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Simonini L, Frijia F, Ait Ali L, Foffa I, Vecoli C, De Gori C, De Cori S, Baroni M, Aquaro GD, Maremmani C, Lombardo F. A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings. Diagnostics (Basel) 2024; 14:359. [PMID: 38396398 PMCID: PMC10888385 DOI: 10.3390/diagnostics14040359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Olfactory dysfunction (OD) is one of the most common symptoms in COVID-19 patients and can impact patients' lives significantly. The aim of this review was to investigate the multifaceted impact of COVID-19 on the olfactory system and to provide an overview of magnetic resonance (MRI) findings and neurocognitive disorders in patients with COVID-19-related OD. Extensive searches were conducted across PubMed, Scopus, and Google Scholar until 5 December 2023. The included articles were 12 observational studies and 1 case report that assess structural changes in olfactory structures, highlighted through MRI, and 10 studies correlating the loss of smell with neurocognitive disorders or mood disorders in COVID-19 patients. MRI findings consistently indicate volumetric abnormalities, altered signal intensity of olfactory bulbs (OBs), and anomalies in the olfactory cortex among COVID-19 patients with persistent OD. The correlation between OD and neurocognitive deficits reveals associations with cognitive impairment, memory deficits, and persistent depressive symptoms. Treatment approaches, including olfactory training and pharmacological interventions, are discussed, emphasizing the need for sustained therapeutic interventions. This review points out several limitations in the current literature while exploring the intricate effects of COVID-19 on OD and its connection to cognitive deficits and mood disorders. The lack of objective olfactory measurements in some studies and potential validity issues in self-reports emphasize the need for cautious interpretation. Our research highlights the critical need for extensive studies with larger samples, proper controls, and objective measurements to deepen our understanding of COVID-19's long-term effects on neurological and olfactory dysfunctions.
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Affiliation(s)
- Ludovica Simonini
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione Toscana G. Monasterio, 56124 Pisa, Italy;
| | - Lamia Ait Ali
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
- Pediatric Cardiology and GUCH Unit, Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy
| | - Ilenia Foffa
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Cecilia Vecoli
- Institute of Clinical Physiology, National Research Council (CNR), 54100 Massa, Italy; (I.F.); (C.V.)
| | - Carmelo De Gori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Sara De Cori
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
| | - Monica Baroni
- Fondazione “G. Monasterio” CNR-Regione Toscana, 54100 Massa, Italy;
| | - Giovanni Donato Aquaro
- Academic Radiology Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56124 Pisa, Italy;
| | - Carlo Maremmani
- Unit of Neurology, Ospedale Apuane, Azienda USL Toscana Nord Ovest, 54100 Massa, Italy;
| | - Francesco Lombardo
- Department of Radiology, Fondazione Monasterio/CNR, 56124 Pisa, Italy; (C.D.G.); (S.D.C.); (F.L.)
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Zijp TR, Izzah Z, Åberg C, Gan CT, Bakker SJL, Touw DJ, van Boven JFM. Clinical Value of Emerging Bioanalytical Methods for Drug Measurements: A Scoping Review of Their Applicability for Medication Adherence and Therapeutic Drug Monitoring. Drugs 2021; 81:1983-2002. [PMID: 34724175 PMCID: PMC8559140 DOI: 10.1007/s40265-021-01618-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Direct quantification of drug concentrations allows for medication adherence monitoring (MAM) and therapeutic drug monitoring (TDM). Multiple less invasive methods have been developed in recent years: dried blood spots (DBS), saliva, and hair analyses. AIM To provide an overview of emerging drug quantification methods for MAM and TDM, focusing on the clinical validation of methods in patients prescribed chronic drug therapies. METHODS A scoping review was performed using a systematic search in three electronic databases covering the period 2000-2020. Screening and inclusion were performed by two independent reviewers in Rayyan. Data from the articles were aggregated in a REDCap database. The main outcome was clinical validity of methods based on study sample size, means of cross-validation, and method description. Outcomes were reported by matrix, therapeutic area and application (MAM and/or TDM). RESULTS A total of 4590 studies were identified and 175 articles were finally included; 57 on DBS, 66 on saliva and 55 on hair analyses. Most reports were in the fields of neurological diseases (37%), infectious diseases (31%), and transplantation (14%). An overview of clinical validation was generated of all measured drugs. A total of 62 drugs assays were applied for MAM and 131 for TDM. CONCLUSION MAM and TDM are increasingly possible without traditional invasive blood sampling: the strengths and limitations of DBS, saliva, and hair differ, but all have potential for valid and more convenient drug monitoring. To strengthen the quality and comparability of future evidence, standardisation of the clinical validation of the methods is recommended.
