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Kamath V, Chen H, Shrestha S, Mechanic-Hamilton D, Deal JA, Mosley TH, Schneider ALC. Normative Data for the 12-Item Sniffin' Sticks Odor Identification Test in Older Adults. Arch Clin Neuropsychol 2024; 39:335-346. [PMID: 37883325 PMCID: PMC11042920 DOI: 10.1093/arclin/acad080] [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] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Quantitative olfactory assessment has demonstrated clinical utility for the evaluation of a range of neurologic, psychiatric, and sinonasal conditions. Here, we provide age, sex, race, and education-specific normative data for the 12-item Sniffin Sticks Odor Identification Test (SSOIT-12) in older Black and White U.S. adults without preclinical or clinical dementia or sinonasal disease. METHOD A sample of 2,224 Atherosclerosis Risk in Communities study participants aged 66-89 years were included. A normative regression equation was developed using a linear model for the association of age, sex, race, and education with odor identification score. Regression-based normative mean scores and percentiles were generated by age, sex, race, and education groups. RESULTS Participants (mean age = 74 years, 59% women, 20% Black, 48% > high school education) had a mean SSOIT-12 score of 9.8. Age, sex, race, and education were all associated with odor identification performance (all ps < .05). A linear regression model for the predicted SSOIT-12 score was developed for use with an individual's actual SSOIT-12 score in order to calculate the Z-score and corresponding percentile for a specific age, sex, race, and education group. Data are also reported in tabular format. CONCLUSIONS Our study provides SSOIT-12 normative data obtained from a large population of White and Black older adults without preclinical or clinical dementia or sinonasal disease living in the USA. These findings can aid clinicians in assessing the degree of olfactory loss, establishing concordance with a person's perception of olfactory difficulties and quantitatively monitoring changes in olfactory performance over time.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
| | - Srishti Shrestha
- The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Dawn Mechanic-Hamilton
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
- Cochlear Center for Hearing and Public Health, Baltimore, MD 21287, USA
| | - Thomas H Mosley
- The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Andrea L C Schneider
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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Vance DE, Del Bene VA, Kamath V, Frank JS, Billings R, Cho DY, Byun JY, Jacob A, Anderson JN, Visscher K, Triebel K, Martin KM, Li W, Puga F, Fazeli PL. Does Olfactory Training Improve Brain Function and Cognition? A Systematic Review. Neuropsychol Rev 2024; 34:155-191. [PMID: 36725781 PMCID: PMC9891899 DOI: 10.1007/s11065-022-09573-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 12/01/2022] [Indexed: 02/03/2023]
Abstract
Olfactory training (OT), or smell training,consists of repeated exposure to odorants over time with the intended neuroplastic effect of improving or remediating olfactory functioning. Declines in olfaction parallel declines in cognition in various pathological conditions and aging. Research suggests a dynamic neural connection exists between olfaction and cognition. Thus, if OT can improve olfaction, could OT also improve cognition and support brain function? To answer this question, we conducted a systematic review of the literature to determine whether there is evidence that OT translates to improved cognition or altered brain morphology and connectivity that supports cognition. Across three databases (MEDLINE, Scopus, & Embase), 18 articles were identified in this systematic review. Overall, the reviewed studies provided emerging evidence that OT is associated with improved global cognition, and in particular, verbal fluency and verbal learning/memory. OT is also associated with increases in the volume/size of olfactory-related brain regions, including the olfactory bulb and hippocampus, and altered functional connectivity. Interestingly, these positive effects were not limited to patients with smell loss (i.e., hyposmia & anosmia) but normosmic (i.e., normal ability to smell) participants benefitted as well. Implications for practice and research are provided.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA.
| | - Victor A Del Bene
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Sandson Frank
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Do-Yeon Cho
- Department of Surgery, Veterans Affairs, University of Alabama at Birmingham, & Division of Otolaryngology, Birmingham, AL, USA
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Alexandra Jacob
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph N Anderson
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristina Visscher
- Department of Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen Triebel
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karli M Martin
- School of Medicine, Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL, USA
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3
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Frank N, Dickinson D, Garcia W, Liu Y, Yu H, Cai J, Patel S, Yao B, Jiang X, Hsu S. Feasibility Study of Developing a Saline-Based Antiviral Nanoformulation Containing Lipid-Soluble EGCG: A Potential Nasal Drug to Treat Long COVID. Viruses 2024; 16:196. [PMID: 38399972 PMCID: PMC10891529 DOI: 10.3390/v16020196] [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: 12/13/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
A recent estimate indicates that up to 23.7 million Americans suffer from long COVID, and approximately one million workers may be out of the workforce each day due to associated symptoms, leading to a USD 50 billion annual loss of salary. Post-COVID (Long COVID) neurologic symptoms are due to the initial robust replication of SARS-CoV-2 in the nasal neuroepithelial cells, leading to inflammation of the olfactory epithelium (OE) and the central nervous system (CNS), and the OE becoming a persistent infection site. Previously, our group showed that Epigallocatechin-3-gallate-palmitate (EC16) nanoformulations possess strong antiviral activity against human coronavirus, suggesting this green tea-derived compound in nanoparticle formulations could be developed as an intranasally delivered new drug to eliminate the persistent SARS-CoV-2 infection, leading to restored olfactory function and reduced inflammation in the CNS. The objective of the current study was to determine the compatibility of the nanoformulations with human nasal primary epithelial cells (HNpECs). METHODS Nanoparticle size was measured using the ZetaView Nanoparticle Tracking Analysis (NTA) system; contact antiviral activity was determined by TCID50 assay for cytopathic effect on MRC-5 cells; post-infection inhibition activity was determined in HNpECs; and cytotoxicity for these cells was determined using an MTT assay. The rapid inactivation of OC43 (a β-coronavirus) and 229E (α-coronavirus) viruses was further characterized by transmission electron microscopy. RESULTS A saline-based nanoformulation containing 0.1% w/v EC16 was able to inactivate 99.9999% β-coronavirus OC43 on direct contact within 1 min. After a 10-min incubation of infected HNpECs with a formulation containing drug-grade EC16 (EGCG-4' mono-palmitate or EC16m), OC43 viral replication was inhibited by 99%. In addition, all nanoformulations tested for their effect on cell viability were comparable to normal saline, a regularly used nasal irrigation solution. A 1-min incubation of an EC16 nanoformulation with either OC43 or 229E showed an altered viral structure. CONCLUSION Nanoformulations containing EC16 showed properties compatible with nasal application to rapidly inactivate SARS-CoV-2 residing in the olfactory mucosa and to reduce inflammation in the CNS, pending additional formulation and safety studies.
