021; 21:1-23. [PMID: 34348321 PMCID: PMC8678181 DOI: 10.1159/000518581] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/19/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19), the far-reaching pandemic, has infected approximately 185 million of the world's population to date. After infection, certain groups, including older adults, men, and people of color, are more likely to have adverse medical outcomes. COVID-19 can affect multiple organ systems, even among asymptomatic/mild severity individuals, with progressively worse damage for those with higher severity infections. SUMMARY The COVID-19 virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily attaches to cells through the angiotensin-converting enzyme 2 (ACE2) receptor, a universal receptor present in most major organ systems. As SARS-CoV-2 binds to the ACE2 receptor, its bioavailability becomes limited, thus disrupting homeostatic organ function and inducing an injury cascade. Organ damage can then arise from multiple sources including direct cellular infection, overactive detrimental systemic immune response, and ischemia/hypoxia through thromboembolisms or disruption of perfusion. In the brain, SARS-CoV-2 has neuroinvasive and neurotropic characteristics with acute and chronic neurovirulent potential. In the cardiovascular system, COVID-19 can induce myocardial and systemic vascular damage along with thrombosis. Other organ systems such as the lungs, kidney, and liver are all at risk for infection damage. Key Messages: Our hypothesis is that each injury consequence has the independent potential to contribute to long-term cognitive deficits with the possibility of progressing to or worsening pre-existing dementia. Already, reports from recovered COVID-19 patients indicate that cognitive alterations and long-term symptoms are prevalent. This critical review highlights the injury pathways possible through SARS-CoV-2 infection that have the potential to increase and contribute to cognitive impairment and dementia.
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Affiliation(s)
- Jeffrey D. Pyne
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Adam M. Brickman
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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Cirillo N. Taste alteration in COVID-19: Significant geographical differences exist in the prevalence of the symptom. J Infect Public Health 2021; 14:1099-1105. [PMID: 34274859 PMCID: PMC8266516 DOI: 10.1016/j.jiph.2021.07.002] [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: 01/25/2021] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 01/08/2023] Open
Abstract
Early detection of COVID-19 is important for reduction in the spread of the disease and gustatory disturbances (GD) are known to have a strong predictive value. In the present study, we aimed to map the geographical differences in the prevalence of GD in individuals infected with SARS-CoV-2 during the first wave of COVID-19 in order to improve case identification and to facilitate prioritization. We undertook a rapid scoping review of articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) and medRxiv from their inception until 3rd September, 2020. The minimum requirements for completing a restricted systematic review were fulfilled. Of the 431 articles retrieved, 61 studies (28,374 cases confirmed with COVID-19) from 20 countries were included in the analysis. GD were most prevalent in the Americas [66.78%, 95% CI 54.77–78.79%] compared to Europe [57.18%, 95% CI 52.35–62.01%], the Middle East [38.83%, 95% CI 27.47–50.19%] and East Asia [13.1%, 95% CI 0.14–26.06%]. No differences of GD prevalence were evident between February and August 2020. The data demonstrate that there is a marked geographical distribution of GD in COVID-19 patients which, possibly, might be explained by differences in diagnostic criteria for COVID-19 case definition during the early phase of the pandemic.
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Affiliation(s)
- Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, 720 Swanson Street, 3053 Carlton, Victoria, Australia.
