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Giussani G, Westenberg E, Garcia-Azorin D, Bianchi E, Yusof Khan AHK, Allegri RF, Atalar AÇ, Baykan B, Crivelli L, Fornari A, Frontera JA, Guekht A, Helbok R, Hoo FK, Kivipelto M, Leonardi M, Lopez Rocha AS, Mangialasche F, Marcassoli A, Özdag Acarli AN, Ozge A, Prasad K, Prasad M, Sviatskaia E, Thakur K, Vogrig A, Leone M, Winkler AS. Prevalence and Trajectories of Post-COVID-19 Neurological Manifestations: A Systematic Review and Meta-Analysis. Neuroepidemiology 2024; 58:120-133. [PMID: 38272015 DOI: 10.1159/000536352] [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: 07/17/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION The aim of this systematic review and meta-analysis was to evaluate the prevalence of thirteen neurological manifestations in people affected by COVID-19 during the acute phase and at 3, 6, 9 and 12-month follow-up time points. METHODS The study protocol was registered with PROSPERO (CRD42022325505). MEDLINE (PubMed), Embase, and the Cochrane Library were used as information sources. Eligible studies included original articles of cohort studies, case-control studies, cross-sectional studies, and case series with ≥5 subjects that reported the prevalence and type of neurological manifestations, with a minimum follow-up of 3 months after the acute phase of COVID-19 disease. Two independent reviewers screened studies from January 1, 2020, to June 16, 2022. The following manifestations were assessed: neuromuscular disorders, encephalopathy/altered mental status/delirium, movement disorders, dysautonomia, cerebrovascular disorders, cognitive impairment/dementia, sleep disorders, seizures, syncope/transient loss of consciousness, fatigue, gait disturbances, anosmia/hyposmia, and headache. The pooled prevalence and their 95% confidence intervals were calculated at the six pre-specified times. RESULTS 126 of 6,565 screened studies fulfilled the eligibility criteria, accounting for 1,542,300 subjects with COVID-19 disease. Of these, four studies only reported data on neurological conditions other than the 13 selected. The neurological disorders with the highest pooled prevalence estimates (per 100 subjects) during the acute phase of COVID-19 were anosmia/hyposmia, fatigue, headache, encephalopathy, cognitive impairment, and cerebrovascular disease. At 3-month follow-up, the pooled prevalence of fatigue, cognitive impairment, and sleep disorders was still 20% and higher. At six- and 9-month follow-up, there was a tendency for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache to further increase in prevalence. At 12-month follow-up, prevalence estimates decreased but remained high for some disorders, such as fatigue and anosmia/hyposmia. Other neurological disorders had a more fluctuating occurrence. DISCUSSION Neurological manifestations were prevalent during the acute phase of COVID-19 and over the 1-year follow-up period, with the highest overall prevalence estimates for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache. There was a downward trend over time, suggesting that neurological manifestations in the early post-COVID-19 phase may be long-lasting but not permanent. However, especially for the 12-month follow-up time point, more robust data are needed to confirm this trend.