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Affiliation(s)
- Tanja R Zijp
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
| | - Zamrotul Izzah
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands
| | - Christoffer Åberg
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands
| | - C Tji Gan
- University of Groningen, University Medical Center Groningen, Respiratory Diseases and Lung Transplantation, Groningen, The Netherlands
| | - Stephan J L Bakker
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, Groningen, The Netherlands
| | - Daan J Touw
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.
- University of Groningen, Groningen Research Institute of Pharmacy, Department of Pharmaceutical Analysis, Groningen, The Netherlands.
- Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, The Netherlands.
| | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
- Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, The Netherlands
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Abstract
Olfactory loss is frequent. However, in public not many people complain of that, or they are even not (fully) aware of it. This indicates that it is possible to live a life without a sense of smell, albeit it is more dangerous, less pleasant, and food tastes much less interesting. Most common causes for smell loss are sinunasal disease (chronic rhinosinusitis with and without nasal polyps), acute infections of the upper airways, head trauma, and neurodegenerative disorders. In many people smell loss seems to be due to the aging process. Before treatment olfactory disorders are diagnosed according to cause with the medical history being a big portion of the diagnostic process. Olfactory disorders are in principle reversible, with a relatively high degree of spontaneous improvement in olfactory loss following infections of the upper respiratory tract. Medical treatment is according to cause. It also involves surgical approaches as well as conservative treatments including the use of corticosteroids, antibiotics, or smell training. Because today olfactory dysfunction seems to receive more attention than in previous years it can be expected that tomorrow we will have more specific and effective treatment options available.
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Vanstraelen K, Maertens J, Augustijns P, Lagrou K, de Loor H, Mols R, Annaert P, Malfroot A, Spriet I. Investigation of Saliva as an Alternative to Plasma Monitoring of Voriconazole. Clin Pharmacokinet 2016; 54:1151-60. [PMID: 25910879 DOI: 10.1007/s40262-015-0269-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Therapeutic drug monitoring (TDM) of voriconazole is increasingly being implemented in clinical practice. However, as blood sampling can be difficult in paediatric and ambulatory patients, a non-invasive technique for TDM is desirable. The aim of this study was to compare the pharmacokinetics of voriconazole in saliva with the pharmacokinetics of unbound and total voriconazole in plasma in order to clinically validate saliva as an alternative to plasma in voriconazole TDM. METHODS In this pharmacokinetic study, paired plasma and saliva samples were taken at steady state in adult haematology and pneumology patients treated with voriconazole. Unbound and bound plasma voriconazole concentrations were separated using high-throughput equilibrium dialysis. Voriconazole concentrations were determined with liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters were calculated using log-linear regression. RESULTS Sixty-three paired samples were obtained from ten patients (seven haematology and three pneumology patients). Pearson's correlation coefficients (R values) for saliva versus unbound and total plasma voriconazole concentrations showed a very strong correlation, with values of 0.970 (p < 0.001) and 0.891 (p < 0.001), respectively. Linear mixed modelling revealed strong agreement between voriconazole concentrations in saliva and unbound plasma voriconazole concentrations, with a mean bias of -0.03 (95 % confidence interval -0.14 to 0.09; p = 0.60). For total concentrations below 10 mg/L, the mean ratio of saliva to total plasma voriconazole concentrations was 0.51 ± 0.08 (n = 63), which did not differ significantly (p = 0.76) from the unbound fraction of voriconazole in plasma of 0.49 ± 0.03 (n = 36). CONCLUSIONS Saliva can serve as a reliable alternative to plasma in voriconazole TDM, and it can easily be implemented in clinical practice.
