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Okrzeja J, Sołomacha S, Alimowski M, Sowa P, Dubatówka M, Łapińska M, Kiszkiel Ł, Szczerbiński Ł, Laskowski PP, Czupryna P, Kubas B, Garkowski A, Kamiński KA, Moniuszko-Malinowska A. Assessment of smell disturbances 6 months after COVID-19 in Polish population. Sci Rep 2024; 14:11251. [PMID: 38755270 PMCID: PMC11099038 DOI: 10.1038/s41598-024-62114-y] [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: 10/01/2023] [Accepted: 05/14/2024] [Indexed: 05/18/2024] Open
Abstract
Considering the frequency and severity of olfactory disorders associated with SARS-CoV-2 infection, attention to the olfactory loss has expanded. The aim of our study was to assess of smell disturbances 6 months after COVID-19. The study population consisted of 2 groups: 196 Post-COVID-19 patients who were hospitalized because of COVID-19, control sample-130 patients without reported smell disorders from general population-Bialystok PLUS study. People from both groups were asked to participate in the Sniffin Sticks Test (half year after the disease). Sniffin Sticks Test consisted of 12 standardized smell samples. The participant's test score was counted based on correct scent recognition. Middle/older age was related with lower likelihood of olfaction recovery. The biggest differences in recognition of particular fragrances were observed for: orange and lemon, lemon and coffee (p.adj < 0.001). Patients had the greatest problem in assessing smell of lemon. The comparison of scores between Delta, Omicron, Wild Type, Wild Type Alpha waves showed statistically significant difference between Delta and Wild Type waves (p = 0.006). Duration of the disease (r = 0.218), age (r = -0.253), IL-6 (r = -0.281) showed significant negative correlations with the score. Statistically significant variables in the case of smell disorders were Omicron wave (CI = 0.045-0.902; P = 0.046) and Wild Type wave (CI = 0.135-0.716; P = 0.007) compared to Delta wave reference. Moreover, patients with PLT count below 150 000/μl had greater olfactory disorders than those with PLT count over 150 000/μl. There are: smell differences between post-COVID-19 patients and healthy population; statistically significant difference between Delta and Wild Type waves in Post-COVID-19 group in score of the Sniffin Sticks Test. Smell disturbances depend on the age, cognitive impairments, clinical characteristics of the COVID-19 disease and sex of the patient.
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Affiliation(s)
- Jakub Okrzeja
- Medical University of Bialystok, Żurawia 14, 15-540, Bialystok, Poland.
| | - Sebastian Sołomacha
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Maciej Alimowski
- Doctoral School of Social Sciences, University of Bialystok, Białystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Marlena Dubatówka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Magda Łapińska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Łukasz Kiszkiel
- Society and Cognition Unit, University of Bialystok, Białystok, Poland
| | - Łukasz Szczerbiński
- Clinical Research Centre, Medical University of Bialystok, Białystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
| | | | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
| | - Bożena Kubas
- Department of Radiology, Medical University of Bialystok, Białystok, Poland
| | - Adam Garkowski
- Department of Radiology, Medical University of Bialystok, Białystok, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Białystok, Poland
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Yoshino A, Murakami R, Hosoya K, Komachi T, Mori E, Nin T, Mahmut MK, Okubo K. A Nationwide survey of safety protocols and chemosensory assessments by Japanese clinicians pre- and post-COVID-19 pandemic. Auris Nasus Larynx 2024; 51:640-646. [PMID: 38626699 DOI: 10.1016/j.anl.2024.04.007] [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: 01/18/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE There has been an increase of attention and awareness of smell and taste loss due to the impact of COVID-19. However, little is known about the influence of COVID-19 on the number of psychophysical tests performed, the timing of these tests, or the protection protocols employed to protect against virus transmission. This study aimed to explore the changes in examination approaches, types of tests employed, and safety measures adopted by clinicians before and after the COVID-19 pandemic. METHODS A survey was distributed to 404 institutes of the Oto-Rhino Laryngological Society of Japan, consisting of otolaryngologists working in university hospitals, general hospitals, and private clinics. The anonymous online survey contained questions related to safety measures and chemosensory assessments performed before and after the COVID-19 pandemic. Specifically, participants were queried on the number and types of examinations conducted, the type of examiners who performed them, the timing of tests in suspected and non-suspected COVID-19 cases, modifications made due to the pandemic, and the protective measures adopted during chemosensory examinations. RESULTS Of the 201 respondents, representing a 50 % response rate, 49 % were from general hospitals, 48 % from university hospitals, and 3 % from private clinics. The study found a slight decrease in the overall number of chemosensory tests conducted post-COVID-19. In terms of who performed the test, there were no differences pre- and post- COVID-19. Most examinations (52-68 %) for suspected COVID-19 cases were performed 1-2 months after the onset of symptoms. Modifications in testing rooms and personal protective equipment (PPE) were reported by the majority of institutions post-pandemic. While different examination rooms or PPE were not commonly used based on a patient's previous COVID-19 diagnosis, changes were observed in testing practices. Most examinations were conducted in rooms with windows or fans, and PPE usage was high; surgical masks, eye visors or face shields, and disposable gloves being commonly used. Virus transmission from patient to examiner was reported in only one case during T&T olfactometer examination. CONCLUSION We investigated the impact of the COVID-19 pandemic on the number of olfactory and gustatory tests performed, the type of examiner, the examination room, and the use of PPE and found no significant difference before and after the COVID-19 pandemic on these factors. Adherence to a protection protocol involving the proper use of PPE in controlled environments enabled the continuation of olfactory and gustatory tests during the pandemic.
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Affiliation(s)
- Ayaho Yoshino
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan.
| | - Ryosuke Murakami
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Kei Hosoya
- Department of Otolaryngology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
| | - Taro Komachi
- Department of Otolaryngology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Eri Mori
- Department of Otolaryngology Head and Neck Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Tomomi Nin
- Department of Otolaryngology Head and Neck Surgery, Hyogo Medical University, Hyogo, Japan
| | - Mehmet K Mahmut
- School of Psychological Sciences, Food, Flavour and Fragrance Lab, Macquarie University, Sydney, Australia
| | - Kimihiro Okubo
- Department of Otolaryngology Head and Neck Surgery, Nippon Medical School Hospital, Tokyo, Japan
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Livni D, Grinstein-Koren O, Zlotogorski-Hurvitz A, Reiter S, Winocour-Arias O, Edel J, Goldman Y, Vered M, Choshen G, Rahamim-Cohen D, Shapiro-Ben David S, Kaplan I. The effect of post-COVID-19 on gustatory and olfactory function: A preliminary case-controlled study. Oral Dis 2024; 30:1669-1679. [PMID: 36929202 DOI: 10.1111/odi.14567] [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: 06/14/2022] [Revised: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
AIMS The aim of the study was to analyze objective and subjective olfactory/gustatory function in post-COVID-19 infection (PCI). MATERIALS AND METHODS Patients with past PCR-confirmed COVID-19 infection and persistent olfactory/gustatory complaints were investigated. Olfactory threshold and identification, gustatory detection, identification, and magnitude scaling were tested. RESULTS A total of 42 PCI subjects were compared to 41 age- and gender-matched controls with no COVID-19 history. All PCI tested had mild COVID-19 disease. Mean interval between COVID-19 confirmations to testing was 7.4 ± 3.1 months. PCI subjects complained of combined dysfunction in 85.7%, isolated olfactory or gustatory dysfunction in 7.1% each. Combined complaints were significantly higher in PCI (p < 0.001). Objective testing showed significantly higher prevalence of dysfunction in PCI versus controls for hyposmia (73.8%, 12.2%), anosmia (11.9%, 0%), odor identification (68.5%, 83.0%), hypogeusia (23% and 2.4%, respectively), and impaired magnitude scaling, (p < 0.05). All PCI subjects with hypogeusia had abnormal gustatory magnitude scaling. CONCLUSIONS While most PCI subjects complained of combined gustatory and olfactory dysfunction, objective testing showed in the majority an isolated single sense dysfunction, with a low level of agreement between subjective and objective findings. Abnormal objective results for all olfactory and gustatory functions tested may suggest a central rather than peripheral mechanism, although concomitant mechanisms cannot be excluded.
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Affiliation(s)
- Dror Livni
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Osnat Grinstein-Koren
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Ayelet Zlotogorski-Hurvitz
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Shoshana Reiter
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Orit Winocour-Arias
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Jeremy Edel
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Yuli Goldman
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Marilena Vered
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
| | - Guy Choshen
- Department of Internal Medicine, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv, Israel
| | | | | | - Ilana Kaplan
- Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University Israel, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv, Israel
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Modesto DS, Silva Neto HM, Leão FC, Mendes Neto JA, Suzuki FA. Alcohol Sniff Test (AST): An Important Tool for Screening Post-Viral Olfactory Loss in Acute Flu-Like Dysfunction. Indian J Otolaryngol Head Neck Surg 2024; 76:604-610. [PMID: 38440626 PMCID: PMC10909055 DOI: 10.1007/s12070-023-04224-z] [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: 07/24/2023] [Accepted: 09/07/2023] [Indexed: 03/06/2024] Open
Abstract
Olfactory disorders have a significant impact on patients' quality of life but are often underestimated in clinical practice. Upper respiratory tract infections (URTIs) are a common cause of olfactory loss. While most cases of olfactory loss due to URTIs are conductive and reversible, post-viral olfactory dysfunction (PVOD) persists despite symptom improvement. PVOD is attributed to damage to the olfactory epithelium and nerves or central olfactory pathway lesions. The Alcohol Sniff Test (AST) has been proposed as a tool to assess olfactory function in the acute phase and aid in differentiating PVOD from conductive disorders. This study aims to evaluate the effectiveness of the AST as a predictor of post-viral olfactory loss in patients with flu-like syndrome. An observational cross-sectional study was conducted among employees with flu-like syndrome at a tertiary hospital. Three groups were formed: flu-like syndrome with conductive disorder without COVID-19 (PVOD-), flu-like syndrome with neurosensory and/or central disorder due to COVID-19 (PVOD +), and an asymptomatic control group. The Alcohol Sniff Test was performed to assess olfactory function. Statistical analysis was conducted to evaluate the AST's performance. For a cut off of 10 cm, 88.57% of PVOD + patients and 60.53% of PVOD - patients showed AST alteration, respectively (p = 0.013, OR = 5.05, 95% CI [1.48-17.25]). There was a statistically significant difference in the mean distance between the PVOD + group (4.35 ± 4.1 cm) and the control group (20 ± 4.33 cm) (p < 0.05). This relationship was also observed between the PVOD + and PVOD- groups (9 cm ± 7.5) (p < 0.05) and between the PVOD- and control groups (p < 0.05). For a cut off of 10 cm, the AST showed a sensitivity of 88% and specificity of 41%, resulting in an Odds Ratio of 9.7 (95% CI 3.3-28.1) (p < 0.001) and a Positive Predictive Value of 69.4% for PVOD. PVOD, including cases associated with COVID-19, is a prevalent cause of olfactory loss. The Alcohol Sniff Test demonstrated promising results in identifying PVOD in patients with flu-like syndrome. The test's simplicity and accessibility make it a valuable tool for early screening and identifying individuals who may benefit from prompt treatment. The Alcohol Sniff Test (AST) shows potential as an effective tool for screening post-viral olfactory loss in patients with flu-like syndrome. It can aid in early identification of PVOD cases and facilitate timely interventions to reduce the likelihood of persistent hyposmia.