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Affiliation(s)
- Nicolette Frank
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | | | - William Garcia
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Hongfang Yu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Jingwen Cai
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Sahaj Patel
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | - Bo Yao
- Changxing Sanju Biotech Co., Ltd., Hangzhou 310013, China; (B.Y.); (X.J.)
| | - Xiaocui Jiang
- Changxing Sanju Biotech Co., Ltd., Hangzhou 310013, China; (B.Y.); (X.J.)
| | - Stephen Hsu
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
- Camellix Research Laboratory, Augusta, GA 30912, USA;
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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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Uchechukwu CF, Anyaduba UL, Udekwu CC, Orababa OQ, Kade AE. Desmoglein-2 and COVID-19 complications: insights into its role as a biomarker, pathogenesis and clinical implications. J Gen Virol 2023; 104. [PMID: 37815458 DOI: 10.1099/jgv.0.001902] [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: 10/11/2023] Open
Abstract
Desmoglein-2 (DSG2) has emerged as a potential biomarker for coronavirus disease 2019 (COVID-19) complications, particularly cardiac and cardiovascular involvement. The expression of DSG2 in lung tissues has been detected at elevated levels, and circulating DSG2 levels correlate with COVID-19 severity. DSG2 may contribute to myocardial injury, cardiac dysfunction and vascular endothelial dysfunction in COVID-19. Monitoring DSG2 levels could aid in risk stratification, early detection and prognostication of COVID-19 complications. However, further research is required to validate DSG2 as a biomarker. Such research will aim to elucidate its precise role in pathogenesis, establishing standardized assays for its measurement and possibly identifying therapeutic targets.
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Affiliation(s)
- Chidiebere F Uchechukwu
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
- Michael Okpara University of Agriculture, Umudike, Nigeria
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Cherobin GB, Guimarães RES, de Paula Gomes MC, Vasconcelos LOG, de Abreu LAN. Intranasal Insulin for the Treatment of Persistent Post-COVID-19 Olfactory Dysfunction. Otolaryngol Head Neck Surg 2023; 169:719-724. [PMID: 37078341 DOI: 10.1002/ohn.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To investigate if intranasal insulin could be a treatment option for those suffering from recalcitrant olfactory dysfunction due to COVID-19. STUDY DESIGN Prospective interventional cohort with a single group. SETTING Sixteen volunteers with anosmia, severe hyposmia, or moderate hyposmia for more than 60 days as sequelae of severe acute respiratory syndrome coronavirus 2 infections were selected for the study. All volunteers reported that standard therapies, such as corticosteroids, have failed to improve their olfactory function. METHODS Olfactory function was assessed by the Chemosensory Clinical Research Center test of olfaction (COT) before and after the intervention. Changes in qualitative, quantitative, and global COT scores were investigated. The insulin therapy session consisted of placing into each olfactory cleft 2 pieces of gelatin sponge soaked with neutral protamine Hagedorn (NPH) insulin, 40 IU on each side. The procedure was repeated twice a week for 1 month. Glycaemic blood level was measured before and after each session. RESULTS The qualitative COT score rose 1.53 points, p = .0001, 95% confidence interval (CI) (-2.12 to -0.94). The quantitative COT score increased by 2.00 points, p = .0002, 95% CI (-3.59 to -1.41). Global COT score had an improvement of 2.01 points, p = .00003, 95% CI (-2.7 to -1.3). Glycaemic blood level dropped on average 10.4 mg/dL, p < .00003, 95% CI (8.1-12.8). CONCLUSION Our results suggest that the administration of NPH insulin into the olfactory cleft yields a rapid improvement in the sense of smell of patients suffering from persistent post-COVID-19 olfactory dysfunction. Moreover, the procedure seems to be safe and tolerable.
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Affiliation(s)
- Giancarlo B Cherobin
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Roberto E S Guimarães
- Department of Ophthalmology and Otolaryngology, Medical School of Federal University of Minas Gerais, Belo Horizonte, Brazil
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Fung S, Contreras RP, Fung AG, Gibson P, LeVasseur MK, McCartney MM, Koch DT, Chakraborty P, Chew BS, Rajapakse MY, Chevy DA, Hicks TL, Davis CE. Portable chemical detection platform for on-site monitoring of odorant levels in natural gas. J Chromatogr A 2023; 1705:464151. [PMID: 37419015 PMCID: PMC11014743 DOI: 10.1016/j.chroma.2023.464151] [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: 04/19/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 07/09/2023]
Abstract
The adequate odorization of natural gas is critical to identify gas leaks and to reduce accidents. To ensure odorization, natural gas utility companies collect samples to be processed at core facilities or a trained human technician smells a diluted natural gas sample. In this work, we report a detection platform that addresses the lack of mobile solutions capable of providing quantitative analysis of mercaptans, a class of compounds used to odorize natural gas. Detailed description of the platform hardware and software components is provided. Designed to be portable, the platform hardware facilitates extraction of mercaptans from natural gas, separation of individual mercaptan species, and quantification of odorant concentration, with results reported at point-of-sampling. The software was developed to accommodate skilled users as well as minimally trained operators. Detection and quantification of six commonly used mercaptan compounds (ethyl mercaptan, dimethyl sulfide, n-propylmercaptan, isopropyl mercaptan, tert‑butyl mercaptan, and tetrahydrothiophene) at typical odorizing concentrations of 0.1-5 ppm was performed using the device. We demonstrate the potential of this technology to ensure natural gas odorizing concentrations throughout distribution systems.
