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Liu M, Ma R, Cao X, Zhang H, Zhou S, Jiang W, Jiang Y, Sun J, Yang Q, Li X, Sun Y, Shi L, Wang M, Song X, Chen F, Zhang X, Wei H, Yu S, Zhu D, Ba L, Cao Z, Xiao X, Wei X, Lin Z, Chen F, Shan C, Wang G, Ye J, Qu S, Zhao C, Wang Z, Li H, Liu F, Cui X, Ye S, Liu Z, Xu Y, Cai X, Huang W, Zhang R, Zhao Y, Yu G, Shi G, Lu M, Shen Y, Zhao Y, Pei J, Xie S, Yu L, Liu Y, Gu S, Yang Y, Cheng L, liu J. Incidence and prognosis of olfactory and gustatory dysfunctions related to SARS-CoV-2 Omicron strain infection in China: A national multicenter survey of 35,566 individuals. World J Otorhinolaryngol Head Neck Surg 2024; 10:113-120. [PMID: 38855290 PMCID: PMC11156687 DOI: 10.1002/wjo2.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/27/2023] [Accepted: 02/15/2024] [Indexed: 06/11/2024] Open
Abstract
Objective This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.
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Affiliation(s)
- Meng‐Fan Liu
- Graduate School of Beijing University of Chinese MedicineBeijingChina
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
| | - Rui‐Xia Ma
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Xian‐Bao Cao
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Hua Zhang
- Department of OtorhinolaryngologyThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Shui‐Hong Zhou
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Wei‐Hong Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Yan Jiang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jing‐Wu Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of USTCHefeiChina
| | - Qin‐Tai Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe Third Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Xue‐Zhong Li
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Ya‐Nan Sun
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Li Shi
- Department of Otolaryngology, The Second Hospital of Shandong UniversityShandong UniversityJinanChina
| | - Min Wang
- Department of Otorhinolaryngology Head and Neck SurgeryPeking University People′s HospitalBeijingChina
| | - Xi‐Cheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding HospitalQingdao UniversityYantaiChina
| | - Fu‐Quan Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Xijing HospitalThe Fourth Military Medical UniversityXi′anChina
| | - Xiao‐Shu Zhang
- Gansu Provincial Center for Disease Control and PreventionLanzhouChina
| | - Hong‐Quan Wei
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of China Medical UniversityShenyangChina
| | - Shao‐Qing Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji HospitalTongji Medical UniversityShanghaiChina
| | - Dong‐Dong Zhu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Luo Ba
- Department of Otorhinolaryngology Head and Neck SurgeryXizang Autonomous Region People′s HospitalLasaChina
| | - Zhi‐Wei Cao
- Department of Otorhinolaryngology Head and Neck SurgeryShengjing Hospital of China Medical UniversityShenyangChina
| | - Xu‐Ping Xiao
- Department of Otorhinolaryngology Head and Neck SurgeryHunan Provincial People′s HospitalChangshaChina
| | - Xin Wei
- Department of Otorhinolaryngology Head and Neck SurgeryHainan General HospitalHaikouChina
| | - Zhi‐Hong Lin
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital, College of MedicineZhejiang UniversityHangzhouChina
| | - Feng‐Hong Chen
- Department of Otorhinolaryngology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Chun‐Guang Shan
- Department of Otorhinolaryngology Head and Neck SurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Guang‐Ke Wang
- Department of Otorhinolaryngology Head and Neck SurgeryHenan Provincial People′s HospitalZhengzhouChina
| | - Jing Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Shen‐Hong Qu
- Department of Otorhinolaryngology Head and Neck SurgeryGuangxi Zhuang Autonomous Region People′s HospitalNanningChina
| | - Chang‐Qing Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryShanxi Medical University Affiliated Second HospitalTaiyuanChina
| | - Zhen‐Lin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, XuanWu HospitalCapital Medical UniversityBeijingChina
| | - Hua‐Bin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Feng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, West China HospitalSichuan UniversityChengduChina
| | - Xiao‐Bo Cui
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | - Sheng‐Nan Ye
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Zheng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yu Xu
- Department of Otorhinolaryngology Head and Neck SurgeryRenmin Hospital of Wuhan UniversityWuhanChina
| | - Xiao Cai
- Department of Otorhinolaryngology Head and Neck SurgeryQinghai Provincial People′s HospitalXiningChina
| | - Wei Huang
- Department of Otorhinolaryngology Head and Neck SurgeryTianjin Huanhu HospitalTianjinChina
| | - Ru‐Xin Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryHuadong Hospital Affiliated to Fudan UniversityShanghaiChina
| | - Yu‐Lin Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Guo‐Dong Yu
- Department of Otorhinolaryngology Head and Neck SurgeryAffiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Guang‐Gang Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial HospitalAffiliated to Shandong First Medical UniversityJinanChina
| | - Mei‐Ping Lu
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Yang Shen
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yu‐Tong Zhao
- Department of Otorhinolaryngology Head and Neck SurgeryThe First People′s Hospital of YinchuanYinchuanChina