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Affiliation(s)
- Domenico Seabra Modesto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Hugo Machado Silva Neto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Felipe Carvalho Leão
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - José Arruda Mendes Neto
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
| | - Fábio Akira Suzuki
- Departamento de Otorrinolaringologia, Hospital Do Servidor Público Estadual Francisco Morato de Oliveira, Rua Loefgren, 1543, Apt 34, Sao Paulo, SP 04040-032 Brazil
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Kasim MF, Abbas AM. Evaluation of Olfactory Dysfunction Among COVID-19 Patients in Baghdad, Iraq. Cureus 2024; 16:e53721. [PMID: 38455837 PMCID: PMC10919444 DOI: 10.7759/cureus.53721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Background SARS‑CoV‑2 (COVID-19) causes olfactory dysfunction which is characterized by anosmia or hyposmia. Characterization of olfactory dysfunction has added value to the diagnosis and prognosis of the disease. Nevertheless, scarce information exists about COVID-19 patients suffering from olfactory dysfunction in Iraq. This study aimed to identify olfactory dysfunction (anosmia or hyposmia) in Iraqi COVID-19 patients and examine their response to smell exercise at Baghdad Medical City Complex, Baghdad, Iraq. Methodology This case series prospective study involving 300 patients (160 males and 140 females) with COVID-19 infection was conducted from June 1, 2020, to October 1, 2021. We recorded signs and symptoms of COVID-19 among patients by examining olfactory dysfunction, n-butanol olfaction test, and smell test exercise. Results Anosmia and hyposmia were found in 69.3% and 30.7% of the patients, respectively; of these, 65.7% were of sudden onset. The association between olfactory dysfunction and smoking was not significant. The most frequent signs and symptoms of COVID-19 were fatigue, fever, loss of taste, myalgia, headache, sore throat, cough, depressed appetite, dyspnea, nausea, abdominal pain, and diarrhea. The highest frequencies of occurrence of anosmia (30.7%) and hyposmia (13.3%) were in the age group of 31-40 years. The majority (47.7%) of patients with olfactory dysfunction recovered within one month of COVID-19 onset. The rest of the patients recovered within one month to 16 months. The most commonly encountered ear, nose, and throat symptoms were nasal obstruction, rhinorrhea, and facial/ear pain. The percentages of patients with anosmia and hyposmia recovering with smell exercise were significant at 64.7% and 25.3%, respectively. Conclusions The prognosis of olfactory dysfunction in COVID-19 patients was good as most cases recovered within a short period with concomitant smell exercise. Olfactory dysfunction in the majority of COVID-19 patients was self-limiting in young age groups, albeit in association with the non-severity of the disease. Being an important public health issue, examining olfactory dysfunction aspects should be considered in the diagnosis, prognosis, and treatment protocols of COVID-19 patients. In-depth exploration is needed to examine olfactory and gustatory dysfunction in patients suffering from severe COVID-19.
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Affiliation(s)
| | - Azzam M Abbas
- Otolaryngology, College of Medicine, University of Baghdad and Martyr Ghazi Al-Hariri Teaching Hospital, Baghdad Medical City, Baghdad, IRQ
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Jezierska K, Lietz-Kijak D, Gronwald H, Oleksy B, Gronwald BJ, Podraza W. Taste dysfunction after COVID-19: Analysis with functional near-infrared spectroscopy. OTOLARYNGOLOGIA POLSKA 2023; 78:14-19. [PMID: 38332707 DOI: 10.5604/01.3001.0053.7423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
<br><b>Introduction:</b> According to official data, COVID-19 emerged in China in December 2019 and has spread worldwide since then.</br> <br><b>Aim:</b> The aim of this study was to investigate differences in functional near-infrared spectroscopy (fNIRS) recordings between convalescent COVID-19 patients and a healthy control group, which could help to clarify the pathomechanism of dysgeusia in COVID-19.</br> <br><b>Material and methods:</b> The study included 16 participants, comprised of 8 convalescent COVID-19 patients and 8 healthy controls. All participants were examined with fNIRS. The amplitude of changes in oxyhemoglobin (oxyHb) concentration in the cerebral cortex was analyzed statistically (for the test and control groups after stimulation with a taste stimulus - citric acid solution).</br> <br><b>Results:</b> The differences in the amplitude of changes in oxyHb concentration in the cerebral cortex were not statistically significant between the groups. Discussion: Using fNIRS, a strong stimulation of the visual cortex was discovered in response to the taste stimulus, consisting of large, repetitive changes in oxyHb concentration occurring in parallel with stimulation of areas of the taste cortex. This phenomenon has not, to our knowledge, been described previously in the scientific literature. The exact location of the primary taste cortex is controversial, but to date the occipital cortex has not been considered to be involved.</br> <br><b>Conclusions: No difference was observed in the dynamics of changes in oxyHb in the examined areas of the cerebral cortex between convalescent COVID-19 patients and healthy controls. However, the determination of the role of the occipital cortex in the perception of taste requires further research.</br>.
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Affiliation(s)
- Karolina Jezierska
- Pomeranian Medical University, Department of Medical Physics, Szczecin, Poland
| | - Danuta Lietz-Kijak
- Pomeranian Medical University, Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Szczecin, Poland
| | - Helena Gronwald
- Pomeranian Medical University, Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Szczecin, Poland
| | - Barbara Oleksy
- Paediatric Neurology Clinic, Institute of Mother and Child in Warsaw, Poland
| | - Barbara Janina Gronwald
- Doctoral Study at the Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Szczecin, Poland
| | - Wojciech Podraza
- Pomeranian Medical University, Department of Medical Physics, Szczecin, Poland
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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. Physiol Behav 2023; 271:114331. [PMID: 37595820 PMCID: PMC10591985 DOI: 10.1016/j.physbeh.2023.114331] [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: 03/26/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
Transient loss of smell is a common symptom of influenza and other upper respiratory infections. Loss of taste is possible but rare with these illnesses, and patient reports of 'taste loss' typically arise from a taste / flavor confusion. Thus, initial reports from COVID-19 patients of loss of taste and chemesthesis (i.e., chemical somatosensation like warming or cooling) were met with skepticism until multiple studies confirmed SARS-CoV-2 infections could disrupt these senses. Many studies have been based on self-report or on single time point assessments after acute illness was ended. Here, we describe intensive longitudinal data over 28 days from adults aged 18-45 years recruited in early 2021 (i.e., prior to the Delta and Omicron SARS-CoV-2 waves). These individuals were either COVID-19 positive or close contacts (per U.S. CDC criteria at the time of the study) in the first half of 2021. Upon enrollment, all participants were given nose clips, blinded samples of commercial jellybeans (Sour Cherry and Cinnamon), and scratch-n-sniff odor identification test cards (ScentCheckPro), which they used for daily assessments. In COVID-19 cases who enrolled on or before Day 10 of infection, Gaussian Process Regression showed two distinct measures of function - odor identification and odor intensity - declined relative to controls (exposed individuals who never developed COVID-19). Because enrollment began upon exposure, some participants became ill only after enrollment, which allowed us to capture baseline ratings, onset of loss, and recovery. Data from these four cases and four age- and sex- matched controls were plotted over 28 days to create panel plots. Variables included mean orthonasal intensity of four odors (ScentCheckPro), perceived nasal blockage, oral burn (Cinnamon jellybeans), and sourness and sweetness (Sour Cherry jellybeans). Controls exhibited stable ratings over time. By contrast, COVID-19 cases showed sharp deviations over time. Changes in odor intensity or odor identification were not explained by nasal blockage. 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 datasets collected only after illness ends. Collectively, intensive daily testing shows orthonasal smell, oral chemesthesis and taste were each altered by acute SARS-CoV-2 infection. This disruption was dyssynchronous for different modalities, with variable loss and recovery rates across both modalities and individuals.
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Affiliation(s)
- Elisabeth M Weir
- Sensory Evaluation Center, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA, 16802, United States of America; Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Cara Exten
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, 16802, United States of America
| | - Richard C Gerkin
- School of Life Sciences, Arizona State University, Tempe, AZ, 85287, United States of America
| | - Steven D Munger
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL, 32610, United States of America; Center for Smell and Taste, University of Florida, Gainesville, FL, 32610, United States of America; Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL, 32610, United States of America
| | - John E Hayes
- Sensory Evaluation Center, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA, 16802, United States of America; Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA, 16802, United States of America.
