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Sekine R, Hernandez AK, Overbeck C, Hofer MK, Mori E, Hähner A, Hummel T. Comparison of Patient Characteristics and Olfactory Sensitivity for Trigger Odorants in Parosmia and Phantosmia. Laryngoscope 2024; 134:3277-3285. [PMID: 38578016 DOI: 10.1002/lary.31379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/30/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aimed to determine the characteristics of patients with qualitative olfactory dysfunction (qualOD) and whether individuals with parosmia exhibit increased olfactory sensitivity to previously reported odorous triggers of parosmia. METHODS This study included individuals aged ≥18 years, divided into quantitative OD only, parosmia, and phantosmia groups. Data collected included: clinical-demographic data, "Sniffin' Sticks" scores, questionnaires (depression scale, importance of olfaction), and information about parosmia and phantosmia. A proportion of patients underwent trigger odor threshold testing for 2-Furfurylthiol [FFT] found in coffee and 2,6-nonadienal [Nonadienal] found in cucumber. RESULTS Those with parosmia were typically younger women, with shorter OD duration due to post-viral OD (PVOD), hyposmic/normosmic, and experienced parosmia more severely. Parosmia was 3.5 times more likely in PVOD. Those with phantosmia were older, with longer OD duration due to idiopathic OD, hyposmic/anosmic, and experienced phantosmia less severely. There were no significant differences between FFT and Nonadienal threshold scores in patients with parosmia, phantosmia, or only quantitative OD, but all groups had significantly increased olfactory sensitivity for trigger odors compared to phenyl ethyl alcohol (PEA). CONCLUSION Parosmia and phantosmia patients have distinct characteristics. This may provide clinicians with a better understanding of possible olfactory outcomes in these patients. The higher olfactory sensitivity of all groups to trigger odors compared to PEA raises interesting points about parosmia triggers and odors in the context of warning for danger, in relation to the pathophysiology of parosmia that may be worth exploring in future studies. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3277-3285, 2024.
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Affiliation(s)
- Rumi Sekine
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Anna Kristina Hernandez
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - Clara Overbeck
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marlise K Hofer
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Rosati D, Mastino P, Romeo M, de Soccio G, Pentangelo D, Petrella C, Barbato C, Minni A. Taste and Smell Alterations (TSAs) in Cancer Patients. Diseases 2024; 12:130. [PMID: 38920562 PMCID: PMC11203271 DOI: 10.3390/diseases12060130] [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: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Recently, smell and taste disorders have seen renewed interest, as these symptoms are frequent complications of SARS-CoV-2 infection, since approximately 60% of patients affected by COVID-19 have shown olfactory and gustatory alterations. Otolaryngology pays attention to taste and smell abnormalities (TSAs), especially when associated with oncology. TSAs are common symptoms in people affected by cancer, yet they are ignored and underestimated. The clinical outcome of TSAs in cancer evidences the importance of identifying them with chemotherapy or radiotherapy in general, and they are associated with many types of cancer. We recognize the findings of the literature on TSAs in cancer, evaluating how it is important to consider and identify these disorders concerning reduced food enjoyment or inappropriate nutrient intake, and modulating the nutritional status, quality of life, and impact of therapy. This review aims to critically evaluate and recognize the assessment and clinical perspectives of taste and smell disorders in a cancer population.
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Affiliation(s)
- Davide Rosati
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Pierluigi Mastino
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Martina Romeo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Giulia de Soccio
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Daniele Pentangelo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Antonio Minni
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
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Afghan R, Heysieattalab S, Zangbar HS, Ebrahimi-Kalan A, Jafari-Koshki T, Samadzadehaghdam N. Lavender Essential Oil Inhalation Improves Attentional Shifting and Accuracy: Evidence from Dynamic Changes of Cognitive Flexibility and Power Spectral Density of Electroencephalogram Signals. JOURNAL OF MEDICAL SIGNALS & SENSORS 2024; 14:12. [PMID: 38993201 PMCID: PMC11111129 DOI: 10.4103/jmss.jmss_57_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/09/2024] [Accepted: 01/30/2024] [Indexed: 07/13/2024]
Abstract
Background Cognitive flexibility, a vital component of executive function, entails the utilization of extended brain networks. Olfactory stimulation has been shown to influence various brain functions, particularly cognitive performance. Method To investigate aroma inhalation's effects on brain activity dynamics associated with cognitive flexibility, 20 healthy adults were recruited to complete a set-shifting task during two experimental conditions: no aroma stimuli vs. lavender essential oil inhalation. Using Thomson's multitaper approach, the normalized power spectral density (NPSD) was assessed for five frequency bands. Results Findings confirm that aroma inhalation significantly affects behavioral indices (i.e., reaction time (RT) and response accuracy) and electroencephalogram (EEG) signatures, especially in the frontal lobe. Participants showed a tremendous increase in theta and alpha NPSD, associated with relaxation, along with beta NPSD, associated with clear and fast thinking after inhaling the aroma. NPSD of the delta band, an indicator of the unconscious mind, significantly decreased when stimulated with lavender essential oil. Further, participants exhibited shorter RT and more accurate responses following aroma inhalation. Conclusion Our findings revealed significant changes in oscillatory power and behavioral performance after aroma inhalation, providing neural evidence that olfactory stimulation with lavender essential oil may facilitate cognitive flexibility.