| | - Jia‐Hong Pei
- Department of OtorhinolaryngologyThe First People′s Hospital of Yunnan ProvinceKunmingChina
| | - Shao‐Bing Xie
- Department of Otorhinolaryngology Head and Neck SurgeryXiangya Hospital Central South UniversityChangshaChina
| | - Long‐Gang Yu
- Department of Otorhinolaryngology Head and Neck SurgeryThe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ye‐Hai Liu
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Shao‐Wei Gu
- Department of Otorhinolaryngology Head and Neck SurgeryQilu Hospital of Shandong UniversityJinanChina
| | - Yu‐Cheng Yang
- Department of Otorhinolaryngology Head and Neck SurgeryThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Lei Cheng
- Department of Otorhinolaryngology & Clinical Allergy Center, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
| | - Jian‐Feng liu
- Department of Otorhinolaryngology Head and Neck SurgeryChina‐Japan Friendship HospitalBeijingChina
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Goudman L, De Smedt A, Noppen M, Moens M. Is Central Sensitisation the Missing Link of Persisting Symptoms after COVID-19 Infection? J Clin Med 2021; 10:jcm10235594. [PMID: 34884296 PMCID: PMC8658135 DOI: 10.3390/jcm10235594] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 12/18/2022] Open
Abstract
Patients recovered from a COVID-19 infection often report vague symptoms of fatigue or dyspnoea, comparable to the manifestations in patients with central sensitisation. The hypothesis was that central sensitisation could be the underlying common aetiology in both patient populations. This study explored the presence of symptoms of central sensitisation, and the association with functional status and health-related quality of life, in patients post COVID-19 infection. Patients who were previously infected with COVID-19 filled out the Central Sensitisation Inventory (CSI), the Post-COVID-19 Functional Status (PCFS) Scale and the EuroQol with five dimensions, through an online survey. Eventually, 567 persons completed the survey. In total, 29.73% of the persons had a score of <40/100 on the CSI and 70.26% had a score of ≥40/100. Regarding functional status, 7.34% had no functional limitations, 9.13% had negligible functional limitations, 37.30% reported slight functional limitations, 42.86% indicated moderate functional limitations and 3.37% reported severe functional limitations. Based on a one-way ANOVA test, there was a significant effect of PCFS Scale group level on the total CSI score (F(4,486) = 46.17, p < 0.001). This survey indicated the presence of symptoms of central sensitisation in more than 70% of patients post COVID-19 infection, suggesting towards the need for patient education and multimodal rehabilitation, to target nociplastic pain.
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Affiliation(s)
- Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium;
- STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Research Foundation—Flanders (FWO), 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-2477-5514
| | - Ann De Smedt
- STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Marc Noppen
- Chief Executive Officer, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium;
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium;
- STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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Piras IS, Huentelman MJ, Walker JE, Arce R, Glass MJ, Vargas D, Sue LI, Intorcia AJ, Nelson CM, Suszczewicz KE, Borja CL, Desforges M, Deture M, Dickson DW, Beach TG, Serrano GE. Olfactory Bulb and Amygdala Gene Expression Changes in Subjects Dying with COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.09.12.21263291. [PMID: 34545375 PMCID: PMC8452114 DOI: 10.1101/2021.09.12.21263291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In this study we conducted RNA sequencing on two brain regions (olfactory bulb and amygdala) from subjects who died from COVID-19 or who died of other causes. We found several-fold more transcriptional changes in the olfactory bulb than in the amygdala, consistent with our own work and that of others indicating that the olfactory bulb may be the initial and most common brain region infected. To some extent our results converge with pseudotime analysis towards common processes shared between the brain regions, possibly induced by the systemic immune reaction following SARS-CoV-2 infection. Changes in amygdala emphasized upregulation of interferon-related neuroinflammation genes, as well as downregulation of synaptic and other neuronal genes, and may represent the substrate of reported acute and subacute COVID-19 neurological effects. Additionally, and only in olfactory bulb, we observed an increase in angiogenesis and platelet activation genes, possibly associated with microvascular damages induced by neuroinflammation. Through coexpression analysis we identified two key genes (CAMK2B for the synaptic neuronal network and COL1A2 for the angiogenesis/platelet network) that might be interesting potential targets to reverse the effects induced by SARS-CoV-2 infection. Finally, in olfactory bulb we detected an upregulation of olfactory and taste genes, possibly as a compensatory response to functional deafferentation caused by viral entry into primary olfactory sensory neurons. In conclusion, we were able to identify transcriptional profiles and key genes involved in neuroinflammation, neuronal reaction and olfaction induced by direct CNS infection and/or the systemic immune response to SARS-CoV-2 infection.