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47
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Ambade V, Ambade S. “SARS-CoV-2 infection of endothelial cell, clinical laboratory and autopsy findings, and outcomes suggest role of hypoxia-inducible factor-1 in COVID-19”. J Med Biochem 2021; 41:14-20. [PMID: 35291496 PMCID: PMC8882013 DOI: 10.5937/jomb0-30659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/13/2021] [Indexed: 11/28/2022] Open
Abstract
Researchers around the world have experienced the dual nature of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), 'tragically lethal in some people while surprisingly benign in others'. There have been congregating studies of the novel coronavirus disease (COVID-19), a disease that mainly attacks the lungs but also has mystifying effects on the heart, kidneys and brain. Researchers are also gathering information to ascertain why people are dying of COVID-19, whether it is solely a respiratory disorder, a coagulation disorder or multi-organ failure. Alterations in laboratory parameters like lactate, ferritin and albumin have been established as risk factors and are associated with outcomes, yet none have not been sub stantiated with a scientific biochemical rationale. SARSCoV-2 affects the alveolar type II epithelial cells which significantly disturbs its surfactant homeostasis, deprives Na,K-ATPase of ATP, thereby disturbing the alveolar lining fluid which then gradually decreases the alveolar gaseous exchange initiating the intracellular hypoxic conditions. This activates AMP-activated kinase, which further inhibits Na,K-ATPase, which can progressively cause respiratory distress syndrome. The virus may infect endothelial cell (EC) which, being less energetic, cannot withstand the huge energy requirement towards viral replication. There - fore glycolysis, the prime energy generating pathway, must be mandatorily upregulated. This can be achieved by Hypoxia-inducible factor-1 (HIF-1). However, HIF-1 also activates transcription of von Willebrand factor, plasminogen activator inhibitor-1, and suppresses the release of thrombomodulin. This in turn sets off the coagulation cascade that can lead to in-situ pulmonary thrombosis and micro clots. The proposed HIF-1 hypothesis justifies various features, biochemical alteration, laboratory as well as autopsy findings such as respiratory distress syndrome, increased blood ferritin and lactate levels, hypoalbuminemia, endothelial invasion, in-situ pulmonary thrombosis and micro clots, and multi-organ failure in COVID-19.
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Affiliation(s)
- Vivek Ambade
- Senior Faculty, Department of Biochemistry, City Pune, State Maharashtra, India
| | - Sonia Ambade
- H V Desai College, Department of Microbiology, City Pune, State Maharashtra, India
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O'Hare AM, Berry K, Fan VS, Crothers K, Eastment MC, Dominitz JA, Shah JA, Green P, Locke E, Ioannou GN. Age differences in the association of comorbid burden with adverse outcomes in SARS-CoV-2. BMC Geriatr 2021; 21:415. [PMID: 34229623 PMCID: PMC8258273 DOI: 10.1186/s12877-021-02340-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 06/06/2021] [Indexed: 01/08/2023] Open
Abstract
Background Older age and comorbid burden are both associated with adverse outcomes in SARS-CoV-2, but it is not known whether the association between comorbid burden and adverse outcomes differs in older and younger adults. Objective To compare the relationship between comorbid burden and adverse outcomes in adults with SARS-CoV-2 of different ages (18–64, 65–79 and ≥ 80 years). Design, setting, and participants Observational longitudinal cohort study of 170,528 patients who tested positive for SARS-CoV-2 in the US Department of Veterans Affairs (VA) Health Care System between 2/28/20 and 12/31/2020 who were followed through 01/31/2021. Measurements Charlson Comorbidity Index (CCI); Incidence of hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death within 30 days of a positive SARS-CoV-2 test. Results The cumulative 30-day incidence of death was 0.8% in cohort members < 65 years, 7.1% in those aged 65–79 years and 20.6% in those aged ≥80 years. The respective 30-day incidences of hospitalization were 8.2, 21.7 and 29.5%, of ICU admission were 2.7, 8.6, and 11% and of mechanical ventilation were 1, 3.9 and 3.2%. Median CCI (interquartile range) ranged from 0.0 (0.0, 2.0) in the youngest, to 4 (2.0, 7.0) in the oldest age group. The adjusted association of CCI with all outcomes was attenuated at older ages such that the threshold level of CCI above which the risk for each outcome exceeded the reference group (1st quartile) was lower in younger than in older cohort members (p < 0.001 for all age group interactions). Limitations The CCI is calculated based on diagnostic codes, which may not provide an accurate assessment of comorbid burden. Conclusions Age differences in the distribution and prognostic significance of overall comorbid burden could inform clinical management, vaccination prioritization and population health during the pandemic and argue for more work to understand the role of age and comorbidity in shaping the care of hospitalized patients with SARS-CoV-2. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02340-5.