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Affiliation(s)
- Reyhaneh Afghan
- Department of Biomedical Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Hamid Soltani Zangbar
- Department of Neurosciences and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Ebrahimi-Kalan
- Department of Neurosciences and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Jafari-Koshki
- Molecular Medicine Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasser Samadzadehaghdam
- Department of Biomedical Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Li Z, Richter L, Krueger T, Eichwald H, Hähner A, Hummel T. Patients with parosmia respond faster to unpleasant odors than patients with hyposmia: Insights from olfactory event-related potentials. Int Forum Allergy Rhinol 2024. [PMID: 38584570 DOI: 10.1002/alr.23350] [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: 01/12/2024] [Revised: 03/12/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Diagnosing parosmia is a challenge. The present study aimed to explore the distinctions between hyposmic patients with and without parosmia utilizing electroencephalography-derived olfactory event-related potentials (ERP). METHODS Forty-four patients with hyposmia were enrolled and divided into a group with parosmia (n = 23, mean age ± standard deviation = 48 ± 14 years, seven men) and a group without parosmia (n = 21, age = 52 ± 12 years, seven men) based on the clinical interview. Additionally, 21 healthy controls (mean age = 45 ± 14 years, six men) were included. Various measurements were obtained, including the Sniffin' Stick test, threshold tests for the odorants furfural mercaptan and 2,6-nonadienal, a modified Sniffin' Stick parosmia test, and well-being ratings. Chemosensory ERPs were recorded separately for each nostril using high-precision, computer-controlled air-dilution olfactometry. RESULTS Patients with parosmia had a decreased olfactory function similar to that observed in patients with hyposmia, although the odor sensitivity of patients with severe parosmia remained relatively unaffected. Patients with parosmia reported a decrease in well-being compared to controls. The severity of parosmia was positively correlated with odor sensitivity. Furthermore, patients with severe parosmia exhibited faster responses to unpleasant odors than patients without parosmia. CONCLUSION Overall, the present findings support the idea that parosmia predominantly occurs during olfactory recovery, significantly disturbing patients and warranting the development of effective treatments. Notably, the relatively faster responses of hyposmic patients with severe parosmia suggest that the generation of distorted olfactory responses may involve early stages of the processing of olfactory information.
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Affiliation(s)
- Zetian Li
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Luisa Richter
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Tanja Krueger
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Bundeswehrkrankenhaus, Berlin, Germany
| | - Herbert Eichwald
- Department of Otorhinolaryngology, Bundeswehrkrankenhaus, Berlin, Germany
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Grote H, Hoffmann A, Kerzel S, Lukasik H, Maier C, Mallon C, Schlegtendal A, Schwarzbach M, van Ackeren K, Volkenstein S, Brinkmann F. Subjective Smell Disturbances in Children with Sars-Cov-2 or Other Viral Infections do not Correspond with Olfactory Test Results. KLINISCHE PADIATRIE 2024; 236:129-138. [PMID: 38262421 DOI: 10.1055/a-2208-6245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Olfactory dysfunction associated with SARS-CoV-2 infection in children has not been verified by a validated olfactory test. We aimed to determine whether these complaints are objectifiable (test-based hyposmia), how often they occur during acute SARS-CoV-2 infection compared to other upper respiratory tract infections (URTI), as well as in children recovered from COVID-19 compared to children with long COVID. METHODS Olfactory testing (U-sniff test; hyposmia<8 points) and survey-based symptom assessments were performed in 434 children (5-17 years; 04/2021-06/2022). 186 symptom-free children served as controls. Of the children with symptoms of acute respiratory tract infection, SARS-CoV-2 PCR test results were positive in 45 and negative in 107 children (URTI group). Additionally, 96 children were recruited at least 4 weeks (17.6±15.2 weeks) after COVID-19, of whom 66 had recovered and 30 had developed long COVID. RESULTS Compared to controls (2.7%), hyposmia frequency was increased in all other groups (11-17%, p<0.05), but no between-group differences were observed. Only 3/41 children with hyposmia reported complaints, whereas 13/16 children with complaints were normosmic, with the largest proportion being in the long-COVID group (23%, p<0.05). CONCLUSION Questionnaires are unsuitable for assessing hyposmia frequency in children. Olfactory complaints and hyposmia are not specific for SARS-CoV-2 infection. The number of complaints in the long-COVID group could result from aversive olfactory perception, which is undetectable with the U-sniff test.