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Affiliation(s)
- Ignazio S. Piras
- Translational Genomics Research Institute, Neurogenomics Division
| | | | | | - Richard Arce
- Banner Sun Health Research Institute, Sun City, AZ
| | | | - Daisy Vargas
- Banner Sun Health Research Institute, Sun City, AZ
| | - Lucia I. Sue
- Banner Sun Health Research Institute, Sun City, AZ
| | | | | | | | | | - Marc Desforges
- Centre Hospitalier Universitaire Sainte-Justine, Laboratory of Virology, Montreal, Canada
| | - Michael Deture
- Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville, FL
| | - Dennis W. Dickson
- Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville, FL
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4
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Nouchi A, Chastang J, Miyara M, Lejeune J, Soares A, Ibanez G, Saadoun D, Morélot-Panzini C, Similowski T, Amoura Z, Boddaert J, Caumes E, Bleibtreu A, Lorenzo A, Tubach F, Pourcher V. Prevalence of hyposmia and hypogeusia in 390 COVID-19 hospitalized patients and outpatients: a cross-sectional study. Eur J Clin Microbiol Infect Dis 2021; 40:691-697. [PMID: 33033955 PMCID: PMC7543958 DOI: 10.1007/s10096-020-04056-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/30/2020] [Indexed: 12/22/2022]
Abstract
Anecdotal evidence rapidly accumulated during March 2020 from sites around the world that sudden hyposmia and hypogeusia are significant symptoms associated with the SARS-CoV-2 pandemic. Our objective was to describe the prevalence of hyposmia and hypogeusia and compare it in hospitalized and non-hospitalized COVID-19 patients to evaluate an association of these symptoms with disease severity. We performed a cross-sectional survey during 5 consecutive days in March 2020, within a tertiary referral center, associated outpatient clinic, and two primary care outpatient facilities in Paris. All SARS-CoV-2-positive patients hospitalized during the study period and able to be interviewed (n = 198), hospital outpatients seen during the previous month (n = 129), and all COVID-19-highly suspect patients in two primary health centers (n = 63) were included. Hospitalized patients were significantly more often male (64 vs 40%) and older (66 vs 43 years old in median) and had significantly more comorbidities than outpatients. Hyposmia and hypogeusia were reported by 33% of patients and occurred significantly less frequently in hospitalized patients (12% and 13%, respectively) than in the health centers' outpatients (33% and 43%, respectively) and in the hospital outpatients (65% and 60%, respectively). Hyposmia and hypogeusia appeared more frequently after other COVID-19 symptoms. Patients with hyposmia and/or hypogeusia were significantly younger and had significantly less respiratory severity criteria than patients without these symptoms. Olfactory and gustatory dysfunction occurs frequently in COVID-19, especially in young, non-severe patients. These symptoms might be a useful tool for initial diagnostic work-up in patients with suspected COVID-19.
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Affiliation(s)
- Agathe Nouchi
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France.
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Julie Chastang
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Makoto Miyara
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Julie Lejeune
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - André Soares
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Gladys Ibanez
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - David Saadoun
- INSERM, UMR-S-959, Immunology-Immunopathology- Immunotherapy (I3), Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Capucine Morélot-Panzini
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Thomas Similowski
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Service de Médecine Interne 2, Groupe Hospitalier Universitaire APHP, Sorbonne-Université, site Pitié-Salpêtrière, Paris, France
| | - Jacques Boddaert
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Service de Gériatrie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Caumes
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Alexandre Bleibtreu
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alain Lorenzo
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Florence Tubach
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Valérie Pourcher
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
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5
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Li N, Zhu L, Sun L, Shao G. The effects of novel coronavirus (SARS-CoV-2) infection on cardiovascular diseases and cardiopulmonary injuries. Stem Cell Res 2021; 51:102168. [PMID: 33485182 PMCID: PMC7801189 DOI: 10.1016/j.scr.2021.102168] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/23/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
COVID-19 caused by a novel coronavirus named SARS-CoV-2, can elites severe acute respiratory syndrome, severe lung injury, cardiac injury, and even death and became a worldwide pandemic. SARS-CoV-2 infection may result in cardiac injury via several mechanisms, including the expression of angiotensin-converting enzyme 2 (ACE2) receptor and leading to a cytokine storm, can elicit an exaggerated host immune response. This response contributes to multi-organ dysfunction. As an emerging infectious disease, there are limited data on the effects of this infection on patients with underlying cardiovascular comorbidities. In this review, we summarize the early-stage clinical experiences with COVID-19, with particular focus on patients with cardiovascular diseases and cardiopulmonary injuries, and explores potential available evidence regarding the association between COVID-19, and cardiovascular complications.