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Affiliation(s)
- Stephanie Fung
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Raquel Pimentel Contreras
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Alexander G Fung
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Patrick Gibson
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Michael K LeVasseur
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Mitchell M McCartney
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA.; VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
| | - Dylan T Koch
- UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA.; Department of Electrical Engineering, University of California Davis, Davis, CA, USA
| | - Pranay Chakraborty
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Bradley S Chew
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Maneeshin Y Rajapakse
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Daniel A Chevy
- UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA.; Department of Electrical Engineering, University of California Davis, Davis, CA, USA
| | - Tristan L Hicks
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA
| | - Cristina E Davis
- Department of Mechanical and Aerospace Engineering, University of California Davis, Davis, CA, USA; UC Davis Lung Center, One Shields Avenue, Davis, CA 95616, USA.; VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA.
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8
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Riccardi G, Niccolini GF, Bellizzi MG, Fiore M, Minni A, Barbato C. Post-COVID-19 Anosmia and Therapies: Stay Tuned for New Drugs to Sniff Out. Diseases 2023; 11:79. [PMID: 37366867 DOI: 10.3390/diseases11020079] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Anosmia is defined as the complete absence of olfactory function, which can be caused by a variety of causes, with upper respiratory tract infections being among the most frequent causes. Anosmia due to SARS-CoV-2 infection has attracted attention given its main role in symptomatology and the social impact of the pandemic. Methods: We conducted systematic research in a clinicaltrials.gov database to evaluate all active clinical trials worldwide regarding drug therapies in adult patients for anosmia following SARS-CoV-2 infection with the intention of identifying the nearby prospects to treat Anosmia. We use the following search terms: "Anosmia" AND "COVID-19" OR "SARS-CoV-2" OR "2019 novel coronavirus". Results: We found 18 active clinical trials that met our criteria: one phase 1, one phase 1-2, five phases 2, two phases 2-3, three phases 3, and six phases 4 studies were identified. The drug therapies that appear more effective and promising are PEA-LUT and Cerebrolysin. The other interesting drugs are 13-cis-retinoic acid plus aerosolized Vitamin D, dexamethasone, and corticosteroid nasal irrigation. Conclusions: COVID-19 has allowed us to highlight how much anosmia is an important and debilitating symptom for patients and, above all, to direct research to find a therapy aimed at curing the symptom, whether it derives from SARS-CoV-2 infection or other infections of the upper airways. Some of these therapies are very promising and are almost at the end of experimentation. They also provide hope in this field, which not addressed until recently.
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Affiliation(s)
- Gabriele Riccardi
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | | | - Mario Giuseppe Bellizzi
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Unit of Translational Biomolecular Medicine, Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| | - Antonio Minni
- Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Unit of Translational Biomolecular Medicine, Department of Sense Organs (DOS), Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
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9
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Hankin MH, Harmon DJ, Martindale JR, Niculescu I, Aschmetat A, Mertens AN, Hanke RE, Koo AS, Kraus AE, Payne JA, Feldman MJ, Soltero Mariscal E. Needs assessment of essential anatomy: The perspective of adult primary care resident physicians. ANATOMICAL SCIENCES EDUCATION 2023; 16:504-520. [PMID: 36622764 DOI: 10.1002/ase.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/22/2022] [Accepted: 12/27/2022] [Indexed: 05/11/2023]
Abstract
Curricular development and modification involve first identifying a problem and then performing a needs assessment, which can guide the design of curricular components. Pedagogical changes, coupled with reductions in curricular time for gross anatomy, pose challenges and impose restrictions within medical school curricula. In order to make anatomy education effective and efficient, it is important to determine the anatomy considered essential for medical education through a targeted needs assessment. In this study, 50 adult primary care resident physicians in family medicine (FM) and internal medicine (IM) were surveyed to assess the importance of 907 anatomical structures, or groups of structures, across all anatomical regions from a curated list based on the boldface terms in four primary anatomy texts. There were no statistically significant differences in the ratings of structures between the two groups for any anatomical region. In total, 17.0% of structures, or groups of structures, were classified as essential, 58.0% as more important, 24.4% as less important, and 0.7% as not important. FM residents rated tissues classified as skeleton, nerves, fasciae, anatomical spaces, blood vessels, lymphatics, and surface anatomy (p < 0.0001) significantly higher than IM residents, but there were no differences in the rating of muscles or organs (p > 0.0056). It was notable that 100.0% of cranial nerves were classified as essential, and 94.5% of surface anatomy structures were classified as essential or more important. It is proposed that results of this study can serve to inform curricular development and revision.