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Affiliation(s)
- Giorgia Giussani
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Erica Westenberg
- Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - David Garcia-Azorin
- Department of Neurology, Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - Elisa Bianchi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Abdul Hanif Khan Yusof Khan
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Arife Çimen Atalar
- Department of Neurology, Kanuni Sultan Süleyman Education and Research Hospital, Istanbul, Turkey
| | - Betul Baykan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | - Arianna Fornari
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Jennifer A Frontera
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry and Russian National Research Medical University, Moscow, Russian Federation
| | - Raimund Helbok
- Neurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - Fan Kee Hoo
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Miia Kivipelto
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ana Sabsil Lopez Rocha
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Mangialasche
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Alessia Marcassoli
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Aynur Ozge
- Mersin University School of Medicine, Mersin, Turkey
| | | | - Manya Prasad
- Clinical Research and Epidemiology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ekaterina Sviatskaia
- Suicide Research and Prevention Department, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation
| | - Kiran Thakur
- Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York, USA
| | - Alberto Vogrig
- Clinical Neurology, Santa Maria Della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Maurizio Leone
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Andrea Sylvia Winkler
- Department of Neurology, Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Kryukov AI, Kunelskaya NL, Zaoeva ZO, Baybakova EV, Chugunova MA, Tovmasyan AS, Panasov SA, Yanyushkina ES, Manaenkova EA, Nikitkina YY, Panova TN, Kishinevskii AE. [Features of olfactory impairment connected with trigeminal nerve system]. Vestn Otorinolaringol 2024; 89:33-39. [PMID: 38805461 DOI: 10.17116/otorino20248902133] [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: 05/30/2024]
Abstract
Data on the state of sense of smell in patients who had a new coronavirus infection caused by the SARS-CoV-2 virus are currently reduced because of the impairment of the olfactory nerve system. There are practically no results in studies of disorders in the trigeminal nerve system. OBJECTIVE Qualitative assessment of olfactory disorders after COVID-19 according to the system of olfactory and trigeminal nerves with a targeted assessment of the functional component of olfactory disorders. MATERIAL AND METHODS We examined 40 patients aged 19 to 66 who had a coronavirus infection. All patients underwent neurological, otorhinolaryngological examinations, olfactometry, filled out the hospital anxiety and depression scale. RESULTS Anosmia was diagnosed in 5 (12.5%) patients, hyposmia in 21 (52.5%) patients, and normosmia in 14 (35%) patients. Formed: the 1st group - 14 patients (35%) with normogram according to olfactometry; the 2nd group - 26 patients (65%) with anosmia/hyposmia. In the 1st group, disorders of the anxiety-depressive spectrum were significantly more common. In the 2nd group, a low identification of odors was found, lying in the spectrum of fresh, sharp, unpleasant, irritating, compared with sweet and pleasant or neutral, which indicates a predominant lesion of the trigeminal system. CONCLUSION In patients with complaints of impaired sense of smell after undergoing COVID-19, the possible functional nature of anosmia/hyposmia should be taken into account, which requires the referral of such patients to psychotherapeutic specialists, and the possible entry of olfactory disorders into the 'trigeminal' spectrum.
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Affiliation(s)
- A I Kryukov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N L Kunelskaya
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Z O Zaoeva
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E V Baybakova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - M A Chugunova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A S Tovmasyan
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - S A Panasov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E S Yanyushkina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E A Manaenkova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - Ya Yu Nikitkina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - T N Panova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A E Kishinevskii
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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3
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Hamed SA. Post-COVID-19 persistent olfactory, gustatory, and trigeminal chemosensory disorders: Definitions, mechanisms, and potential treatments. World J Otorhinolaryngol 2023; 10:4-22. [DOI: 10.5319/wjo.v10.i2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/28/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
The nose and the oral cavities are the main sites for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry into the body. Smell and taste deficits are the most common acute viral manifestations. Persistent smell disorders are the most common and bothersome complications after SARS-CoV-2 infection, lasting for months to years. The mechanisms and treatment of persistent post-coronavirus disease 2019 (COVID-19) smell and taste disorders are still challenges. Information sources for the review are PubMed, Centers for Disease Control and Prevention, Ovid Medline, Embase, Scopus, Web of Science, International Prospective Register of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Elton Bryson Stephens Company, Cochrane Effective Practice and Organization of Care, Cooperation in Science and Technology, International Clinical Trials Registry Platform, World Health Organization, Randomized Controlled Trial Number Registry, and MediFind. This review summarizes the up-to-date information about the prevalence, patterns at onset, and prognoses of post-COVID-19 smell and taste disorders, evidence for the neurotropism of SARS-CoV-2 and the overlap between SARS-CoV-1, Middle East respiratory syndrome coronavirus, and SARS-CoV-2 in structure, molecular biology, mode of replication, and host pathogenicity, the suggested cellular and molecular mechanisms for these post-COVID19 chemosensory disorders, and the applied pharmacotherapies and interventions as trials to treat these disorders, and the recommendations for future research to improve understanding of predictors and mechanisms of these disorders. These are crucial for hopeful proper treatment strategies.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University, Faculty of Medicine, Assiut 71516, Egypt
