1
|
Du W, Dang Y, Xu Z, Chen F. Self-Reported Olfactory and Gustatory Dysfunctions in Hospitalized Patients Infected with SARS-CoV-2 Delta Variant. EAR, NOSE & THROAT JOURNAL 2024; 103:85S-90S. [PMID: 35861210 DOI: 10.1177/01455613221116985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to examine the olfactory and gustatory dysfunctions (OGDs) among hospitalized patients with a novel strain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), lineage B.1.617.2, also known as the delta variant, in Xi'an, China through verbal interviews. METHODS Clinical information of 370 hospitalized patients infected with the delta variant in the Aerospace City Branch of Xi'an People's Hospital in Xi'an, China from December 27, 2021 to January 10, 2022 were collected. The prevalence and characteristics of OGDs were collected using a simple questionnaire submitted to all infected patients, including questions about the presence and absence of OGDs. RESULTS Among the 370 patients infected with the delta variant, 28 (7.6%) reported OGDs. A significant proportion of patients with self-reported OGDs were younger than those without (28.9 ± 10.5 vs. 35.3 ± 13.9, P = 0.005) and had significantly higher rates of sore throat and rhinitis (28.6% vs. 12.3%, P = 0.033; 42.9% vs. 9.9%, P = 0.000). Women were significantly more affected by OGDs than men (67.9% vs. 32.1%, P = 0.012). Vaccinated and unvaccinated delta variant-infected patients showed statistically significant differences in terms of disease severity (P = 0.002). CONCLUSIONS The prevalence of OGDs in the delta variant infection was lower than that in wild-type SARS-CoV-2 infection. Meanwhile, young age, female sex, and upper respiratory tract symptoms could be closely related to the occurrence of OGDs in the delta variant infection. In addition, a satisfactory level of efficacy was obtained with coronavirus disease 2019 vaccines against moderate and severe delta variant infections.
Collapse
Affiliation(s)
- Weijia Du
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yan Dang
- Nursing Department, Xi'an People's Hospital, Xi'an, China
| | - Zhuo Xu
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Fuquan Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| |
Collapse
|
2
|
Cabrera CI, Hicks K, Rodriguez K, Gerka Stuyt JA, McComsey GA, D'Anza B. Comparison of the incidence of smell and taste disorders between influenza and COVID-19. Am J Otolaryngol 2024; 45:104176. [PMID: 38157588 DOI: 10.1016/j.amjoto.2023.104176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Smell and taste disorders among patients with COVID-19 has become increasingly reported in the literature, however the prevalence varies. Post-infectious respiratory dysfunction has also been linked to influenza. In this study, we aimed to compare the rates of smell and taste disorders between COVID-19 and Influenza in unvaccinated patients. STUDY DESIGN Retrospective cohort study. SETTING TriNetX research network. METHODS Two queries were made on 7/1/2023 to include Influenza without a diagnosis of COVID-19 and a COVID-19 without a diagnosis of Influenza. The queries included patients from January 1 to December 31, 2022 from 102 Healthcare Organizations. The resultant population of patients with ICD-10 codes for COVID-19 and Influenza were matched using demographic characteristics to evaluate the risk of smell disorders. RESULTS The overall 3-month incidence of smell and taste disorders was 0.73 % in the COVID-19 population and 0.1 % in the influenza population. The 3-month matched risk ratios were 11.1 [95 % CI (8.8,13.8)]; p < 0.001) times higher for disorders of the smell and taste secondary to COVID-19 compared to influenza. CONCLUSIONS Disorders of the smell and taste are more common among patients with COVID-19 compared to patients with Influenza. Beyond smell loss, patients experience additional nasal and sinus-related rhinological symptoms, pointing to COVID-19's and influenza's wider impact on overall rhinological health. We believe that due to the transient nature of these disorders, they might go underreported.
Collapse
Affiliation(s)
- Claudia I Cabrera
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kayla Hicks
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kenneth Rodriguez
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - John A Gerka Stuyt
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Grace A McComsey
- Case Western Reserve University School of Medicine, Cleveland, OH, USA; Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Infectious Diseases, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Brian D'Anza
- Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA. Brian.D'
| |
Collapse
|
3
|
Iravani K, Malekpour B, Rasekhi A, Faramarzi A, Soltaniesmaeili A, Golkhar B, Jahanandish F, Babaei A. Functional magnetic resonance imaging in coronavirus disease 2019 induced olfactory dysfunction. J Laryngol Otol 2024; 138:178-183. [PMID: 37795811 DOI: 10.1017/s0022215123001652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To evaluate the functional magnetic resonance imaging changes in the olfactory structures of coronavirus disease 2019 patients experiencing olfactory dysfunction. METHODS This study included patients aged 25-65 years who presented with a sudden loss of smell, confirmed coronavirus disease 2019 infection, and persistent olfactory dysfunction for a minimum of 2 months without any treatment. RESULTS Irrespective of the side of brain activation, the analysis of the cumulative maximum diameter of the activation zones revealed significantly lower activation in the upper frontal lobe (p = 0.037) and basal ganglia (p = 0.023) in olfactory dysfunction patients. Irrespective of the side of activation, the analysis of the number of activation points demonstrated significantly lower activation in the upper frontal lobe (p = 0.036) and basal ganglia (p = 0.009) in olfactory dysfunction patients. CONCLUSION Patients with coronavirus-triggered olfactory dysfunction exhibited lower activity in their basal ganglia and upper frontal lobe.
Collapse
Affiliation(s)
- Kamyar Iravani
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behzad Malekpour
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rasekhi
- Medical Imaging Research Center ('MIRC'), Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Faramarzi
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Soltaniesmaeili
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnaz Golkhar
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farimah Jahanandish
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Babaei
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
4
|
Afsahi AM, Norbash AM, Syed SF, Sedaghat M, Afsahi G, Shahidi R, Tajabadi Z, Bagherzadeh-Fard M, Karami S, Yarahmadi P, Shirdel S, Asgarzadeh A, Baradaran M, Khalaj F, Sadeghsalehi H, Fotouhi M, Habibi MA, Jang H, Alavi A, Sedaghat S. Brain MRI findings in neurologically symptomatic COVID-19 patients: a systematic review and meta-analysis. J Neurol 2023; 270:5131-5154. [PMID: 37535100 DOI: 10.1007/s00415-023-11914-9] [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: 05/25/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been associated with nervous system involvement, with more than one-third of COVID-19 patients experiencing neurological manifestations. Utilizing a systematic review, this study aims to summarize brain MRI findings in COVID-19 patients presenting with neurological symptoms. METHODS Systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The electronic databases of PubMed/MEDLINE, Embase, Scopus, and Web of Science were systematically searched for literature addressing brain MRI findings in COVID-19 patients with neurological symptoms. RESULTS 25 publications containing a total number of 3118 COVID-19 patients with neurological symptoms who underwent MRI were included. The most common MRI findings and the respective pooled incidences in decreasing order were acute/subacute infarct (22%), olfactory bulb abnormalities (22%), white matter abnormalities (20%), cerebral microbleeds (17%), grey matter abnormalities (12%), leptomeningeal enhancement (10%), ADEM (Acute Disseminated Encephalomyelitis) or ADEM-like lesions (10%), non-traumatic ICH (10%), cranial neuropathy (8%), cortical gray matter signal changes compatible with encephalitis (8%), basal ganglia abnormalities (5%), PRES (Posterior Reversible Encephalopathy Syndrome) (3%), hypoxic-ischemic lesions (4%), venous thrombosis (2%), and cytotoxic lesions of the corpus callosum (2%). CONCLUSION The present study revealed that a considerable proportion of patients with COVID-19 might harbor neurological abnormalities detectable by MRI. Among various findings, the most common MRI alterations are acute/subacute infarction, olfactory bulb abnormalities, white matter abnormalities, and cerebral microbleeds.
Collapse
Affiliation(s)
| | | | - Shahla F Syed
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Maya Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Ghazaleh Afsahi
- Department of Biotechnology Research, Blue California Ingredients, Rancho Santa Margarita, CA, USA
| | - Ramin Shahidi
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zohreh Tajabadi
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shaghayegh Karami
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pourya Yarahmadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Shirdel
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Ali Asgarzadeh
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mansoureh Baradaran
- Department of Radiology, Imam Ali Hospital, North Khorasan University of Medical Science, Bojnurd, Iran
| | - Fattaneh Khalaj
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Sadeghsalehi
- Department of Artificial Intelligence in Medical Sciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Fotouhi
- Quantitative MR Imaging and Spectroscopy Group (QMISG), Research Centre for Molecular and Cellular Imaging (RCMCI), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, CA, USA
| | - Abass Alavi
- Department of Diagnostic Radiology and Nuclear Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sam Sedaghat
- Department of Radiology, University of California, San Diego, CA, USA
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| |
Collapse
|
5
|
Rastmanesh R, Krishnia L, Kashyap MK. The Influence of COVID-19 in Endocrine Research: Critical Overview, Methodological Implications and a Guideline for Future Designs. Clin Med Insights Endocrinol Diabetes 2023; 16:11795514231189073. [PMID: 37529301 PMCID: PMC10387761 DOI: 10.1177/11795514231189073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 06/14/2023] [Indexed: 08/03/2023] Open
Abstract
The COVID-19 pandemic has changed many aspects of people's lives, including not only individual social behavior, healthcare procedures, and altered physiological and pathophysiological responses. As a result, some medical studies may be influenced by one or more hidden factors brought about by the COVID-19 pandemic. Using the literature review method, we are briefly discussing the studies that are confounded by COVID-19 and facemask-induced partiality and how these factors can be further complicated with other confounding variables. Facemask wearing has been reported to produce partiality in studies of ophthalmology (particularly dry eye and related ocular diseases), sleep studies, cognitive studies (such as emotion-recognition accuracy research, etc.), and gender-influenced studies, to mention a few. There is a possibility that some other COVID-19 related influences remain unrecognized in medical research. To account for heterogeneity, current and future studies need to consider the severity of the initial illness (such as diabetes, other endocrine disorders), and COVID-19 infection, the timing of analysis, or the presence of a control group. Face mask-induced influences may confound the results of diabetes studies in many ways.