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Affiliation(s)
- Kim Vanstraelen
- Clinical Pharmacology and Pharmacotherapy, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000, Leuven, Belgium.
| | - Johan Maertens
- Acute Leukaemia and Stem Cell Transplantation Unit, Clinical Department of Haematology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Patrick Augustijns
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000, Leuven, Belgium
| | - Katrien Lagrou
- Clinical Department of Laboratory Medicine, Department of Microbiology and Immunology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Henriette de Loor
- Laboratory of Nephrology and Renal Transplantation, KU Leuven Department of Microbiology and Immunology, Herestraat 49, 3000, Leuven, Belgium
| | - Raf Mols
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000, Leuven, Belgium
| | - Pieter Annaert
- Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000, Leuven, Belgium
| | - Anne Malfroot
- Cystic Fibrosis Clinic, Research Group GRON, Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Isabel Spriet
- Clinical Pharmacology and Pharmacotherapy, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, 3000, Leuven, Belgium
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Meusel T, Albinus J, Welge-Luessen A, Hähner A, Hummel T. Short-term effect of caffeine on olfactory function in hyposmic patients. Eur Arch Otorhinolaryngol 2016; 273:2091-5. [DOI: 10.1007/s00405-015-3879-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/23/2015] [Indexed: 10/22/2022]
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Peris-Vicente J, Rambla-Alegre M, Durgavanshi A, Bose D, Esteve-Romero J, Marco-Peiro S. Xanthine Derivatives Quantification in Serum by Capillary Zone Electrophoresis. J Chromatogr Sci 2013; 52:1121-6. [DOI: 10.1093/chromsci/bmt164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Human saliva-based quantitative monitoring of clarithromycin by flow injection chemiluminescence analysis: a pharmacokinetic study. Appl Biochem Biotechnol 2013; 172:1320-31. [PMID: 24166104 DOI: 10.1007/s12010-013-0605-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 10/18/2013] [Indexed: 01/30/2023]
Abstract
Human saliva quantitative monitoring of clarithromycin (CLA) by chemiluminescence (CL) with flow injection analysis was proposed for the first time, which was based on the quenching effect of CLA on luminol-bovine serum albumin (BSA) CL system with a linear range from 7.5 × 10(-4) to 2.0 ng/ml. This proposed approach, offering a maximum sample throughput of 100 h(-1), was successfully applied to the quantitative monitoring of CLA levels in human saliva during 24 h after a single oral dose of 250 mg intake, with recoveries of 95.2 ∼ 109.0% and relative standard deviations lower than 6.5 % (N = 7). Results showed that CLA reached maximum concentration of 2.28 ± 0.02 μg/ml at approximately 3 h, and the total elimination ratio was 99.6 % in 24 h. The pharmacokinetic parameters including absorption rate constant (0.058 ± 0.006 h(-1)), elimination rate constant (0.149 ± 0.009 h(-1)) and elimination half-life time (4.66 ± 0.08 h) were obtained. A comparison of human saliva and urine monitoring was also given. The mechanism study of BSA-CLA interaction revealed the binding of CLA to BSA is an entropy driven and spontaneous process through hydrophobic interaction, with binding constant K BSA-CLA of 4.78 × 10(6) l/mol and the number of binding sites n of 0.82 by flow injection-chemiluminescence model. Molecular docking analysis further showed CLA might be in subdomain IIA of BSA, with K BSA-CLA of 6.82 × 10(5) l/mol and ΔG of -33.28 kJ/mol.
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