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4
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Weir EM, Exten C, Gerkin RC, Munger SD, Hayes JE. Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19: a small case-control series. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.27.23287763. [PMID: 37034638 PMCID: PMC10081393 DOI: 10.1101/2023.03.27.23287763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Anosmia is common with respiratory virus infections, but loss of taste or chemesthesis is rare. Reports of true taste loss with COVID-19 were viewed skeptically until confirmed by multiple studies. Nasal menthol thresholds are elevated in some with prior COVID-19 infections, but data on oral chemesthesis are lacking. Many patients recover quickly, but precise timing and synchrony of recovery are unclear. Here, we collected broad sensory measures over 28 days, recruiting adults (18-45 years) who were COVID-19 positive or recently exposed (close contacts per U.S. CDC criteria at the time of the study) in the first half of 2021. Participants received nose clips, red commercial jellybeans (Sour Cherry and Cinnamon), and scratch-n-sniff cards (ScentCheckPro). Among COVID-19 cases who entered the study on or before Day 10 of infection, Gaussian Process Regression showed odor identification and odor intensity (two distinct measures of function) each declined relative to controls (close contacts who never developed COVID-19), but effects were larger for intensity than identification. To assess changes during early onset, we identified four COVID-19 cases who enrolled on or prior to Day 1 of their illness â€" this allowed for visualization of baseline ratings, loss, and recovery of function over time. Four controls were matched for age, gender, and race. Variables included sourness and sweetness (Sour Cherry jellybeans), oral burn (Cinnamon jellybeans), mean orthonasal intensity of four odors (ScentCheckPro), and perceived nasal blockage. Data were plotted over 28 days, creating panel plots for the eight cases and controls. Controls exhibited stable ratings over time. By contrast, COVID-19 cases showed sharp deviations over time. No single pattern of taste loss or recovery was apparent, implying different taste qualities might recover at different rates. Oral burn was transiently reduced for some before recovering quickly, suggesting acute loss may be missed in data collected after acute illness ends. Changes in odor intensity or odor identification were not explained by nasal blockage. Collectively, intensive daily testing shows orthonasal smell, oral chemesthesis and taste were each altered by acute COVID-19 infection, and this disruption was dyssynchronous for different modalities, with variable loss and recovery rates across modalities and individuals.
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Affiliation(s)
- Elisabeth M. Weir
- Sensory Evaluation Center, The Pennsylvania State University, University Park PA 16802
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park PA 16802
| | - Cara Exten
- Ross and Carol Nese College of Nursing, the Pennsylvania State University, University Park PA 16802
| | | | - Steven D. Munger
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville FL, 32610
- Center for Smell and Taste, University of Florida, Gainesville FL, 32610
- Department of Otolaryngology, University of Florida College of Medicine, Gainesville FL, 32610
| | - John E. Hayes
- Sensory Evaluation Center, The Pennsylvania State University, University Park PA 16802
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park PA 16802
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5
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Utomo NP, Iswarini AD. Impaired olfaction post-coronavirus disease 2019: a systematic review of smell recovery predictive factors. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [PMCID: PMC9261196 DOI: 10.1186/s43163-022-00271-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background The devastating coronavirus disease (COVID-19) pandemic seemed not yet to cease. Numerous studies regarding its typical sign and symptoms have been done, presenting one of the most promising predictors of the infection: olfactory dysfunction. Although not life-threatening, the symptom could decrease one’s quality of life, especially if persistent throughout their entire life. Among the countless literature regarding loss of smell, only limited studies denote predictors of smell recovery. This systematic review aimed to bridge the knowledge gap of olfactory impairment prevalence and recovery predictors in people with COVID-19. Methods This review was carried out through journal databases, including PubMed, Science Direct, Google Scholar, and medRxiv. Literature published from 2020 to 2022 that complied with the inclusion and exclusion criteria was retrieved, scanned for duplicates with Zotero, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2020 (PRISMA) guidelines. Results Of the 2243 studies, seven were assessed with the Prediction model Risk Of Bias ASsessment Tool (PROBAST) to analyze the risk of bias, which five cohort studies deemed relevant. Olfactory dysfunction, olfactory recovery, and its predictive factors are noted. This review is registered in PROSPERO (Registration Number CRD42022318412). Conclusions No clinical markers predicted the recovery of olfactory dysfunction, but patients who are more likely to recover are associated with younger age, female sex, and having COVID-19-related symptoms such as nasal congestion and trigeminal sensation. Modifiable factors are still dubious in predicting the olfaction recovery.