Collapse
Affiliation(s)
| | - Lucky Krishnia
- Amity Centre of Nanotechnology, Amity University Haryana, Panchgaon, Haryana, India
| | - Manoj Kumar Kashyap
- Amity Medical School, Amity Stem Cell Institute, Amity University Haryana, Panchgaon, Haryana, India
- Clinical Biosamples & Research Services (CBRS), Noida, Uttar Pradesh, India
| |
Collapse
|
6
|
Paul SG, Saha A, Biswas AA, Zulfiker MS, Arefin MS, Rahman MM, Reza AW. Combating Covid-19 using machine learning and deep learning: Applications, challenges, and future perspectives. ARRAY 2023; 17:100271. [PMID: 36530931 PMCID: PMC9737520 DOI: 10.1016/j.array.2022.100271] [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: 10/28/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
COVID-19, a worldwide pandemic that has affected many people and thousands of individuals have died due to COVID-19, during the last two years. Due to the benefits of Artificial Intelligence (AI) in X-ray image interpretation, sound analysis, diagnosis, patient monitoring, and CT image identification, it has been further researched in the area of medical science during the period of COVID-19. This study has assessed the performance and investigated different machine learning (ML), deep learning (DL), and combinations of various ML, DL, and AI approaches that have been employed in recent studies with diverse data formats to combat the problems that have arisen due to the COVID-19 pandemic. Finally, this study shows the comparison among the stand-alone ML and DL-based research works regarding the COVID-19 issues with the combinations of ML, DL, and AI-based research works. After in-depth analysis and comparison, this study responds to the proposed research questions and presents the future research directions in this context. This review work will guide different research groups to develop viable applications based on ML, DL, and AI models, and will also guide healthcare institutes, researchers, and governments by showing them how these techniques can ease the process of tackling the COVID-19.
Collapse
Affiliation(s)
- Showmick Guha Paul
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Arpa Saha
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Al Amin Biswas
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh,Corresponding author
| | - Md. Sabab Zulfiker
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Mohammad Shamsul Arefin
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh,Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chittagong, Bangladesh
| | - Md. Mahfujur Rahman
- Department of Computer Science and Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Ahmed Wasif Reza
- Department of Computer Science and Engineering, East West University, Dhaka, Bangladesh
| |
Collapse
|
7
|
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.
Collapse
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.
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Naclerio R, Mullol J, Stevens WW. A Decade of Clinical Advances in Chronic Rhinosinusitis: 2012-2022. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:43-50. [PMID: 36610759 DOI: 10.1016/j.jaip.2022.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 01/07/2023]
Abstract
The field of chronic rhinosinusitis (CRS) is constantly evolving. In the past 10 years, key advancements in basic and translational research as well as clinical studies have improved our understanding and management of CRS. Notably, treatment options have expanded to include novel therapeutic drugs, devices, and surgical techniques. Assessments of patient symptoms and their impact on quality of life have become more standardized. Progress has also been made in both determining the true prevalence of CRS and recognizing comorbidities that can impact CRS severity. Practice guidelines have also shifted from expert opinion to more data-driven analyses. This review highlights major clinical advancements made in the field of CRS over the past 10 years as well as identifies current gaps in knowledge that can form the basis for new areas of study over the next decade.
Collapse
Affiliation(s)
- Robert Naclerio
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Md
| | - Joaquim Mullol
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, University of Barcelona; Clinical and Experimental Respiratory Immunoallergy, Institute of Biomedical Investigations 'August Pi i Sunyer' (IDIBAPS) Centre for Biomedical Investigations in Respiratory Diseases (CIBERES), Institute of Health Carlos III, Barcelona, Catalonia, Spain
| | - Whitney W Stevens
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
| |
Collapse
|
10
|
De R, Azad RK. Molecular signatures in the progression of COVID-19 severity. Sci Rep 2022; 12:22058. [PMID: 36543855 PMCID: PMC9768786 DOI: 10.1038/s41598-022-26657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 is the causative agent of COVID-19 that has infected over 642 million and killed over 6.6 million people around the globe. Underlying a wide range of clinical manifestations of this disease, from moderate to extremely severe systemic conditions, could be genes or pathways differentially expressing in the hosts. It is therefore important to gain insights into pathways involved in COVID-19 pathogenesis and host defense and thus understand the host response to this pathogen at the physiological and molecular level. To uncover genes and pathways involved in the differential clinical manifestations of this disease, we developed a novel gene co-expression network based pipeline that uses gene expression obtained from different SARS-CoV-2 infected human tissues. We leveraged the network to identify novel genes or pathways that likely differentially express and could be physiologically significant in the COVID-19 pathogenesis and progression but were deemed statistically non-significant and therefore not further investigated in the original studies. Our network-based approach aided in the identification of co-expression modules enriched in differentially expressing genes (DEGs) during different stages of COVID-19 and enabled discovery of novel genes involved in the COVID-19 pathogenesis, by virtue of their transcript abundance and association with genes expressing differentially in modules enriched in DEGs. We further prioritized by considering only those enriched gene modules that have most of their genes differentially expressed, inferred by the original studies or this study, and document here 7 novel genes potentially involved in moderate, 2 in severe, 48 in extremely severe COVID-19, and 96 novel genes involved in the progression of COVID-19 from severe to extremely severe conditions. Our study shines a new light on genes and their networks (modules) that drive the progression of COVID-19 from moderate to extremely severe condition. These findings could aid development of new therapeutics to combat COVID-19.
Collapse
Affiliation(s)
- Ronika De
- Department of Biological Sciences and BioDiscovery Institute, University of North Texas, Denton, TX, 76203, USA
| | - Rajeev K Azad
- Department of Biological Sciences and BioDiscovery Institute, University of North Texas, Denton, TX, 76203, USA.
- Department of Mathematics, University of North Texas, Denton, TX, 76203, USA.
| |
Collapse
|
11
|
Asthma and Cacosmia Could Be Predictive Factors of Olfactory Dysfunction Persistence 9 Months after SARS-CoV-2 Infection: The ANOSVID Study. LIFE (BASEL, SWITZERLAND) 2022; 12:life12070929. [PMID: 35888019 PMCID: PMC9319724 DOI: 10.3390/life12070929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Background. Long-term evolution data of olfactory disorders (OD) in COVID-19 are limited. Method. ANOSVID is a retrospective study in Nord Franche-Comté Hospital (France) that included COVID-19 patients from the first wave. The aim was to describe OD evolution, especially in patients with persistent OD (p-OD group) in comparison with patients with resolved OD (r-OD group). Results. Among 354 COVID-19 patients, 229 reported OD were included. Eighty-five percent of patients (n = 195) recovered from their OD within 90 days. However, 9.5 months (in average) after symptoms onset, OD were persisting in 93 patients (40.6%) and resolved in 136 patients (59.4%). In the p-OD group (n = 93), the mean age was 51.4 years (19-98) ± 20.2, and 65 patients (69.9%) were female; the three main comorbidities in the p-OD group were: asthma (20.4%, n = 19), allergic rhinitis (19.4%, n = 18), and arterial hypertension (16.1%, n = 15). Eleven patients (12%) presented anosmia, and 82 patients (88%) presented hyposmia. Asthma was more described in p-OD group than r-OD group (19 (20.4%) versus 10 (7.4%), p = 0.006). Cacosmia was more described in p-OD group than r-OD group (27 (29.0%) versus 18 (13.2%), p = 0.005). There was no significant difference between the two groups concerning other comorbidities and symptoms, clinical, biological, and imaging findings, and outcome or about the impact of OD on the quality of life of the patients between the p-OD group and r-OD group. sQOD-NS brief version score was 10.7 ± 5.89 and 12.0 ± 6.03, respectively (p = 0.137). Conclusion. Forty-one percent of patients with OD reported OD persistence 9.5 months after COVID-19 (hyposmia in 88% of cases). Asthma and cacosmia could be predictive factors of OD persistence.
Collapse
|
12
|
Mao Y, Ye B, Fan C, Wu J, Wang B, Shen Y, Shi Z, Xiang M. Correlation Between Coronavirus Disease 2019 and Olfactory Dysfunction. Front Public Health 2022; 10:843850. [PMID: 35392472 PMCID: PMC8980590 DOI: 10.3389/fpubh.2022.843850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 12/20/2022] Open
Abstract
A great number of patients with Coronavirus Disease 2019 (COVID-19) experience olfactory dysfunction, typically of a short duration and with a high incidence rate, during the early stages of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This kind of olfactory dysfunction appears more likely in young people and women. This study presents a review of the clinical features and pathogenic mechanism of the olfactory dysfunction related to SARS-CoV-2 infection, aiming to provide a clinical reference for the diagnosis, differential diagnosis, treatment, and prevention of olfactory dysfunction in COVID-19 patients.