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Affiliation(s)
- Hanna Grote
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Anna Hoffmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Sebastian Kerzel
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Hannah Lukasik
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Christoph Maier
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Claire Mallon
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Anne Schlegtendal
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Michaela Schwarzbach
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Konstantin van Ackeren
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Stefan Volkenstein
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Paediatric Pneumology, University Hospital Schleswig Holstein Campus Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), German Center for Lung Research, Lübeck, Germany
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Png LH, Ng DHL, Teo NWY. Infectious disease for the rhinologist. Curr Opin Otolaryngol Head Neck Surg 2024; 32:28-34. [PMID: 37997887 DOI: 10.1097/moo.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the recent literature relating to viral, fungal and bacterial infections and their interactions within the sinonasal tract in the past 18 months. RECENT FINDINGS Coronavirus disease 2019 (COVID-19)-associated olfactory dysfunction (OD) is variant dependent. Magnetic resonance imaging studies have found greater olfactory cleft opacification and higher olfactory bulb volume in post-COVID-19 OD. Olfactory training remains the mainstay of treatment, while platelet-rich plasma injections and ultramicronized palmitoylethanolamide and luteolin combination oral supplementation have shown early promise.Consensus statements on paranasal sinus fungal balls and acute invasive fungal sinusitis have been released.Studies on the nasal microbiome have reported Staphylococcus and Corynebacterium as the most abundant genera, with higher levels of Staphylococcus and Corynebacterium being found in patients with chronic rhinosinusitis (CRS) and healthy individuals respectively. However, there is conflicting evidence on the significance of biodiversity of the nasal microbiome found in CRS versus healthy patients. SUMMARY While the peak of the COVID-19 pandemic is behind us, its sequelae continue to pose treatment challenges. Further studies in OD have implications in managing the condition, beyond those afflicted post-COVID-19 infection. Similarly, more research is needed in studying the nasal microbiome and its implications in the development and treatment of CRS.
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Affiliation(s)
- Lu Hui Png
- Department of Otorhinolaryngology - Head and Neck Surgery, Singapore General Hospital, Singapore
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Dorothy Hui Lin Ng
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Neville Wei Yang Teo
- Department of Otorhinolaryngology - Head and Neck Surgery, Singapore General Hospital, Singapore
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Murphy C, Dalton P, Boateng K, Hunter S, Silberman P, Trachtman J, Schrandt S, Naimi B, Garvey E, Joseph PV, Frank C, Albertazzi A, Nyquist G, Rawson NE. Integrating the patient's voice into the research agenda for treatment of chemosensory disorders. Chem Senses 2024; 49:bjae020. [PMID: 38761171 PMCID: PMC11154145 DOI: 10.1093/chemse/bjae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Indexed: 05/20/2024] Open
Abstract
World-wide some 658 million people were infected with coronavirus disease 2019 (COVID-19) and millions suffer from chemosensory impairment associated with long COVID. Current treatments for taste and smell disorders are limited. Involving patients has the potential to catalyze the dynamic exchange and development of new ideas and approaches to facilitate biomedical research and therapeutics. We assessed patients' perceptions of the efficacy of treatments for chemosensory impairment using an online questionnaire completed by 5,815 people in the US Logistic regression determined variables predictive of reported treatment efficacy for patients aged 18 to 24, 25 to 39, 40 to 60, and 60+ yrs. who were treated with nasal steroids, oral steroids, zinc, nasal rinse, smell training, theophylline, platelet-rich plasma, and Omega 3. The most consistent predictor was age, with the majority of those 40 to 60 and 60+ reporting that nasal steroids, oral steroids, zinc, nasal rinse, and smell training were only slightly effective or not effective at all. Many of these treatment strategies target regeneration and immune response, processes compromised by age. Only those under 40 reported more than slight efficacy of steroids or smell training. Findings emphasize the need to include patients of all ages in clinical trials. Older adults with olfactory impairment are at increased risk for Alzheimer's disease (AD). We speculate that olfactory impairment associated with long COVID introduces the potential for a significant rise in AD. Long COVID-associated chemosensory impairment increases the urgency for translational and clinical research on novel treatment strategies. Suggestions for high-priority areas for epidemiological, basic, and clinical research on chemosensory impairment follow.
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Affiliation(s)
- Claire Murphy
- Department of Psychology, San Diego State University, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Pamela Dalton
- Monell Chemical Senses Center, Philadelphia, A, United States
| | - Katie Boateng
- The Smell and Taste Association of North America, Philadelphia, PA, United States
| | | | - Pamela Silberman
- The Smell and Taste Association of North America, Philadelphia, PA, United States
| | | | | | - Bita Naimi
- Department of Otolaryngology and Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Emily Garvey
- Department of Otolaryngology and Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, Section of Sensory Science and Metabolism and National Institute of Nursing Research, Bethesda, MD, United States
| | - Conner Frank
- Department of Psychology, San Diego State University, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Abigail Albertazzi
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Gurston Nyquist
- Department of Otolaryngology and Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - Nancy E Rawson
- Monell Chemical Senses Center, Philadelphia, PA, United States
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Hintschich CA, Wege-Lüssen A, Göktas Ö, Stuck BA, Müller CA, Hummel T. [Persistent olfactory impairment after COVID-19-recommendations of the Working Group on Olfactology and Gustology of the German Society of Oto-rhino-laryngology, Head and Neck Surgery]. HNO 2023; 71:739-743. [PMID: 37801102 PMCID: PMC10589143 DOI: 10.1007/s00106-023-01368-w] [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] [Accepted: 08/17/2023] [Indexed: 10/07/2023]
Abstract
This article does not intend to comprehensively review the existing literature on coronavirus disease 2019 (COVID-19)-associated smell disorders, but aims to summarize scientific evidence for otorhinolaryngological practice and provide recommendations for diagnosis and treatment of persistent smell disorders following COVID-19.