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Affiliation(s)
- Ni Li
- Department of Cardiothoracic Surgery, Lihuili Hospital affiliated to Ningbo University, Ningbo, Zhejiang 315041, China; Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Linwen Zhu
- Department of Cardiothoracic Surgery, Lihuili Hospital affiliated to Ningbo University, Ningbo, Zhejiang 315041, China
| | - Lebo Sun
- Department of Cardiothoracic Surgery, Lihuili Hospital affiliated to Ningbo University, Ningbo, Zhejiang 315041, China
| | - Guofeng Shao
- Department of Cardiothoracic Surgery, Lihuili Hospital affiliated to Ningbo University, Ningbo, Zhejiang 315041, China.
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6
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Porta-Etessam J, Núñez-Gil IJ, González García N, Fernandez-Perez C, Viana-Llamas MC, Eid CM, Romero R, Molina M, Uribarri A, Becerra-Muñoz VM, Aguado MG, Huang J, Rondano E, Cerrato E, Alfonso E, Mejía AFC, Marin F, Roubin SR, Pepe M, Feltes G, Maté P, Cortese B, Buzón L, Mendez JJ, Estrada V. COVID-19 anosmia and gustatory symptoms as a prognosis factor: a subanalysis of the HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) registry. Infection 2021; 49:677-684. [PMID: 33646505 PMCID: PMC7917537 DOI: 10.1007/s15010-021-01587-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022]
Abstract
Olfactory and gustatory dysfunctions (OGD) are a frequent symptom of coronavirus disease 2019 (COVID-19). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19. These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 infection included in the multicenter international HOPE Registry (NCT04334291). There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension, dyslipidemia, diabetes, smoke, renal insufficiency, lung, heart, cancer and neurological disease. We did not find statistical differences in pregnant (p = 0.505), patient suffering cognitive (p = 0.484), liver (p = 0.1) or immune disease (p = 0.32). There was inverse relation (protective) between OGD and prone positioning (0.005) and death (< 0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression, OGD was found to be inversely related to death in COVID-19 patients. The odds ratio was 0.26 (0.15-0.44) (p < 0.001) and Z was - 5.05. The presence of anosmia is fundamental in the diagnosis of SARS.CoV-2 infection, but also could be important in classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, hypertension, renal insufficiency, or increase of C-reactive protein (CRP) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient. The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment.
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Affiliation(s)
- Jesús Porta-Etessam
- Hospital Clínico San Carlos, Madrid, Spain. .,Universidad Complutense de Madrid, Madrid, Spain. .,Neurology Department. C/Profesor Martín Lagos S/N, 28049, Madrid, Spain.