Collapse
Affiliation(s)
- Yufeng Mao
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cui Fan
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jichang Wu
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beilei Wang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Shen
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihong Shi
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology and Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
13
|
Tan CJW, Tan BKJ, Tan XY, Liu HT, Teo CB, See A, Xu S, Toh ST, Kheok SW, Charn TC, Teo NWY. Neuroradiological Basis of COVID-19 Olfactory Dysfunction: A Systematic Review and Meta-Analysis. Laryngoscope 2022; 132:1260-1274. [PMID: 35318656 PMCID: PMC9088641 DOI: 10.1002/lary.30078] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 12/13/2022]
Abstract
Objective Olfactory dysfunction (OD) is a common presenting symptom of COVID‐19 infection. Radiological imaging of the olfactory structures in patients with COVID‐19 and OD can potentially shed light on its pathogenesis, and guide clinicians in prognostication and intervention. Methods PubMed, Embase, Cochrane, SCOPUS were searched from inception to August 1, 2021. Three reviewers selected observational studies, case series, and case reports reporting radiological changes in the olfactory structures, detected on magnetic resonance imaging, computed tomography, or other imaging modalities, in patients aged ≥18 years with COVID‐19 infection and OD, following preferred reporting items for systematic reviews and meta‐analyses guidelines and a PROSPERO‐registered protocol (CRD42021275211). We described the proportion of radiological outcomes, and used random‐effects meta‐analyses to pool the prevalence of olfactory cleft opacification, olfactory bulb signal abnormalities, and olfactory mucosa abnormalities in patients with and without COVID‐19‐associated OD. Results We included 7 case–control studies (N = 353), 11 case series (N = 154), and 12 case reports (N = 12). The pooled prevalence of olfactory cleft opacification in patients with COVID‐19 infection and OD (63%, 95% CI = 0.38–0.82) was significantly higher than that in controls (4%, 95% CI = 0.01–0.13). Conversely, similar proportions of cases and controls demonstrated olfactory bulb signal abnormalities (88% and 94%) and olfactory mucosa abnormalities (2% and 0%). Descriptive analysis found that 55.6% and 43.5% of patients with COVID‐19 infection and OD had morphological abnormalities of the olfactory bulb and olfactory nerve, respectively, while 60.0% had abnormal olfactory bulb volumes. Conclusion Our findings implicate a conductive mechanism of OD, localized to the olfactory cleft, in approximately half of the affected COVID‐19 patients. Laryngoscope, 132:1260–1274, 2022
Collapse
Affiliation(s)
- Claire Jing-Wen Tan
- Department of Undergraduate Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Benjamin Kye Jyn Tan
- Department of Undergraduate Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Xin Yan Tan
- Department of Undergraduate Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Hui Ting Liu
- Department of Undergraduate Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Chong Boon Teo
- Department of Undergraduate Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
| | - Anna See
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital (SGH), Singapore, Singapore.,Departments of Otorhinolaryngology-Head and Neck Surgery, Sengkang General Hospital (SKH), Singapore, Singapore
| | - Shuhui Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital (SGH), Singapore, Singapore
| | - Song Tar Toh
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital (SGH), Singapore, Singapore
| | - Si Wei Kheok
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore
| | - Tze Choong Charn
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital (SGH), Singapore, Singapore.,Departments of Otorhinolaryngology-Head and Neck Surgery, Sengkang General Hospital (SKH), Singapore, Singapore
| | - Neville Wei Yang Teo
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital (SGH), Singapore, Singapore
| |
Collapse
|
14
|
Olfactory Dysfunction in COVID-19 Patients Who Do Not Report Olfactory Symptoms: A Pilot Study with Some Suggestions for Dentists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031036. [PMID: 35162061 PMCID: PMC8834295 DOI: 10.3390/ijerph19031036] [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: 01/03/2022] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Smell and taste dysfunction are frequently reported by SARS-CoV-2 positive patients. The degree of olfactory and gustatory dysfunction varies from a very mild reduction to their complete loss. Several studies have been performed to determine their prevalence in COVID-19 patients, mostly using subjective measurement methods. The literature lacks long-term studies regarding duration and recovery. METHODS We assessed olfactory performance, using the Sniffin' Sticks olfactory test, in a group of patients who had not reported olfactory dysfunction, around 131 days after their COVID-19 diagnosis. RESULTS 11 out of 20 subjects showed no olfactory reduction (65%), while 9 subjects showed reduced TDI score (45%). A total of 13 subjects (65%) scored above the cutoff point for Threshold, 16 subjects (80%) scored above the cutoff point for discrimination and 13 subjects (65%) scored above the cutoff point for identification. CONCLUSION Objective measurement methods of olfactory performance show a higher prevalence of olfactory reduction compared to patients' self-reported questionnaires. Olfactory dysfunction can last even months after its onset and because of its high prevalence, it could be a screening symptom for suspect COVID-19 cases.
Collapse
|
15
|
Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
Collapse
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
| |
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- Khang Wen Pang
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore 119228, Singapore; (S.-L.T.); (L.S.N.)
| | | | | |
Collapse
|
17
|
Hoang MP, Staibano P, McHugh T, Sommer DD, Snidvongs K. Self-reported olfactory and gustatory dysfunction and psychophysical testing in screening for Covid-19: A systematic review and meta-analysis. Int Forum Allergy Rhinol 2021; 12:744-756. [PMID: 34725952 PMCID: PMC8652821 DOI: 10.1002/alr.22923] [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: 10/02/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 12/01/2022]
Abstract
Background A substantial proportion of coronavirus disease‐2019 (COVID‐19) patients demonstrate olfactory and gustatory dysfunction (OGD). Self‐reporting for OGD is widely used as a predictor of COVID‐19. Although psychophysical assessment is currently under investigation in this role, the sensitivity of these screening tests for COVID‐19 remains unclear. In this systematic review we assess the sensitivity of self‐reporting and psychophysical tests for OGD. Methods A systematic search was performed on PubMed, EMBASE, and ClinicalTrials.gov from inception until February 16, 2021. Studies of suspected COVID‐19 patients with reported smell or taste alterations were included. Data were pooled for meta‐analysis. Sensitivity, specificity, and diagnostic odds ratio (DOR) were reported in the outcomes. Results In the 50 included studies (42,902 patients), self‐reported olfactory dysfunction showed a sensitivity of 43.9% (95% confidence interval [CI], 37.8%‐50.2%), a specificity of 91.8% (95% CI, 89.0%‐93.9%), and a DOR of 8.74 (95% CI, 6.67‐11.46) for predicting COVID‐19 infection. Self‐reported gustatory dysfunction yielded a sensitivity of 44.9% (95% CI, 36.4%‐53.8%), a specificity of 91.5% (95% CI, 87.7%‐94.3%), and a DOR of 8.83 (95% CI, 6.48‐12.01). Olfactory psychophysical tests analysis revealed a sensitivity of 52.8% (95% CI, 25.5%‐78.6%), a specificity of 88.0% (95% CI, 53.7%‐97.9%), and a DOR of 8.18 (95% CI, 3.65‐18.36). One study used an identification test for gustatory sensations assessment. Conclusion Although demonstrating high specificity and DOR values, neither self‐reported OGD nor unvalidated and limited psychophysical tests were sufficiently sensitive in screening for COVID‐19. They were not suitable adjuncts in ruling out the disease.
Collapse
Affiliation(s)
- Minh P Hoang
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Department of Otolaryngology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Phillip Staibano
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Tobial McHugh
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Doron D Sommer
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, McMaster University, Hamilton, ON, Canada
| | - Kornkiat Snidvongs
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| |
Collapse
|
18
|
Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.09.21264771. [PMID: 34671775 PMCID: PMC8528083 DOI: 10.1101/2021.10.09.21264771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 35.34-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
Collapse
Affiliation(s)
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
- Department of Public Health, University of California Merced, Merced, CA 95348
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| |
Collapse
|
19
|
von Bartheld CS, Hagen MM, Butowt R. The D614G Virus Mutation Enhances Anosmia in COVID-19 Patients: Evidence from a Systematic Review and Meta-analysis of Studies from South Asia. ACS Chem Neurosci 2021; 12:3535-3549. [PMID: 34533304 PMCID: PMC8482322 DOI: 10.1021/acschemneuro.1c00542] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Indexed: 02/08/2023] Open
Abstract
The prevalence of chemosensory dysfunction in patients with COVID-19 varies greatly between populations. It is unclear whether such differences are due to factors at the level of the human host, or at the level of the coronavirus, or both. At the host level, the entry proteins which allow virus binding and entry have variants with distinct properties, and the frequency of such variants differs between ethnicities. At the level of the virus, the D614G mutation enhances virus entry to the host cell. Since the two virus strains (D614 and G614) coexisted in the first six months of the pandemic in most populations, it has been difficult to distinguish between contributions of the virus and contributions of the host for anosmia. To answer this question, we conducted a systematic review and meta-analysis of studies in South Asian populations when either the D614 or the G614 virus was dominant. We show that populations infected predominantly with the G614 virus had a much higher prevalence of anosmia (pooled prevalence of 31.8%) compared with the same ethnic populations infected mostly with the D614 virus strain (pooled anosmia prevalence of 5.3%). We conclude that the D614G mutation is a major contributing factor that increases the prevalence of anosmia in COVID-19, and that this enhanced effect on olfaction constitutes a previously unrecognized phenotype of the D614G mutation. The new virus strains that have additional mutations on the background of the D614G mutation can be expected to cause a similarly increased prevalence of chemosensory dysfunctions.