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Affiliation(s)
- Constantin A Hintschich
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | | | | | - Boris A Stuck
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland
| | - Christian A Müller
- Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Thomas Hummel
- Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
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Vilarello BJ, Jacobson PT, Tervo JP, Gallagher LW, Caruana FF, Gary JB, Saak TM, Gudis DA, Joseph PV, Goldberg TE, Devanand D, Overdevest JB. BMI Increases in Individuals with COVID-19-Associated Olfactory Dysfunction. Nutrients 2023; 15:4538. [PMID: 37960191 PMCID: PMC10648323 DOI: 10.3390/nu15214538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: Reports suggest COVID-19-associated olfactory dysfunction (OD) may result in alterations in dietary behaviors and perceived weight change, but few studies using psychophysical evaluation of post-COVID-19-associated chemosensory dysfunction and body mass index (BMI) exist. The purpose of this study is to assess the impact of both quantitative and qualitative features of COVID-19-associated OD on BMI; (2) Methods: Recruitment of thirty-one participants with self-reported OD in the form of quantitative loss with and without qualitative features. Surveys with questions specific to qualitative olfactory function, Sniffin' Sticks tests, and BMI measures were completed at two visits, one year apart. Group differences were assessed with Wilcoxon signed-rank tests and the Holm-Bonferroni method; (3) Results: Individuals with persistent quantitative OD (n = 15) and self-reported parosmia (n = 19) showed statistically significant increases in BMI after 1 year (p = 0.004, adjusted α = 0.0125; p = 0.011, adjusted α = 0.0167). Controls with transient quantitative OD (n = 16) and participants without self-reported parosmia (n = 12) showed no statistically significant changes in BMI over the same time period (p = 0.079, adjusted α = 0.05; p = 0.028, adjusted α = 0.025); (4) Conclusions: This study shows an association between COVID-19-associated OD and BMI, suggesting olfaction may play a role in altering dietary habits and nutrition in this population. Larger study cohorts are needed to further evaluate this relationship.
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Affiliation(s)
- Brandon J. Vilarello
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Patricia T. Jacobson
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jeremy P. Tervo
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Liam W. Gallagher
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Francesco F. Caruana
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Joseph B. Gary
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Tiana M. Saak
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - David A. Gudis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Paule V. Joseph
- National Institute of Alcohol Abuse and Alcoholism, Section of Sensory Science and Metabolism & National Institute of Nursing Research, Bethesda, MD 20892, USA
| | - Terry E. Goldberg
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY 10032, USA
| | - D.P. Devanand
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Department of Psychiatry, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jonathan B. Overdevest
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY 10032, USA
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Khanafer N, Henaff L, Bennia S, Termoz A, Chapurlat R, Escuret V, Proriol M, Duvert F, Mena C, Planckaert C, Trehet-Mandez N, Saadatian-Elahi M, Vanhems P. Factors Associated with Long COVID-19 in a French Multicentric Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6678. [PMID: 37681818 PMCID: PMC10488030 DOI: 10.3390/ijerph20176678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
(1) Background: A substantial proportion of COVID-19 patients continue to experience long-lasting effects that hamper their quality of life. The objectives of this study were (1) to report the prevalence of persistent clinical symptoms 6-12 months after the onset of COVID-19 and (2) to identify potential factors at admission associated with the occurrence of long COVID. (2) Methods: A prospective study was conducted among COVID-19 adult patients, hospitalized in four French university hospitals. Patients were invited to two ambulatory follow-up medical visits, 6-8 months (visit #1) and one year (visit #2) after the onset of their COVID-19. A multivariate logistic regression was performed to assess factors associated with long COVID. (3) Results: In total, 189 patients participated in this study (mean age of 63.4 years). BMI > 30 kg/m2 (aOR 3.52), AST levels between 31 and 42 U/L (aOR 8.68), and AST levels > 42 U/L (aOR 3.69) were associated with persistent clinical symptoms at visit #1. Anosmia (aOR 13.34), AST levels between 31 and 42 U/L (aOR 10.27), stay in ICU (aOR 5.43), pain (aOR 4.31), and longer time before hospitalization (aOR 1.14) were significantly associated with persistent clinical symptoms at visit #2. Patients with ageusia (aOR 0.17) had a lower risk of long COVID. (4) Conclusions: This study showed that some patients experienced persistent clinical symptoms one year after COVID-19 onset that were associated with some determinants at the acute phase/stage.
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Affiliation(s)
- Nagham Khanafer
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
| | - Laetitia Henaff
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
| | - Sabrina Bennia
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
| | - Anne Termoz
- Service Recherche et Epidémiologie Cliniques, Hospices Civils de Lyon, Pôle Santé Publique, 69003 Lyon, France;
| | - Roland Chapurlat
- Department of Rheumatology, Edouard Herriot University Hospital, Hospices Civils de Lyon, 69003 Lyon, France; (R.C.); (M.P.)
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Vanessa Escuret
- Institut des Agents Infectieux, Hospices Civils de Lyon, 69317 Lyon, France;
| | - Mathilde Proriol
- Department of Rheumatology, Edouard Herriot University Hospital, Hospices Civils de Lyon, 69003 Lyon, France; (R.C.); (M.P.)
| | - Florence Duvert
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Camille Mena
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Catherine Planckaert
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Nadège Trehet-Mandez
- INSERM UMR 1033, University of Lyon, 69003 Lyon, France; (F.D.); (C.M.); (C.P.); (N.T.-M.)