| | | | - Nuria González García
- Hospital Clínico San Carlos, Madrid, Spain.,Neurology Department. C/Profesor Martín Lagos S/N, 28049, Madrid, Spain
| | | | | | - Charbel Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | - María Molina
- Hospital Universitario Severo Ochoa, Leganés, Spain
| | - Aitor Uribarri
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Jia Huang
- The Second Affiliated Hospital of Southern, University of Science and Technology Shenzhen, Shenzhen, China
| | | | - Enrico Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | - Emilio Alfonso
- Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba
| | | | | | | | - Martino Pepe
- Azienda Ospedaliero-Universitaria Consorziale Policlinico Di Bari, Bari, Italy
| | | | - Paloma Maté
- Hospital Universitario Infanta Sofia, San Sebastian de Los Reyes, Madrid, Spain
| | | | - Luis Buzón
- Hospital Universitario de Burgos, Burgos, Spain
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7
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Serrano GE, Walker JE, Arce R, Glass MJ, Vargas D, Sue LI, Intorcia AJ, Nelson CM, Oliver J, Papa J, Russell A, Suszczewicz KE, Borja CI, Belden C, Goldfarb D, Shprecher D, Atri A, Adler CH, Shill HA, Driver-Dunckley E, Mehta SH, Readhead B, Huentelman MJ, Peters JL, Alevritis E, Bimi C, Mizgerd JP, Reiman EM, Montine TJ, Desforges M, Zehnder JL, Sahoo MK, Zhang H, Solis D, Pinsky BA, Deture M, Dickson DW, Beach TG. Mapping of SARS-CoV-2 Brain Invasion and Histopathology in COVID-19 Disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.02.15.21251511. [PMID: 33619496 PMCID: PMC7899461 DOI: 10.1101/2021.02.15.21251511] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The coronavirus SARS-CoV-2 (SCV2) causes acute respiratory distress, termed COVID-19 disease, with substantial morbidity and mortality. As SCV2 is related to previously-studied coronaviruses that have been shown to have the capability for brain invasion, it seems likely that SCV2 may be able to do so as well. To date, although there have been many clinical and autopsy-based reports that describe a broad range of SCV2-associated neurological conditions, it is unclear what fraction of these have been due to direct CNS invasion versus indirect effects caused by systemic reactions to critical illness. Still critically lacking is a comprehensive tissue-based survey of the CNS presence and specific neuropathology of SCV2 in humans. We conducted an extensive neuroanatomical survey of RT-PCR-detected SCV2 in 16 brain regions from 20 subjects who died of COVID-19 disease. Targeted areas were those with cranial nerve nuclei, including the olfactory bulb, medullary dorsal motor nucleus of the vagus nerve and the pontine trigeminal nerve nuclei, as well as areas possibly exposed to hematogenous entry, including the choroid plexus, leptomeninges, median eminence of the hypothalamus and area postrema of the medulla. Subjects ranged in age from 38 to 97 (mean 77) with 9 females and 11 males. Most subjects had typical age-related neuropathological findings. Two subjects had severe neuropathology, one with a large acute cerebral infarction and one with hemorrhagic encephalitis, that was unequivocally related to their COVID-19 disease while most of the 18 other subjects had non-specific histopathology including focal β-amyloid precursor protein white matter immunoreactivity and sparse perivascular mononuclear cell cuffing. Four subjects (20%) had SCV2 RNA in one or more brain regions including the olfactory bulb, amygdala, entorhinal area, temporal and frontal neocortex, dorsal medulla and leptomeninges. The subject with encephalitis was SCV2-positive in a histopathologically-affected area, the entorhinal cortex, while the subject with the large acute cerebral infarct was SCV2-negative in all brain regions. Like other human coronaviruses, SCV2 can inflict acute neuropathology in susceptible patients. Much remains to be understood, including what viral and host factors influence SCV2 brain invasion and whether it is cleared from the brain subsequent to the acute illness.
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Affiliation(s)
| | | | - Richard Arce
- Banner Sun Health Research Institute, Sun City, AZ
| | | | - Daisy Vargas
- Banner Sun Health Research Institute, Sun City, AZ
| | - Lucia I. Sue
- Banner Sun Health Research Institute, Sun City, AZ
| | | | | | - Javon Oliver
- Banner Sun Health Research Institute, Sun City, AZ
| | - Jaclyn Papa
- Banner Sun Health Research Institute, Sun City, AZ
| | | | | | | | | | | | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, AZ
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Charles H. Adler
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ
| | | | | | - Shyamal H. Mehta
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ
| | - Benjamin Readhead
- Arizona State University-Banner Neurodegenerative Disease Research Center, Tempe, AZ
| | | | | | | | | | | | | | - Thomas J. Montine
- Stanford University School of Medicine, Department of Pathology, Stanford, CA
| | - Marc Desforges
- Centre Hospitalier Universitaire Sainte-Justine, Laboratory of Virology, Montreal, Canada
| | - James L. Zehnder
- Stanford University School of Medicine, Department of Pathology, Stanford, CA
| | - Malaya K. Sahoo
- Stanford University School of Medicine, Department of Pathology, Stanford, CA
| | - Haiyu Zhang
- Stanford University School of Medicine, Department of Pathology, Stanford, CA
| | - Daniel Solis
- Stanford University School of Medicine, Department of Pathology, Stanford, CA
| | - Benjamin A. Pinsky
- Stanford University Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, CA
| | - Michael Deture
- Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville FL
| | - Dennis W. Dickson
- Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville FL
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8
