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Green T, Mastinu M, Wolf A, Oleszkiewicz A, Aronis A, Hummel T, Pepino MY, Niv MY. Home screening of taste and oral trigeminal function: a feasibility study. Eur Arch Otorhinolaryngol 2024; 281:4835-4844. [PMID: 38630275 PMCID: PMC11392964 DOI: 10.1007/s00405-024-08654-5] [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: 12/20/2023] [Accepted: 04/01/2024] [Indexed: 09/14/2024]
Abstract
PURPOSE gustatory ability is a marker of health not routinely tested in the medical practice. The current study wants to assess whether taste strips can be useful to monitor taste function from home. METHODS we performed simple sensory tests in lab setting vs. unassisted testing at home, and compared the results with self-reports ability to taste and smell. Using paper strips impregnated with sweet, bitter, salty, or sour tastants, and with two trigeminal stimuli (capsaicin, tannins) in high and low concentrations, we assessed gustatory and trigeminal function in 74 participants (47 women) in the lab, where paper strips were administered by an experimenter, and in 77 participants (59 women) at home, where they self-administered the test. RESULTS we found that high (but not low) concentration taste strips are correctly identified by vast majority of participants. On average, taste identification, intensity and pleasantness scores did not differ for the 8 taste strips, while identification of capsaicin was significantly better in the lab. Taste identification scores correlated with intensity ratings in both settings (r = 0.56, in the lab, r = 0.48, at home, p < 0.005). Self-rated taste ability correlated with self-rated smell ability (r = 0.68, and r = 0.39, p ≤ 0.005), but not with scores in the strips test. CONCLUSION home testing with impregnated taste strips is feasible, and can be used for telemedical purposes.
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Affiliation(s)
- Tomer Green
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mariano Mastinu
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany.
| | - Anne Wolf
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Anna Oleszkiewicz
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
- Institute of Psychology, University of Wroclaw, Wrocław, Poland
| | - Anna Aronis
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - M Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Masha Y Niv
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Jerusalem, Israel
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2
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Cecchini MP, Pizzini FB, Boschi F, Marcon A, Moro L, Gordon E, Guizard N, Cavedo E, Ricatti MJ, Veronese S, Tamburin S, Tinazzi M, Mansueto G, Sbarbati A. Long-term effects of SARS-CoV-2 infection in patients with and without chemosensory disorders at disease onset: a psychophysical and magnetic resonance imaging exploratory study. Neurol Sci 2024; 45:2409-2418. [PMID: 38441790 PMCID: PMC11082021 DOI: 10.1007/s10072-024-07429-4] [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: 10/27/2023] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
A preserved sense of smell and taste allows us to understand many environmental "messages" and results in meaningfully improvements to quality of life. With the COVID-19 pandemic, it became clear how important these senses are for social and nutritional status and catapulted this niche chemosensory research area towards widespread interest. In the current exploratory work, we assessed two groups of post-COVID-19 patients who reported having had (Group 1) or not (Group 2) a smell/taste impairment at the disease onset. The aim was to compare them using validated smell and taste tests as well as with brain magnetic resonance imaging volumetric analysis. Normative data were used for smell scores comparison and a pool of healthy subjects, recruited before the pandemic, served as controls for taste scores. The majority of patients in both groups showed an olfactory impairment, which was more severe in Group 1 (median UPSIT scores: 24.5 Group 1 vs 31.0 Group 2, p = 0.008), particularly among women (p = 0.014). No significant differences emerged comparing taste scores between Group 1 and Group 2, but dysgeusia was only present in Group 1 patients. However, for taste scores, a significant difference was found between Group 1 and controls (p = 0.005). No MRI anatomical abnormalities emerged in any patients while brain volumetric analysis suggested a significant difference among groups for the right caudate nucleus (p = 0.028), although this was not retained following Benjamini-Hochberg correction. This exploratory study could add new information in COVID-19 chemosensory long-lasting impairment and address future investigations on the post-COVID-19 patients' research.