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Affiliation(s)
- Mark H Hankin
- Anatomical Sciences Education Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Derek J Harmon
- Division of Anatomy, Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - James R Martindale
- Office of Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Iuliana Niculescu
- Department of Internal Medicine, Beaumont Health, William Beaumont Hospital, Royal Oak, Michigan, USA
| | - Adrienne Aschmetat
- Department of Internal Medicine, Oaklawn Hospital, Marshall, Michigan, USA
- Department of Pediatrics, Oaklawn Hospital, Marshall, Michigan, USA
| | - Amy N Mertens
- Michigan Heart Group at St. Joseph Mercy (Trinity Health), Ann Arbor, Michigan, USA
| | - Rachel E Hanke
- Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Andrew S Koo
- Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Anthony E Kraus
- Department of Emergency Medicine, Signature Healthcare, Brockton Hospital, Brockton, Massachusetts, USA
| | - James A Payne
- Middle Tennessee Urology Specialists, Murfreesboro, Tennessee, USA
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10
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Khan AM, Piccirillo J, Kallogjeri D, Piccirillo JF. Efficacy of Combined Visual-Olfactory Training With Patient-Preferred Scents as Treatment for Patients With COVID-19 Resultant Olfactory Loss: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2023; 149:141-149. [PMID: 36580304 PMCID: PMC9857399 DOI: 10.1001/jamaoto.2022.4112] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022]
Abstract
Importance The number of olfactory dysfunction cases has increased dramatically because of the COVID-19 pandemic. Identifying therapies that aid and accelerate recovery is essential. Objective To determine the efficacy of bimodal visual-olfactory training and patient-preferred scents vs unimodal olfactory training and physician-assigned scents in COVID-19 olfactory loss. Design, Setting, and Participants This was a randomized, single-blinded trial with a 2-by-2 factorial design (bimodal, patient preferred; unimodal, physician assigned; bimodal, physician assigned; unimodal, patient preferred) and an independent control group. Enrollment occurred from February 1 to May 27, 2021. Participants were adults 18 to 71 years old with current olfactory loss defined as University of Pennsylvania Smell Identification Test (UPSIT) score less than 34 for men and less than 35 for women and duration of 3 months or longer. Olfactory loss was initially diagnosed within 2 weeks of COVID-19 infection. Interventions Participants sniffed 4 essential oils for 15 seconds with a 30-second rest in between odors for 3 months. Participants in the physician-assigned odor arms trained with rose, lemon, eucalyptus, and clove. Participants randomized to the patient-preferred arms chose 4 of 24 available scents. If assigned to the bimodal arm, participants were shown digital images of the essential oil they were smelling. Main Outcomes and Measures The primary end point was postintervention change in UPSIT score from baseline; measures used were the UPSIT (validated, objective psychometric test of olfaction), Clinical Global Impressions Impression-Improvement (CGI-I; self-report improvement scale), and Olfactory Dysfunction Outcomes Rating (ODOR; olfaction-related quality-of-life questionnaire). Results Among the 275 enrolled participants, the mean (SD) age was 41 (12) years, and 236 (86%) were female. The change in UPSIT scores preintervention to postintervention was similar between the study arms. The marginal mean difference for change in UPSIT scores preintervention to postintervention between participants randomized to patient-preferred vs physician-assigned olfactory training was 0.73 (95% CI, -1.10 to 2.56), and between participants randomized to bimodal vs unimodal olfactory training was 1.10 (95% CI, -2.92 to 0.74). Five (24%) participants in the control arm had clinically important improvement on UPSIT compared with 18 (53%) in the bimodal, patient-preferred arm for a difference of 29% (95% CI, 4%-54%). Four (19%) participants in the control group self-reported improvement on CGI-I compared with 12 (35%) in the bimodal, patient-preferred arm for a difference of 16% (95% CI, -7% to 39%). The mean change in ODOR score preintervention to postintervention was 11.6 points (95% CI, 9.2-13.9), which was not deemed clinically important nor significantly different between arms. Conclusions and Relevance Based on the change in UPSIT scores, this randomized clinical trial did not show any difference between intervention arms, but when exploring within-patient change in UPSIT as well as self-reported impression of improvement, active interventions were associated with larger improvement than controls with a potential advantage of bimodal intervention. While not definitive, these results suggest that patients with COVID-19 olfactory loss may benefit from bimodal visual-olfactory training with patient-preferred scents. Trial Registration ClinicalTrials.gov Identifier: NCT04710394.
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Affiliation(s)
- Amish M. Khan
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jeffrey Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Statistics Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor in Chief, JAMA Otolaryngology–Head & Neck Surgery
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11
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Debbaneh P, McKinnon L, Haidari M, Liang J. Drug-induced olfactory and gustatory dysfunction: Analysis of FDA adverse events reporting system. Auris Nasus Larynx 2023:S0385-8146(22)00240-1. [PMID: 36682949 DOI: 10.1016/j.anl.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES With the COVID-19 pandemic, there is growing interest and research in olfactory and gustatory dysfunction (OGD). Drug-induced dysfunction is an often overlooked etiology. While several medications include smell or taste disturbance as a side effect, there are no publications describing which medications are most frequently implicated. We aim to describe the patterns of these adverse drug reactions (ADRs) using the FDA Adverse Events Reporting System (FAERS). METHODS The FAERS database was queried from 2011 to 2021 for terms describing ADRs related to OGD. Terms included anosmia, hyposmia, olfactory test abnormal, olfactory nerve disorder, hallucination olfactory, parosmia, ageusia, hypogeusia, dysgeusia, and taste disorder. We identified the top reported medications associated with general smell dysfunction, general taste dysfunction, reduced smell, and altered smell. RESULTS From 2011 to 2021, 16,091 ADRs were reported with OGD, of which13,641 (84.8%) and 2,450 (15.2%) were associated with gustatory and olfactory reactions, respectively. Zinc products (370 reports) and fluticasone propionate (214) were most commonly associated with olfactory dysfunction, specifically reduced olfaction. Varenicline (24) and fluticasone propionate (23) were most commonly associated with altered smell. Lenalidomide (490) and sunitinib (468) were most commonly associated with gustatory dysfunction. Antineoplastic and immunomodulating medications accounted for 21.6% and 36.3% of olfactory and gustatory ADRs, respectively. Among this category, immunoglobulin drugs were the most commonly associated with OGD ADRs. CONCLUSION Gustatory dysfunction is more commonly reported ADR compared with olfactory dysfunction. Immunologic/rheumatologic medications are the leading culprit of reported OGD. With increasing numbers of patients presenting to otolaryngologists for OGD, it is important to consider drug-induced etiology. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Peter Debbaneh
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, 3600 Broadway, Oakland, CA 94611, USA.
| | | | - Muhib Haidari
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Jonathan Liang
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, 3600 Broadway, Oakland, CA 94611, USA
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12
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Stankevice D, Fjaeldstad AW, Agergaard J, Ovesen T. Long-Term COVID-19 Smell and Taste Disorders Differ Significantly from Other Post-Infectious Cases. Laryngoscope 2023; 133:169-174. [PMID: 36305529 PMCID: PMC9874579 DOI: 10.1002/lary.30453] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION COVID-19 is causing a wide range of clinical manifestations. Severe complications and long-lasting sequelae have been identified. Thus, olfactory disorders are reported in up to 86% of cases in mild and moderate COVID-19 infections. We present the first study comparing simple and complex post-COVID-19 cases with matched non-COVID-19 post-infectious smell and taste disorders. METHODS A total of 328 patients were recruited from the University Clinic for Flavour, Balance and Sleep, Ear-nose-throat Department, Goedstrup Hospital, Denmark. A non-COVID -19 post-infectious population of 148 individuals was identified from the Redcap database, and was matched by duration of smell and taste disorders. Post-COVID-19 patients were divided into 99 patients with simple smell and taste disorders (only suffering from smell and taste disorders after COVID-19); and (81 patients with complex smell and taste disorder plus several other post-COVID-19 complaints). Besides patient-reported outcome measures (PROM) questionnaires and quality of life score (QoL), ear-nose-throat examination, Mini-Mental State Examination (MMSE), orthonasal smell test (Sniffing's sticks), retronasal quick test, and taste screening were performed. RESULTS Cases with post-COVID-19-related smell and taste disorders deviated from non-COVID-19 post-infectious cases; the patients were younger, had a lower occurrence of anosmia/ageusia, and had higher overall smell test scores. In contrast, patients with post-COVID-19-related smell and taste disorders more frequently complained of distorted senses. Parosmia and phantosmia were more prevalent among patients with simple post-COVID-19 complaints than among complex cases and their QoL were more negatively affected. CONCLUSION Smell and taste function differ significantly between post-COVID-19 and other non-COVID-19 post-viral cases. LEVEL OF EVIDENCE 3 Laryngoscope, 133:169-174, 2023.