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Fornazieri MA, da Silva JLB, Gameiro JG, Scussiato HO, Ramos RAMR, Cunha BM, Figueiredo AF, Takahashi EH, Marin GA, Caetano IRDA, Meli TK, Higuchi DI, dos Santos RRP, Rampazzo ACM, Pinna FDR, Voegels RL, Doty RL. Chemosensory Dysfunction 3-Months After COVID-19, Medications and Factors Associated with Complete Recovery. Ann Otol Rhinol Laryngol 2023; 132:1177-1185. [PMID: 36482672 PMCID: PMC9742352 DOI: 10.1177/00034894221138485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the longitudinal prevalence and recovery of olfactory, gustatory, and oral chemesthetic deficits in a sizable cohort of SARS-CoV-2 infected persons using quantitative testing. To determine whether demographic and clinical factors, mainly the medications used after the COVID-19 diagnosis, influence the test measures. METHODS Prospective cohort in a hospital with primary, secondary, tertiary, and quaternary care. Patients with confirmed COVID-19 were tested during the acute infection phase (within 15 days of initial symptom, n = 187) and one (n = 113) and 3 months later (n = 73). The University of Pennsylvania Smell Identification Test, the Global Gustatory Test, and a novel test for chemesthesis were administered at all visits. RESULTS During the acute phase, 93% were anosmic or microsmic and 29.4% were hypogeusic. No one was ageusic. A deficit in oral chemesthesis was present in 13.4%. By 3 months, taste and chemesthesis had largely recovered, however, some degree of olfactory dysfunction remained in 54.8%. Remarkably, patients who had been treated with anticoagulants tended to have more olfactory improvement. Recovery was greater in men than in women, but was unrelated to disease severity, smoking behavior, or the use of various medications prior to, or during, COVID-19 infection. CONCLUSIONS When using quantitative testing, olfactory disturbances were found in nearly all SARS-CoV-2 infected patients during the acute infection phase. Taste or chemesthetic deficits were low. Olfactory impairment persisted to some degree in over half of the patients at the 3-month follow-up evaluation, being more common in women and less common in those who had been treated earlier with anticoagulants. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Marco Aurélio Fornazieri
- Londrina State University, Londrina, Paraná, Brazil
- Pontifical Catholic University of Paraná, Londrina, Brazil
- University of São Paulo, São Paulo, State of São Paulo, Brazil
- Smell and Taste Center, Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Richard L. Doty
- Smell and Taste Center, Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Elmazny A, Magdy R, Hussein M, Elsebaie EH, Ali SH, Abdel Fattah AM, Hassan M, Yassin A, Mahfouz NA, Elsayed RM, Fathy W, Abdel-Hamid HM, Abdelbadie M, Soliman SH. Neuropsychiatric post-acute sequelae of COVID-19: prevalence, severity, and impact of vaccination. Eur Arch Psychiatry Clin Neurosci 2023; 273:1349-1358. [PMID: 36707454 PMCID: PMC9882743 DOI: 10.1007/s00406-023-01557-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023]
Abstract
The potential long-term neuropsychiatric effects of COVID-19 are of global concern. This study aimed to determine the prevalence and predictors of neuropsychiatric post-acute sequelae of COVID-19 among Egyptian COVID-19 survivors and to study the impact of full vaccination before COVID-19 infection on the occurrence and severity of these manifestations. Three months after getting COVID-19 infection, 1638 COVID-19 survivors were screened by phone for possible neuropsychiatric sequelae. Subjects suspected to suffer from these sequelae were invited to a face-to-face interview for objective evaluation. They were requested to rate the severity of their symptoms using visual analogue scales (VAS). The mean age of participants was 38.28 ± 13 years. Only 18.6% were fully vaccinated before COVID-19 infection. Neuropsychiatric post-acute sequelae of COVID-19 were documented in 598 (36.5%) subjects, fatigue was the most frequent one (24.6%), followed by insomnia (16.4%), depression (15.3%), and anxiety (14.4%). Moderate and severe COVID-19 infection and non-vaccination increased the odds of developing post-COVID-19 neuropsychiatric manifestations by 2 times (OR 1.95, 95% CI = 1.415-2.683), 3.86 times (OR 3.86, 95% CI = 2.358-6.329), and 1.67 times (OR 1.67, 95% CI = 1.253-2.216), respectively. Fully vaccinated subjects before COVID-19 infection (n = 304) had significantly lesser severity of post-COVID-19 fatigue, ageusia/hypogeusia, dizziness, tinnitus, and insomnia (P value = 0.001, 0.008, < 0.001, 0.025, and 0.005, respectively) than non-vaccinated subjects. This report declared neuropsychiatric sequelae in 36.5% of Egyptian COVID-19 survivors, fatigue being the most prevalent. The effectiveness of COVID-19 vaccines in reducing the severity of some post-COVID-19 neuropsychiatric manifestations may improve general vaccine acceptance.
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Affiliation(s)
- Alaa Elmazny
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
- College of Medicine and Medial Science, Arabian Gulf University, Manama, Bahrain
| | - Rehab Magdy
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Hussein
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Salah Salem Street, Beni Suef, 62511, Egypt.
| | - Eman H Elsebaie
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sara H Ali
- Department of Otolaryngology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Ali M Abdel Fattah
- Department of Gastroenterology, Hepatology, and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Mahmoud Hassan
- Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Ahmed Yassin
- Department of Critical Care Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Noha A Mahfouz
- Department of Psychiatry Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Radwa M Elsayed
- Department of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wael Fathy
- Department of Anesthesiology, Surgical ICU and Pain Management, Beni-Suef University, Beni Suef, Egypt
| | - Hoda M Abdel-Hamid
- Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Abdelbadie
- Department of Anesthesiology, Surgical ICU and Pain Management, Beni-Suef University, Beni Suef, Egypt
| | - Shaimaa H Soliman
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
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10
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Hernandez AK, Walke A, Haehner A, Cuevas M, Hummel T. Correlations between gustatory, trigeminal, and olfactory functions and nasal airflow. Eur Arch Otorhinolaryngol 2023; 280:4101-4109. [PMID: 37129608 PMCID: PMC10153028 DOI: 10.1007/s00405-023-07962-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/01/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE To determine the relationship of chemosensory screening and nasal airflow tests among the same set of participants, and to determine other factors that are related to the outcomes of these tests. METHODS Participants had no chemosensory complaints. Structured medical history was taken. Participants underwent 5 screening tests: q-sticks (orthonasal olfaction), q-powders (retronasal olfaction), trigeminal lateralization test, taste sprays, and peak nasal inspiratory flow (PNIF). Ratings of smell/taste ability and nasal airflow were obtained using visual analogue scales (VAS). Composite sinusitis symptoms and significance of olfaction questionnaire scores were also determined. RESULTS Four hundred participants were included in the study, 156 men, 244 women; aged 18-82 years (mean: 46). The q-powders and taste spray scores were weakly positively correlated with all the other chemosensory tests and PNIF. However, chemosensory test scores were not correlated with VAS, composite sinusitis symptoms, and significance of olfaction questionnaire scores. Various tests showed significant decrease starting at specific ages (in years, PNIF and trigeminal lateralization: 40, q-powders: 60, and q-sticks: 70). CONCLUSION Chemosensory screening tests and self-rated chemosensory function showed no correlation in participants without chemosensory complaints. In addition, gustatory function appeared to be correlated with olfactory and trigeminal function but also with nasal airflow, and nasal airflow was related not only to olfactory but also to trigeminal and taste function. Over all, the results suggest that chemosensory functions (orthonasal olfactory, trigeminal, retronasal olfactory, gustatory) and nasal airflow are correlated with each other, which we propose may be possibly mediated, at least in part, through central nervous system interactions.
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Affiliation(s)
- Anna Kristina Hernandez
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany.
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines.
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines.
| | - Antje Walke
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Mandy Cuevas
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Haus 5, Fetscherstrasse 74, 01307, Dresden, Germany
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11
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Hamed SA, Ahmed MAAR. The effectiveness of cerebrolysin, a multi-modal neurotrophic factor, for treatment of post-covid-19 persistent olfactory, gustatory and trigeminal chemosensory dysfunctions: a randomized clinical trial. Expert Rev Clin Pharmacol 2023; 16:1261-1276. [PMID: 37950370 DOI: 10.1080/17512433.2023.2282715] [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: 02/15/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND This trial aimed to monitor the outcomes of persistent post-covid-19 smell and taste disorders after cerebrolysin therapy, a NTF, and olfactory and gustatory trainings. RESEARCH DESIGN AND METHODS This was a prospective randomized trial. It included 250 patients (male = 93, female = 157; age: 31.3 ± 8.9 years). Patients were randomized into group 1 (n = 150): received cerebrolysin [5 ml/d (IM), 5d/week] and practiced olfactory and gustatory trainings, and group 2 (n = 100): practiced olfactory and gustatory trainings only, for ≥ 8-24 weeks. Measures of outcomes were: a clinical questionnaire; sniffin' odor, taste and flavor identification tests; and global rating scales for smell and taste. RESULTS The duration of disorders was 11.7 ± 3.7mo (range: 6-24mo). The majority (n = 167; 66.8%) developed parosmia within months (3.6 ± 2.7mo) after anosmia. Objective testing showed anosmia in all and taste, flavor, and trigeminal sensory losses in 18% (n = 45). Analyses for secondary outcome were done on 202 patients (group 1 = 130; group 2 = 72). Recovery was complete in 61.5% (n = 80) with cerebrolysin therapy and partial in 17% (n = 22). There was no recovery with trainings only. There were no predictors for recovery. CONCLUSIONS Cerebrolysin had fast, promising, and constant effect, with cure rate of > 60%. This might be due to its ability to initiate and enhance neuronal regeneration and reorganization of sensory epithelia. TRIAL REGISTRATION NCT04830943.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
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12
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Hamed SA, Kamal-Eldeen EB, Ahmed MAAR. Evaluation of children and adults with post-COVID-19 persistent smell, taste and trigeminal chemosensory disorders: A hospital based study. World J Clin Pediatr 2023; 12:133-150. [PMID: 37342446 PMCID: PMC10278074 DOI: 10.5409/wjcp.v12.i3.133] [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: 02/27/2023] [Revised: 03/16/2023] [Accepted: 04/20/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019 (COVID-19) complications.
AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.
METHODS Assessment was done to 185 patients (adults = 150, age: 31.41 ± 8.63 years; children = 35; age: 15.66 ± 1.63 years). Otolaryngology and neuropsychiatric evaluations were done. Measurements included: A clinical questionnaire (for smell and taste); sniffin' odor, taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS).
RESULTS Duration of disorders was 11.53 ± 3.97 ms (6-24 ms). Parosmia (n = 119; 64.32%) was developed months after anosmia (3.05 ± 1.87 ms). Objective testing showed anosmia in all, ageusia and flavor loss in 20% (n = 37) and loss of nasal and oral trigeminal sensations in 18% (n = 33) and 20% (n = 37), respectively. Patients had low scoring of sQOD-NS (11.41 ± 3.66). There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.
CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises. Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders. Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders. There were no demographics, clinical variables at onset or specific profile of these disorders in children compared to adults.