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Mehraeen E, Behnezhad F, Salehi MA, Noori T, Harandi H, SeyedAlinaghi S. Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence. Eur Arch Otorhinolaryngol 2021; 278:307-312. [PMID: 32556781 PMCID: PMC7297932 DOI: 10.1007/s00405-020-06120-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION It is reported that coronavirus disease (COVID-19) can affect the sense of smell and taste of infected people. The pathobiology of this virus is still incompletely known, and it is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions. We aimed to review current evidence on olfactory and gustatory dysfunctions caused by COVID-19. METHODS This study was a narrative review performed in 2020 to investigate the olfactory and gustatory dysfunctions of the COVID-19. We searched eight keywords in six databases to determine the related documents on the main objective of the study. To discover studies meeting the inclusion criteria, the authors screened the titles and abstracts of the identified articles. The appropriate studies were included and their results were discussed to make the final selection. RESULTS We have studied 24 current articles on the olfactory and gustatory dysfunctions due to COVID-19. A review of current studies has shown that we have a surge in the spread of olfactory and gustatory dysfunctions that happened during the epidemic of COVID-19 infection. Most studies (95.8%) have confirmed the symptoms of anosmia in patients with SARS-CoV-2 infection. A review of current studies showed that, in addition to anosmia, evidence of ageusia and dysgeusia (parageusia) was also seen in patients with COVID-19. CONCLUSION The results of our study support recent reports that SARS-CoV-2 may infect oral and nasal tissues and cause olfactory and gustatory dysfunctions. These findings may aid future research on the diagnosis, prevention, and treatment of COVID-19 consequences.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Noori
- Department of Health Information Technology, School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran
| | - Hamid Harandi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
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9
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Tham AC, Thein TL, Lee CS, Tan GSE, Manauis CM, Siow JK, Leo YS, Lim MY. Olfactory taste disorder as a presenting symptom of COVID-19: a large single-center Singapore study. Eur Arch Otorhinolaryngol 2020; 278:1853-1862. [PMID: 33159556 PMCID: PMC7648204 DOI: 10.1007/s00405-020-06455-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/22/2020] [Indexed: 12/23/2022]
Abstract
Purpose To investigate the prevalence and epidemiological risk factors of olfactory and/or taste disorder (OTD), in particular isolated OTD, in patients with laboratory-confirmed COVID-19 infection. Methods We conducted a retrospective and cross-sectional study. Patients with laboratory-confirmed COVID-19 infection were recruited from the National Centre for Infectious Diseases (NCID) Singapore between 24 March 2020 and 16 April 2020. The electronic health records of these patients were accessed, and demographic data and symptoms reported (respiratory, self-reported OTD and other symptoms such as headache, myalgia and lethargy) were collected. Results A total of 1065 patients with laboratory-confirmed COVID-19 were recruited. Overall, the prevalence of OTD was 12.6%. Twelve patients (1.1%) had isolated OTD. The top three symptoms associated with OTD were cough, fever and sore throat. The symptoms of runny nose and blocked nose were experienced by only 29.8 and 19.3% of patients, respectively. Multivariate analysis demonstrated that the female gender, presence of blocked nose and absence of fever were significantly associated with OTD (adjusted relative risks 1.77, 3.31, 0.42, respectively). All these factors were statistically significant. Conclusion Patients with COVID-19 infection can present with OTD, either in isolation or in combination with other general symptoms. Certain demographic profile, such as being female, and symptomatology such as the presence of blocked nose and absence of fever, were more likely to have OTD when infected by COVID-19. Further studies to elucidate the pathophysiology of OTD in these patients will be beneficial.
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Affiliation(s)
- Alex C Tham
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
| | - Tun-Linn Thein
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Chrisanda S Lee
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | | | - Charmaine M Manauis
- Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - J K Siow
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Y S Leo
- National Centre for Infectious Diseases, Singapore, Singapore
| | - M Y Lim
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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10
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Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, Blomberg WR, Meigs DD, Hasan M, Patel M, Kline P, Chang RCC, Chang L, Gendelman HE, Kevadiya BD. The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol 2020; 15:359-386. [PMID: 32696264 PMCID: PMC7373339 DOI: 10.1007/s11481-020-09944-5] [Citation(s) in RCA: 319] [Impact Index Per Article: 79.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/08/2020] [Indexed: 02/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2, is a positive-sense single-stranded RNA virus with epithelial cell and respiratory system proclivity. Like its predecessor, SARS-CoV, COVID-19 can lead to life-threatening disease. Due to wide geographic impact affecting an extremely high proportion of the world population it was defined by the World Health Organization as a global public health pandemic. The infection is known to readily spread from person-to-person. This occurs through liquid droplets by cough, sneeze, hand-to-mouth-to-eye contact and through contaminated hard surfaces. Close human proximity accelerates SARS-CoV-2 spread. COVID-19 is a systemic disease that can move beyond the lungs by blood-based dissemination to affect multiple organs. These organs include the kidney, liver, muscles, nervous system, and spleen. The primary cause of SARS-CoV-2 mortality is acute respiratory distress syndrome initiated by epithelial infection and alveolar macrophage activation in the lungs. The early cell-based portal for viral entry is through the angiotensin-converting enzyme 2 receptor. Viral origins are zoonotic with genomic linkages to the bat coronaviruses but without an identifiable intermediate animal reservoir. There are currently few therapeutic options, and while many are being tested, although none are effective in curtailing the death rates. There is no available vaccine yet. Intense global efforts have targeted research into a better understanding of the epidemiology, molecular biology, pharmacology, and pathobiology of SARS-CoV-2. These fields of study will provide the insights directed to curtailing this disease outbreak with intense international impact. Graphical Abstract.