Collapse
Affiliation(s)
- Christopher S. von Bartheld
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada 89557, USA
| | - Molly M. Hagen
- School of Public Health, University of Nevada, Reno, Nevada 89557, USA
| | - Rafal Butowt
- L. Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland
| |
Collapse
|
20
|
O'Neill B, Kalia S, Gill P, Hum S, Moran-Venegas C, Stoller R, Greiver M, Agarwal P, Kirubarajan A, DeKoven S, Eisen D, Pinto A, Dunn S. Association between new-onset anosmia and positive SARS-CoV-2 tests among people accessing outpatient testing in Toronto, Ontario: a retrospective cross-sectional study. CMAJ Open 2021; 9:E1134-E1140. [PMID: 34876415 PMCID: PMC8673484 DOI: 10.9778/cmajo.20210085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Reports have suggested that anosmia is strongly associated with SARS-CoV-2 infection, but patients were often asked about this symptom after their diagnosis. This study assessed associations between prospectively reported anosmia and other symptoms related to SARS-CoV-2 infection, and SARS-CoV-2 positivity in community testing centres in Toronto, Ontario. METHODS We conducted a retrospective cross-sectional study in which data were collected from 2 COVID-19 assessment centres affiliated with 2 hospitals in Toronto, Ontario, from Apr. 5 to Sept. 30, 2020. We included symptomatic profiles of all people who underwent a SARS-CoV-2 test at either clinic within the study period. We used generalized estimating equations to account for repeat visits and to assess associations between anosmia and other symptoms and SARS-CoV-2 positivity. RESULTS A total of 83 443 SARS-CoV-2 tests were conducted across the 2 sites for 72 692 participants during the study period. Of all tests, 1640 (2.0%) were positive; 837 (51.0%) of people who tested positive were asymptomatic. The adjusted odds ratio for the association between anosmia and test positivity was 5.29 (95% confidence interval [CI] 4.50-6.22), with sensitivity of 0.138 (95% CI 0.121-0.154), specificity of 0.980 (95% CI 0.979-0.981), a positive predictive value of 0.120 (95% CI 0.106-0.135) and a negative predictive value of 0.983 (95% CI 0.982-0.984). INTERPRETATION Anosmia had high specificity and a positive predictive value of 12% for SARS-CoV-2 infection in this community population with low prevalence of SARS-CoV-2 positivity. The presence of anosmia should increase clinical suspicion of SARS-CoV-2 infection, and our findings suggest that people presenting with this symptom should be tested.
Collapse
Affiliation(s)
- Braden O'Neill
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.
| | - Sumeet Kalia
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Peter Gill
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Susan Hum
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Carla Moran-Venegas
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Rebecca Stoller
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Michelle Greiver
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Payal Agarwal
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Abirami Kirubarajan
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Samuel DeKoven
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - David Eisen
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Andrew Pinto
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Sheila Dunn
- MAP Centre for Urban Health Solutions (O'Neill, Pinto), Li Ka Shing Knowledge Institute; Department of Family and Community Medicine (O'Neill, Pinto), St. Michael's Hospital, Unity Health; Department of Family and Community Medicine (O'Neill, Kalia, Greiver, Agarwal, Eisen, Pinto, Dunn), Temerty Faculty of Medicine, University of Toronto; SickKids Research Institute (Gill), Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning; Department of Family and Community Medicine (Hum, Agarwal, Dunn), Women's College Hospital; North York General Hospital (Moran-Venegas); Department of Family and Community Medicine (Stoller, Greiver, Eisen), North York General Hospital; Postgraduate Medical Education (Kirubarajan, DeKoven), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| |
Collapse
|
21
|
Koyama AK, Siegel DA, Oyegun E, Hampton W, Maddox N, Koumans EH. Symptoms Reported With New Onset of Loss of Taste or Smell in Individuals With and Without SARS-CoV-2 Infection. JAMA Otolaryngol Head Neck Surg 2021; 147:911-914. [PMID: 34473217 DOI: 10.1001/jamaoto.2021.2239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alain K Koyama
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David A Siegel
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eghosa Oyegun
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William Hampton
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole Maddox
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | |
Collapse
|
22
|
Lindsay L, Secrest MH, Rizzo S, Keebler DS, Yang F, Tsai L. Factors associated with COVID-19 viral and antibody test positivity and assessment of test concordance: a retrospective cohort study using electronic health records from the USA. BMJ Open 2021; 11:e051707. [PMID: 34598988 PMCID: PMC8488284 DOI: 10.1136/bmjopen-2021-051707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To identify factors associated with COVID-19 test positivity and assess viral and antibody test concordance. DESIGN Observational retrospective cohort study. SETTING Optum de-identified electronic health records including over 700 hospitals and 7000 clinics in the USA. PARTICIPANTS There were 891 754 patients who had a COVID-19 test identified in their electronic health record between 20 February 2020 and 10 July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Per cent of viral and antibody tests positive for COVID-19 ('positivity rate'); adjusted ORs for factors associated with COVID-19 viral and antibody test positivity; and per cent concordance between positive viral and subsequent antibody test results. RESULTS Overall positivity rate was 9% (70 472 of 771 278) and 12% (11 094 of 91 741) for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Antibody test concordance among patients with an initial positive viral test was 91% (71%-95% depending on time between tests). Among tests separated by at least 2 weeks, discordant results occurred in 7% of patients and 9% of immunocompromised patients. Factors associated with increased odds of viral and antibody positivity in multivariable models included: male sex, Hispanic or non-Hispanic black or Asian race/ethnicity, uninsured or Medicaid insurance and Northeast residence. We identified a negative dose effect between the number of comorbidities and viral and antibody test positivity. Paediatric patients had reduced odds (OR=0.60, 95% CI 0.57 to 0.64) of a positive viral test but increased odds (OR=1.90, 95% CI 1.62 to 2.23) of a positive antibody test compared with those aged 18-34 years old. CONCLUSIONS This study identified sociodemographic and clinical factors associated with COVID-19 test positivity and provided real-world evidence demonstrating high antibody test concordance among viral-positive patients.
Collapse
Affiliation(s)
- Lisa Lindsay
- Personalized Healthcare, Data Science, Genentech, South San Francisco, California, USA
| | - Matthew H Secrest
- Personalized Healthcare, Data Science, Genentech, South San Francisco, California, USA
| | - Shemra Rizzo
- Personalized Healthcare, Data Science, Genentech, South San Francisco, California, USA
| | - Daniel S Keebler
- Personalized Healthcare, Data Science, Genentech, South San Francisco, California, USA
| | - Fei Yang
- Roche Information Solutions, Roche Diagnostics International, Rotkreuz, Switzerland
| | - Larry Tsai
- Product Development, Genentech, South San Francisco, California, USA
| |
Collapse
|
23
|
Simple Disposable Odor Identification Tests for Predicting SARS-CoV-2 Positivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910185. [PMID: 34639486 PMCID: PMC8507979 DOI: 10.3390/ijerph181910185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Olfactory dysfunction (OD) is a common manifestation of COVID-19 and may be useful for screening. Survey-based olfactory evaluation tends to underestimate the prevalence of OD, while psychophysical olfactory testing during a pandemic has the disadvantage of being time consuming, expensive, and requiring standardized laboratory settings. We aimed to develop a quick, simple, affordable, and reliable test to objectively assess the prevalence and diagnostic accuracy of OD in COVID-19. The olfactory function of 64 COVID-19 inpatients and 34 controls was evaluated using a questionnaire and a simple disposable odor identification test (SDOIT) developed for this study. Four SDOIT models were assessed: 10-SDOIT, 9-SDOIT, 8-SDOIT, and 4-SDOIT, with 10, 9, 8 and 4 samples, respectively. We found a high frequency of self-reported OD in COVID-19 patients, with 32.8% and 42.2% reporting current and recent OD, respectively. Different SDOIT models revealed smell impairment in 54.7-64.1% of COVID-19 patients. The combination of either 10-SDOIT results and self-reported OD, or 8-SDOIT results and self-reported OD, were the best predictors of COVID-19, both with an AUC value of 0.87 (0.85 and 0.86 for the age-matched subjects). OD is a common symptom of COVID-19. A combination of self-reported smell deterioration and OD psychophysically evaluated using SDOIT appears to be a good predictor of COVID-19.
Collapse
|
24
|
Huamaní C, Velásquez L, Montes S, Mayanga-Herrera A, Bernabé-Ortiz A. SARS-CoV-2 seroprevalence in a high-altitude setting in Peru: adult population-based cross-sectional study. PeerJ 2021; 9:e12149. [PMID: 34616616 PMCID: PMC8459728 DOI: 10.7717/peerj.12149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There are several ecological studies, but few studies of the prevalence of SARS-COV-2 at high altitude. We aimed to estimate the population-based seroprevalence of SARS-COV-2 in three settings of Cusco at the end of the first wave among adults. METHODS A population-based survey was conducted in September 2020, in three settings in the region of Cusco: (1) Cusco city at 3,300 meters above the sea level (m.a.s.l.), (2) the periphery of Cusco (Santiago, San Jerónimo, San Sebastián, and Wanchaq) at 3,300 m.a.s.l., and (3) Quillabamba city, located at 1,050 m.a.s.l. People aged ≥ 18 years within a family unit were included. The diagnosis of SARS-CoV-2 infection was based on identifying anti- SARS-CoV-2 total antibodies (IgM and IgG) in serum using the Elecsys Anti-SARS-CoV-2 chemiluminescence test. RESULTS We enrolled 1924 participants from 712 families. Of the total, 637 participants were anti-SARS-CoV-2 seropositive. Seroprevalence was 38.8% (95% CI [33.4%-44.9%]) in Cusco city, 34.9% (95% CI [30.4%-40.1%]) in the periphery of Cusco, and 20.3% (95% CI [16.2%-25.6%]) in Quillabamba. In 141 families (19.8%; 95% CI [17.0%-22.8%]) the whole members were positive to the test. Living with more than three persons in the same house, a positive COVID-19 case at home, and a member who died in the last five months were factors associated with SARS-COV-2 seropositivity. Dysgeusia/dysosmia was the symptom most associated with seropositivity (aPR = 2.74, 95% CI [2.41-3.12]); whereas always wearing a face shield (aPR = 0. 73; 95% CI [0.60-0.89]) or a facial mask (aPR = 0.76, 95% CI [0.63-0. 92) reduced that probability. CONCLUSIONS A great proportion of Cusco's city inhabitants presented anti-SARS-CoV-2 antibodies at the end of the first wave, with significant differences between settings. Wearing masks and face shields were associated with lower rate of seropositivity; however, efforts must be made to sustain them over time since there is still a high proportion of susceptible people.