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6
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Cosentino G, Maiorano E, Todisco M, Prunetti P, Antoniazzi E, Tammam G, Quartesan I, Lettieri S, De Icco R, Corsico AG, Benazzo M, Pisani A, Tassorelli C, Alfonsi E. Electrophysiological evidence of subclinical trigeminal dysfunction in patients with COVID-19 and smell impairment: A pilot study. Front Neurol 2022; 13:981888. [PMID: 36313508 PMCID: PMC9615421 DOI: 10.3389/fneur.2022.981888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Smell and taste disturbances are among the most frequent neurological symptoms in patients with COVID-19. A concomitant impairment of the trigeminal nerve has been suggested in subjects with olfactory dysfunction, although it has not been confirmed with objective measurement techniques. In this study, we explored the trigeminal function and its correlations with clinical features in COVID-19 patients with impaired smell perception using electrophysiological testing. Methods We enrolled 16 consecutive patients with mild COVID-19 and smell impairment and 14 healthy controls (HCs). Olfactory and gustatory symptoms were assessed with self-reported questionnaires. Electrophysiological evaluation of the masseter inhibitory reflex (MIR) and blink reflex (BR) was carried out to test the trigeminal function and its connections within the brainstem. Results Masseter inhibitory reflex (MIR) analysis revealed higher latency of ipsilateral and contralateral early silent period in patients when compared with HCs. No significant differences between groups were detected as regards the duration of the early and late silent period. However, several patients showed a prolonged duration of the early silent period. BR evaluation disclosed only an increased amplitude of early components in patients. Conclusions Patients with COVID-19 and smell impairment show a subclinical trigeminal nerve impairment. Trigeminal alterations mainly involve the oligosynaptic pathway, as a result of either direct viral damage or secondary neuroinflammation of the peripheral trigeminal fibers, whereas the polysynaptic ponto-medullary circuits seem to be spared. The prolonged duration of the early silent period and the increased amplitude of early BR response might reflect a compensatory upregulation of the trigeminal function as a consequence of the olfactory dysfunction.
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Affiliation(s)
- Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- *Correspondence: Giuseppe Cosentino
| | - Eugenia Maiorano
- Department of Otolaryngology–Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimiliano Todisco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Paolo Prunetti
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa Antoniazzi
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giulia Tammam
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Quartesan
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sara Lettieri
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Angelo Guido Corsico
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marco Benazzo
- Department of Otolaryngology–Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Movement Disorders Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Enrico Alfonsi
- Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy
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7
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Ferreli F, Gaino F, Russo E, Di Bari M, Rossi V, De Virgilio A, Malvezzi L, Colombo G, Cristalli G, Spriano G, Mercante G. Long-standing gustatory and olfactory dysfunction in COVID-19 patients: a prospective study. Eur Arch Otorhinolaryngol 2022; 279:4633-4640. [PMID: 35767055 PMCID: PMC9244308 DOI: 10.1007/s00405-022-07428-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Purpose Our study aimed to describe recovery of gustatory dysfunction (GD) and olfactory dysfunction (OD) in COVID-19 patients, and to analyze variables associated with early or late recovery. Methods Telephone surveys were administered during an 18-month follow-up after COVID-19 diagnosis. One hundred and thirty-two included patients rated olfactory and gustatory function at each follow-up. Results One hundred and twenty-nine patients reported GD, of whom 91 (70.5%) reported severe GD, and 99 patients reported OD, of whom 84 (84.9%) reported severe OD. Seventy-two/129 (55.8%) and 52/99 (52.5%) patients reported an improvement in GD and in OD during the first 7 days from the onset, respectively. At 3-month follow-up, 110/120 patients (85.3%) recovered from GD, while 80/99 patients (80.8%) recovered from OD. At 18-month follow-up, a total of 120/129 patients (93.0%) recovered from GD and 86/99 patients (86.9%) recovered from OD; while 10 patients (7.0%) still reported GD and 13 patients (13.1%) still reported OD. Severe GD/OD at presentation were associated with late complete recovery of taste/smell (p = 0.019 and p = 0.034, respectively). Improvement over the first 7 days from onset was significantly associated with faster recovery (p < 0.001). Conclusions More than 80% of patients reported complete recovery of olfactory/gustatory function in the first 3 months after symptom onset. At 18-month follow-up, patients reporting complete recovery of gustatory and olfactory function were 93% and 87%, respectively. Severity of chemosensory dysfunction at the onset was negatively correlated to recovery, and improvement of taste and/or smell function within the first 7 days from symptom onset was significantly associated with early resolution.