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Affiliation(s)
- Dovile Stankevice
- University Clinic for Flavour, Balance and Sleep, ENT DepartmentGoedstrup HospitalHerningDenmark
| | - Alexander Wieck Fjaeldstad
- University Clinic for Flavour, Balance and Sleep, ENT DepartmentGoedstrup HospitalHerningDenmark
- Department of Clinical MedicineAarhus UniversityAarhus NDenmark
| | - Jane Agergaard
- Department of Infectious DiseasesAarhus University HospitalAarhus NDenmark
| | - Therese Ovesen
- University Clinic for Flavour, Balance and Sleep, ENT DepartmentGoedstrup HospitalHerningDenmark
- Department of Clinical MedicineAarhus UniversityAarhus NDenmark
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13
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Bourgon C, Albin AS, Ando-Grard O, Da Costa B, Domain R, Korkmaz B, Klonjkowski B, Le Poder S, Meunier N. Neutrophils play a major role in the destruction of the olfactory epithelium during SARS-CoV-2 infection in hamsters. Cell Mol Life Sci 2022; 79:616. [PMID: 36460750 PMCID: PMC9734468 DOI: 10.1007/s00018-022-04643-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/02/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022]
Abstract
The loss of smell (anosmia) related to SARS-CoV-2 infection is one of the most common symptoms of COVID-19. Olfaction starts in the olfactory epithelium mainly composed of olfactory sensory neurons surrounded by supporting cells called sustentacular cells. It is now clear that the loss of smell is related to the massive infection by SARS-CoV-2 of the sustentacular cells in the olfactory epithelium leading to its desquamation. However, the molecular mechanism behind the destabilization of the olfactory epithelium is less clear. Using golden Syrian hamsters infected with an early circulating SARS-CoV-2 strain harboring the D614G mutation in the spike protein; we show here that rather than being related to a first wave of apoptosis as proposed in previous studies, the innate immune cells play a major role in the destruction of the olfactory epithelium. We observed that while apoptosis remains at a low level in the damaged area of the infected epithelium, the latter is invaded by Iba1+ cells, neutrophils and macrophages. By depleting the neutrophil population or blocking the activity of neutrophil elastase-like proteinases, we could reduce the damage induced by the SARS-CoV-2 infection. Surprisingly, the impairment of neutrophil activity led to a decrease in SARS-CoV-2 infection levels in the olfactory epithelium. Our results indicate a counterproductive role of neutrophils leading to the release of infected cells in the lumen of the nasal cavity and thereby enhanced spreading of the virus in the early phase of the SARS-CoV-2 infection.
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Affiliation(s)
- Clara Bourgon
- Unité de Virologie et Immunologie Moléculaires (UR892), INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Audrey St Albin
- Unité de Virologie et Immunologie Moléculaires (UR892), INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Ophélie Ando-Grard
- Unité de Virologie et Immunologie Moléculaires (UR892), INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Bruno Da Costa
- Unité de Virologie et Immunologie Moléculaires (UR892), INRAE, Université Paris-Saclay, Jouy-en-Josas, France
| | - Roxane Domain
- INSERM UMR-1100, "Research Center for Respiratory Diseases" and University of Tours, 37032, Tours, France
| | - Brice Korkmaz
- INSERM UMR-1100, "Research Center for Respiratory Diseases" and University of Tours, 37032, Tours, France
| | - Bernard Klonjkowski
- UMR 1161 Virologie, INRAE-ENVA-ANSES, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, 94704, Paris, France
| | - Sophie Le Poder
- UMR 1161 Virologie, INRAE-ENVA-ANSES, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, 94704, Paris, France
| | - Nicolas Meunier
- Unité de Virologie et Immunologie Moléculaires (UR892), INRAE, Université Paris-Saclay, Jouy-en-Josas, France.
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14
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Tchekmedyian R, Lundberg M, Buchheit KM, Maurer R, Gakpo D, Mullur J, Bensko JC, Laidlaw TM. Loss of smell in patients with aspirin-exacerbated respiratory disease impacts mental health and quality of life. Clin Exp Allergy 2022; 52:1414-1421. [PMID: 35506180 PMCID: PMC9630163 DOI: 10.1111/cea.14157] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The impact of anosmia on quality-of-life (QoL) for patients with aspirin-exacerbated respiratory disease (AERD) is poorly understood. We aimed to investigate how the severity of smell loss and olfactory dysfunction (OD) in patients with AERD affects their QoL, mental health and physical well-being. METHODS Five validated QoL questionnaires (Sinonasal Outcome Test-22, Asthma Control Test, Healthy Days Core Module-4, Short Form-36 and Patient Health Questionnaire-4) and two newly developed questionnaires assessing severity and consequences of OD were electronically sent to all 2913 patients in the Brigham and Women's Hospital AERD registry. Responses were received from 853 participants for analysis. RESULTS Overall, 85% of participants reported a present diminished sense of smell and/or taste, and 30% categorized their OD severity was, "as bad as it can be." There were significant relationships between the severity of self-reported OD and both psychological distress and general health scores, even after adjusting for asthma control. Additionally, incidence rates for physically and mentally unhealthy days in the prior month were higher for patients with moderate or severe OD than for normosmic patients. Patients with diminished smell responded that they could not identify spoiled food (86%), did not enjoy food (71%), felt unsafe (63%) and had encountered dangerous situations (51%) as consequences of their OD. CONCLUSIONS Anosmia and hyposmia severely impact the physical, emotional and mental health of AERD patients, and lead to safety concerns in their daily lives. The importance of olfaction and the relevance of OD to patients' QoL should be acknowledged and evaluated by clinicians caring for these patients.