- Prévention des Maladies Osseuses, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Mitra Saadatian-Elahi
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
| | - Philippe Vanhems
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon 1 University, CEDEX 07, 69364 Lyon, France; (L.H.); (M.S.-E.); (P.V.)
- Department of Hygiene, Epidemiology, and Prevention, Edouard Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France;
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Chen S, Wang S. The immune mechanism of the nasal epithelium in COVID-19-related olfactory dysfunction. Front Immunol 2023; 14:1045009. [PMID: 37529051 PMCID: PMC10387544 DOI: 10.3389/fimmu.2023.1045009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
During the first waves of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, olfactory dysfunction (OD) was reported as a frequent clinical sign. The nasal epithelium is one of the front-line protections against viral infections, and the immune responses of the nasal mucosa may be associated with OD. Two mechanisms underlying OD occurrence in COVID-19 have been proposed: the infection of sustentacular cells and the inflammatory reaction of the nasal epithelium. The former triggers OD and the latter likely prolongs OD. These two alternative mechanisms may act in parallel; the infection of sustentacular cells is more important for OD occurrence because sustentacular cells are more likely to be the entry point of SARS-CoV-2 than olfactory neurons and more susceptible to early injury. Furthermore, sustentacular cells abundantly express transmembrane protease, serine 2 (TMPRSS2) and play a major role in the olfactory epithelium. OD occurrence in COVID-19 has revealed crucial roles of sustentacular cells. This review aims to elucidate how immune responses of the nasal epithelium contribute to COVID-19-related OD. Understanding the underlying immune mechanisms of the nasal epithelium in OD may aid in the development of improved medical treatments for COVID-19-related OD.
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Affiliation(s)
| | - Shufen Wang
- *Correspondence: Shunmei Chen, ; Shufen Wang,
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12
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Vandersteen C, Plonka A, Manera V, Sawchuk K, Lafontaine C, Galery K, Rouaud O, Bengaied N, Launay C, Guérin O, Robert P, Allali G, Beauchet O, Gros A. Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments. Front Aging Neurosci 2023; 15:1206123. [PMID: 37416323 PMCID: PMC10320294 DOI: 10.3389/fnagi.2023.1206123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction The risk of developing Alzheimer's disease (AD) in older adults increasingly is being discussed in the literature on Post-Acute COVID-19 Syndrome (PACS). Remote digital Assessments for Preclinical AD (RAPAs) are becoming more important in screening for early AD, and should always be available for PACS patients, especially for patients at risk of AD. This systematic review examines the potential for using RAPA to identify impairments in PACS patients, scrutinizes the supporting evidence, and describes the recommendations of experts regarding their use. Methods We conducted a thorough search using the PubMed and Embase databases. Systematic reviews (with or without meta-analysis), narrative reviews, and observational studies that assessed patients with PACS on specific RAPAs were included. The RAPAs that were identified looked for impairments in olfactory, eye-tracking, graphical, speech and language, central auditory, or spatial navigation abilities. The recommendations' final grades were determined by evaluating the strength of the evidence and by having a consensus discussion about the results of the Delphi rounds among an international Delphi consensus panel called IMPACT, sponsored by the French National Research Agency. The consensus panel included 11 international experts from France, Switzerland, and Canada. Results Based on the available evidence, olfaction is the most long-lasting impairment found in PACS patients. However, while olfaction is the most prevalent impairment, expert consensus statements recommend that AD olfactory screening should not be used on patients with a history of PACS at this point in time. Experts recommend that olfactory screenings can only be recommended once those under study have reported full recovery. This is particularly important for the deployment of the olfactory identification subdimension. The expert assessment that more long-term studies are needed after a period of full recovery, suggests that this consensus statement requires an update in a few years. Conclusion Based on available evidence, olfaction could be long-lasting in PACS patients. However, according to expert consensus statements, AD olfactory screening is not recommended for patients with a history of PACS until complete recovery has been confirmed in the literature, particularly for the identification sub-dimension. This consensus statement may require an update in a few years.