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Affiliation(s)
- Maria Paola Cecchini
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy.
| | | | - Federico Boschi
- Department of Engineering for Innovation Medicine, Engineering and Physics Section, Verona University, Verona, Italy
| | - Alessandro Marcon
- Department of Diagnostics and Public Heath, Unit of Epidemiology and Medical Statistics, Verona University, Verona, Italy
| | - Lucia Moro
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore, Negrar, Italy
| | | | | | | | - Maria Jimena Ricatti
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Sheila Veronese
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicines and Movement Sciences, Neurology Unit, Verona University, Verona, Italy
| | - Giancarlo Mansueto
- Department of Engineering for Innovation Medicine, Radiology Unit, Verona University, Verona, Italy
| | - Andrea Sbarbati
- Department of Neurosciences, Biomedicines and Movement Sciences, Anatomy and Histology Section, Verona University, Strada Le Grazie 8, 37134, Verona, Italy
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Drummond J, Makdani A, Pawling R, Walker SC. Congenital Anosmia and Facial Emotion Recognition. Physiol Behav 2024; 278:114519. [PMID: 38490365 DOI: 10.1016/j.physbeh.2024.114519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024]
Abstract
Major functions of the olfactory system include guiding ingestion and avoidance of environmental hazards. People with anosmia report reliance on others, for example to check the edibility of food, as their primary coping strategy. Facial expressions are a major source of non-verbal social information that can be used to guide approach and avoidance behaviour. Thus, it is of interest to explore whether a life-long absence of the sense of smell heightens sensitivity to others' facial emotions, particularly those depicting threat. In the present, online study 28 people with congenital anosmia (mean age 43.46) and 24 people reporting no olfactory dysfunction (mean age 42.75) completed a facial emotion recognition task whereby emotionally neutral faces (6 different identities) morphed, over 40 stages, to express one of 5 basic emotions: anger, disgust, fear, happiness, or sadness. Results showed that, while the groups did not differ in their ability to identify the final, full-strength emotional expressions, nor in the accuracy of their first response, the congenital anosmia group successfully identified the emotions at significantly lower intensity (i.e. an earlier stage of the morph) than the control group. Exploratory analysis showed this main effect was primarily driven by an advantage in detecting anger and disgust. These findings indicate the absence of a functioning sense of smell during development leads to compensatory changes in visual, social cognition. Future work should explore the neural and behavioural basis for this advantage.
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Affiliation(s)
- James Drummond
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Adarsh Makdani
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Ralph Pawling
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Susannah C Walker
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK.
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4
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Golzardi M, Hromić-Jahjefendić A, Šutković J, Aydin O, Ünal-Aydın P, Bećirević T, Redwan EM, Rubio-Casillas A, Uversky VN. The Aftermath of COVID-19: Exploring the Long-Term Effects on Organ Systems. Biomedicines 2024; 12:913. [PMID: 38672267 PMCID: PMC11048001 DOI: 10.3390/biomedicines12040913] [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: 04/03/2024] [Revised: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Post-acute sequelae of SARS-CoV-2 infection (PASC) is a complicated disease that affects millions of people all over the world. Previous studies have shown that PASC impacts 10% of SARS-CoV-2 infected patients of which 50-70% are hospitalised. It has also been shown that 10-12% of those vaccinated against COVID-19 were affected by PASC and its complications. The severity and the later development of PASC symptoms are positively associated with the early intensity of the infection. RESULTS The generated health complications caused by PASC involve a vast variety of organ systems. Patients affected by PASC have been diagnosed with neuropsychiatric and neurological symptoms. The cardiovascular system also has been involved and several diseases such as myocarditis, pericarditis, and coronary artery diseases were reported. Chronic hematological problems such as thrombotic endothelialitis and hypercoagulability were described as conditions that could increase the risk of clotting disorders and coagulopathy in PASC patients. Chest pain, breathlessness, and cough in PASC patients were associated with the respiratory system in long-COVID causing respiratory distress syndrome. The observed immune complications were notable, involving several diseases. The renal system also was impacted, which resulted in raising the risk of diseases such as thrombotic issues, fibrosis, and sepsis. Endocrine gland malfunction can lead to diabetes, thyroiditis, and male infertility. Symptoms such as diarrhea, nausea, loss of appetite, and taste were also among reported observations due to several gastrointestinal disorders. Skin abnormalities might be an indication of infection and long-term implications such as persistent cutaneous complaints linked to PASC. CONCLUSIONS Long-COVID is a multidimensional syndrome with considerable public health implications, affecting several physiological systems and demanding thorough medical therapy, and more study to address its underlying causes and long-term effects is needed.
