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Kasim MF, Abbas AM. Evaluation of Olfactory Dysfunction Among COVID-19 Patients in Baghdad, Iraq. Cureus 2024; 16:e53721. [PMID: 38455837 PMCID: PMC10919444 DOI: 10.7759/cureus.53721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Background SARS‑CoV‑2 (COVID-19) causes olfactory dysfunction which is characterized by anosmia or hyposmia. Characterization of olfactory dysfunction has added value to the diagnosis and prognosis of the disease. Nevertheless, scarce information exists about COVID-19 patients suffering from olfactory dysfunction in Iraq. This study aimed to identify olfactory dysfunction (anosmia or hyposmia) in Iraqi COVID-19 patients and examine their response to smell exercise at Baghdad Medical City Complex, Baghdad, Iraq. Methodology This case series prospective study involving 300 patients (160 males and 140 females) with COVID-19 infection was conducted from June 1, 2020, to October 1, 2021. We recorded signs and symptoms of COVID-19 among patients by examining olfactory dysfunction, n-butanol olfaction test, and smell test exercise. Results Anosmia and hyposmia were found in 69.3% and 30.7% of the patients, respectively; of these, 65.7% were of sudden onset. The association between olfactory dysfunction and smoking was not significant. The most frequent signs and symptoms of COVID-19 were fatigue, fever, loss of taste, myalgia, headache, sore throat, cough, depressed appetite, dyspnea, nausea, abdominal pain, and diarrhea. The highest frequencies of occurrence of anosmia (30.7%) and hyposmia (13.3%) were in the age group of 31-40 years. The majority (47.7%) of patients with olfactory dysfunction recovered within one month of COVID-19 onset. The rest of the patients recovered within one month to 16 months. The most commonly encountered ear, nose, and throat symptoms were nasal obstruction, rhinorrhea, and facial/ear pain. The percentages of patients with anosmia and hyposmia recovering with smell exercise were significant at 64.7% and 25.3%, respectively. Conclusions The prognosis of olfactory dysfunction in COVID-19 patients was good as most cases recovered within a short period with concomitant smell exercise. Olfactory dysfunction in the majority of COVID-19 patients was self-limiting in young age groups, albeit in association with the non-severity of the disease. Being an important public health issue, examining olfactory dysfunction aspects should be considered in the diagnosis, prognosis, and treatment protocols of COVID-19 patients. In-depth exploration is needed to examine olfactory and gustatory dysfunction in patients suffering from severe COVID-19.
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Affiliation(s)
| | - Azzam M Abbas
- Otolaryngology, College of Medicine, University of Baghdad and Martyr Ghazi Al-Hariri Teaching Hospital, Baghdad Medical City, Baghdad, IRQ
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2
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Hu B, Gong M, Xiang Y, Qu S, Zhu H, Ye D. Mechanism and treatment of olfactory dysfunction caused by coronavirus disease 2019. J Transl Med 2023; 21:829. [PMID: 37978386 PMCID: PMC10657033 DOI: 10.1186/s12967-023-04719-x] [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: 09/08/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the start of the pandemic, olfactory dysfunction (OD) has been reported as a common symptom of COVID-19. In some asymptomatic carriers, OD is often the first and even the only symptom. At the same time, persistent OD is also a long-term sequela seen after COVID-19 that can have a serious impact on the quality of life of patients. However, the pathogenesis of post-COVID-19 OD is still unclear, and there is no specific treatment for its patients. The aim of this paper was to review the research on OD caused by SARS-CoV-2 infection and to summarize the mechanism of action, the pathogenesis, and current treatments.
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Affiliation(s)
- Bian Hu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
- Department of Otorhinolaryngology-Head and Neck Surgery, Ninghai First Hospital, Ningbo, 315600, Zhejiang, China
| | - Mengdan Gong
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Yizhen Xiang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Siyuan Qu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Hai Zhu
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Dong Ye
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, 315040, Zhejiang, China.