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Affiliation(s)
- Jatin Machhi
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Jonathan Herskovitz
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Ahmed M Senan
- Glycomics and Glycan Bioengineering Research Center (GGBRC), College of Food Science and Technology, Nanjing Agricultural University, Nanjing, 20095, China
| | - Debashis Dutta
- Department of Immunology and Microbiology, The Scripps Research Institute, Jupiter, FL, 33458, USA
| | - Barnali Nath
- Viral Immunology Lab, Indian Institute of Technology Guwahati, Guwahati, Assam, 781039, India
| | - Maxim D Oleynikov
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Wilson R Blomberg
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Douglas D Meigs
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Mahmudul Hasan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Milankumar Patel
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA
| | - Peter Kline
- SARS-CoV-2 Patient Survivor, Chicago, IL, 60204, USA
| | - Raymond Chuen-Chung Chang
- Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, and State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China
| | - Linda Chang
- University of Maryland, School of Medicine, Baltimore, MD, 21201, USA
| | - Howard E Gendelman
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Bhavesh D Kevadiya
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5880, USA.
- Interventional Regenerative Medicine and Imaging Laboratory, Department of Radiology, Stanford University, Palo Alto, CA, 94304, USA.
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11
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Spoldi C, Castellani L, Pipolo C, Maccari A, Lozza P, Scotti A, Pisani A, De Donato G, Portaleone S, Cariati M, Felisati G, Saibene AM. Isolated olfactory cleft involvement in SARS-CoV-2 infection: prevalence and clinical correlates. Eur Arch Otorhinolaryngol 2020; 278:557-560. [PMID: 32577901 PMCID: PMC7309200 DOI: 10.1007/s00405-020-06165-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/20/2020] [Indexed: 11/30/2022]
Abstract
Purpose Smell alterations are a symptom of COVID-19 and have been associated with olfactory cleft mucosal thickening (OCMT). Although their pathogenesis is unclear, evidences link them to viral neuroinvasive potential. This study aims at estimating the prevalence of OCMT in CT scans of COVID-19 patients and investigating its clinical correlates. Methods In a single-institution retrospective cross-sectional study, we included all patients hospitalized for COVID-19 undergoing head CT scan for any reason. Exclusion criteria were history of recent head trauma or chronic rhinosinusitis; opacification > 2 mm in any sinonasal space other than the olfactory cleft; CT performed during/after invasive ventilation or feeding via nasogastric tube. We recorded the prevalence of OCMT and related it to age, sex, need for invasive ventilation during hospital stay, outcome, length of hospital stay, diffusion of lung SARS-CoV-19 lesions and outcome. Results 63 eligible patients were identified (39 male, 24 female; median age 77.82 ± 17.77 years). OCMT was identified in 16 patients (25.4%; 95% CI 15.3–37.9%). Patients with OCMT had longer hospital stays (median 16 ± 4 vs. 9 ± 14.5 days, p = .009, Mann–Whitney U test) and required invasive ventilation more frequently than patients without mucosal thickening (OR 4.89, 95% CI 0.96–24.89, p = .063, Fisher’s test). No other difference was observed. Conclusion OCMT affects nearly one in four patients hospitalized for COVID-19. It is associated with a worse disease course irrespective of age, sex and diffusion of lung lesions, although with no direct effect on survival.
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Affiliation(s)
- Chiara Spoldi
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Luca Castellani
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Carlotta Pipolo
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Alberto Maccari
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Paolo Lozza
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Alberto Scotti
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Antonia Pisani
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Giuseppe De Donato
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Sara Portaleone
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Maurizio Cariati
- Radiology and Interventional Radiology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Giovanni Felisati
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy
| | - Alberto Maria Saibene
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy.