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Affiliation(s)
- Raffi Tchekmedyian
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Marie Lundberg
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kathleen M. Buchheit
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Rie Maurer
- Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Jyotsna Mullur
- Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jillian C. Bensko
- Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tanya M. Laidlaw
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Division of Allergy and Clinical Immunology, Brigham and Women’s Hospital, Boston, Massachusetts
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15
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Bhutani DL, Ross AG, Lehman AY, Shindler KS. Resolution of COVID-19 induced anosmia following treatment with ST266. OTOLARYNGOLOGY CASE REPORTS 2022; 25:100475. [PMID: 36090590 PMCID: PMC9444303 DOI: 10.1016/j.xocr.2022.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Devica L Bhutani
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmara G Ross
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Amanda Y Lehman
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Kenneth S Shindler
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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16
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Jensen MM, Larsen KD, Homøe AS, Simonsen AL, Arndal E, Koch A, Samuelsen GB, Nielsen XC, Todsen T, Homøe P. Subjective and psychophysical olfactory and gustatory dysfunction among COVID-19 outpatients; short- and long-term results. PLoS One 2022; 17:e0275518. [PMID: 36191024 PMCID: PMC9529127 DOI: 10.1371/journal.pone.0275518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/19/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Olfactory and gustatory dysfunctions are early symptoms of SARS-CoV-2 infection. Between 20-80% of infected individuals report subjective altered sense of smell and/or taste during infection. Up to 2/3 of previously infected experience persistent olfactory and/or gustatory dysfunction after 6 months. The aim of this study was to examine subjective and psychophysical olfactory and gustatory function in non-hospitalized individuals with acute COVID-19 up to 6 months after infection. METHODS Individuals aged 18-80-years with a positive SARS-CoV-2 PCR test no older than 10 days, were eligible. Only individuals able to visit the outpatient examination facilities were included. Gustatory function was tested with the Burgharts Taste Strips and olfactory function was examined with the Brief Smell Identifications test (Danish version). Subjective symptoms were examined through an online questionnaire at inclusion, day 30, 90 and 180 after inclusion. RESULTS Fifty-eight SARS-CoV-2 positive and 56 negative controls were included. 58.6% (34/58) of SARS-CoV-2 positive individuals vs. 8.9% (5/56) of negative controls reported subjective olfactory dysfunction at inclusion. For gustatory dysfunction, 46.5% (27/58) of positive individuals reported impairment compared to 8.9% (5/56) of negative controls. In psychophysical tests, 75.9% (46/58) had olfactory dysfunction and 43.1% (25/58) had gustatory dysfunction among the SARS-CoV-2 positive individuals at inclusion. Compared to negative controls, SARS-CoV-2 infected had significantly reduced olfaction and gustation. Previously infected individuals continued to report lower subjective sense of smell 30 days after inclusion, whereafter the difference between the groups diminished. However, after 180 days, 20.7% (12/58) positive individuals still reported reduced sense of smell and taste. CONCLUSION Olfactory and gustatory dysfunctions are prevalent symptoms of SARS-CoV-2 infection, but there is inconsistency between subjective reporting and psychophysical test assessment of especially olfaction. Most individuals regain normal function after 30 days, but approximately 20% report persistent olfactory and gustatory dysfunction 6 months after infection.
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Affiliation(s)
- Mads Mose Jensen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- * E-mail:
| | - Kasper Daugaard Larsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Sophie Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otorhinolaryngology, Nordsjaellands Hospital, Hilleroed, Denmark
| | | | - Elisabeth Arndal
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Anders Koch
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Staten Serum Institut (SSI), Copenhagen, Denmark
| | | | - Xiaohui Chen Nielsen
- Department of Clinical Microbiology, Zealand University Hospital, Koege, Denmark
| | - Tobias Todsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Otolaryngology—Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Park JW, Wang X, Xu RH. Revealing the mystery of persistent smell loss in Long COVID patients. Int J Biol Sci 2022; 18:4795-4808. [PMID: 35874953 PMCID: PMC9305264 DOI: 10.7150/ijbs.73485] [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: 03/31/2022] [Accepted: 06/09/2022] [Indexed: 11/05/2022] Open
Abstract
COVID-19 is hopefully approaching its end in many countries as herd immunity develops and weaker strains of SARS-CoV-2 dominate. However, a new concern occurs over the long-term effects of COVID-19, collectively called "Long COVID", as some symptoms of the nervous system last even after patients recover from COVID-19. This review focuses on studies of anosmia, i.e., impairment of smell, which is the most common sensory defect during the disease course and is caused by olfactory dysfunctions. It remains mysterious how the olfactory functions are affected since the virus can't invade olfactory receptor neurons. We describe several leading hypotheses about the mystery in hope to provide insights into the pathophysiology and treatment strategies for anosmia.