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Affiliation(s)
- A M O'Hare
- Division of Nephrology, Veterans Affairs Puget Sound Healthcare System and University of Washington, 1660 South Columbian Way, Seattle, WA, 98108, USA. .,Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
| | - K Berry
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - V S Fan
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Division of Pulmonary and Critical Care, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - K Crothers
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Division of Pulmonary and Critical Care, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - M C Eastment
- Division of Allergy and Infectious Disease, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - J A Dominitz
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Division of Gastroenterology, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - J A Shah
- Division of Allergy and Infectious Disease, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
| | - P Green
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - E Locke
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - G N Ioannou
- Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Division of Gastroenterology, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA
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Barrantes FJ. The unfolding palette of COVID-19 multisystemic syndrome and its neurological manifestations. Brain Behav Immun Health 2021; 14:100251. [PMID: 33842898 PMCID: PMC8019247 DOI: 10.1016/j.bbih.2021.100251] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Abstract
Although our current knowledge of the pathophysiology of COVID-19 is still fragmentary, the information so far accrued on the tropism and life cycle of its etiological agent SARS-CoV-2, together with the emerging clinical data, suffice to indicate that the severe acute pulmonary syndrome is the main, but not the only manifestation of COVID-19. Necropsy studies are increasingly revealing underlying endothelial vasculopathies in the form of micro-haemorrhages and micro-thrombi. Intertwined with defective antiviral responses, dysregulated coagulation mechanisms, abnormal hyper-inflammatory reactions and responses, COVID-19 is disclosing a wide pathophysiological palette. An additional property in categorising the disease is the combination of tissue (e.g. neuro- and vasculo-tropism) with organ tropism, whereby the virus preferentially attacks certain organs with highly developed capillary beds, such as the lungs, gastrointestinal tract, kidney and brain. These multiple clinical presentations confirm that the acute respiratory syndrome as described initially is increasingly unfolding as a more complex nosological entity, a multiorgan syndrome of systemic breadth. The neurological manifestations of COVID-19, the focus of this review, reflect this manifold nature of the disease.
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Affiliation(s)
- Francisco J. Barrantes
- Institute of Biomedical Research (BIOMED), UCA-CONICET, Av. Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina
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50
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van Eijk LE, Binkhorst M, Bourgonje AR, Offringa AK, Mulder DJ, Bos EM, Kolundzic N, Abdulle AE, van der Voort PHJ, Olde Rikkert MGM, van der Hoeven JG, den Dunnen WFA, Hillebrands J, van Goor H. COVID-19: immunopathology, pathophysiological mechanisms, and treatment options. J Pathol 2021; 254:307-331. [PMID: 33586189 PMCID: PMC8013908 DOI: 10.1002/path.5642] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread globally despite the worldwide implementation of preventive measures to combat the disease. Although most COVID-19 cases are characterised by a mild, self-limiting disease course, a considerable subset of patients develop a more severe condition, varying from pneumonia and acute respiratory distress syndrome (ARDS) to multi-organ failure (MOF). Progression of COVID-19 is thought to occur as a result of a complex interplay between multiple pathophysiological mechanisms, all of which may orchestrate SARS-CoV-2 infection and contribute to organ-specific tissue damage. In this respect, dissecting currently available knowledge of COVID-19 immunopathogenesis is crucially important, not only to improve our understanding of its pathophysiology but also to fuel the rationale of both novel and repurposed treatment modalities. Various immune-mediated pathways during SARS-CoV-2 infection are relevant in this context, which relate to innate immunity, adaptive immunity, and autoimmunity. Pathological findings in tissue specimens of patients with COVID-19 provide valuable information with regard to our understanding of pathophysiology as well as the development of evidence-based treatment regimens. This review provides an updated overview of the main pathological changes observed in COVID-19 within the most commonly affected organ systems, with special emphasis on immunopathology. Current management strategies for COVID-19 include supportive care and the use of repurposed or symptomatic drugs, such as dexamethasone, remdesivir, and anticoagulants. Ultimately, prevention is key to combat COVID-19, and this requires appropriate measures to attenuate its spread and, above all, the development and implementation of effective vaccines. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Larissa E van Eijk
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Mathijs Binkhorst
- Department of Paediatrics, Subdivision of NeonatologyRadboud University Medical Center Amalia Children's HospitalNijmegenThe Netherlands
| | - Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Annette K Offringa
- Microbiology and System BiologyNetherlands Organisation for Applied Scientific ResearchZeistThe Netherlands
| | - Douwe J Mulder
- Department of Internal Medicine, Division of Vascular Medicine, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Eelke M Bos
- Department of NeurosurgeryErasmus University Medical CenterRotterdamThe Netherlands
| | - Nikola Kolundzic
- Stem Cell Laboratory, Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Assisted Conception Unit, Guy's HospitalLondonUK
| | - Amaal E Abdulle
- Department of Internal Medicine, Division of Vascular Medicine, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Peter HJ van der Voort
- Department of Critical Care, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Marcel GM Olde Rikkert
- Department of Geriatric MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Wilfred FA den Dunnen
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Jan‐Luuk Hillebrands
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
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