Collapse
Affiliation(s)
- Charles Huamaní
- Universidad Andina del Cusco, Cusco, Peru
- Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | - Lucio Velásquez
- Universidad Andina del Cusco, Cusco, Peru
- Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | - Sonia Montes
- Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | | | | |
Collapse
|
25
|
Anyfantakis D, Mantadaki AE, Mastronikolis S, Spandidos DA, Symvoulakis EK. COVID-19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review). Exp Ther Med 2021; 22:1039. [PMID: 34373725 PMCID: PMC8343896 DOI: 10.3892/etm.2021.10471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 12/23/2022] Open
Abstract
The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the World Health Organization to characterize the pandemic as a public health emergency of international concern. National health care systems in countries during the initial surge of the pandemic were unable to handle the sanitarian crisis that had emerged. Thus, the prevention and control of future global health emergencies must be a priority. The present scoping review aimed to retrieve articles that summarize the current experience on issues related to historical knowledge, and epidemiology, clinical features and overall burden of SARS-CoV-2 on health care services. In summary, a comprehensive overview of the information that has been learnt during this period is presented in the current review. Furthermore, taking into account the global experience, the need for planning cohesive and functional health services before similar pandemic events occur in the future is highlighted. The next public health issue should be prevented rather than treated. In spite of the vaccination benefits, a number of sporadic cases of SARS-CoV-2infections will persist. Information collected remains relevant for appraising how similar threats can be faced in the future. Overall, collaborative health care plans need to be rethought to increase preparedness.
Collapse
Affiliation(s)
| | - Aikaterini E. Mantadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Stylianos Mastronikolis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece
| |
Collapse
|
26
|
Marin C, Tubita V, Langdon C, Fuentes M, Rojas‐Lechuga MJ, Valero A, Alobid I, Mullol J. ACE2 downregulation in olfactory mucosa: Eosinophilic rhinosinusitis as COVID-19 protective factor? Allergy 2021; 76:2904-2907. [PMID: 33987850 PMCID: PMC8222895 DOI: 10.1111/all.14904] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/26/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Concepció Marin
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
| | - Valeria Tubita
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Universitat de Barcelona Barcelona Spain
| | - Cristóbal Langdon
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
- Rhinology Unit and Smell Clinic ENT Department Hospital Clínic Barcelona Spain
| | - Mireya Fuentes
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
| | - María Jesús Rojas‐Lechuga
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
- Rhinology Unit and Smell Clinic ENT Department Hospital Clínic Barcelona Spain
| | - Antonio Valero
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
| | - Isam Alobid
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
- Rhinology Unit and Smell Clinic ENT Department Hospital Clínic Barcelona Spain
| | - Joaquim Mullol
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centre for Biomedical Investigation in Respiratory Diseases (CIBERES) Barcelona Spain
- Rhinology Unit and Smell Clinic ENT Department Hospital Clínic Barcelona Spain
| |
Collapse
|
27
|
Shams Vahdati S, Ala A, Rahmanpour D, Sadeghi-Hokmabadi E, Tahmasbi F. Neurological manifestations of COVID-19 infection: an umbrella review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021; 57:113. [PMID: 34483649 PMCID: PMC8401342 DOI: 10.1186/s41983-021-00366-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Neurological involvements of COVID-19 are one of the most reported manifestations of this infection. This study aims to systematically review the previous systematic reviews which addressed the neurological manifestations of the COVID-19 infection. METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science databases and Google Scholar from December 2019 to December 2020. Articles were critically screened by two independent reviewers and if met the inclusion criteria, entered the study. Assessment of methodological quality was conducted by Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. Statistical analysis was not applicable. From a total of 1302 studies, 308 studies were removed due to their irrelevant title and abstract. After screening the full texts, a total of 66 found to be eligible. Twenty-one studies reported general manifestations of the COVID-19, 13 studies reported cerebrovascular events, 19 olfactory and oral dysfunctions, 5 systematic reviews on Guillen-Barré syndrome (GBS) and 8 articles on the sporadic manifestations like ocular signs and symptoms. The majority of the studies were classified as critically low or low in terms of quality. CONCLUSION Despite great heterogeneity in the current literature, neurological involvements are an important extra-pulmonary aspect of the COVID-19; most commonly in the form of general manifestations like headache and olfactory disturbances. Long-term effects of this virus on the nervous system must be a research priority for future references. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s41983-021-00366-5.
Collapse
Affiliation(s)
- Samad Shams Vahdati
- Emergency Medicine Research Team, Emergency Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ala
- Emergency Medicine Research Team, Emergency Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dara Rahmanpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elyar Sadeghi-Hokmabadi
- Neurosciences Research Center, Neurology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fateme Tahmasbi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
28
|
Sebo P, Maisonneuve H, Lourdaux J, Cuzin C, Floquet M, Tudrej B, Haller DM. Self-reported symptoms in French primary care SARS-CoV-2 patients: association with gender and age group. Fam Pract 2021; 38:i37-i44. [PMID: 34448483 PMCID: PMC8513396 DOI: 10.1093/fampra/cmab009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The early identification of COVID-19 patients is of outmost importance in the current pandemic. As with other pathogens, presenting symptoms of SARS-CoV-2 may vary, depending on sociodemographic factors. We aimed to describe the clinical characteristics of COVID-19 patients by age/gender and to assess whether the diagnostic performance of these symptoms varied according to these variables. METHODS We analysed data from a cross-sectional study involving primary care patients undergoing RT-PCR testing in Lyon, France. Among patients who tested positive, we examined whether there was an association between age/gender and various symptoms. In addition, we calculated the diagnostic performance of the most specific symptoms (smell/taste disorder). RESULTS Among 1543 consecutive patients, 253 tested positive (16%). There were significant age/gender-related differences in symptoms. In middle-aged women, the diagnostic performance of smell/taste disorders were AUC = 0.65 [95%CI 0.59-0.71] and PPV = 72% [95%CI 53-87%], that is higher than in the entire sample (smell/taste disorders: AUC = 0.59 [95%CI 0.57-0.62] and PPV = 57% [95%CI 47-67%]. In contrast, the negative predictive values of smell/taste disorders were similar in both groups (85% [95%CI 81-89%] for middle-age women and 86% [95%CI 85-88%] for the entire sample). CONCLUSION We found significant age/gender-related differences in the clinical characteristics of COVID-19 patients. Screening strategies based on smell/taste disorders performed better in middle-aged women, but could not ensure a diagnosis of COVID-19 in any subgroup of patients. Future diagnostic strategies should use age/gender differentiated approaches.
Collapse
Affiliation(s)
- Paul Sebo
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,University College of General Medicine, University Claude Bernard Lyon 1.,Mermoz Primary Health Centre, Lyon, France
| | | | - Clara Cuzin
- University College of General Medicine, University Claude Bernard Lyon 1
| | - Martin Floquet
- University College of General Medicine, University Claude Bernard Lyon 1
| | - Benoit Tudrej
- University College of General Medicine, University Claude Bernard Lyon 1.,Mermoz Primary Health Centre, Lyon, France
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
29
|
Akinbami LJ, Petersen LR, Sami S, Vuong N, Lukacs SL, Mackey L, Atas J, LaFleur BJ. Coronavirus Disease 2019 Symptoms and Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Positivity in a Large Survey of First Responders and Healthcare Personnel, May-July 2020. Clin Infect Dis 2021; 73:e822-e825. [PMID: 33515250 PMCID: PMC7929062 DOI: 10.1093/cid/ciab080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Indexed: 12/02/2022] Open
Abstract
A SARS-CoV-2 serosurvey among first responder/healthcare personnel showed that loss of taste/smell was most predictive of seropositivity; percent seropositivity increased with number of COVID-19 symptoms. However, 22.9% with nine symptoms were seronegative, and 8.3% with no symptoms were seropositive. These findings demonstrate limitations of symptom-based surveillance and importance of testing.
Collapse
Affiliation(s)
- Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Lyle R Petersen
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Samira Sami
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nga Vuong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan L Lukacs
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Lisa Mackey
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Jenny Atas
- Region 2 South Healthcare Coalition, Detroit, Michigan, USA
| | | |
Collapse
|
30
|
Boscutti A, Delvecchio G, Pigoni A, Cereda G, Ciappolino V, Bellani M, Fusar-Poli P, Brambilla P. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health 2021; 15:100268. [PMID: 34027497 PMCID: PMC8129998 DOI: 10.1016/j.bbih.2021.100268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. METHODS A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. RESULTS After the selection process, 155 studies were included, with a total of 70,920 patients and 105,291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0%-98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. CONCLUSIONS OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.
Collapse
Affiliation(s)
- A. Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - G. Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - A. Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - G. Cereda
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
| | - V. Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| | - M. Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata, Verona (AOUI), Italy
| | - P. Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - P. Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122, Milan, Italy
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122, Milan, Italy
| |
Collapse
|
31
|
Hagemann J, Onorato GL, Jutel M, Akdis CA, Agache I, Zuberbier T, Czarlewski W, Mullol J, Bedbrook A, Bachert C, Bennoor KS, Bergmann K, Braido F, Camargos P, Caraballo L, Cardona V, Casale T, Cecchi L, Chivato T, Chu DK, Cingi C, Correia‐de‐Sousa J, Giacco S, Dokic D, Dykewicz M, Ebisawa M, El‐Gamal Y, Emuzyte R, Fauquert J, Fiocchi A, Fokkens WJ, Fonseca JA, Gemicioglu B, Gomez R, Gotua M, Haahtela T, Hamelmann E, Iinuma T, Ivancevich JC, Jassem E, Kalayci O, Kardas P, Khaitov M, Kuna P, Kvedariene V, Larenas‐Linnemann DE, Lipworth B, Makris M, Maspero JF, Miculinic N, Mihaltan F, Mohammad Y, Montefort S, Morais‐Almeida M, Mösges R, Naclerio R, Neffen H, Niedoszytko M, O’Hehir RE, Ohta K, Okamoto Y, Okubo K, Panzner P, Papadopoulos NG, Passalacqua G, Patella V, Pereira A, Pfaar O, Plavec D, Popov TA, Prokopakis EP, Puggioni F, Raciborski F, Reijula J, Regateiro FS, Reitsma S, Romano A, Rosario N, Rottem M, Ryan D, Samolinski B, Sastre J, Solé D, Sova M, Stellato C, Suppli‐Ulrik C, Tsiligianni I, Valero A, Valiulis A, Valovirta E, Vasankari T, Ventura MT, Wallace D, Wang DY, Williams S, Yorgancioglu A, Yusuf OM, Zernotti M, Bousquet J, Klimek L. Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold: An ARIA-EAACI-GA 2 LEN consensus. Allergy 2021; 76:2354-2366. [PMID: 33730365 PMCID: PMC8250633 DOI: 10.1111/all.14815] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
Background Although there are many asymptomatic patients, one of the problems of COVID‐19 is early recognition of the disease. COVID‐19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID‐19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases. Methods A modified Delphi process was used. The ARIA members who were seeing COVID‐19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID‐19, common cold and allergic rhinitis. Results Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two‐way ANOVA revealed significant differences in the symptom intensity between the three diseases (p < .001). Conclusions This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID‐19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.