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Affiliation(s)
- Clair Vandersteen
- Institut Universitaire de la Face et du Cou, ENT Department, Centre Hospitalier Universitaire, Nice, France
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
| | - Alexandra Plonka
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
- Institut NeuroMod, Université Côte d'Azur, Sophia Antipolis, France
| | - Valeria Manera
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
- Institut NeuroMod, Université Côte d'Azur, Sophia Antipolis, France
| | - Kim Sawchuk
- ACTLab, engAGE: Centre for Research on Aging, Concordia University Montreal, Montreal, QC, Canada
| | - Constance Lafontaine
- ACTLab, engAGE: Centre for Research on Aging, Concordia University Montreal, Montreal, QC, Canada
| | - Kevin Galery
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Olivier Rouaud
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nouha Bengaied
- Federation of Quebec Alzheimer Societies, Montreal, QC, Canada
| | - Cyrille Launay
- Mc Gill University Jewish General Hospital, Montreal, QC, Canada
| | - Olivier Guérin
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Université Côte d'Azur, CNRS UMR 7284/INSERM U108, Institute for Research on Cancer and Aging Nice, UFR de Médecine, Nice, France
| | - Philippe Robert
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Beauchet
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
- Mc Gill University Jewish General Hospital, Montreal, QC, Canada
- Departments of Medicine and Geriatric, University of Montreal, Montreal, QC, Canada
| | - Auriane Gros
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Département d'Orthophonie, UFR Médecine, Université Côte d'Azur, Nice, France
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Espetvedt A, Wiig S, Myrnes-Hansen KV, Brønnick KK. The assessment of qualitative olfactory dysfunction in COVID-19 patients: a systematic review of tools and their content validity. Front Psychol 2023; 14:1190994. [PMID: 37408960 PMCID: PMC10319418 DOI: 10.3389/fpsyg.2023.1190994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023] Open
Abstract
Background There is a lack of overview of the tools used to assess qualitative olfactory dysfunction, including parosmia and phantosmia, following COVID-19 illness. This could have an impact on the diagnosis and treatment offered to patients. Additionally, the formulations of symptoms are inconsistent and often unclear, and consensus around the wording of questions and responses is needed. Aim of study The aim of this systematic review is to provide an overview of tools used to assess qualitative olfactory dysfunction after COVID-19, in addition to addressing the content validity (i.e., item and response formulations) of these tools. Methods MEDLINE, Web of Science, and EMBASE were searched 5th of August 2022 and updated on the 25th of April 2023 to identify studies that assess qualitative olfactory dysfunction in COVID-19 patients. Primary outcomes were the tool used (i.e., questionnaire or objective test) and item and response formulations. Secondary outcomes included psychometric properties, study design, and demographic variables. Results The assessment of qualitative olfactory dysfunction is characterized by heterogeneity, inconsistency, and lack of validated tools to determine the presence and degree of symptoms. Several tools with overlapping and distinct features were identified in this review, of which some were thorough and detailed, while others were merely assessing the presence of symptoms as a binary measure. Item and response formulations are also inconsistent and often used interchangeably, which may lead to confusion, incorrect diagnoses, and inappropriate methods for solving the problem. Conclusions There is an unmet need for a reliable and validated tool for assessing qualitative olfactory dysfunction, preferably one that also captures quantitative olfactory issues (i.e., loss of smell), to ensure time-effective and specific assessment of the ability to smell. A consensus around the formulation of items and response options is also important to increase the understanding of the problem, both for clinicians, researchers, and the patient, and ultimately to provide the appropriate diagnosis and treatment. Registration and protocol The URL is https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=351621. A preregistered protocol was submitted and accepted (12.09.22) in the International prospective register of systematic reviews (PROSPERO) with the registration number CRD42022351621.
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Affiliation(s)
- Annelin Espetvedt
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- SHARE–Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Cognitive and Behavioral Neuroscience Lab, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- SHARE–Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kai Victor Myrnes-Hansen
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Norwegian School of Hotel Management, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Kallesten Brønnick
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Cognitive and Behavioral Neuroscience Lab, University of Stavanger, Stavanger, Norway
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14
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Neuman N, Sandvik P, Lindholm NB, Bömer-Schulte K, Lövestam E. Food-related experiences and behavioral responses among people affected by chemosensory dysfunctions following COVID-19: A scoping review. Res Nurs Health 2023. [PMID: 37171788 DOI: 10.1002/nur.22315] [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: 02/04/2023] [Revised: 04/19/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023]
Abstract
A category of symptoms that became characteristic early in the first wave of the coronavirus disease 2019 (COVID-19) pandemic was chemosensory dysfunctions (alterations of smell and taste). Such symptoms substantially affect food and eating-cornerstones for both nutrition-related health outcomes and for quality of life. Based on this, this scoping review aimed to map out existing scientific literature on food-related experiences and related behavioral responses among people affected by chemosensory dysfunctions following COVID-19. A librarian-supported search of PsycInfo, PubMed, and Scopus for publications written in English (2020 to April 26, 2022) was conducted. Two authors searched for and screened publications and three others extracted and collated data. These are reported following the Preferred Reporting Items of Systematic reviews and Meta-Analyses extension for Scoping Reviews. Of 1169 hits, 9 publications were included in the review. The results are thematized as "Psychological and social aspects" and "Nutritional aspects," each with the subsections "Experiences" and "Behavioral responses." A great variety of food-related problems, nutritional and mental health effects, and implications for social life are identified. People affected by chemosensory dysfunctions following COVID-19 suffer, as evident both in stories from qualitative studies and in measurements of quality of life. The results impact all professions who are and may come to be involved in treating these patients, such as nurses, physicians, dietitians, and psychologists. With more knowledge about the dysfunctions' manifestation, duration, and impact on everyday life, multiprofessional teams need to collaborate in supporting patients medically, psychosocially, and nutritionally.