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3
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Abha Mishra KM, Podili R, Pathlavath TS, Sethi KK. A critical review on brain and heart axis response in COVID-19 patients: Molecular mechanisms, mediators, biomarkers, and therapeutics. J Biochem Mol Toxicol 2023; 37:e23409. [PMID: 37341157 DOI: 10.1002/jbt.23409] [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: 07/26/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023]
Abstract
Since the outbreak of highly virulent coronaviruses, significant interest was assessed to the brain and heart axis (BHA) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-affected patients. The majority of clinical reports accounted for unusual symptoms associated with SARS-CoV-2 infections which are of the neurological type, such as headache, nausea, dysgeusia, anosmia, and cerebral infarction. The SARS-CoV-2 enters the cells through the angiotensin-converting enzyme (ACE-2) receptor. Patients with prior cardiovascular disease (CVD) have a higher risk of COVID-19 infection and it has related to various cardiovascular (CV) complications. Infected patients with pre-existing CVDs are also particularly exposed to critical health outcomes. Overall, COVID-19 affected patients admitted to intensive care units (ICU) and exposed to stressful environmental constraints, featured with a cluster of neurological and CV complications. In this review, we summarized the main contributions in the literature on how SARS-CoV-2 could interfere with the BHA and its role in affecting multiorgan disorders. Specifically, the central nervous system involvement, mainly in relation to CV alterations in COVID-19-affected patients, is considered. This review also emphasizes the biomarkers and therapy options for COVID-19 patients presenting with CV problems.
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Affiliation(s)
- K M Abha Mishra
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Runesh Podili
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Teja S Pathlavath
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Kalyan K Sethi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
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4
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Zhao M, Zhang M, Yang Z, Zhou Z, Huang J, Zhao B. Role of E3 ubiquitin ligases and deubiquitinating enzymes in SARS-CoV-2 infection. Front Cell Infect Microbiol 2023; 13:1217383. [PMID: 37360529 PMCID: PMC10288995 DOI: 10.3389/fcimb.2023.1217383] [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: 05/05/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Ever since its emergence in 2019, COVID-19 has rapidly disseminated worldwide, engendering a pervasive pandemic that has profoundly impacted healthcare systems and the socio-economic milieu. A plethora of studies has been conducted targeting its pathogenic virus, SARS-CoV-2, to find ways to combat COVID-19. The ubiquitin-proteasome system (UPS) is widely recognized as a crucial mechanism that regulates human biological activities by maintaining protein homeostasis. Within the UPS, the ubiquitination and deubiquitination, two reversible modifications, of substrate proteins have been extensively studied and implicated in the pathogenesis of SARS-CoV-2. The regulation of E3 ubiquitin ligases and DUBs(Deubiquitinating enzymes), which are key enzymes involved in the two modification processes, determines the fate of substrate proteins. Proteins associated with the pathogenesis of SARS-CoV-2 may be retained, degraded, or even activated, thus affecting the ultimate outcome of the confrontation between SARS-CoV-2 and the host. In other words, the clash between SARS-CoV-2 and the host can be viewed as a battle for dominance over E3 ubiquitin ligases and DUBs, from the standpoint of ubiquitin modification regulation. This review primarily aims to clarify the mechanisms by which the virus utilizes host E3 ubiquitin ligases and DUBs, along with its own viral proteins that have similar enzyme activities, to facilitate invasion, replication, escape, and inflammation. We believe that gaining a better understanding of the role of E3 ubiquitin ligases and DUBs in COVID-19 can offer novel and valuable insights for developing antiviral therapies.
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Affiliation(s)
- Mingjiu Zhao
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mengdi Zhang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhou Yang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhiguang Zhou
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jiaqi Huang
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Bin Zhao
- National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Furong Laboratory, Central South University, Changsha, China
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Carpio-Orantes LD, Garcia-Mendez S, Diaz JSS, Solis-Sanchez I, Aguilar-Silva A. Anosmia and dysgeusia as markers of severity and prognosis in COVID-19. Brain Circ 2023; 9:50-51. [PMID: 37151791 PMCID: PMC10158657 DOI: 10.4103/bc.bc_65_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 05/09/2023] Open
Affiliation(s)
- Luis Del Carpio-Orantes
- Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Veracruz, Mexico
- Address for correspondence: Dr. Luis Del Carpio-Orantes, 12 de Octubre 603, Veracruz, ZC 91900, Mexico. E-mail:
| | - Sergio Garcia-Mendez
- Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Veracruz, Mexico
| | | | - Ishar Solis-Sanchez
- Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Veracruz, Mexico
| | - Andres Aguilar-Silva
- Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Veracruz, Mexico
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Galvin V, Cheek DJ, Zhang Y, Collins G, Gaskin D. Short Communication: Stellate Ganglion Blockade for Persistent Olfactory and Gustatory Symptoms Post-COVID-19. Local Reg Anesth 2023; 16:25-30. [PMID: 37162813 PMCID: PMC10164395 DOI: 10.2147/lra.s402197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/25/2023] [Indexed: 05/11/2023] Open
Abstract
One hundred ninety-five patients presenting with post-COVID symptomology, including parosmia and dysgeusia, underwent reversible stellate ganglion blockade. Stellate ganglion blockade was performed at an outpatient facility, and patients were evaluated via survey at seven days post-injection. Of the 195 participants, ages ranged from 18-69 years of age with the breakdown of sexes being females n = 157 and males n = 38. The most significant finding was a reported improvement in olfaction post-injection in 87.4% of subjects. The effectiveness of this novel treatment for post-COVID is promising and warrants further investigation.