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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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13
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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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14
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Almaamuri AM, Mohammed MM. COVID-19 olfactory dysfunction, evaluation of onset, and persistence. J Adv Pharm Technol Res 2023; 14:137-141. [PMID: 37255874 PMCID: PMC10226702 DOI: 10.4103/japtr.japtr_48_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 06/01/2023] Open
Abstract
Olfactory dysfunction (OD) is a common feature of COVID-19. The goal of the study was to define the modes of onset of OD in the clinical course of the disease and to follow the cases for 12-18 months in order to estimate the differences in the recovery time from OD over the course of the disease. We managed to follow a total of 325 patients (females: 198, males: 127) in the Babylon governorate in Iraq. All were COVID-19 patients who should have OD during the course of the disease. COVID-19 infection was established in all patients by swab test, i.e. polymerase chain reaction (PCR) and/or chest computed tomography findings of pneumonia compatible with COVID-19. Detailed medical records were obtained directly from the patients or their relatives. The patients were then followed up by telephone and questioned with structured questionnaires concentrating upon general clinical features and the sense of olfaction. Information about the presence of olfactory disorders, their occurrence, and development was recorded. Based on the onset of OD, the patients were categorized into three groups. Olfactory functions were assessed primarily by face-to-face interview and then (if necessary) by a telephone questionnaire assessing self-reported olfactory function and olfactory-related quality of life, which measures the subjective olfactory capability (SOC). In the first 2 weeks, 148 (45.5%) patients reported complete recovery from OD, of which 90 (73.2%) patients joined at the end of the 1st month. OD persistence was observed in 11 (3.3%) patients toward the end of the 1st year, in 5 (1.5%) patients at the end of the 15th month, and only in two (0.6%) patients at the end of the 18th month. We found no significant correlation between the type of onset of OD and the duration and persistence of OD. Most sufferers of COVID-associated OD recover their sense of smell within the 1st month.
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Affiliation(s)
| | - Mohammed M. Mohammed
- Department of Pediatric, Al-Tarmia General Hospital, Al-Karkh Health Directorate, Baghdad, Iraq
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15
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Cardoso Soares P, Moreira de Freitas P, de Paula Eduardo C, Hiramatsu Azevedo L. COVID-19-Related Long-Term Taste Impairment: Symptom Length, Related Taste, Smell Disturbances, and Sample Characteristics. Cureus 2023; 15:e38055. [PMID: 37228557 PMCID: PMC10208161 DOI: 10.7759/cureus.38055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION The COVID-19 infection triggered in some patients a prolonged reduction in the perception of both gustatory and olfactory senses (ageusia and anosmia). These symptoms could be manifested during the first days after the contagion, acting as predictors of COVID-19 infection, and additionally, they could be the only symptoms manifested at all. Clinical resolution of anosmia and ageusia was expected to occur within a few weeks, yet in some cases, patients began to demonstrate COVID-19-related long-term taste impairment (CRLTTI), a condition that can persist for longer than two months, contradicting initial evidence. Objectives: The authors' aimed to describe the characteristics of the sample of 31 participants with COVID-19-related long-term taste impairment, and their capacity to quantify taste and rate their smell perception. Material and Methods: Participants were submitted to a taste evaluation of four hyper-concentrated tastes perceived by the tongue (0-10), self-reported their smell (0-10), and answered a semi-structured questionnaire. Results: Different tastes seemed to be affected differently by COVID-19, despite the lack of statistical relevance observed in this study. Dysgeusia was only expressed in bitter, sweet, and acidic tastes. The mean age observed was 40.2 (SD 12.06) years, with women representing 71% of the sample. Taste impairment persisted for an average period of 10.8 months (SD 5.7). Self-reported smell impairment was reported by the majority of participants with taste impairment. Non-vaccinated people represented 80.6% of the sample. Conclusions: COVID-19 infection could trigger taste and smell disturbances that lasted as long as 24 months. CRLTTI seems not to affect the four main taste perceptions (hyper-concentrated) equally. Women represented the majority of the sample, with an average age of 40 years (SD 12.06). Previous diseases, medication use, and behavioral aspects seem not to be linked to CRLTTI development.
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Affiliation(s)
- Pedro Cardoso Soares
- Special Laboratory of Lasers in Dentistry, Department of Operative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, BRA
| | - Patrícia Moreira de Freitas
- Special Laboratory of Lasers in Dentistry, Department of Operative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, BRA
| | - Carlos de Paula Eduardo
- Special Laboratory of Lasers in Dentistry, Department of Operative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, BRA
| | - Luciane Hiramatsu Azevedo
- Special Laboratory of Lasers in Dentistry, Department of Operative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, BRA
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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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Bhatia-Dey N, Csoka AB, Heinbockel T. Chemosensory Ability and Sensitivity in Health and Disease: Epigenetic Regulation and COVID-19. Int J Mol Sci 2023; 24:ijms24044179. [PMID: 36835589 PMCID: PMC9959623 DOI: 10.3390/ijms24044179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Throughout the animal kingdom, our two chemical senses, olfaction and gustation, are defined by two primary factors: genomic architecture of the organisms and their living environment. During the past three years of the global COVID-19 pandemic, these two sensory modalities have drawn much attention at the basic science and clinical levels because of the strong association of olfactory and gustatory dysfunction with viral infection. Loss of our sense of smell alone, or together with a loss of taste, has emerged as a reliable indicator of COVID-19 infection. Previously, similar dysfunctions have been detected in a large cohort of patients with chronic conditions. The research focus remains on understanding the persistence of olfactory and gustatory disturbances in the post-infection phase, especially in cases with long-term effect of infection (long COVID). Also, both sensory modalities show consistent age-related decline in studies aimed to understand the pathology of neurodegenerative conditions. Some studies using classical model organisms show an impact on neural structure and behavior in offspring as an outcome of parental olfactory experience. The methylation status of specific odorant receptors, activated in parents, is passed on to the offspring. Furthermore, experimental evidence indicates an inverse correlation of gustatory and olfactory abilities with obesity. Such diverse lines of evidence emerging from basic and clinical research studies indicate a complex interplay of genetic factors, evolutionary forces, and epigenetic alterations. Environmental factors that regulate gustation and olfaction could induce epigenetic modulation. However, in turn, such modulation leads to variable effects depending on genetic makeup and physiological status. Therefore, a layered regulatory hierarchy remains active and is passed on to multiple generations. In the present review, we attempt to understand the experimental evidence that indicates variable regulatory mechanisms through multilayered and cross-reacting pathways. Our analytical approach will add to enhancement of prevailing therapeutic interventions and bring to the forefront the significance of chemosensory modalities for the evaluation and maintenance of long-term health.
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Winkelmann S, Korth A, Voss B, Nasr MA, Behrend N, Pudszuhn A, Hofmann VM, Schendzielorz P, Maetzler C, Hermes A, Borzikowsky C, Bahmer T, Lieb W, Schreiber S, Stork S, Montellano FA, Witzenrath M, Keil T, Krawczak M, Laudien M, On Behalf Of The Napkon Study Group NSG. Persisting chemosensory dysfunction in COVID-19 - a cross-sectional population-based survey. Rhinology 2023; 61:12-23. [PMID: 36323438 DOI: 10.4193/rhin22.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chemosensory dysfunction (CD) has been reported as a common symptom of SARS-CoV-2 infection, but it is not well understood whether and for how long changes of smell, taste and chemesthesis persist in infected individuals. METHODOLOGY Unselected adult residents of the German federal state of Schleswig-Holstein with Polymerase Chain Reaction (PCR)-test-confirmed SARS-CoV-2 infection were invited to participate in this large cross-sectional study. Data on the medical history and subjective chemosensory function of participants were obtained through questionnaires and visual analogue scales (VAS). Olfactory function (OF) was objectified with the Sniffin Sticks test (SST), including threshold (T), discrimination (D) and identification (I) test as well as summarized TDI score, and compared to that in healthy controls. Gustatory function (GF) was evaluated with the suprathreshold taste strips (TS) test, and trigeminal function was tested with an ampoule containing ammonia. RESULTS Between November 2020 and June 2021, 667 infected individuals (mean age: 48.2 years) were examined 9.1 months, on average, after positive PCR testing. Of these, 45.6% had persisting subjective olfactory dysfunction (OD), 36.2% had subjective gustatory dysfunction (GD). Tested OD, tested GD and impaired trigeminal function were observed in 34.6%, 7.3% and 1.8% of participants, respectively. The mean TDI score of participants was significantly lower compared to healthy subjects. Significant associations were observed between subjective OD and GD, and between tested OD and GD. CONCLUSION Nine months after SARS-CoV-2 infection, OD prevalence is significantly increased among infected members of the general population. Therefore, OD should be included in the list of symptoms collectively defining Long-COVID.
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Affiliation(s)
- S Winkelmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - A Korth
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - B Voss
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - M A Nasr
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - N Behrend
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - A Pudszuhn
- Department of Otorhinolaryngology, Head and Neck Surgery, Charity-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - V M Hofmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Charity-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - P Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wurzburg, Wurzburg, Germany
| | - C Maetzler
- Neurology Department, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - A Hermes
- Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Borzikowsky
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - T Bahmer
- Division of Pneumology, Department of Medicine 1, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - W Lieb
- Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Schreiber
- Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - S Stork
- Comprehensive Heart Failure Center and Dept. Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany
| | - F A Montellano
- Comprehensive Heart Failure Center and Dept. Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Wurzburg, Wurzburg, Germany; Department of Neurology, University Hospital Wurzburg, Wurzburg, Germany
| | - M Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charity - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
| | - T Keil
- Institute of Clinical Epidemiology and Biometry, University of Wurzburg, Wurzburg, Germany; Institute of Social Medicine, Epidemiology and Health Economics, Charity-Universitatsmedizin Berlin, Berlin, Germany
| | - M Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - M Laudien
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
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Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell. Eur Arch Otorhinolaryngol 2023; 280:757-763. [PMID: 35904631 PMCID: PMC9335450 DOI: 10.1007/s00405-022-07570-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The management of post-COVID-19 persistent olfactory dysfunction (OD) is uncertain. Currently, olfactory training is the only evidence-based therapy for post-viral OD. In this study, we evaluated the effectiveness of classical olfactory training (COT) in the treatment of post-COVID-19 persistent OD. MATERIALS AND METHODS Patients with persistent OD after COVID-19 were assessed using the Sniffin' Sticks test. Fifty-one patients were then divided into two groups based on personal preference: the COT group (n = 31) included subjects who performed COT over 12 weeks, and the control group (n = 20) included subjects who did not receive any treatment. After the exclusion of eight patients, the olfactory performances of 43 patients were re-evaluated and compared to the baseline values. RESULTS A significantly higher proportion of patients in the COT group improved their olfactory scores above the clinically important difference compared to the control group (40% versus 6%) (p = 0.014). The subjective smell improvement by COT was independent of age, gender, OD duration, presence of parosmia, or the initial olfactory score (all p > 0.05). CONCLUSION Twelve weeks of COT appears to increase the olfactory sensitivity in patients with persistent OD following COVID-19.