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Affiliation(s)
- Jung Woo Park
- Center of Reproduction, Development & Aging, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Ministry of Education Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau, China
| | - Xiaoyan Wang
- Center of Reproduction, Development & Aging, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Ministry of Education Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau, China
| | - Ren-He Xu
- Center of Reproduction, Development & Aging, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Ministry of Education Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau, China
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18
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Michanowicz DR, Dayalu A, Nordgaard CL, Buonocore JJ, Fairchild MW, Ackley R, Schiff JE, Liu A, Phillips NG, Schulman A, Magavi Z, Spengler JD. Home is Where the Pipeline Ends: Characterization of Volatile Organic Compounds Present in Natural Gas at the Point of the Residential End User. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:10258-10268. [PMID: 35762409 PMCID: PMC9301916 DOI: 10.1021/acs.est.1c08298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The presence of volatile organic compounds (VOCs) in unprocessed natural gas (NG) is well documented; however, the degree to which VOCs are present in NG at the point of end use is largely uncharacterized. We collected 234 whole NG samples across 69 unique residential locations across the Greater Boston metropolitan area, Massachusetts. NG samples were measured for methane (CH4), ethane (C2H6), and nonmethane VOC (NMVOC) content (including tentatively identified compounds) using commercially available USEPA analytical methods. Results revealed 296 unique NMVOC constituents in end use NG, of which 21 (or approximately 7%) were designated as hazardous air pollutants. Benzene (bootstrapped mean = 164 ppbv; SD = 16; 95% CI: 134-196) was detected in 95% of samples along with hexane (98% detection), toluene (94%), heptane (94%), and cyclohexane (89%), contributing to a mean total concentration of NMVOCs in distribution-grade NG of 6.0 ppmv (95% CI: 5.5-6.6). While total VOCs exhibited significant spatial variability, over twice as much temporal variability was observed, with a wintertime NG benzene concentration nearly eight-fold greater than summertime. By using previous NG leakage data, we estimated that 120-356 kg/yr of annual NG benzene emissions throughout Greater Boston are not currently accounted for in emissions inventories, along with an unaccounted-for indoor portion. NG-odorant content (tert-butyl mercaptan and isopropyl mercaptan) was used to estimate that a mean NG-CH4 concentration of 21.3 ppmv (95% CI: 16.7-25.9) could persist undetected in ambient air given known odor detection thresholds. This implies that indoor NG leakage may be an underappreciated source of both CH4 and associated VOCs.
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Affiliation(s)
- Drew R. Michanowicz
- Harvard
T.H. Chan School of Public Health, C-CHANGE, Boston, Massachusetts 02215 United States
- PSE
Healthy Energy, Oakland, California 94612, United States
- ,
| | - Archana Dayalu
- Atmospheric
and Environmental Research (AER), Lexington, Massachusetts 02421, United States
| | | | - Jonathan J. Buonocore
- Harvard
T.H. Chan School of Public Health, C-CHANGE, Boston, Massachusetts 02215 United States
| | - Molly W. Fairchild
- Home
Energy Efficiency Team (HEET), Cambridge, Massachusetts 02139, United States
| | - Robert Ackley
- Gas
Safety Inc., Southborough, Massachusetts 01772, United States
| | - Jessica E. Schiff
- Harvard
T.H. Chan School of Public Health, Boston, Massachusetts 02215, United States
| | - Abbie Liu
- Harvard
T.H. Chan School of Public Health, Boston, Massachusetts 02215, United States
| | | | - Audrey Schulman
- Home
Energy Efficiency Team (HEET), Cambridge, Massachusetts 02139, United States
| | - Zeyneb Magavi
- Home
Energy Efficiency Team (HEET), Cambridge, Massachusetts 02139, United States
| | - John D. Spengler
- Harvard
T.H. Chan School of Public Health, Boston, Massachusetts 02215, United States
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19
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Lee JJ, Gupta S, Kallogjeri D, Piccirillo JF. Safety of High-Dose Nasal Theophylline Irrigation in the Treatment of Postviral Olfactory Dysfunction: a Dose-Escalation Study. JAMA Otolaryngol Head Neck Surg 2022; 148:885-886. [PMID: 35797023 DOI: 10.1001/jamaoto.2022.1574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jake J Lee
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Shruti Gupta
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.,Medical College of Georgia, Augusta University, Augusta
| | - Dorina Kallogjeri
- 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
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20
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Gupta S, Lee JJ, Perrin A, Khan A, Smith HJ, Farrell N, Kallogjeri D, Piccirillo JF. Efficacy and Safety of Saline Nasal Irrigation Plus Theophylline for Treatment of COVID-19-Related Olfactory Dysfunction: The SCENT2 Phase 2 Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2022; 148:830-837. [PMID: 35797024 DOI: 10.1001/jamaoto.2022.1573] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Recent studies suggest that theophylline added to saline nasal irrigation (SNI) can be an effective treatment for postviral olfactory dysfunction (OD), a growing public health concern during the COVID-19 pandemic. Objective To evaluate the efficacy and safety of theophylline added to SNI compared with placebo for COVID-19-related OD. Design, Setting, and Participants This triple-blinded, placebo-controlled, phase 2 randomized clinical trial was conducted virtually between March 15 and August 31, 2021. Adults residing in Missouri or Illinois were recruited during this time period if they had OD persisting for 3 to 12 months following suspected COVID-19 infection. Data analysis was conducted from October to December 2021. Interventions Saline sinus rinse kits and bottles of identical-appearing capsules with either 400 mg of theophylline (treatment) or 500 mg of lactose powder (control) were mailed to consenting study participants. Participants were instructed to dissolve the capsule contents into the saline rinse and use the solution to irrigate their nasal cavities in the morning and at night for 6 weeks. Main Outcomes and Measures The primary outcome was the difference in the rate of responders between the treatment and the control arms, defined as a response of at least slightly better improvement in the Clinical Global Impression-Improvement scale posttreatment. Secondary outcome measures included changes in the University of Pennsylvania Smell Identification Test (UPSIT), the Questionnaire for Olfactory Disorders, the 36-Item Short Form Health Survey on general health, and COVID-19-related questions. Results A total of 51 participants were enrolled in the study; the mean (SD) age was 46.0 (13.1) years, and 36 (71%) participants were women. Participants were randomized to SNI with theophylline (n = 26) or to SNI with placebo (n = 25). Forty-five participants completed the study. At the end of treatment, 13 (59%) participants in the theophylline arm reported at least slight improvement in the Clinical Global Impression-Improvement scale (responders) compared with 10 (43%) in the placebo arm (absolute difference, 15.6%; 95% CI, -13.2% to 44.5%). The median difference for the UPSIT change between baseline and 6 weeks was 3.0 (95% CI, -1.0 to 7.0) for participants in the theophylline arm and 0.0 (95% CI, -2.0 to 6.0) for participants in the placebo arm. Mixed-model analysis revealed that the change in UPSIT scores through study assessments was not statistically significantly different between the 2 study arms. Eleven (50%) participants in the theophylline arm and 6 (26%) in the placebo arm had a change of 4 or more points in UPSIT scores from baseline to 6 weeks. The difference in the rate of responders as measured by the UPSIT was 24% (95% CI, -4% to 52%) in favor of theophylline. Conclusions and Relevance This randomized clinical trial suggests that the clinical benefit of theophylline nasal irrigations on olfaction in participants with COVID-19-related OD is inconclusive, though suggested by subjective assessments. Larger studies are warranted to investigate the efficacy of this treatment more fully. Trial Registration ClinicalTrials.gov Identifier: NCT04789499.