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Affiliation(s)
- Nicklas Neuman
- Department of Food Studies, Nutrition and Dietetics, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
| | - Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
| | - Ninni Bellini Lindholm
- Department of Food Studies, Nutrition and Dietetics, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
| | - Katharina Bömer-Schulte
- Department of Food Studies, Nutrition and Dietetics, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
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Di Stadio A, Cantone E, De Luca P, Di Nola C, Massimilla EA, Motta G, La Mantia I, Motta G. Parosmia COVID-19 Related Treated by a Combination of Olfactory Training and Ultramicronized PEA-LUT: A Prospective Randomized Controlled Trial. Biomedicines 2023; 11:biomedicines11041109. [PMID: 37189728 DOI: 10.3390/biomedicines11041109] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/29/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
During COVID-19 pandemic, clinicians have had to deal with an ever-increasing number of cases of olfactory disturbances after SARS-CoV-2 infections and in some people this problem persisted for long time after negativization from virus. This a prospective randomized controlled trial aims at evaluating the efficacy of ultramicronized palmitoylethanolamide (PEA) and Luteolin (LUT) (umPEA-LUT) and olfactory training (OT) compared to OT alone for the treatment of smell disorders in Italian post-COVID population. We included patients with smell loss and parosmia who were randomized and assigned to Group 1 (intervention group; daily treatment with umPEA-LUT oral supplement and OT) or Group 2 (control group; daily treatment with placebo and OT). All subjects were treated for 90 consecutive days. The Sniffin’ Sticks identification test was used to assess the olfactory functions at the baseline (T0) and the end of the treatment (T1). Patients were queried regarding any perception of altered olfaction (parosmia) or aversive smell, such as cacosmia, gasoline-type smell, or otherwise at the same observational points. This study confirmed the efficacy of combination of umPEA-LUT and olfactory training as treatment of quantitative smell alteration COVID-19 related, but the efficacy of the supplement for parosmia was limited. UmpEA-LUT is useful for the treatment of brain neuro-inflammation (origin of quantity smell disorders) but has limited/no effect on peripheral damage (olfactory nerve, neuro-epithelium) that is responsible of quality disorders.
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Affiliation(s)
- Arianna Di Stadio
- Department GF Ingrassia, Otolaryngology Unit, University of Catania, 95131 Catania, Italy
| | - Elena Cantone
- Department of Otolaryngology, Federico II University, 80131 Naples, Italy
| | - Pietro De Luca
- Department of Otolaryngology, San-Giovanni Addolorata Hospital, 00100 Rome, Italy
| | - Claudio Di Nola
- Department of Otolaryngology, Federico II University, 80131 Naples, Italy
| | - Eva A. Massimilla
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
| | - Giovanni Motta
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
| | - Ignazio La Mantia
- Department GF Ingrassia, Otolaryngology Unit, University of Catania, 95131 Catania, Italy
| | - Gaetano Motta
- Department of Otolaryngology, Volvatellid University, 81055 Naples, Italy
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Kelly CE. Parosmia and altered taste in patients recovering from Covid 19. CLINICAL NUTRITION OPEN SCIENCE 2023; 48:1-10. [PMID: 36514442 PMCID: PMC9731923 DOI: 10.1016/j.nutos.2022.11.008] [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: 09/27/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Parosmia is a well-documented consequence of smell loss associated with Covid 19. Those who experience this qualitative olfactory disorder during recovery find that the odour of common foods and household items is distorted, and the experience can range from merely altered to profoundly disgusting. This can lead to a greatly altered relationship with food, including the physical symptoms of loss of appetite, nausea, vomiting, as well as wider reaching issues such as withdrawal from social situations, emotional distancing from others in their close social circles, and anhedonia. There is at present no known cure or intervention to mitigate the condition. The AbScent Parosmia and Phantosmia support group on Facebook became an important resource for patients with this condition during the early part of the pandemic, and the crowd-sourcing of experiences, tips and peer-to-peer advice became a valuable source of information for the community as well as researchers trying to understand the condition. Using protocols described in earlier literature on the use of social media for qualitative research, this paper provides information on the management of parosmia based on the experiences of over 30k patients in the AbScent Parosmia and Phantosmia group on Facebook and 6k member of the AbScent Network.
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Lechien JR, Wajsblat S, Horoi M, Boscolo-Rizzo P, Le Bon SD, Vaira LA, Saussez S. Comparison of prevalence and evolution of COVID-19 olfactory disorders in patients infected by D614 (wild) and B.1.1.7. Alpha variant: a brief report. Eur Arch Otorhinolaryngol 2023; 280:3461-3467. [PMID: 36943439 PMCID: PMC10029791 DOI: 10.1007/s00405-023-07923-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To investigate the prevalence and the evolution of olfactory disorders (OD) related to coronavirus disease 2019 (COVID-19) in patients infected during the first and the second European waves. METHODS From March 2020 to October 2020, COVID-19 patients with OD were recruited and followed over the 12-month post-infection. The following data were collected: demographic, treatments, vaccination status, and olfactory function. Olfaction was assessed with the Olfactory Disorder Questionnaire (ODQ), and threshold, discrimination, and identification (TDI) test. Outcomes were compared between patients of the first wave (group 1: wild/D614G virus) and the second wave (group 2: B.1.1.7. Alpha variant) at 1-, 3- and 12-month post-infection. RESULTS Sixty patients completed the evaluations accounting for 33 and 27 patients in group 1 and 2, respectively. The 1-month TDI score (23.7 ± 5.3) was significantly lower in group 2 compared to group 1 (29.8 ± 8.7; p = 0.017). Proportion of normosmic patients at 1-month post-infection was significantly higher in group 1 compared to group 2 (p = 0.009). TDI scores only significantly increased from 1- to 3-month post-infection in anosmic and hyposmic patients. Focusing on There was a negative association between the 1-month ODQ and the 1-month TDI (rs = - 0.493; p = 0.012). ODQ was a significant predictor of TDI scores at 3- and 12-month post-infection. The 12-month prevalence of parosmia was 60.6% in group 1 and 42.4% in group 2, respectively. There was no significant influence of oral corticosteroid treatment, adherence to an olfactory training and vaccination status on the olfactory outcomes. CONCLUSIONS Patients of the second wave (Alpha B.1.1.7. variant) reported significant higher proportion of psychophysical test abnormalities at 1-month post-infection than patients infected during the first wave (D614G virus).