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Vaira LA, Lechien JR, Deiana G, Salzano G, Maglitto F, Piombino P, Mazzatenta A, Boscolo-Rizzo P, Hopkins C, De Riu G. Prevalence of olfactory dysfunction in D614G, alpha, delta and omicron waves: a psychophysical case-control study. Rhinology 2023; 61:32-38. [PMID: 36272169 DOI: 10.4193/rhin22.294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this study was to compare the prevalence of olfactory dysfunction (OD) at different stages of the COVID-19 pandemic by evaluating subjects diagnosed with SARS-CoV-2 infection during the Omicron wave with psychophysical tests and comparing the results with those obtained from patients infected during the D614G, Alpha and Delta waves and with those of a control group. METHODOLOGY The study included adult patients diagnosed with SARS-CoV-2 infection. Depending on the time of diagnosis, the subjects were divided into four study groups: D614G; Alpha, Delta and Omicron variant groups. A group of uninfected individuals was used as control. All subjects underwent psychophysical evaluation of the olfactory function with the Connecticut Chemosensory Clinical Research Center olfactory test (D614G and Alpha groups) or the extended version of the Sniffin'Sticks test (Delta, Omicron and control groups). RESULTS 372 cases (134 D614G group, 118 Alpha group, 32 in Delta group and 88 Omicron group) were recruited and evaluated within 10 days of infection, alongside 80 controls. Patients self-reported olfactory loss in 72.4% of cases in the D614G group, in 75.4% of cases in the Alpha group, in 65.6% of cases in the Delta group and in 18.1% in the Omicron group. Psychophysical evaluation revealed a prevalence of OD: 80.6%, 83.0%, 65.6% and 36.3% in the D614G, Alpha, Delta and Omicron group respectively. The differences between the D614G, Alpha and Delta groups were not statistically significant. The Omicron group demonstrated a significantly lower prevalence of OD than the other variants but still significantly higher than the controls. CONCLUSIONS During the Omicron wave OD was less prevalent than during the D614G, Alpha and Delta periods. One-third of patients have reduced olfactory function on psychophysical evaluation during the Omicron wave. Our results should be considered with caution as the VOC has not been determined with certainty.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - J R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS. Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Hospital, Paris, France
| | - G Deiana
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - G Salzano
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - F Maglitto
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - P Piombino
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - A Mazzatenta
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, G. d Annunzio, University of Chieti-Pescara, Chieti Scalo, Italy
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - C Hopkins
- King's College, London, UK; British Rhinological Society (President), London, UK
| | - G De Riu
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Loss of Sour Taste Is the Striking Feature among Four Basic Taste Qualities in Tunisian COVID-19 Patients. J Clin Med 2023; 12:jcm12020597. [PMID: 36675526 PMCID: PMC9865029 DOI: 10.3390/jcm12020597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Taste disorders (TDs) have been reported to be very common in patients suffering from coronavirus disease 2019 (COVID-19), which is caused by the SARS-CoV-2 virus. In most of the hitherto conducted studies, a gustatory assessment was performed on the basis of surveys or self-reports by patients. The aim of our study was to undertake an objective assessment of four basic taste qualities by conducting tasting sessions that allowed detection thresholds in COVID-19 Tunisian patients and to study their associations with inflammation. METHODS This analytical cross-sectional study was conducted on 89 patients aged between 21 to 70 years who had been diagnosed with COVID-19. We used Burghart taste strips to assess taste perception of the four taste qualities, i.e., sour, bitter, sweet, and salty. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) were measured. RESULTS Taste disorders were reported by 40.4% of the patients, while objective assessments revealed that 63.8% of participants were suffering from hypogeusia and/or ageusia. Sour taste was the most altered (70.8%) gustatory quality. Patients with severe COVID-19 had significantly lower sour and bitter taste scores when compared to patients with minor/moderate forms. There was no significant association between serum inflammatory markers and taste disorders. However, the relationship between bitter and sweet taste qualities and IL-1β levels was significant (p = 0.018 and p = 0.041). CONCLUSIONS Our results demonstrate the interest in the objective assessment of taste dysfunctions in COVID-19 patients.
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Chee J, Chern B, Loh WS, Mullol J, Wang DY. Pathophysiology of SARS-CoV-2 Infection of Nasal Respiratory and Olfactory Epithelia and Its Clinical Impact. Curr Allergy Asthma Rep 2023; 23:121-131. [PMID: 36598732 PMCID: PMC9811886 DOI: 10.1007/s11882-022-01059-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW While the predominant cause for morbidity and mortality with SARS-CoV-2 infection is the lower respiratory tract manifestations of the disease, the effects of SARS-CoV-2 infection on the sinonasal tract have also come to the forefront especially with the increased recognition of olfactory symptom. This review presents a comprehensive summary of the mechanisms of action of the SARS-CoV-2 virus, sinonasal pathophysiology of COVID-19, and the correlation with the clinical and epidemiological impact on olfactory dysfunction. RECENT FINDINGS ACE2 and TMPRSS2 receptors are key players in the mechanism of infection of SARS-CoV-2. They are present within both the nasal respiratory as well as olfactory epithelia. There are however differences in susceptibility between different groups of individuals, as well as between the different SARS-CoV-2 variants. The sinonasal cavity is an important route for SARS-CoV-2 infection. While the mechanism of infection of SARS-CoV-2 in nasal respiratory and olfactory epithelia is similar, there exist small but significant differences in the susceptibility of these epithelia and consequently clinical manifestations of the disease. Understanding the differences and nuances in sinonasal pathophysiology in COVID-19 would allow the clinician to predict and counsel patients suffering from COVID-19. Future research into molecular pathways and cytokine responses at different stages of infection and different variants of SARS-CoV-2 would evaluate the individual clinical phenotype, prognosis, and possibly response to vaccines and therapeutics.
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Affiliation(s)
- Jeremy Chee
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology - Head & Neck Surgery, National University Health System, 1E Kent Ridge Road, Singapore, 119228 Singapore
| | - Beverlyn Chern
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology - Head & Neck Surgery, National University Health System, 1E Kent Ridge Road, Singapore, 119228 Singapore
| | - Woei Shyang Loh
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology - Head & Neck Surgery, National University Health System, 1E Kent Ridge Road, Singapore, 119228 Singapore ,grid.4280.e0000 0001 2180 6431Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joaquim Mullol
- grid.10403.360000000091771775Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Catalonia Spain
| | - De Yun Wang
- Department of Otolaryngology - Head & Neck Surgery, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore. .,Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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23
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 DOI: 10.1093/chemse/bjad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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Koyama S, Mori E, Ueha R. Insight into the mechanisms of olfactory dysfunction by COVID-19. Auris Nasus Larynx 2022:S0385-8146(22)00230-9. [PMID: 36529610 PMCID: PMC9731926 DOI: 10.1016/j.anl.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
One of the unique symptoms of COVID-19 is chemosensory dysfunction. Almost three years since the beginning of the pandemic of COVID-19, there have been many studies on the symptoms, progress, and possible causes, and also studies on methods that may facilitate recovery of the senses. Studies have shown that some people recover their senses even within a couple of weeks whereas there are other patients that fail to recover chemosensory functions fully for several months and some never fully recover. Here we summarize the symptoms and the progress, and then review the papers on the causation as well as the treatments that may help facilitate the recovery of the symptoms. Depending on the differences in the levels of severity and the locations where the main pathological venues are, what is most effective in facilitating recovery can vary largely across patients and thus may require individualized strategies for each patient. The goal of this paper is to provide some thoughts on these choices depending on the differences in the causes and severity.
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Affiliation(s)
- Sachiko Koyama
- Indiana University, School of Medicine, Department of Medicine, United States,Correspondence author at: Indiana University, Richard L. Roudebush VA Medical Center, 1481 W Tenth St., Indianapolis, IN, 46202, United States
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Japan
| | - Rumi Ueha
- Swallowing Center, The University of Tokyo Hospital, Japan,Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, the University of Tokyo, Japan
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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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Pieniak M, Oleszkiewicz A, Avaro V, Calegari F, Hummel T. Olfactory training - Thirteen years of research reviewed. Neurosci Biobehav Rev 2022; 141:104853. [PMID: 36064146 DOI: 10.1016/j.neubiorev.2022.104853] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
The sense of smell is interrelated with psychosocial functioning. Olfactory disorders often decrease quality of life but treatment options for people with olfactory loss are limited. Additionally, olfactory loss accompanies and precedes psychiatric and neurodegenerative diseases. Regular, systematic exposure to a set of odors, i.e., olfactory training (OT) has been offered for rehabilitation of the sense of smell in clinical practice. As signals from the olfactory bulb are directly projected to the limbic system it has been also debated whether OT might benefit psychological functioning, i.e., mitigate cognitive deterioration or improve emotional processing. In this review we synthesize key findings on OT utility in the clinical practice and highlight the molecular, cellular, and neuroanatomical changes accompanying olfactory recovery in people with smell loss as well as in experimental animal models. We discuss how OT and its modifications have been used in interventions aiming to support cognitive functions and improve well-being. We delineate main methodological challenges in research on OT and suggest areas requiring further scientific attention.
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Affiliation(s)
- Michal Pieniak
- Smell and Taste Clinic, Technische Universitat Dresden, Dresden, Germany; University of Wrocław, Faculty of Historical and Pedagogical Sciences, Institute of Psychology, Wroclaw, Poland.
| | - Anna Oleszkiewicz
- Smell and Taste Clinic, Technische Universitat Dresden, Dresden, Germany; University of Wrocław, Faculty of Historical and Pedagogical Sciences, Institute of Psychology, Wroclaw, Poland
| | - Vittoria Avaro
- CRTD-Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
| | - Federico Calegari
- CRTD-Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Technische Universitat Dresden, Dresden, Germany
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Post-COVID-19 neurologic syndrome. JAAPA 2022; 35:19-24. [DOI: 10.1097/01.jaa.0000854524.40560.f3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Natural trajectory of recovery of COVID-19 associated olfactory loss. Am J Otolaryngol 2022; 43:103572. [PMID: 35969913 PMCID: PMC9355743 DOI: 10.1016/j.amjoto.2022.103572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/31/2022] [Indexed: 11/21/2022]
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, <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 outcome(s) and measure(s) 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 <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 <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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Vandersteen C, Payne M, Dumas LÉ, Cancian É, Plonka A, D’Andréa G, Chirio D, Demonchy É, Risso K, Askenazy-Gittard F, Savoldelli C, Guevara N, Robert P, Castillo L, Manera V, Gros A. Olfactory Training in Post-COVID-19 Persistent Olfactory Disorders: Value Normalization for Threshold but Not Identification. J Clin Med 2022; 11:jcm11123275. [PMID: 35743346 PMCID: PMC9224948 DOI: 10.3390/jcm11123275] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/27/2022] [Accepted: 06/05/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Persistent post-viral olfactory disorders (PPVOD) are estimated at 30% of patients one year after COVID-19 infection. No treatment is, to date, significantly effective on PPVOD with the exception of olfactory training (OT). The main objective of this work was to evaluate OT efficiency on post-COVID-19 PPVOD. (2) Methods: Consecutive patients consulting to the ENT department with post-COVID-19 PPVOD were included after completing clinical examination, the complete Sniffin’ Stick Test (TDI), the short version of the Questionnaire of olfactory disorders and the SF-36. Patients were trained to practice a self-olfactory training with a dedicated olfactory training kit twice a day for 6 months before returning to undergo the same assessments. (3) Results: Forty-three patients were included and performed 3.5 months of OT in average. We observed a significant TDI score improvement, increasing from 24.7 (±8.9) before the OT to 30.9 (±9.8) (p < 0.001). Based on normative data, a significant increase in the number of normosmic participants was observed only for the threshold values (p < 0.001). Specific and general olfaction-related quality of life improved after the OT. (4) Conclusions: Olfactory function appeared to improve only in peripheral aspects of post-COVID-19 PPVOD after OT. Future controlled studies must be performed to confirm the OT role and justify new therapeutic strategies that may focus on the central aspects of post-COVID-19 PPVOD.