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Affiliation(s)
- Maryam Golzardi
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina; (M.G.); (J.Š.)
| | - Altijana Hromić-Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina; (M.G.); (J.Š.)
| | - Jasmin Šutković
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina; (M.G.); (J.Š.)
| | - Orkun Aydin
- Department of Psychology, Faculty of Arts and Social Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina; (O.A.); (P.Ü.-A.)
| | - Pinar Ünal-Aydın
- Department of Psychology, Faculty of Arts and Social Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina; (O.A.); (P.Ü.-A.)
| | - Tea Bećirević
- Atrijum Polyclinic, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Elrashdy M. Redwan
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Centre of Excellence in Bionanoscience Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Therapeutic and Protective Proteins Laboratory, Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg EL-Arab, Alexandria 21934, Egypt
| | - Alberto Rubio-Casillas
- Autlan Regional Hospital, Health Secretariat, Autlan 48900, Jalisco, Mexico;
- Biology Laboratory, Autlan Regional Preparatory School, University of Guadalajara, Autlan 48900, Jalisco, Mexico
| | - Vladimir N. Uversky
- Department of Molecular Medicine and USF Health Byrd Alzheimer’s Research Institute, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
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Dumas LE, Vandersteen C, Metelkina-Fernandez V, Gros A, Auby P, Askenazy-Gittard F. Impact of post-COVID-19 olfactory disorders on quality of life, hedonic experiences and psychiatric dimensions in general population. BMC Psychiatry 2024; 24:111. [PMID: 38331799 PMCID: PMC10854070 DOI: 10.1186/s12888-024-05538-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Olfactory disorders in COVID-19 impact quality of life and may lead to psychological impairments. Prevalence ranges from 8 to 85%, persisting in about 30% of cases. This study aimed to evaluate the 6-month post-COVID-19 impact on quality of life, hedonic experiences, anxiety and depression due to olfactory disorders. Additionally, it sought to compare psychophysical tests and self-perceived olfactory evaluations. METHODS A prospective, longitudinal study was conducted over baseline (T0) and 6 months (T1) on individuals with persistent olfactory disorders post-COVID-19 for more than 6 weeks. Psychophysical tests employed the Sniffin' Sticks Test® (TDI score), and self-perceived olfactory evaluation used a Visual Analogue Scale. Quality of life was assessed with an Olfactive Disorder Questionnaire and the French version of the Quality of Life and Diet Questionnaire. Hedonic experiences were gauged using the Snaith-Hamilton Pleasure Scale, while anxiety and depression dimensions were measured by The State-Trait Anxiety Inventory, The Post Traumatic Stress Checklist Scale, and Hamilton Rating Scale for Depression. Participants were classified into the "normosmic group" (NG) and the "olfactory disorders group" (ODG) at T0 and T1 based on the TDI score. RESULTS Were included 56 participants (58.93% women, 41.07% men) with a mean age of 39.04 years and a mean duration of post-COVID-19 olfactory disorders of 5.32 months. At T1, ODG had a significantly lower quality of life and hedonic experiences than NG. No significant differences in anxiety and depression dimensions were observed between groups. At T0, psychophysical tests and self-perceived olfactory evaluations were significantly correlated with quality of life and hedonic experiences in both groups. At T1, self-perceived olfactory evaluation in NG correlated significantly with quality of life, hedonic experiences, anxiety and depression dimensions, whereas ODG only correlated with hedonic experiences. CONCLUSION Individuals with persistent post-COVID-19 olfactory disorders after six months demonstrated compromised quality of life and hedonic experiences. Self-perceived olfactory evaluation played a more significant role in influencing quality of life and the dimension of anxiety and depression than the psychophysical presence of olfactory disorders. These findings emphasize the importance of considering patients' perceptions to comprehensively assess the impact of olfactory disorders on their well-being. TRIAL REGISTRATION ClinicalTrials.gov number (ID: NCT04799977).