Collapse
Affiliation(s)
- Jan Hagemann
- Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany
| | | | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical University Wroclaw Poland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Torsten Zuberbier
- Comprehensive Allergy Center Department of Dermatology and Allergy Charité, Universitätsmedizin Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - Joaquim Mullol
- Rhinology Unit & Smell Clinic ENT Department Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy IDIBAPS CIBERES University of Barcelona Barcelona Spain
| | - Anna Bedbrook
- MACVIA‐France Montpellier France
- MASK‐air Montpellier France
| | - Claus Bachert
- Upper Airways Research Laboratory ENT Department Ghent University Hospital Ghent Belgium
- Sun Yat‐sen University International Airway Research Center First Affiliated Hospital Guangzou Guangzou China
- Division of ENT Diseases CLINTEC, Karolinska Institutet Stockholm Sweden
- Department of ENT Diseases Karolinska University Hospital Stockholm Sweden
| | - Kazi S. Bennoor
- Department of Respiratory Medicine National Institute of Diseases of the Chest and Hospital Dhaka Bangladesh
| | - Karl‐Christian Bergmann
- Comprehensive Allergy Center Department of Dermatology and Allergy Charité, Universitätsmedizin Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Fulvio Braido
- Department of Internal Medicine (DiMI) and IRCCS Ospedale Policlinico San Martino University of Genoa Genoa Italy
| | - Paulo Camargos
- Department of Pediatrics Federal University of Minas Gerais Medical School Belo Horizonte Brazil
| | - Luis Caraballo
- Institute for Immunological Research University of Cartagena Campus de Zaragocilla, Edificio Biblioteca Primer piso Cartagena Colombia
- Foundation for the Development of Medical and Biological Sciences (Fundemeb) Cartagena Colombia
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL Research Network Barcelona Spain
| | - Thomas Casale
- Division of Allergy/immunology University of South Florida Tampa FL USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology USL Toscana Centro Prato Italy
| | - Tomas Chivato
- School of Medicine University CEU San Pablo Madrid Spain
| | - Derek K. Chu
- Departments of Medicine and Health Research Methods Evidence & Impact McMaster University Hamilton ON Canada
| | - Cemal Cingi
- ENT Department Medical Faculty Eskisehir Osmangazi University Eskisehir Turkey
| | - Jaime Correia‐de‐Sousa
- Life and Health Sciences Research Institute (ICVS School of Medicine University of Minho Braga Portugal
- PT Government Associate Laboratory Braga/Guimarães Portugal
- International Primary Care Respiratory Group IPCRG London UK
| | - Stefano Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology University Hospital ‘Duilio Casula’ University of Cagliari Cagliari Italy
| | - Dejan Dokic
- University Clinic of Pulmology and Allergy Medical Faculty Skopje Skopje Republic of Macedonia
| | - Mark Dykewicz
- Section of Allergy and Immunology Saint Louis University School of Medicine Saint Louis MO USA
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology NHO Sagamihara National Hospital Sagamihara Japan
| | - Yehia El‐Gamal
- Pediatric Allergy and Immunology Unit Children's hospital Ain Shams University Cairo Egypt
| | - Regina Emuzyte
- Clinic of Children's Diseases Institute of Clinical Medicine Faculty of Medicine Vilnius University Vilnius Lithuania
| | - Jean‐Luc Fauquert
- CHU Clermont‐Ferrand Unité d'Allergologie de l'Enfant Pole pédiatrique Hopital Estaing Clermont‐Ferrand France
| | - Alessandro Fiocchi
- Division of Allergy Department of Pediatric Medicine The Bambino Gesù Children's Research Hospital Holy see IRCCS Rome Italy
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Academic Medical Centers AMC Amsterdam The Netherlands
- EUFOREA Brussels Belgium
| | - Joao A. Fonseca
- CINTESIS Center for Health Technology and Services Research Faculdade de Medicina Universidade do Porto Porto Portugal
- Allergy Unit CUF Porto Porto Portugal
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases Istanbul University‐Cerrahpasa Cerrahpasa Faculty of Medicine Istanbul Turkey
| | | | - Maia Gotua
- Center of Allergy and Immunology Georgian Association of Allergology and Clinical Immunology Tbilisi Georgia
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - Eckard Hamelmann
- University Hospital Bielefeld Children's Center Bethel, EvKB Bielefeld Germany
| | - Tomohisa Iinuma
- Department of Otorhinolaryngology Chiba University Hospital Chiba Japan
| | | | - Ewa Jassem
- Department of Allergology Medical University of Gdańsk Gdansk Poland
| | - Omer Kalayci
- Pediatric Allergy and Asthma Unit Hacettepe University School of Medicine Ankara Turkey
| | - Przemyslaw Kardas
- Department of Family Medicine Medical University of Lodz Lodz Poland
| | - Musa Khaitov
- National Research Center Institute of Immunology Federal Medicobiological Agency Laboratory of Molecular Immunology Moscow Russian Federation
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland
| | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University and Institute of Clinical Medicine Clinic of Chest Diseases and Allergology Faculty of Medicine Vilnius University Vilnius Lithuania
| | | | - Brian Lipworth
- Scottish Centre for Respiratory Research Cardiovascular & Diabetes Medicine Medical Research Institute Ninewells Hospital University of Dundee Dundee UK
| | - Michael Makris
- Allergy Unit ‘D Kalogeromitros’ 2nd Department of Dermatology and Venereology National & Kapodistrian University of Athens ‘Attikon’ University Hospital Athens Greece
| | - Jorge F. Maspero
- Argentine Association of Allergy and Clinical Immunology Buenos Aires Argentina
| | | | | | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases Tishreen University School of Medicine Latakia and Syrian Private University‐Damascus Damascus Syria
| | - Stephen Montefort
- Respiratory Physician Mater Dei Hospital Malta Medicine University of Malta Faculty of Medicine and Surgery University of Medicine La Valette Malta
| | | | - Ralph Mösges
- CRI‐Clinical Research International‐Ltd Hamburg Germany
| | | | - Hugo Neffen
- Center of Allergy Immunology and Respiratory Diseases Santa Fe Argentina
| | - Marek Niedoszytko
- Department of Allergology Medical University of Gdańsk Gdansk Poland
| | - Robyn E. O’Hehir
- Department of Allergy, Immunology and Respiratory Medicine Alfred Hospital and Central Clinical School Monash University Melbourne Vic. Australia
- Department of Immunology Monash University Melbourne Vic. Australia
| | - Ken Ohta
- National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology Chiba University Hospital Chiba Japan
| | - Kimi Okubo
- Department of Otolaryngology Nippon Medical School Tokyo Japan
| | - Petr Panzner
- Department of Immunology and Allergology Faculty of Medicine and Faculty Hospital in Pilsen Charles University in Prague Pilsen Czech Republic
| | - Nikolaos G. Papadopoulos
- Division of Infection Immunity & Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases Ospedale Policlino San Martino ‐University of Genoa Genoa Italy
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology Department of Medicine Agency of Health ASL Salerno, ‘Santa Maria della Speranza’ Hospital Salerno Italy
| | - Ana Pereira
- Center for Research in Health Technologies and Information Systems‐ CINTESIS University of Porto Porto Portugal
- Allergy Unit Instituto CUF Porto and Hospital CUF Porto Porto Portugal
- Department of Community Medicine Health Information and Decision ‐ MEDCIDsS Faculty of Medicina University of Porto Porto Portugal
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Davor Plavec
- Children's Hospital Srebrnjak Zagreb, School of Medicine University J.J. Strossmayer Osijek Croatia
| | | | - Emmanuel P. Prokopakis
- Department of Otorhinolaryngology University of Crete School of Medicine Heraklion Greece
| | - Francesca Puggioni
- Personalized Medicine Clinic Asthma & Allergy Humanitas Clinical and Research Center IRCCS Rozzano, and Department of Biomedical Sciences Humanitas University Pieve Emanuele Milan Italy
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | - Jere Reijula
- Department of Pulmonology Helsinki University Central Hospital Helsinki, Department of Public Health University of Helsinki Helsinki Finland
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra and Institute of Immunology Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology Amsterdam University Medical Centres AMC Amsterdam The Netherlands
| | - Antonino Romano
- Oasi Research Institute‐IRCCS Troina Italy
- bFondazione Mediterranea GB Morgagni Catania Italy
| | - Nelson Rosario
- Hospital de Clinicas University of Parana Curitiba Brazil
| | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology Emek Medical Center Afula Israel
| | - Dermot Ryan
- Usher Institute University of Edinburgh Edinburgh UK
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | - Joaquin Sastre
- Fundacion Jimenez Diaz CIBERES Faculty of Medicine Autonoma University of Madrid Madrid Spain
| | - Dirceu Solé
- Division of Allergy Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil
| | - Milan Sova
- Department of Respiratory Medicine University Hospital Olomouc Olomouc Czech Republic
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’ University of Salerno Salerno Italy
| | - Charlotte Suppli‐Ulrik
- Department of Respiratory Medicine Copenhagen University Hospital‐Hvidovre, and Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Ioanna Tsiligianni
- Health Planning Unit Department of Social Medicine Faculty of Medicine University of Crete Greece and International Primary Care Respiratory Group IPCRG Aberdeen Scotland
| | - Antonio Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona Barcelona Spain
| | - Arunas Valiulis
- Vilnius University Faculty of Medicine Institute of Clinical Medicine & Institute of Health Sciences Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS‐SP) Brussels Belgium
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology University of Turku and Terveystalo allergy clinic Turku Finland
| | - Tuula Vasankari
- Filha, Finnish Lung Health Association Helsinki Finland
- University of Turku Turku Finland
| | - Maria Teresa Ventura
- University of Bari Medical School Unit of Geriatric Immunoallergology Bari Italy
| | - Dana Wallace
- Nova Southeastern University Fort Lauderdale FL USA
| | - De Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Siân Williams
- International Primary Care Respiratory Group IPCRG London UK
| | | | | | - Mario Zernotti
- Universidad Católica de Córdoba Universidad Nacional de Villa Maria Córdoba Argentina
| | - Jean Bousquet
- MACVIA‐France Montpellier France
- Comprehensive Allergy Center Department of Dermatology and Allergy Charité, Universitätsmedizin Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
- University Hospital Montpellier Montpellier France
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany
- Center for Rhinology and Allergology Wiesbaden Germany
| |
Collapse
|
32
|
Larremore DB, Toomre D, Parker R. Modeling the effectiveness of olfactory testing to limit SARS-CoV-2 transmission. Nat Commun 2021; 12:3664. [PMID: 34135322 PMCID: PMC8209051 DOI: 10.1038/s41467-021-23315-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
A central problem in the COVID-19 pandemic is that there is not enough testing to prevent infectious spread of SARS-CoV-2, causing surges and lockdowns with human and economic toll. Molecular tests that detect viral RNAs or antigens will be unable to rise to this challenge unless testing capacity increases by at least an order of magnitude while decreasing turnaround times. Here, we evaluate an alternative strategy based on the monitoring of olfactory dysfunction, a symptom identified in 76-83% of SARS-CoV-2 infections-including those with no other symptoms-when a standardized olfaction test is used. We model how screening for olfactory dysfunction, with reflexive molecular tests, could be beneficial in reducing community spread of SARS-CoV-2 by varying testing frequency and the prevalence, duration, and onset time of olfactory dysfunction. We find that monitoring olfactory dysfunction could reduce spread via regular screening, and could reduce risk when used at point-of-entry for single-day events. In light of these estimated impacts, and because olfactory tests can be mass produced at low cost and self-administered, we suggest that screening for olfactory dysfunction could be a high impact and cost-effective method for broad COVID-19 screening and surveillance.