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Affiliation(s)
- Clair Vandersteen
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Correspondence: ; Tel.: +33-4-9203-1705
| | - Magali Payne
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
| | - Louise-Émilie Dumas
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire, Université Côte d’Azur, 57 Avenue de la Californie, 06200 Nice, France
| | - Élisa Cancian
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Alexandra Plonka
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Institut NeuroMod, INRIA Centre de Recherche Sophia Antipolis, Université Côte d’Azur, 2004 Route des Lucioles, 06902 Valbonne, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
| | - Grégoire D’Andréa
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Élisa Demonchy
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Karine Risso
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Florence Askenazy-Gittard
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire, Université Côte d’Azur, 57 Avenue de la Californie, 06200 Nice, France
| | - Charles Savoldelli
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Nicolas Guevara
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Philippe Robert
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
| | - Laurent Castillo
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Valeria Manera
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
| | - Auriane Gros
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
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Olfactory Dysfunction in COVID-19: Pathology and Long-Term Implications for Brain Health. Trends Mol Med 2022; 28:781-794. [PMID: 35810128 PMCID: PMC9212891 DOI: 10.1016/j.molmed.2022.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
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COVID-19 Induced Taste Dysfunction and Recovery: Association with Smell Dysfunction and Oral Health Behaviour. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060715. [PMID: 35743978 PMCID: PMC9231283 DOI: 10.3390/medicina58060715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Disruption to taste and smell are common symptoms of COVID-19 infection. The current literature overlooks taste symptoms and tends to focus on the sense of smell. Persisting cases (>28 days) of taste dysfunction are increasingly recognised as a major future healthcare challenge. This study focuses on the severity and recovery of COVID-19 induced taste loss and association with olfactory symptoms, lifestyle and oral health factors. Materials and Methods: This study was a cross-sectional survey comparing 182 rapid taste recovery participants (≤28 days) with 47 participants with prolonged taste recovery >28 days. Analyses of taste loss in association with smell loss, age, sex, illness severity, diet, BMI, vitamin-D supplementation, antidepressants, alcohol use, smoking, brushing frequency, flossing, missing teeth, appliances and number of dental restorations were conducted. Differences in the severity of the loss of sour, sweet, salt, bitter and umami tastes were explored. Results: Both the severity and the duration of taste and smell loss were closely correlated (p < 0.001). Salt taste was significantly less affected than all other taste qualities (p < 0.001). Persisting taste loss was associated with older age (mean ± 95% CI = 31.73 ± 1.23 years vs. 36.66 ± 3.59 years, p < 0.001) and reduced likelihood of using floss (odds ratio ± 95% CI = 2.22 (1.15−4.25), p = 0.047). Conclusions: Smell and taste loss in COVID-19 are closely related, although a minority of individuals can experience taste or smell dysfunction in the absence of the other. The taste of salt may be less severely affected than other taste qualities and future work exploring this finding objectively is indicated. The association of flossing with rapid taste recovery adds to the growing evidence of a link between good periodontal health and favourable COVID-19 outcomes.
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Changes in smell and taste perception related to COVID-19 infection: a case-control study. Sci Rep 2022; 12:8192. [PMID: 35581235 PMCID: PMC9112641 DOI: 10.1038/s41598-022-11864-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/22/2022] [Indexed: 01/05/2023] Open
Abstract
The main aim of the present study was to psychophysically evaluate smell and taste functions in hospitalized COVID-19 patients and to compare those results with a group of healthy subjects. Another aim of the study was to assess the relationship of changes in patients’ smell and taste functions with a number of clinical parameters, symptoms, and other physiological signs as well as with severity of disease. Olfactory and gustatory functions were tested in 61 hospitalized patients positive for SARS-CoV-2 infection and in a control group of 54 healthy individuals. Overall, we found a significant impairment of olfactory and gustatory functions in COVID-19 patients compared with the control group. Indeed, about 45% of patients self-reported complaints about or loss of either olfactory or gustatory functions. These results were confirmed by psychophysical testing, which showed a significantly reduced performance in terms of intensity perception and identification ability for both taste and smell functions in COVID-19 patients. Furthermore, gustatory and olfactory impairments tended to be more evident in male patients suffering from more severe respiratory failure (i.e., pneumonia with need of respiratory support need during hospitalization).
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Long-Lasting Olfactory Dysfunction in Hospital Workers Due to COVID-19: Prevalence, Clinical Characteristics, and Most Affected Odorants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095777. [PMID: 35565169 PMCID: PMC9105378 DOI: 10.3390/ijerph19095777] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/24/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023]
Abstract
Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin' Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin' Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.
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Barlow LA. The sense of taste: Development, regeneration, and dysfunction. WIREs Mech Dis 2022; 14:e1547. [PMID: 34850604 PMCID: PMC11152580 DOI: 10.1002/wsbm.1547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 12/12/2022]
Abstract
Gustation or the sense of taste is a primary sense, which functions as a gatekeeper for substances that enter the body. Animals, including humans, ingest foods that contain appetitive taste stimuli, including those that have sweet, moderately salty and umami (glutamate) components, and tend to avoid bitter-tasting items, as many bitter compounds are toxic. Taste is mediated by clusters of heterogeneous taste receptors cells (TRCs) organized as taste buds on the tongue, and these convey taste information from the oral cavity to higher order brain centers via the gustatory sensory neurons of the seventh and ninth cranial ganglia. One remarkable aspect of taste is that taste perception is mostly uninterrupted throughout life yet TRCs within buds are constantly renewed; every 1-2 months all taste cells have been steadily replaced. In the past decades we have learned a substantial amount about the cellular and molecular regulation of taste bud cell renewal, and how taste buds are initially established during embryogenesis. Here I review more recent findings pertaining to taste development and regeneration, as well as discuss potential mechanisms underlying taste dysfunction that often occurs with disease or its treatment. This article is categorized under: Infectious Diseases > Stem Cells and Development Cancer > Stem Cells and Development Neurological Diseases > Stem Cells and Development.
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Affiliation(s)
- Linda A Barlow
- Department of Cell & Developmental Biology, Graduate Program in Cell Biology, Stem Cells & Development, and the Rocky Mountain Taste & Smell Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Ludwig S, Schell A, Berkemann M, Jungbauer F, Zaubitzer L, Huber L, Warken C, Held V, Kusnik A, Teufel A, Ebert M, Rotter N. Post-COVID-19 Impairment of the Senses of Smell, Taste, Hearing, and Balance. Viruses 2022; 14:v14050849. [PMID: 35632590 PMCID: PMC9145380 DOI: 10.3390/v14050849] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/01/2022] [Accepted: 04/18/2022] [Indexed: 12/21/2022] Open
Abstract
Background: Various symptoms have been associated with COVID-19, but little is known about the impacts of COVID-19 on the sensory system, risk factors, and the duration of symptoms. This study assesses olfactory, gustatory, hearing, and vestibular systems after COVID-19. Methods: This cross-sectional, single-center study involved 50 patients one to six months after COVID-19 and reports their patient records and the extent, onset, and duration of olfactory, gustatory, hearing, and balance disorders using questionnaires during and after COVID-19. Sensory symptoms were objectively studied using the following clinical tests after COVID-19 Sniffin’ Sticks, taste tests, tone/speech audiometry, and video head impulse test. Results: Post-COVID-19-patients were suffering from olfactory and gustatory impairment for up to six months. According to the Dizziness Handicap Inventory, balance disorders were less noticed: Overall, about 40% of the patients during COVID-19 and nearly all patients recovered within six months. After COVID-19, clinical tests revealed that 75% were suffering from hyposomnia/anosmia, and 20% of all patients reported mild hypogeusia for up to six months. Vestibular disorders and hearing impairment rarely/did not occur. Females were significantly more affected by sensory impairments than males. Conclusions: COVID-19 particularly caused olfactory and gustatory impairment; balance disorders were present too; vestibular and auditory symptoms were negligible.
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Affiliation(s)
- Sonja Ludwig
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
- Correspondence:
| | - Angela Schell
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Michelle Berkemann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Frederic Jungbauer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Lena Zaubitzer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Lena Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Christian Warken
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
| | - Valentin Held
- Department of Neurology, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;
| | - Alexander Kusnik
- Department of Medicine II, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.K.); (A.T.); (M.E.)
- Department of Internal Medicine, Rochester Regional Health, Unity Hospital, 1555 Long Pond Rd, Rochester, NY 14626, USA
| | - Andreas Teufel
- Department of Medicine II, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.K.); (A.T.); (M.E.)
| | - Matthias Ebert
- Department of Medicine II, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.K.); (A.T.); (M.E.)
| | - Nicole Rotter
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; (A.S.); (M.B.); (F.J.); (L.Z.); (L.H.); (C.W.); (N.R.)
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Persisting olfactory dysfunction in post-COVID-19 is associated with gustatory impairment: Results from chemosensitive testing eight months after the acute infection. PLoS One 2022; 17:e0265686. [PMID: 35320821 PMCID: PMC8942205 DOI: 10.1371/journal.pone.0265686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/06/2022] [Indexed: 11/19/2022] Open
Abstract
Olfactory and gustatory disorders are prominent symptoms of acute COVID-19. Although both senses recover in many patients within weeks to months, persistency has been described in up to 60%. However up to now most reports on the course of chemosensitive disorders after COVID-19 are not based on psychophysical testing but only on subjective patients' ratings. In this study we assessed both olfaction and gustation using psychophysical tests eight months after COVID-19. Validated psychophysical testing revealed hyposmia in 18% and hypogeusia in even 32% of 303 included patients. This shows that olfactory and especially gustatory disorders have to be seen as important chronic symptoms post-COVID-19. The high prevalence of gustatory dysfunction indicates that gustatory function does not recover or might even deteriorate in the months following the acute infection.