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Affiliation(s)
- Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Francesca Gaino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy. .,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy.
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Matteo Di Bari
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vanessa Rossi
- Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giovanni Colombo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giovanni Cristalli
- Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud "Madre Teresa Di Calcutta", Padua, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.,Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
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8
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Szewczyk AK, Skrobas U, Jamroz-Wiśniewska A, Mitosek-Szewczyk K, Rejdak K. Facial Diplegia-Complication or Manifestation of SARS-CoV-2 Infection? A Case Report and Systemic Literature Review. Healthcare (Basel) 2021; 9:healthcare9111492. [PMID: 34828542 PMCID: PMC8618007 DOI: 10.3390/healthcare9111492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/24/2022] Open
Abstract
Since the outbreak of the new coronavirus, healthcare systems around the world have witnessed not only COVID-19 symptoms but also long-term complications of the aforementioned, including neurological problems. We report a clinical case of an adult patient with bilateral facial nerve palsy and progressive ascending paresis of the limbs after contracting the novel coronavirus (COVID-19). Additionally, the systematic review aimed to identify and summarize specific clinical features, outcomes and complications of the studies focusing on bilateral facial diplegia as a sequela of COVID-19 infection. The total number of analyzed patients was 15. Only one patient was diagnosed with isolated bilateral palsy; the rest had Guillain-Barré Syndrome (GBS). With one exception, all the presented cases had favorable outcomes, with facial palsy recovery from slight to almost complete. In patients with a confirmed COVID-19 diagnosis, bilateral facial palsy may be an isolated symptom as well as a variant of GBS. Symptoms of cranial nerve damage during a COVID-19 infection may explain the appearance of facial nerve damage. In order to clarify the spectrum of neurological manifestations and a causal relation between SARS-CoV-2, COVID-19 vaccination and neurological symptoms, direct attention towards the study of this virus is crucial. It seems reasonable to recognize human coronavirus as another potential GBS trigger.
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Affiliation(s)
- Anna K. Szewczyk
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland; (U.S.); (A.J.-W.); (K.R.)
- Correspondence:
| | - Urszula Skrobas
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland; (U.S.); (A.J.-W.); (K.R.)
| | - Anna Jamroz-Wiśniewska
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland; (U.S.); (A.J.-W.); (K.R.)
| | - Krystyna Mitosek-Szewczyk
- Department of Child Neurology, Medical University of Lublin, ul. Profesora Antoniego Gębali 6, 20-093 Lublin, Poland;
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954 Lublin, Poland; (U.S.); (A.J.-W.); (K.R.)
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Otte MS, Bork ML, Zimmermann PH, Klußmann JP, Lüers JC. Patients with COVID-19-associated olfactory impairment also show impaired trigeminal function. Auris Nasus Larynx 2021; 49:147-151. [PMID: 34366241 PMCID: PMC8310725 DOI: 10.1016/j.anl.2021.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Abstract
Objective Next to olfactory function, the nose can also perceive chemestetic sensations mediated by the trigeminal nerve. While olfactory dysfunction as a symptom of COVID-19 is well described, there has been little research on the limitation of other nasal sensory inputs due to SARS-CoV-2 infection. The aim of this study was to determine possible limitations of nasal chemesthesis after COVID-19 infection by a psychophysiological diagnostic tool. Methods In 65 patients with a PCR-confirmed, former COVID-19 disease, olfaction was tested by means of a sniffin' sticks test, tasting by taste sprays and chemesthesis with a menthol dilution series. The subjective self-assessment of the patients was recorded via a questionnaire. Results We found a restriction of nasal chemesthesis and the extent correlated with the loss of smell, as well as with the values of the taste score, but not with subjective self-assessment. Conclusion Not only the ability to smell and taste, but also nasal chemesthesis is affected by COVID-19.
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Affiliation(s)
- Martin Sylvester Otte
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne 50924, Germany.
| | - Marie-Luise Bork
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne 50924, Germany
| | - Philipp Heinrich Zimmermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne 50924, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne 50924, Germany; Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jan-Christoffer Lüers
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne 50924, Germany
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