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Affiliation(s)
- Louise-Emilie Dumas
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Hôpitaux Pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France.
- CoBTeK-Lab, Université Côte d'Azur, Nice, France.
| | - Clair Vandersteen
- CoBTeK-Lab, Université Côte d'Azur, Nice, France
- Institut Universitaire de la Face et du Cou (IUFC), ENT Department, Centre Hospitalier Universitaire, Nice, France
| | - Victoria Metelkina-Fernandez
- CoBTeK-Lab, Université Côte d'Azur, Nice, France
- Service de Psychiatrie, Centre Hospitalier Universitaire, Nice, France
| | - Auriane Gros
- CoBTeK-Lab, Université Côte d'Azur, Nice, France
- Département d'Orthophonie (DON), Université Côte d'Azur, Nice, France
| | - Philippe Auby
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Hôpitaux Pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK-Lab, Université Côte d'Azur, Nice, France
| | - Florence Askenazy-Gittard
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent (SUPEA), Hôpitaux Pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK-Lab, Université Côte d'Azur, Nice, France
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6
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Schepens EJA, Stegeman I, Kamalski DMA. Diagnostic accuracy of the screenings Sniffin' Sticks Test (SST-12) in COVID-19 induced olfactory disorders. PLoS One 2024; 19:e0295911. [PMID: 38198490 PMCID: PMC10781020 DOI: 10.1371/journal.pone.0295911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
Objective olfactory function can be assessed using validated olfactory tests like the Sniffin' Sticks Test (SST). However, their extensive nature makes them less suitable for clinical practice. To address this, shorter olfactory tests like the screenings Sniffin' Sticks Test (SST-12) can be used for screening purposes and reduce testing time. The SST-12 serves as a diagnostic tool for screening olfaction in cases unrelated to COVID-19. However, these screening tests are uncertain regarding their accuracy in detecting olfactory dysfunction in patients with COVID-19 as the plausible cause. We aim to determine the diagnostic accuracy of the SST-12 in adults with post-COVID-19 olfactory dysfunction. We performed a diagnostic accuracy study with data from 113 consecutive COVID-19 diagnosed patients who experienced objectified smell loss ever since. At approximately 6 months after their diagnosis, all participants underwent the SST (reference standard), part of the SST was the SST-12 (index test). Diagnostic accuracy of the SST-12 is measured as negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity. The SST-12 detected smell loss in 85 patients among 91 patients with smell loss and ruled out smell loss in 15 patients among the 22 patients without smell loss based on the reference standard. Making sensitivity 93.4% (CI 0.87-0.97), and specificity 68.2% (CI 0.48-0.85). Out of the 92 patients with a positive test result on SST-12, 85 patients had indeed smell loss (PPV 92.4% CI 0.86-0.97), and out of the 21 patients with a negative test result, 15 patients had no smell loss regarding the reference standard (NPV 71.4% CI 0.50-0.88). The findings suggest that the SST-12 holds promise as a useful tool for identifying individuals with smell loss, also in individuals with COVID-19 as cause, but it is important to have a good understanding of the interpretation of the results of the SST-12 when considering its implementation in clinical practice.