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Bhutani S, Coppin G, Veldhuizen MG, Parma V, Joseph PV. COVID-19 related chemosensory changes in individuals with self-reported obesity. Rhinology 2022; 60:128-138. [PMID: 35191431 PMCID: PMC11036347 DOI: 10.4193/rhin21.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Self-reported smell loss is a prominent symptom of COVID-19 infection and a potentially useful clinical tool for remote pre-screening of this disease. However, pre-existing chemosensory dysfunction with obesity may diminish the usefulness of self-reported smell loss in this vulnerable group. Here we aim to compare COVID-19 related chemosensory alterations in participants with and without obesity and determine if self-reported smell loss is predictive of lab-based COVID-19 diagnosis in both groups in the context of restrictive clinical data collection. SUBJECTS/METHODS In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to have obesity (C19+; n = 433, C19-; n = 86) or not. RESULTS Participants with obesity and without obesity reported a similar decline in smell, taste, and chemesthesis during illness. In C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory and GI symptoms. Critically, we found that the model previously proposed also predicts C19+ diagnosis in participants with obesity. CONCLUSIONS We conclude that COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity. In both groups self-reported chemosensory symptoms are similarly predictive of COVID-19 infection, thus highlighting the potential of collecting self-report of symptoms and comorbidities remotely when clinical observations are restrictive.
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Affiliation(s)
- S Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - G Coppin
- Department of Psychology, Formation Universitaire Distance (UniDistance), Brig, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - M G Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - V Parma
- Department of Psychology, Temple University, Monell Chemical Senses Center, Philadelphia, PA, USA
| | - P V Joseph
- National Institutes of Alcohol Abuse and Alcoholism and National Institute of Nursing Research, Bethesda, MD, USA
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Trecca EM, Cassano M, Longo F, Petrone P, Miani C, Hummel T, Gelardi M. Results from psychophysical tests of smell and taste during the course of SARS-CoV-2 infection: a review. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:S20-S35. [PMID: 35763272 PMCID: PMC9137382 DOI: 10.14639/0392-100x-suppl.1-42-2022-03] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/23/2023]
Abstract
Only a few studies have assessed smell and taste in Coronavirus Disease 2019 (COVID-19) patients with psychophysical tests, while the majority performed self-rating evaluations. Given the heterogeneity of the published literature, the aim of this review was to systematically analyse the articles on this topic with a focus on psychophysical testing. A search on PubMed and Web of Science from December 2019, to November 2021, with cross-references, was executed. The main eligibility criteria were English-language articles, investigating the clinical features of olfaction and gustation in COVID-19 patients using self-rating assessment, psychophysical testing and imaging techniques. A total of 638 articles were identified and 66 were included. Self-rating assessment was performed in 31 studies, while psychophysical testing in 30 and imaging techniques in 5. The prevalence of chemosensory dysfunction was the most investigated topic, followed by the recovery time. About the psychophysical assessment, the extended version of the Sniffin’ Sticks was used in 11 articles and the Connecticut Chemosensory Clinical Research Center test in another 11. The olfactory threshold performance was the most impacted compared to the discrimination and identification capacities in accordance with the hypothesis of a tropism of SARS-CoV-2 for the olfactory mucosa. The timing significantly influenced the results of the psychophysical testing with 20% of patients presenting olfactory dysfunction at one month after infection.
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Tsuchiya H. Gustatory and Saliva Secretory Dysfunctions in COVID-19 Patients with Zinc Deficiency. Life (Basel) 2022; 12:life12030353. [PMID: 35330104 PMCID: PMC8950751 DOI: 10.3390/life12030353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 12/22/2022] Open
Abstract
Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients.
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Long-Term Subjective and Objective Assessment of Smell and Taste in COVID-19. Cells 2022; 11:cells11050788. [PMID: 35269410 PMCID: PMC8909596 DOI: 10.3390/cells11050788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 12/24/2022] Open
Abstract
Among the first clinical symptoms of the SARS-CoV-2 infection is olfactory−gustatory deficit; this continues for weeks and, in some cases, can be persistent. We prospectively evaluated 162 patients affected by COVID-19 using a visual analogue scale (VAS) for nasal and olfactory−gustatory symptoms. Patients were checked after 7, 14, 21, 28, 90, and 180 days. A total of 118 patients (72.8%) reported an olfactory VAS < 7 at baseline (group B), and 44 (27.2%) reported anosmia (VAS ≥ 7) (group A) and underwent the Brief Smell Identification Test (B-SIT) and Burghart Taste Strips (BTS) to quantify the deficit objectively and repeated the tests to confirm the sense recovery. Group A patients showed B-SIT anosmia and hyposmia in 44.2% and 55.8% of cases, respectively. A total of 88.6% of group A patients reported ageusia with VAS ≥ 7, and BTS confirmed 81.8% of ageusia and 18.2% of hypogeusia. VAS smell recovery was recorded starting from 14 days, with normalization at 28 days. The 28-day B-SIT score showed normosmia in 90.6% of group A patients. The mean time for full recovery (VAS = 0) was shorter in group B (22.9 days) than in group A (31.9 days). Chemosensory deficit is frequently the first symptom in patients with COVID-19, and, in most cases, recovery occurs after four weeks.
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Niklassen AS, Sakthivel S, Fjaeldstad AW, Ovesen T. Danish Validation of a Retronasal Olfactory Powder Test and Development of a Novel Quick Retronasal Olfactory Test. Int Arch Otorhinolaryngol 2022; 26:e615-e623. [PMID: 36405477 PMCID: PMC9668440 DOI: 10.1055/s-0041-1740597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/08/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction
Quality of life is closely linked to retronasal olfactory function. Familiarity with odors vary, so tests need validation. Testing can be time-consuming, so a quick test and a thorough test are needed for clinical and research settings.
Objectives
The objectives of this study were to validate the original retronasal powder olfactory test in a Danish population and to develop a novel quick retronasal test for easy application.
Methods
Ninety-seven participants were included in the study, 59 healthy controls and 38 patients with olfactory impairment. The retronasal test was modified by substituting unfamiliar odors and descriptors and validated with a criterion of correct identification rate of 50% in the original test and 90% in the quick test. Items with over 90% correct identification rate in the modified original test were included in the quick test, resulting in a 10-item test.
Results
The modified retronasal olfactory test achieved good test characteristics, with a 10th percentile cut-off value of 13: sensitivity was 88.9%, specificity 83.0%, positive predictive value 78%, negative predictive value 91.7%, and the receiver operating characteristics area under the curve (ROC-AUC) was 0.86. The quick test achieved acceptable test characteristics, with a 10th percentile cut-off value of 8.2: sensitivity was 72.2%, specificity 90.6%, positive predictive value 83.9%, negative predictive value was 82.8%, and ROC-AUC 0.81.
Conclusion
Validation of both tests demonstrated satisfactory accuracy. We recommend the quick test for screening purposes, and the modified original version for a thorough evaluation. The tests are easily implemented as they are easy to understand and very affordable.
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Affiliation(s)
- Andreas Steenholt Niklassen
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Alexander Wieck Fjaeldstad
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Therese Ovesen
- University Clinic for Flavour, Balance and Sleep, Ear, Nose and Throat Department, Regional Hospital Gødstrup, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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42
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Hintschich CA, Brosig A, Hummel T, Andorfer KE, Wenzel JJ, Bohr C, Vielsmeier V. Gustatory Function in Acute
COVID
‐19 ‐ Results from
Home‐Based
Psychophysical Testing. Laryngoscope 2022; 132:1082-1087. [PMID: 35188975 PMCID: PMC9088467 DOI: 10.1002/lary.30080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/19/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022]
Abstract
Objective Gustatory function during COVID‐19 is self‐reported by around 50% of patients. However, only a few studies assessed gustation using psychophysical testing during acute infection. The objective of this study is to test gustatory function on threshold tests in the very first days of COVID‐19. Methods Psychophysical testing consisted of validated and blinded tests for olfaction (NHANES Pocket Smell Test) and gustation (Taste Strips Test). These test kits were sent to home‐quarantined patients and self‐administered using a detailed instruction sheet. Results A total of 51 patients were included in this study. Testing was performed 6.5 ± 2.7 days after sampling of respiratory swabs. At this time 37% of patients stated to currently experience a gustatory impairment. The mean Taste Strips score was 10.0 ± 3.4 with 28% scoring in the range of hypogeusia. Interestingly, no significant difference in the results of gustatory testing could be observed between the group with subjectively preserved gustation and the group with self‐rated taste impairment. Conclusion During the very first days of COVID‐19, psychophysical gustatory testing revealed hypogeusia in 28%. This is far lower than patients' self‐reports. Different from previous studies, we did not find clear evidence for an impairment of only certain taste qualities. Level of Evidence 3 Laryngoscope, 132:1082–1087, 2022
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Affiliation(s)
| | - Anja Brosig
- Department of Otorhinolaryngology Regensburg University Hospital Regensburg Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology TU Dresden Dresden Germany
| | - Kornelia E. Andorfer
- Department of Otorhinolaryngology Regensburg University Hospital Regensburg Germany
| | - Jürgen J. Wenzel
- Institute of Clinical Microbiology and Hygiene Regensburg University Hospital Regensburg Germany
| | - Christopher Bohr
- Department of Otorhinolaryngology Regensburg University Hospital Regensburg Germany
| | - Veronika Vielsmeier
- Department of Otorhinolaryngology Regensburg University Hospital Regensburg Germany
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43
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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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44
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The Effects of Persistent Olfactory and Gustatory Dysfunctions on Quality of Life in Long-COVID-19 Patients. Life (Basel) 2022; 12:life12020141. [PMID: 35207429 PMCID: PMC8878431 DOI: 10.3390/life12020141] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 12/26/2021] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Persistent olfactory (POD) and gustatory (PGD) dysfunctions are one of the most frequent symptoms of long-Coronavirus Disease 2019 but their effect on the quality of life (QoL) of patients is still largely unexplored. (2) Methods: An online survey was administered to individuals who reported to have had SARS-CoV-2 infection at least 6 months prior with persisting COVID-19 symptoms (using the COVID symptom index), including ratings of POD and PGD, and their physical (PCS) and mental (MCS) components of quality of life were assessed using the standardized short form 12 questionnaire (SF-12). (3) Results: Responses from 431 unique individuals were included in the analyses. The most frequent persistent symptoms were: fatigue (185 cases, 42.9%), olfactory dysfunction (127 cases, 29.5%), gustatory dysfunction (96 cases, 22.3%) and muscle pain (83 cases, 19.3%). Respondents who reported persisting muscle pain, joint pain, fatigue, headache, gastrointestinal disturbances, and dyspnea had significantly worse PCS. Those experiencing persistent fatigue and dyspnea also showed significantly lower MCS. Respondents reporting POD or PGD showed significantly worse QoL, but only pertaining to the MCS. Multiple regressions predicted MCS based on olfactory and marginally on gustatory ratings, but not PCS. Age significantly affected the prediction of PCS but not MCS, and gender and temporal distance from the COVID-19 diagnosis had no effect. (4) Conclusions: POD and PGD are frequent symptoms of the long-COVID-19 syndrome and significantly reduce QoL, specifically in the mental health component. This evidence should stimulate the establishment of appropriate infrastructure to support individuals with persistent CD, while research on effective therapies scales up.