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Affiliation(s)
- Shruti Gupta
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.,Medical College of Georgia, Augusta University, Augusta
| | - Jake J Lee
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Amber Perrin
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Amish Khan
- Washington University School of Medicine in St Louis, St Louis, Missouri
| | | | - Nyssa Farrell
- Division of Rhinology, 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
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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21
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Herz RS, Larsson M, Trujillo R, Casola MC, Ahmed FK, Lipe S, Brashear ME. A three-factor benefits framework for understanding consumer preference for scented household products: psychological interactions and implications for future development. Cogn Res Princ Implic 2022; 7:28. [PMID: 35362845 PMCID: PMC8972642 DOI: 10.1186/s41235-022-00378-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/10/2022] [Indexed: 11/15/2022] Open
Abstract
Humans have deliberately scented their environment for purpose or pleasure for millennia. In the contemporary marketplace most consumers prefer and purchase scented versions of common household products. However, the drivers of this consumer preference have not been elucidated. To explain the attraction to scent in household products we propose a novel three-factor framework, comprising functional benefits (malodor mitigation, base odor coverage, freshening), in-use experience benefits (cleanliness, efficacy, pleasure), and emotional benefits (increasing in confidence, mood and nostalgia). To support this framework, we present new data from a market research survey on US consumer purchasing habits and attitudes towards home cleaning, laundry, and air freshening products. Further substantiating our framework, a focused review of olfactory psychological science illustrating the central role of scent in cognition, wellbeing, motivated behavior, and social behavior, as well as sensory marketing research highlights the benefits and implications of scent in consumer household products. Based on our three-factor framework we go on to discuss the potential for scent to influence health and raise issues to consider (such as potential negative responding to fragranced products). We conclude by showcasing new opportunities for future research in olfactory science and on scented household products that can advance the positive impacts of scent.
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Affiliation(s)
- Rachel S Herz
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Medical School, 146 Thayer St., Providence, RI, 02912, USA. .,Department of Psychology and Neuroscience, Boston College, Chestnut Hill, USA.
| | - Maria Larsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | | | | | - Stacy Lipe
- The Procter & Gamble Company, Cincinnati, OH, USA
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22
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Khan AM, Lee J, Rammaha T, Gupta S, Smith H, Kannampallil T, Farrell N, Kallogjeri D, Piccirillo JF. Natural Trajectory of Recovery of COVID-19 Associated Olfactory Loss. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.17.22270551. [PMID: 35194618 PMCID: PMC8863162 DOI: 10.1101/2022.02.17.22270551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
IMPORTANCE Prevalence of post-viral olfactory loss has increased dramatically due to the frequency and severity of olfactory dysfunction associated with infection by the SARS-CoV-2 virus. OBJECTIVE To determine the trajectory of COVID-19 olfactory loss over a six-month period. A key secondary objective is to assess predictive factors associated with the recovery of olfaction. DESIGN Longitudinal repeated-measures study that enrolled from May 5, 2020 to February 2, 2021, with the last date of data collection on June 15, 2021. SETTING Barnes-Jewish HealthCare/Washington University School of Medicine facilities (Saint Louis, Missouri, USA). PARTICIPANTS Individuals who tested positive for SARS-CoV-2 by real-time polymerase chain reaction on nasopharyngeal swab and indicated olfactory loss on COVID-19 screening questionnaire. Individuals were excluded if they had previously diagnosed history of olfactory loss, neurodegenerative disorders, less than 18 years of age, admitted to hospital service, unable to read, write, and understand English, or lacked computer or internet access. INTERVENTIONS/EXPOSURES Watch and wait for spontaneous recovery. MAIN OUTCOMES AND MEASURES Participants completed olfactory assessments every 30 days for six months. Each assessment consisted of the University of Pennsylvania Smell Identification Test (UPSIT), an objective "scratch-and-sniff" test, and Clinical Global Impressions (CGI), a subjective Likert rating scale. RESULTS The mean age was 41 years old (SD = 16). 39 (80%) were female and 42 (86%) white. At baseline assessment of objective olfaction, 18 (36%) participants had anosmia or severe hyposmia. Subjective, complete recovery at six months was 81% (95% CI 74% to 88%). Likelihood of recovery was associated with age less than 50 years (aHR = 8.1 (95% CI 1.1 to 64.1)) and mild olfactory loss at baseline (UPSIT = 30-33 for males and 31-34 for females) (aHR 6.2 (95% CI 1.2 to 33.0)). CONCLUSIONS AND RELEVANCE The trajectory of olfactory recovery among adults with COVID-19 olfactory loss illustrated rapid recovery within 2-3 weeks of infection, and by six months 81% had recovered based on self-report. Age less than 50 years old and mild severity of olfactory loss at baseline were associated with increased likelihood of recovery of olfaction. These findings can be used to inform shared decision-making with patients.
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23
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Hendaus MA. Anosmia (smell failure) and dysgeusia (taste distortion) in COVID-19: it is genetic. J Biomol Struct Dyn 2022; 41:3162-3165. [PMID: 35147485 DOI: 10.1080/07391102.2022.2039773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The COVID-19 pandemic is a very contagious respiratory illness with has affected millions of individuals worldwide. In addition to the well-known symptoms of any respiratory virus, COVID-19 can present with anosmia (failure to smell) and dysgeusia (distortion of the sense of taste). It appears to be a genetic link to the biological mechanisms underlying COVID-19-related anosmia and dysgeusia. Significant locus in the vicinity of the UGT2A1 and UGT2A2 genes are currently considered as the main culprit of the symptoms. However, more studies are needed to delineate a clear pathophysiology.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Mohamed A Hendaus
- Department of Pediatrics, Sidra Medicine, Doha, Qatar.,Weill Cornell Medicine, Doha, Qatar
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