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12
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Otolaryngology in the COVID-19 pandemic era: the impact on our clinical practice. Eur Arch Otorhinolaryngol 2020; 278:629-636. [PMID: 32577905 PMCID: PMC7310591 DOI: 10.1007/s00405-020-06161-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/19/2020] [Indexed: 11/09/2022]
Abstract
Purpose To give an overview of the current knowledge about COVID-19 pandemic and its impact on otolaryngology clinical practice. Methods Recent findings about SARS-CoV-2 virus and the COVID-19 infection it causes are reviewed. In addition to international databases and in the absence of hard scientific data, literature search included reports published online from scientific societies and other institutions. Results The role of anosmia as a COVID-19-related symptom is presented. Further, considerations about steroid administration in ENT-related conditions are also discussed. Due to the close work with mucosa surfaces of the upper aerodigestive tract, otolaryngologists and surrounding staff are considered high risk for coronavirus transmission. Hence, staff protection measures for ENT examinations, surgeries and other procedures during COVID-19 pandemic are recommended. Conclusion Knowledge and evidence about the impact of COVID-19 infection on otolaryngology clinical practice are accumulating rapidly. Additionally to patient’s management, safety of health care professionals should be a main goal right now by following strict safety guidelines.
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13
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Printza A, Constantinidis J. The role of self-reported smell and taste disorders in suspected COVID‑19. Eur Arch Otorhinolaryngol 2020; 277:2625-2630. [PMID: 32447496 PMCID: PMC7245504 DOI: 10.1007/s00405-020-06069-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/18/2020] [Indexed: 12/20/2022]
Abstract
Purpose The sudden onset of smell and taste loss has been reported as a symptom related to COVID-19. There is urgent need to provide insight to the pandemic and evaluate anosmia as a potential screening symptom that might contribute to the decision to test suspected cases or guide quarantine instructions. Methods Systematic review of the PubMed/Medline, Cochrane databases and preprints up to May 3, 2020. Combined search terms included: “COVID-19”, “SARS-CoV-2”, “coronavirus”, “nose”, “anosmia”, “hyposmia”, “olfactory loss”, “smell loss”, “taste loss”, and “hypogeusia”. Results Our search identified 18 reviewed articles and 6 manuscript preprints, including a large epidemiological study, four observational case series, five case–controlled studies, five cross-sectional studies, five case series of anosmic patients and four electronic surveys. Great methodological differences were noted. A significant prevalence of anosmia is reported in COVID-19 patients. Controlled studies indicate that anosmia is more common in COVID-19 patients than in patients suffering from other viral infections or controls. Most of the studies reported either smell loss or smell plus taste loss. Less severe COVID-19 disease is related to a greater prevalence of anosmia. A quick recovery of the smell loss may be expected in most COVID-19 cases. Conclusion Anosmia is more prevalent in COVID-19 patients than in patients suffering from other respiratory infections or controls.
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Affiliation(s)
- Athanasia Printza
- 1st Otolaryngology Department, Medical Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloníki, Greece.
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloníki, Greece
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14
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Karapetyan LS, Svistushkin VM. [Olfactory dysfunction and COVID-19 - current state of the problem]. Vestn Otorinolaringol 2020; 85:100-104. [PMID: 33474926 DOI: 10.17116/otorino202085061100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
According to data from China, Italy, South Korea, Iran, USA, France, from 17 to 87% of patients with confirmed COVID-19 have a violation of smell and taste. Acute sudden anosmia may precede symptoms such as cough and shortness of breath. Also, hypo/anosmia may be the only symptom of mild COVID-19. European, American and domestic associations of otorhinolaryngologists warn that, these patients may be hidden carriers that contribute to the spread of COVID-19 infection, because they have no indications for testing for the virus and self-isolation. Including anosmia in the criteria for self-isolation can help prevent the spread of COVID-19 infection. In addition, it would signal the medical staff to use full personal protection when dealing with these patients and help reduce the number of infected doctors. It is known that olfactory disorders can be conductive, perceptual or mixed. Olfactory disturbances in COVID-19 are most likely of a perceptual nature. Although, at the moment, there is insufficient data to determine the exact mechanisms of the onset of anosmia in patients diagnosed with COVID-19, however, there are studies that confirm these or those theories. The article provides an overview of the data available in the literature on this topic.
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Affiliation(s)
- L S Karapetyan
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - V M Svistushkin
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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