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Affiliation(s)
- Emma J. A. Schepens
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Digna M. A. Kamalski
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Trecca EMC, Marano PG, Madaro F, Fortunato F, Frisotti DR, Caponio VCA, Vocale M, Cassano M. Impact of obstructive sleep apnea syndrome on olfactory and gustatory capacity. Chem Senses 2024; 49:bjae022. [PMID: 38818785 DOI: 10.1093/chemse/bjae022] [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: 01/27/2023] [Indexed: 06/01/2024] Open
Abstract
Only a few studies have investigated olfactory function in patients with obstructive sleep apnea syndrome (OSAS) using psychophysical testing, and there is a scarcity of data regarding taste evaluation in the existing literature. The primary objectives of this study were to assess both smell and taste in patients with OSAS and to explore the correlation between the severity of symptoms and sensory perception. A total of 85 OSAS patients and a control group comprising 81 subjects were enrolled. Initial assessments included anamnesis, nasal endoscopy, and the completion of questionnaires (Epworth Sleepiness Scale, Visual Analogue Scale, Questionnaire of Olfactory Disorders, and the importance of olfaction questionnaire). The diagnosis of OSAS was confirmed by polysomnography, while nasal airflow was evaluated using rhinomanometry. Olfaction was assessed using the Sniffin' Sticks test, and the Threshold-Discrimination-Identification (TDI) score was calculated. Taste evaluation was conducted in a subgroup of participants (42 patients, 38 controls) using taste strips. The mean TDI score was 31 ± 5.6 for OSAS patients and 35 ± 4.6 for controls, indicating a significant difference (P < 0.001). Similarly, the taste score was 7 ± 3.0 for OSAS patients and 12.6 ± 3.2 for controls (P < 0.001). No correlations were observed between TDI and Apnea Hypopnea Index (AHI) (r = -0.12; P = 0.28), as well as between the taste score and AHI (r = -0.31; P = 0.22). However, a weak but significant correlation between TDI score and Epworth Sleepiness Scale was detected (r = -0.05; P = 0.002). The study revealed a significant decrease in sensory perception among patients with OSAS, though open questions persist about the pathophysiology.
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Affiliation(s)
- Eleonora M C Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Head and Neck Surgery, Foggia, Italy
- IRCCS Casa Sollievo Della Sofferenza, Department of Maxillofacial Surgery and Otorhinolaryngology, San Giovanni Rotondo (Foggia), Italy
| | - Pier Gerardo Marano
- Department of Otorhinolaryngology, University Hospital of Foggia, Head and Neck Surgery, Foggia, Italy
| | - Ferruccio Madaro
- "Vito Fazzi" Hospital, Department of Otorhinolaryngology-Head and Neck Surgery, Lecce, Italy
| | - Francesca Fortunato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Daniela R Frisotti
- Department of Physical Medicine and Rehabilitation, University Hospital of Foggia; Foggia, Italy
| | | | - Matteo Vocale
- Department of Otorhinolaryngology, University Hospital of Foggia, Head and Neck Surgery, Foggia, Italy
| | - Michele Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Head and Neck Surgery, Foggia, Italy
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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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Reiss AB, Greene C, Dayaramani C, Rauchman SH, Stecker MM, De Leon J, Pinkhasov A. Long COVID, the Brain, Nerves, and Cognitive Function. Neurol Int 2023; 15:821-841. [PMID: 37489358 PMCID: PMC10366776 DOI: 10.3390/neurolint15030052] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
SARS-CoV-2, a single-stranded RNA coronavirus, causes an illness known as coronavirus disease 2019 (COVID-19). Long-term complications are an increasing issue in patients who have been infected with COVID-19 and may be a result of viral-associated systemic and central nervous system inflammation or may arise from a virus-induced hypercoagulable state. COVID-19 may incite changes in brain function with a wide range of lingering symptoms. Patients often experience fatigue and may note brain fog, sensorimotor symptoms, and sleep disturbances. Prolonged neurological and neuropsychiatric symptoms are prevalent and can interfere substantially in everyday life, leading to a massive public health concern. The mechanistic pathways by which SARS-CoV-2 infection causes neurological sequelae are an important subject of ongoing research. Inflammation- induced blood-brain barrier permeability or viral neuro-invasion and direct nerve damage may be involved. Though the mechanisms are uncertain, the resulting symptoms have been documented from numerous patient reports and studies. This review examines the constellation and spectrum of nervous system symptoms seen in long COVID and incorporates information on the prevalence of these symptoms, contributing factors, and typical course. Although treatment options are generally lacking, potential therapeutic approaches for alleviating symptoms and improving quality of life are explored.