Collapse
Affiliation(s)
- Daniel B Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA.
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA.
| | - Derek Toomre
- Department of Cell Biology, Yale University School of Medicine, New Haven, CT, USA.
| | - Roy Parker
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA.
- Department of Biochemistry, University of Colorado Boulder, Boulder, CO, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
| |
Collapse
|
33
|
Sen A. Does serotonin deficiency lead to anosmia, ageusia, dysfunctional chemesthesis and increased severity of illness in COVID-19? Med Hypotheses 2021; 153:110627. [PMID: 34139598 PMCID: PMC8180092 DOI: 10.1016/j.mehy.2021.110627] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/24/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022]
Abstract
Different mechanisms forwarded to understand anosmia and ageusia in coronavirus patients are not adequate to explain reversible anosmia and ageusia, which are resolved quickly. In addition, the reason behind the impaired chemesthetic sensations in some coronavirus patients remains unknown. In the present paper it is proposed that SARS-CoV-2 patients suffer from depletion of tryptophan, as ACE2, a key element in the process of absorption of tryptophan from the food, is significantly reduced in the patients as coronavirus uses ACE2 as the receptor to enter the host cells. The tryptophan depletion leads to a deficit of serotonin (5-HT) in SARS-COV-2 patients because tryptophan is the precursor in the synthesis of 5-HT. Such 5-HT deficiency can explain anosmia, ageusia and dysfunctional chemesthesis in COVID-19, given the fact that 5-HT is an important neuromodulator in the olfactory neurons, taste receptor cells and transient receptor potential channels (TRP channels) involved in chemesthesis. In addition, 5-HT deficiency worsens silent hypoxemia and depresses hypoxic pulmonary vasoconstriction leading to increased severity of the disease. Also, the levels of anti-inflammatory melatonin (synthesized from 5-HT) and nicotinamide adenine dinucleotide (NAD+, produced from niacin whose precursor is the tryptophan) might decrease in coronavirus patients resulting in the aggravation of the disease. Interestingly, selective serotonin reuptake inhibitors (SSRIs) may not be of much help in correcting the 5-HT deficiency in COVID-19 patients, as their efficacy goes down significantly when there is depletion of tryptophan in the system. Hence, tryptophan supplementation may herald a radical change in the treatment of COVID-19 and accordingly, clinical trials (therapeutic / prophylactic) should be conducted on coronavirus patients to find out how tryptophan supplementation (oral or parenteral, the latter in severe cases where there is hardly any absorption of tryptophan from the food) helps in curing, relieving or preventing the olfactory, gustatory and chemesthetic dysfunctions and in lessening the severity of the disease.
Collapse
Affiliation(s)
- Amarnath Sen
- 40 Jadunath Sarbovouma Lane, Kolkata 700035, India.
| |
Collapse
|
34
|
COVID-19's natural course among ambulatory monitored outpatients. Sci Rep 2021; 11:10124. [PMID: 33980931 PMCID: PMC8115337 DOI: 10.1038/s41598-021-89545-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/27/2021] [Indexed: 12/14/2022] Open
Abstract
Research objective was to detail COVID-19's natural trajectory in relation to the Czech population's viral load. Our prospective detailed daily questionnaire-based telemonitoring study evaluated COVID-19's impact among 105 outpatients. In accordance with government quarantine requirements, outpatients were divided into a cohort with two negative tests at the end of the disease (40 patients) and a cohort with a new algorithm (65 patients) following a 14-day quarantine. Median follow-up differed significantly between the 2 groups (23 days vs. 16 days). Only 6% of patients were asymptomatic during the entire telemonitoring period. Another 13% of patients were diagnosed asymptomatic, as suspected contacts, yet later developed symptoms, while the remaining 81% were diagnosed as symptomatic on average 6 days following symptom onset. Telemonitoring enabled precise symptom status chronicling. The most frequently reported complaints were fevers, respiratory issues, and anosmia. Six patients were eventually hospitalized for complications detected early after routine telemonitoring. During the extended follow-up (median 181 days), anosmia persisted in 26% of patients. 79% of patients in the new quarantine algorithm cohort reported no symptoms on day 11 compared to just 56% of patients in the two negative test cohort upon first testing negative (median-19 days). The highest viral load occurred within 0-2 days of initial symptom onset. Both the PCR viral load and two consecutive PCR negative sample realizations indicated high interindividual variability with a surprisingly fluctuating pattern among 43% of patients. No definitive COVID-19 symptoms or set of symptoms excepting anosmia (59%) and/or ageusia (47%) were identified. No preexisting medical conditions specifically foreshadowed disease trajectory in a given patient. Without a PCR negativity requirement for quarantine cessation, patients could exhibit fewer symptoms. Our study therefore highlights the urgent need for routine ambulatory patient telemedicine monitoring, early complication detection, intensive mass education connecting disease demeanor with subsequent swift diagnostics, and, notably, the need to reevaluate and modify quarantine regulations for better control of SARS-CoV-2 proliferation.
Collapse
|
35
|
Jalessi M, Bagheri SH, Azad Z, Firouzabadi FD, Amini E, Alizadeh R, Chaibakhsh S, Ghalehbaghi B, Hopkins C, Farhadi M. The outcome of olfactory impairment in patients with otherwise paucisymptomatic coronavirus disease 2019 during the pandemic. J Laryngol Otol 2021; 135:426-435. [PMID: 33883051 PMCID: PMC8111181 DOI: 10.1017/s0022215121001110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to measure the duration and recovery rate of olfactory loss in patients complaining of recent smell loss as their prominent symptom during the coronavirus disease 2019 outbreak. METHOD This was a prospective telephone follow-up observational study of 243 participants who completed an online survey that started on 12 March 2020. RESULTS After a mean of 5.5 months from the loss of smell onset, 98.3 per cent of participants reported improvement with a 71.2 per cent complete recovery rate after a median of 21 days. The chance of complete recovery significantly decreased after 131 days from the onset of loss of smell (100 per cent sensitive and 97.7 per cent specific). Younger age and isolated smell loss were associated with a rapid recovery, whereas accompanying rhinological and gastrointestinal symptoms were associated with longer loss of smell duration. CONCLUSION Smell loss, occurring as a prominent symptom during the coronavirus disease 2019 pandemic, showed a favourable outcome. However, after 5.5 months from the onset, around 10 per cent of participants still complained of moderate or severe hyposmia.