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology, Polyclinic of Poitiers, Elsan, Poitiers, France.
- Division of Laryngology and, Bronchoesophagology, EpiCURA Hospital, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Foch Hospital, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Shannon Wajsblat
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Mihaela Horoi
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Serge D Le Bon
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Genève, Geneva, Suisse
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100, Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100, Sassari, Italy
| | - Sven Saussez
- Division of Laryngology and, Bronchoesophagology, EpiCURA Hospital, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
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Levine CG. Advancing Rhinology Through Research. Am J Rhinol Allergy 2023; 37:4-6. [PMID: 36471630 DOI: 10.1177/19458924221141948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Winter AL, Henecke S, Lundström JN, Thunell E. Impairment of quality of life due to COVID-19-induced long-term olfactory dysfunction. Front Psychol 2023; 14:1165911. [PMID: 37151341 PMCID: PMC10157159 DOI: 10.3389/fpsyg.2023.1165911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Olfactory dysfunction is one of many long-lasting symptoms associated with COVID-19, estimated to affect approximately 60% of individuals and often lasting several months after infection. The associated daily life problems can cause a decreased quality of life. Methods Here, we assessed the association between perceived quality of life and both qualitative and quantitative olfactory function (distorted and weakened sense of smell, respectively) in 58 individuals who had undergone confirmed SARS-CoV-2 infection and who complained about olfactory dysfunction. Results Participants with large quantitative olfactory dysfunction experienced a greater reduction in their quality of life. Moreover, our participants had a high prevalence of qualitative olfactory dysfunction (81%) with a significant correlation between qualitative olfactory dysfunction and daily life impairment. Strong drivers of low quality of life assessments were lack of enjoyment of food as well as worries related to coping with long-term dysfunctions. Discussion These results stress the clinical importance of assessing qualitative olfactory dysfunction and the need to develop relevant interventions. Given the poor self-rated quality of life observed, healthcare systems should consider developing support structures, dietary advice, and guidelines adapted to individuals experiencing qualitative olfactory dysfunction.
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Affiliation(s)
- Anja L. Winter
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Anja L. Winter,
| | - Sofie Henecke
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johan N. Lundström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Monell Chemical Senses Center, Philadelphia, PA, United States
- Stockholm University Brain Imaging Centre, Stockholm University, Stockholm, Sweden
| | - Evelina Thunell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
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Shih MC, Soler ZM, Germroth M, Snyder J, Nguyen SA, Schlosser RJ. Impact of Hedonics and Magnitude Upon Validated Psychophysical Olfactory Tests and Olfactory-Specific Quality of Life. Am J Rhinol Allergy 2022; 37:253-263. [PMID: 36341557 DOI: 10.1177/19458924221136649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction Patients often describe the olfactory loss as either the inability to detect unpleasant odors (eg, smoke or spoiled food) or noticeable impairment in enjoying pleasant odors (eg, food and fragrances). This complex relationship between the hedonics of various odors, their perceived magnitude in odor strength, and the impact on patient quality of life is not well understood. Methods Sixty-five subjects underwent testing with the Henkin olfaction test which assesses hedonics and magnitude for odors traditionally deemed unpleasant (pyridine/dead fish and thiophene/gasoline) and pleasant (amyl acetate/banana and nitrobenzene/almond). Subjects also completed Smell Identification Test-40 (SIT-40), Sniffin’ Sticks (Sniffin’ Sticks), and Snap & Sniffin’ Sticks (Snap) Olfactory Tests, as well as the 17-item Questionnaire for Olfactory Disorders Negative Statements (QODNS) and olfactory symptom visual analog scale (VAS). Spearman's rank correlations were conducted between various olfactory domains, QODNS and VAS. Results Mean age was 52.1 years (range: 28-86), with 63.1% females. Magnitude estimation was greatest for pyridine. Most people rated thiophene (75.4%) and pyridine (92.3%) as “unpleasant.” Although most people rated amyl acetate (47.7%) and nitrobenzene (56.9%) as “pleasant,” many rated amyl acetate (52.3%) and nitrobenzene (43.1%) as “neutral” or “unpleasant” scents. Hedonics for unpleasant odors correlated with each other ( rs = 0.60), but not with hedonics for pleasant odors. Hedonics for unpleasant odors also correlated with magnitude estimation and other psychophysical tests. These findings were not seen for hedonics of pleasant odors. Conclusions The use of unpleasant odors in Henkin testing showed unique relationship patterns with patient-reported outcome measures and validated olfactory tests, which may provide utility in characterizing olfactory dysfunction. The incorporation of more unpleasant odors in current psychophysical olfactory testing may provide enhanced information regarding the patient impact of olfactory dysfunction.
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Affiliation(s)
- Michael C. Shih
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Zachary M. Soler
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Matthew Germroth
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Jacob Snyder
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Shaun A. Nguyen
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rodney J. Schlosser
- Department of Otolaryngology – Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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