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Affiliation(s)
- Allison B Reiss
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Caitriona Greene
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Christopher Dayaramani
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | | | | | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Aaron Pinkhasov
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
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Panhoca VH, Ferreira LT, de Souza VB, Ferreira SA, Simão G, de Aquino Junior AE, Bagnato VS, Hanna R. Can photobiomodulation restore anosmia and ageusia induced by COVID-19? A pilot clinical study. JOURNAL OF BIOPHOTONICS 2023; 16:e202300003. [PMID: 36929335 DOI: 10.1002/jbio.202300003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/07/2023]
Abstract
Along with other COVID-19 clinical manifestations, management of both olfactory and gustatory dysfunction have drawn a considerable attention. Photobiomodulation (PBM) has emerged to be a possible effective therapy in restoring taste and smell functionality, but the evidence is scarce. Hence, the present pilot study is aimed to evaluate the effectiveness of intranasal and intraoral PBM administrations in management of anosmia and ageusia respectively. Twenty Caucasian subjects who diagnosed with anosmia and ageusia were recruited. Visual analogue scale was utilised to evaluate patients' self-reported for both olfactory and gustatory functionality. The laser-PBM parameters and treatment protocols for anosmia and ageusia were as follows respectively: 660 nm, 100 mW, two points intranasally, 60 J/session, 12 sessions; dual wavelengths (660 nm and 808 nm), 100 mW, three points intraorally, 216 J/session, 12 sessions. Our results showed a significant functionality improvement of both olfactory and gustatory functionality. Extensive studies with large data and long-term follow-up period are warranted.
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Affiliation(s)
- Vitor Hugo Panhoca
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
| | - Laís Tatiane Ferreira
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
- Central Paulista University Center-UNICEP, Sao Carlos, Brazil
| | - Viviane Brocca de Souza
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
- Central Paulista University Center-UNICEP, Sao Carlos, Brazil
| | - Simone Aparecida Ferreira
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
- Central Paulista University Center-UNICEP, Sao Carlos, Brazil
| | - Gabriely Simão
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
- Central Paulista University Center-UNICEP, Sao Carlos, Brazil
| | - Antonio Eduardo de Aquino Junior
- Institute of Physics of Sao Carlos, University of Sao Paulo (USP), Sao Paulo, Brazil
- Development and Training Center for Post-Covid-19 Patient Rehabilitation Technologies and Procedures (CITESC-INOVA), Sao Carlos, Brazil
| | | | - Reem Hanna
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, SE5 9RS, UK
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy
- Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London, WC1E 6DE, UK
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11
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Song J, Jing Q, Zhu E, Liu Q, Fei M, Zhang H, An G, Cao S, Tang J, Xu G, Liu Y, Ai Z, Tao Y, Li C, Xiong L. Alterations in smell or taste in individuals infected with SARS-CoV-2 during periods of Omicron variant dominance. Int J Infect Dis 2023; 128:278-284. [PMID: 36657518 PMCID: PMC9840980 DOI: 10.1016/j.ijid.2023.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To characterize the prevalence, severity, correlation with initial symptoms, and role of vaccination in patients with COVID-19 with smell or taste alterations (STAs). METHODS We conducted an observational study of patients infected with SARS-CoV-2 Omicron admitted to three hospitals between May 17 and June 16, 2022. The olfactory and gustatory functions were evaluated using the taste and smell survey and the numerical visual analog scale at two time points. RESULTS The T1 and T2 time point assessments were completed by 688 and 385 participants, respectively. The prevalence of STAs at two time points was 41.3% vs 42.6%. Furthermore, no difference existed in the severity distribution of taste and smell survey, smell, or taste visual analog scale scores between the groups. Patients with initial symptoms of headache (P = 0.03) and muscle pain (P = 0.04) were more likely to develop STAs, whereas higher education; three-dose vaccination; no symptoms yet; or initial symptoms of cough, throat discomfort, and fever demonstrated protective effects, and the results were statistically significant. CONCLUSION The prevalence of STAs did not decrease significantly during the Omicron dominance, but the severity was reduced, and vaccination demonstrated a protective effect. In addition, the findings suggest that the presence of STAs is likely to be an important indicator of viral invasion of the nervous system.