Collapse
Affiliation(s)
- M Jalessi
- Skull Base Research Centre, Tehran, Iran
| | - S H Bagheri
- ENT Department and Head and Neck Research Centre, Tehran, Iran
| | - Z Azad
- Skull Base Research Centre, Tehran, Iran
| | - F D Firouzabadi
- ENT Department and Head and Neck Research Centre, Tehran, Iran
| | - E Amini
- Skull Base Research Centre, Tehran, Iran
| | - R Alizadeh
- ENT Department and Head and Neck Research Centre, Tehran, Iran
| | - S Chaibakhsh
- Eye Research Centre, The Five Senses Health Institute, Hazrat Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - B Ghalehbaghi
- ENT Department and Head and Neck Research Centre, Tehran, Iran
| | - C Hopkins
- Guy's and St Thomas’ Hospital, King's College, London, UK
| | - M Farhadi
- ENT Department and Head and Neck Research Centre, Tehran, Iran
| |
Collapse
|
36
|
Huart C, Philpott CM, Altundag A, Fjaeldstad AW, Frasnelli J, Gane S, Hsieh JW, Holbrook EH, Konstantinidis I, Landis BN, Macchi A, Mueller CA, Negoias S, Pinto JM, Poletti SC, Ramakrishnan VR, Rombaux P, Vodicka J, Welge-Lüessen A, Whitcroft KL, Hummel T. Systemic corticosteroids in coronavirus disease 2019 (COVID-19)-related smell dysfunction: an international view. Int Forum Allergy Rhinol 2021; 11:1041-1046. [PMID: 33728824 PMCID: PMC8251281 DOI: 10.1002/alr.22788] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
The frequent association between coronavirus disease 2019 (COVID‐19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID‐19–related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID‐19–related olfactory dysfunction is high; and (3) corticosteroids have well‐known potential adverse effects. We encourage randomized placebo‐controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.
Collapse
Affiliation(s)
- Caroline Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Institute of Neuroscience, Univeristé catholique de Louvain, Brussels, Belgium
| | - Carl M Philpott
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, Gorleston, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Aytug Altundag
- Department of Otorhinolaryngology, Biruni University, Istanbul, Turkey
| | - Alexander W Fjaeldstad
- Flavour Clinic, Department of Otorhinolaryngology, Regional Hospital West Jutland, Holstebro, Denmark.,Flavour Institute, Aarhus University, Aarhus, Denmark
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Simon Gane
- Department of Rhinology, Royal National ENT Hospital, University College London Hospitals NHS Foundation Trust, London, UK.,UCL Ear Institute, University College London, London, UK
| | - Julien W Hsieh
- Department of Otorhinolaryngology-Head and Neck Surgery, Rhinology-Olfactory Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Eric H Holbrook
- Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts
| | - Iordanis Konstantinidis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - Basile N Landis
- Department of Otorhinolaryngology-Head and Neck Surgery, Rhinology-Olfactory Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Alberto Macchi
- ENT clinic Asst-Settelaghi-University of Insubriae, Varese, Italy
| | - Christian A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Simona Negoias
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, CH-4051, Basel, Switzerland
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, Illinois
| | - Sophia C Poletti
- Department of Otorhinolaryngology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Vijay R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Philippe Rombaux
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Institute of Neuroscience, Univeristé catholique de Louvain, Brussels, Belgium
| | - Jan Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital of Pardubice, Pardubice, Czech Republic
| | - Antje Welge-Lüessen
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, CH-4051, Basel, Switzerland
| | - Katherine L Whitcroft
- UCL Ear Institute, University College London, London, UK.,The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Study, London, UK
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| |
Collapse
|
37
|
Callejon-Leblic MA, Moreno-Luna R, Del Cuvillo A, Reyes-Tejero IM, Garcia-Villaran MA, Santos-Peña M, Maza-Solano JM, Martín-Jimenez DI, Palacios-Garcia JM, Fernandez-Velez C, Gonzalez-Garcia J, Sanchez-Calvo JM, Solanellas-Soler J, Sanchez-Gomez S. Loss of Smell and Taste Can Accurately Predict COVID-19 Infection: A Machine-Learning Approach. J Clin Med 2021; 10:570. [PMID: 33546319 PMCID: PMC7913595 DOI: 10.3390/jcm10040570] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 outbreak has spread extensively around the world. Loss of smell and taste have emerged as main predictors for COVID-19. The objective of our study is to develop a comprehensive machine learning (ML) modelling framework to assess the predictive value of smell and taste disorders, along with other symptoms, in COVID-19 infection. A multicenter case-control study was performed, in which suspected cases for COVID-19, who were tested by real-time reverse-transcription polymerase chain reaction (RT-PCR), informed about the presence and severity of their symptoms using visual analog scales (VAS). ML algorithms were applied to the collected data to predict a COVID-19 diagnosis using a 50-fold cross-validation scheme by randomly splitting the patients in training (75%) and testing datasets (25%). A total of 777 patients were included. Loss of smell and taste were found to be the symptoms with higher odds ratios of 6.21 and 2.42 for COVID-19 positivity. The ML algorithms applied reached an average accuracy of 80%, a sensitivity of 82%, and a specificity of 78% when using VAS to predict a COVID-19 diagnosis. This study concludes that smell and taste disorders are accurate predictors, with ML algorithms constituting helpful tools for COVID-19 diagnostic prediction.
Collapse
Affiliation(s)
- María A Callejon-Leblic
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain
| | - Ramon Moreno-Luna
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Alfonso Del Cuvillo
- Rhinology and Asthma Unit, ENT Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain
| | - Isabel M Reyes-Tejero
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Miguel A Garcia-Villaran
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Marta Santos-Peña
- COVID-19 Unit, Infectious Disease Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain; (M.S.-P.); (J.M.S.-C.)
| | - Juan M Maza-Solano
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Daniel I Martín-Jimenez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Jose M Palacios-Garcia
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Carlos Fernandez-Velez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Jaime Gonzalez-Garcia
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Juan M Sanchez-Calvo
- COVID-19 Unit, Infectious Disease Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain; (M.S.-P.); (J.M.S.-C.)
| | - Juan Solanellas-Soler
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Serafin Sanchez-Gomez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| |
Collapse
|
38
|
Abstract
Age-related olfactory dysfunction, or presbyosmia, is a common sensory impairment in aging adults. People in this demographic group with comorbid conditions or exposure to viral, traumatic, or environmental insults remain at the greatest risk for impairment. Several methods for assessing olfaction exist, but they are only available in special settings and require consideration of age, sex, ancestry, and cognition. Perhaps most importantly, olfactory dysfunction has been suggested as an early sign of Alzheimer's and Parkinson's disease and therefore may serve as a tool in the diagnosis and prognosis of these neurodegenerative conditions. Outside of this context, olfactory loss also impacts nutrition, safety, and social relationships, and even predicts mortality itself. This review covers the detection and manifestations of olfactory decline in aging individuals and the myriad ways in which olfactory impairment is connected to their health and well-being.
Collapse
Affiliation(s)
- Emily J Papazian
- Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, IL, USA
| |
Collapse
|
39
|
Chemosensory Dysfunction in Patients with COVID-19: What Do We Learn from the Global Outbreak? Curr Allergy Asthma Rep 2021; 21:6. [PMID: 33537862 PMCID: PMC7857344 DOI: 10.1007/s11882-020-00987-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Chemosensory dysfunction in the patients with COVID-19 has been reported frequently in the studies from different regions of the world. However, the prevalence of smell and/or taste disorders presents significant ethnic and geographic variability. In addition, the pathogenesis of chemosensory dysfunction remains unclarified. RECENT FINDINGS This is a narrative review on the recent state of the prevalence, mechanism, and diagnostic and therapeutic strategy of chemosensory dysfunction in COVID-19 patients during the global pandemic. The chemosensory dysfunction was analysis based on recent studies, which either used questionnaires, Likert scales (0-10), or smell tests to estimate the smell and taste dysfunction. The ethnic and geographic difference of the prevalence of smell and/or taste disorders and the potential underlying mechanisms have been discussed. Several suggestions on the diagnosis and treatment of COVID-19 patients with smell and taste disorders were summarized for the physicians. This review provides a comprehensive overview of the current studies regarding the chemosensory dysfunction during the COVID-19 worldwide outbreak.
Collapse
|
40
|
Olfactory Dysfunction in a Mexican Population Outside of COVID-19 Pandemic: Prevalence and Associated Factors (the OLFAMEX Study). Curr Allergy Asthma Rep 2020; 20:78. [PMID: 33161494 PMCID: PMC7649040 DOI: 10.1007/s11882-020-00975-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW To study the prevalence of olfactory loss and its associated factors in a Mexican population a cross-sectional analytical study based on a population interviewed about health, epidemiologic aspects, and sense of smell (tested with four scents: rose, banana, perfume, and gas) was conducted to evaluate olfactory detection, memory, and identification. Levels of sense of smell perception were determined when the participants detected, recognized, or identified all (normosmia), 1-3 (hyposmia), or none (anosmia) of the odorants. Associated factors of olfactory dysfunction were identified by multivariate analysis (odds ratio, 95%CI). RECENT FINDINGS Olfactory dysfunction is a prevalent disorder affecting up to 20% of the general population. In addition to viral infection, including COVID-19, a number of other causes and factors may also be involved. 1,956 surveys were conducted and 1,921 were analyzed. Most of the participants (62.1%) were women. The general prevalence of olfactory dysfunction, regarding detection, was 7.2% (7.1% hyposmia, 0.1% anosmia). Age-related olfactory deterioration was observed in both sexes from the 5th decade of life (OR 2.74, p = 0.0050). Women showed better olfactory identification (OR 0.73, p = 0.0010). Obesity (OR 1.97, p = 0.0070), low educational level, bad/very bad self-perceived olfactory function (OR 2.74, p = 0.0050), olfactory loss for less than one week (OR 1.35, p = 0.0030), exposure to toxics/irritants (OR 1.31, p = 0.0030), active smoking (OR 1.58, p < 0.0010), and type 2 diabetes mellitus (OR 2.68, 95%CI 1.74-4.10, p < 0.0001) were identified as factors associated with olfactory dysfunction. These results in a Mexican population suggest better olfactory identification (verbalization) in females. Age was a determining factor in the olfactory deterioration process and obesity and diabetes mellitus were also associated with olfactory disorders. Finally, these findings reinforce the differential diagnosis with other potential causes of sense of smell loss, during the COVID-19 outbreak.
Collapse
|