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45
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Olfactory function in congenital cytomegalovirus infection: a prospective study. Eur J Pediatr 2022; 181:1859-1869. [PMID: 35028730 PMCID: PMC8758467 DOI: 10.1007/s00431-022-04375-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/28/2022]
Abstract
Congenital cytomegalovirus (CMV) infection leads to olfactory bulb lesions in the fetus, yet little is known about its impact on olfaction after birth. Here, we have assessed in a prospective study conducted on children in two French hospitals from 2016 to 2019, infection severity and olfactory performance after congenital CMV infection. Children with congenital CMV infection aged 3 to 10 years and healthy controls (CTL) matched for age and sex to CMV children symptomatic at birth (sCMV) were enrolled. Olfactory discrimination was assessed using mono-odorants and binary mixtures. Data were analyzed for 54 children with PCR-confirmed congenital CMV infection, including 34 sCMV (median [IQR] age, 6 [5-8] years; 19 [55.9%] male), and 20 CMV asymptomatic at birth (aCMV, median [IQR] age, 4 [3-6] years; 12 [60.0%] male). sCMV were compared to 34 CTL children. Olfactory scores in CMV-infected children were independent from vestibular deficit and hearing loss. The olfactory score was efficient to discriminate between CTL and sCMV for children > 6 years (area under the receiver-operating characteristic curve (AUC, 0.85; P = 0.0006), but not for children < 7 years. For children > 6 years, the proportion of children with total olfactory score < 4 differed between sCMV and CTL groups (91.2% and 18.7%, P < 0.001), but not between aCMV and age-matched healthy control groups. Conclusion: Congenital CMV infection is associated with reduced olfactory performance in children with infection symptoms at birth. Clinical trial registration: NCT02782988 (registration date: May 26, 2016). What is Known: •Congenital cytomegalovirus infection leads to olfactory bulb lesions in the fetus, yet little is known about its impact on olfaction after birth. •Depending on neonatal clinical presentation, children are either categorized as having a symptomatic or asymptomatic infection at birth. What is New: •Congenital cytomegalovirus infection is associated with reduced olfactory performance in children with infection symptoms at birth.
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46
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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47
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Badenoch JB, Rengasamy ER, Watson C, Jansen K, Chakraborty S, Sundaram RD, Hafeez D, Burchill E, Saini A, Thomas L, Cross B, Hunt CK, Conti I, Ralovska S, Hussain Z, Butler M, Pollak TA, Koychev I, Michael BD, Holling H, Nicholson TR, Rogers JP, Rooney AG. Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis. Brain Commun 2021; 4:fcab297. [PMID: 35169700 PMCID: PMC8833580 DOI: 10.1093/braincomms/fcab297] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Abstract
The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with I 2. Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (n = 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14-182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] and post-traumatic stress [15.7% (9.9-24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high (I 2 = 79.6-98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.
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Affiliation(s)
- James B. Badenoch
- Barts Health NHS Trust, London, UK
- Queen Mary University of London, London, UK
| | - Emma R. Rengasamy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Cameron Watson
- Barts Health NHS Trust, London, UK
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Katrin Jansen
- Department of Psychology, University of Münster, Münster, Germany
| | - Stuti Chakraborty
- Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Vellore, India
- Occupational Therapy Unit, Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Vellore, India
| | | | - Danish Hafeez
- Homerton University Hospitals Foundation Trust, London, UK
| | - Ella Burchill
- Faculty of Medicine and Life Sciences, King’s College London, London, UK
| | - Aman Saini
- Medical School, University College London, London, UK
| | - Lucretia Thomas
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | | | - Isabella Conti
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Sylvia Ralovska
- Sofia University ‘St Kliment Ohridski’, bul, ‘Tsar Osvoboditel’ 15, Sofia, Bulgaria
| | - Zain Hussain
- Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
- School of Medicine, University of Dundee, Dundee, UK
| | - Matthew Butler
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Thomas A. Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Benedict D. Michael
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Zoological Science, University of Liverpool, Liverpool, UK
| | - Heinz Holling
- Department of Psychology, University of Münster, Münster, Germany
| | - Timothy R. Nicholson
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jonathan P. Rogers
- Division of Psychiatry, University College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alasdair G. Rooney
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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48
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Massively collaborative crowdsourced research on COVID19 and the chemical senses: Insights and outcomes. Food Qual Prefer 2021; 97:104483. [PMID: 34848930 PMCID: PMC8616712 DOI: 10.1016/j.foodqual.2021.104483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/12/2021] [Accepted: 11/21/2021] [Indexed: 11/24/2022]
Abstract
In March 2020, the Global Consortium of Chemosensory Research (GCCR) was founded by chemosensory researchers to address emerging reports of unusual smell and taste dysfunction arising from the SARS-CoV-2 pandemic. Over the next year, the GCCR used a highly collaborative model, along with contemporary Open Science practices, to produce multiple high impact publications on chemosensation and COVID19. This invited manuscript describes the founding of the GCCR, the tools and approaches it used, and a summary of findings to date. These findings are contextualized within a summary of some of the broader insights about chemosensation (smell, taste, and chemesthesis) and COVID19 gained over the last 18 months, including potential mechanisms of loss. Also, it includes a detailed discussion of some current Open Science approaches and practices used by the GCCR to increase transparency, rigor, and reproducibility.
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49
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Pang KW, Tham SL, Ng LS. Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review. Life (Basel) 2021; 11:1315. [PMID: 34947846 PMCID: PMC8706269 DOI: 10.3390/life11121315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The diagnosis of COVID-19 is made using reverse transcription polymerase chain reaction (RT-PCR) but its sensitivity varies from 20 to 100%. The presence of gustatory dysfunction (GD) in a patient with upper respiratory tract symptoms might increase the clinical suspicion of COVID-19. AIMS To perform a systematic review and meta-analysis to determine the pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-) and diagnostic odds ratio (DOR) of using GD as a triage symptom prior to RT-PCR. METHODS PubMed and Embase were searched up to 20 June 2021. Studies published in English were included if they compared the frequency of GD in COVID-19 adult patients (proven by RT-PCR) to COVID-19 negative controls in case control or cross-sectional studies. The Newcastle-Ottawa scale was used to assess the methodological quality of the included studies. RESULTS 21,272 COVID-19 patients and 52,298 COVID-19 negative patients were included across 44 studies from 21 countries. All studies were of moderate to high risk of bias. Patients with GD were more likely to test positive for COVID-19: DOR 6.39 (4.86-8.40), LR+ 3.84 (3.04-4.84), LR- 0.67 (0.64-0.70), pooled sensitivity 0.37 (0.29-0.47) and pooled specificity 0.92 (0.89-0.94). While history/questionnaire-based assessments were predictive of RT-PCR positivity (DOR 6.62 (4.95-8.85)), gustatory testing was not (DOR 3.53 (0.98-12.7)). There was significant heterogeneity among the 44 studies (I2 = 92%, p < 0.01). CONCLUSIONS GD is useful as a symptom to determine if a patient should undergo further testing, especially in resource-poor regions where COVID-19 testing is scarce. Patients with GD may be advised to quarantine while repeated testing is performed if the initial RT-PCR is negative. FUNDING None.
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Affiliation(s)
- Khang Wen Pang
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore 119228, Singapore; (S.-L.T.); (L.S.N.)
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50
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Vaira LA, De Vito A, Lechien JR, Chiesa-Estomba CM, Mayo-Yàñez M, Calvo-Henrìquez C, Saussez S, Madeddu G, Babudieri S, Boscolo-Rizzo P, Hopkins C, De Riu G. New Onset of Smell and Taste Loss Are Common Findings Also in Patients With Symptomatic COVID-19 After Complete Vaccination. Laryngoscope 2021; 132:419-421. [PMID: 34812498 PMCID: PMC9011575 DOI: 10.1002/lary.29964] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022]
Abstract
The aim of this study is to investigate the clinical profile of patients who developed coronavirus disease 2019 (COVID‐19) after full vaccination. Demographic, epidemiological and clinical data were collected through medical records and online patient‐reported outcome questionnaire from patients who developed symptomatic SARS‐CoV‐2 infection, confirmed by nasopharyngeal swab, at least 2 weeks after completion of vaccination. A total of 153 subjects were included. The most frequent symptoms were: asthenia (82.4%), chemosensory dysfunction (63.4%), headache (59.5%), runny nose (58.2%), muscle pain (54.9%), loss of appetite (54.3%), and nasal obstruction (51.6%). Particularly, 62.3% and 53.6% of subjects reported olfactory and gustatory dysfunction, respectively. Symptom severity was mild or moderate in almost all cases. Chemosensory dysfunctions have been observed to be a frequent symptom even in subjects who contracted the infection after full vaccination. For this reason, the sudden loss of smell and taste could continue to represent a useful and specific diagnostic marker to raise the suspicion of COVID‐19 even in vaccinated subjects. In the future, it will be necessary to establish what the recovery rate is in these patients.
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Affiliation(s)
- Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science PhD School, Biomedical Science Department, University of Sassari, Sassari, Italy
| | - Andrea De Vito
- Infectious and Tropical Diseases Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Jerome R Lechien
- COVID-19 Task Force, Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Carlos M Chiesa-Estomba
- COVID-19 Task Force, Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Miguel Mayo-Yàñez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of A Coruña, A Coruña, Spain
| | - Christian Calvo-Henrìquez
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Sven Saussez
- COVID-19 Task Force, Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Giordano Madeddu
- Infectious and Tropical Diseases Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Infectious and Tropical Diseases Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Claire Hopkins
- Otorhinolaryngology Department, King's College, London, U.K
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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