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Affiliation(s)
- Jian Song
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Qi Jing
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Enzhao Zhu
- Department of Medical Statistics, Tongji University School of Medicine, Shanghai, China
| | - Qidong Liu
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopedic Department of Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Miaomiao Fei
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Hui Zhang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Guanghui An
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Silu Cao
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Jinxuan Tang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Guanghui Xu
- Department of Spine Surgery, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yi Liu
- Department of Nursing, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zisheng Ai
- Department of Medical Statistics, Tongji University School of Medicine, Shanghai, China
| | - Yingna Tao
- Department of Traditional Chinese Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.
| | - Lize Xiong
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation Shanghai, China; Translational Research Institute of Brain and Brain-like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China; Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.
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12
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Molnár A, Maihoub S, Mavrogeni P, Krasznai M, Tamás L, Kraxner H. The Correlation between the Results of the Sniffin' Sticks Test, Demographic Data, and Questionnaire of Olfactory Disorders in a Hungarian Population after a SARS-CoV-2 Infection. J Clin Med 2023; 12:jcm12031041. [PMID: 36769688 PMCID: PMC9917422 DOI: 10.3390/jcm12031041] [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: 12/18/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND After a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, smell disorders frequently occur, significantly affecting patients' quality of life (QoL). METHODS 110 patients with persistent olfactory disorder after coronavirus infection were enrolled. These patients underwent chemosensory testing using the Sniffin' Sticks test, and completed the Questionnaire of Olfactory Disorders (QOD). RESULTS 30% of the patients reported anosmia, and 70% reported hyposmia. Upon comparing subjective and chemosensory testing categories, good category matching was observed in 75.3% (i.e., anosmia based on both methods in 10 and hyposmia in 48 cases). Statistical analysis using the Chi-square test revealed a significant result (p = 0.001 *). Between the TDI (i.e., Threshold, Discrimination, Identification) results of the three subjective report groups (i.e., hyposmia, anosmia, and parosmia), no significant differences were observed. When the TDI and QOD results were compared, no consistent significant correlations were found in most TDI and QOD outcomes. Between the TDI and Scale 2 results, a significant, although slight correlation was observed by the Spearman's (rho = 0.213, p = 0.027 *) and Pearson's (rho = 0.201, p = 0.037 *) tests. CONCLUSIONS The nonsignificant correlation between objective and subjective methods suggests that these results should be interpreted independently. Moreover, adequate management is essential even in mild cases.
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Affiliation(s)
- András Molnár
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
- Correspondence:
| | - Stefani Maihoub
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
| | - Panayiota Mavrogeni
- Tóth Ilona Health Service Clinical Medical Institute, Görgey Artúr tér 8, 1212 Budapest, Hungary
| | - Magdolna Krasznai
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
| | - László Tamás
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
- Department of Voice, Speech and Swallowing Therapy, Faculty of Health Sciences, Semmelweis University, Vas u. 17, 1088 Budapest, Hungary
| | - Helga Kraxner
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Semmelweis University, Szigony u. 36, 1083 Budapest, Hungary
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13
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Desai DD, Yu SE, Salvatore B, Goldberg Z, Bowers EMR, Moore JA, Phan B, Lee SE. Olfactory and neurological outcomes of SARS-CoV-2 from acute infection to recovery. FRONTIERS IN ALLERGY 2022; 3:1019274. [DOI: 10.3389/falgy.2022.1019274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
Educational objectiveTo investigate the impact of SARS-CoV-2 on sinonasal quality of life, olfaction, and cognition at different stages of viral infection and evaluate the association between olfaction and cognition in this population cohort.ObjectivesWhile olfactory dysfunction (OD) is a frequently reported symptom of COVID-19 (98% prevalence), neurocognitive symptoms are becoming more apparent as patients recover from infection. This study aims to address how different stages of infection [active infection (positive PCR test, symptomatic) vs. recovered (7 days post-symptoms)] compared to healthy control patients influence sinonasal quality of life, olfactory function, and cognition.Study designProspective, longitudinal, case-control.MethodsParticipants completed the SNOT-22, University of Pennsylvania Smell Identification Test (UPSIT) and validated cognitive examinations to assess degree of smell loss and neurocognitive function at baseline and at 1 and 3 months for the active group and 3 months for the recovered group. Self-reported olfactory function and overall health metrics were also collected.ResultsThe recovered group had the lowest average UPSIT score of 27.6 compared to 32.7 (active) and 32.6 (healthy control). 80% (n = 24) of the recovered patients and 56.3% (n = 9) of the active patients suffered from smell loss. In follow-up, the active group showed improvement in UPSIT scores while the recovered group scores worsened. In terms of neurocognitive performance, recovered patients had lower processing speed despite an improving UPSIT score.ConclusionSARS-CoV-2 infection was found to impact olfactory function in a delayed fashion with significant impact despite recovery from active infection. Although olfactory function improved, decrements in cognitive processing speed were detected in our cohort.
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Chemosensory Dysfunction in Long-Term COVID-19 Assessed by Self-Reported and Direct Psychophysical Methods. Life (Basel) 2022; 12:life12101487. [PMID: 36294922 PMCID: PMC9604579 DOI: 10.3390/life12101487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/24/2022] Open
Abstract
Chemosensory dysfunction is a frequent postacute sequela of COVID-19. Depending on the type of test used to measure it (self-report vs. direct test), the degree of chemosensory dysfunction in long-term COVID-19 has been found to be highly variable. In this manuscript, we report the cross-sectional data (first assessment) of a longitudinal study (6-month follow-up) examining smell, taste, and chemesthesis in participants affected by long-term COVID-19 (COVID+) and participants without COVID-19 (COVID−) by means of both self-reported and direct psychophysical methods. In total, 208 Italian participants (COVID+ n = 133; COVID− n = 75) completed the Smell and Taste Check developed by the Global Consortium for Chemosensory Research (GCCR), which includes self-reports on smell, taste, and chemesthetic abilities as well as direct intensity ratings of unstandardized smell, taste, and chemesthetic household items. Furthermore, all participants completed SCENTinel, a validated direct smell test. We found a positive association between the self-reported, unstandardized direct test and the validated direct test for smell, indicating moderate to large agreement across measures. Furthermore, the performance on SCENTinel was significantly associated with self-reported smell loss. A positive association between the self-reports and the intensity of household items was also retrieved for taste and chemesthesis. The time relative to COVID-19 onset (267.3 ± 113.9 days) did not modulate the chemosensory performance of self-reported abilities, intensity ratings, and SCENTinel. All in all, we confirm the impairment of three chemical senses (smell, taste, and chemesthesis) in an independent sample of Italian participants affected by long-term COVID-19 by using and comparing self-reported and direct psychophysical methods. We contribute to the discussion on best practices to monitor chemosensory dysfunction in individuals affected by long-term COVID-19.
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