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Affiliation(s)
- Vaughna Galvin
- School of Nurse Anesthesia, Texas Christian University, Fort Worth, TX, USA
- Correspondence: Vaughna Galvin, School of Nurse Anesthesia, Annie Richardson Bass Building, 2800 West Bowie Street, Suite 3101, Fort Worth, TX, 76109, USA, Tel +1 817-257-7887, Fax +1 817-257-5472, Email
| | - Dennis J Cheek
- School of Nursing, Texas Christian University, Fort Worth, TX, USA
| | - Yan Zhang
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA
| | - Gregory Collins
- School of Nurse Anesthesia, Texas Christian University, Fort Worth, TX, USA
| | - David Gaskin
- Republic Pain Specialists, Physicians Centre Hospital, Bryan, TX, USA
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7
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What Is the Long-Term Findings of Olfactory and Taste Loss due to COVID-19? SISLI ETFAL HASTANESI TIP BULTENI 2022; 56:466-472. [PMID: 36660391 PMCID: PMC9833342 DOI: 10.14744/semb.2022.56492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Objectives The objective of this study was to determine prevalance, severity, course, and long-term findings of smell and taste disorders of coronavirus disease 2019 (COVID-19) patients in mild-moderate and severe-critical disease spectrum. Methods All adult patients conducted in our hospital with positive severe acute respiratory syndrome coronavirus 2 between March and April 2020 were surveyed during disease course and those with olfactory and taste loss were re-surveyed to determine the course and progress of these symptoms after at least 12-month follow-up. Demographic features and clinical findings were evaluated as well as disease severity. Results A total of 77 patients with smell and/or taste loss symptoms were included in the study. At diagnosis, 58 (75.3%) patients had loss of smell and 75 (97.4%) had loss of taste. After a follow-up period of 12-14 months, 12 (15.6%) patients had ongoing loss of smell and six (8%) patients had ongoing loss of taste. Three (3.9%) patients complained of cacosmia and 5 (6.5%) complained of parosmia at follow-up. The presence of ongoing visual analog scale scores of smell and/or taste was not statistically significant between male and female patients. When presence and severity of symptoms were compared by disease severity, no statistically significant difference was found. Conclusion Smell and taste loss seem to be among the presenting symptoms of COVID-19. The prognosis and the treatment of the smell loss and taste loss in COVID-19 patients remains unclear. To improve and accelerate recovery, the pathophysiology and the treatment options must be validated.
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Pushparaj TL, Irudaya Raj EF, Irudaya Rani EF. A detailed review of contrast-enhanced fluorescence magnetic resonance imaging techniques for earlier prediction and easy detection of COVID-19. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2022. [DOI: 10.1080/21681163.2022.2144762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - E. Fantin Irudaya Raj
- Department of Electrical and Electronics Engineering, Dr. Sivanthi Aditanar College of Engineering, India
| | - E. Francy Irudaya Rani
- Department of Electronics and Communication Engineering, Francis Xavier Engineering College, India
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9
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Moradi S, Alizadeh R, Yazdian F, Farhadi M, Kamrava SK, Simorgh S. A TGF-α and TGF-β1 Poloxamer-based micelle/hydrogel composite: A promising novel candidate for the treatment of anosmia. Biotechnol Prog 2022; 38:e3294. [PMID: 36054541 DOI: 10.1002/btpr.3294] [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: 06/14/2022] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 01/19/2023]
Abstract
Anosmia is the inability to smell or loss of the sense of smell. It can reduce your ability to detect the smell of smoke, gas leaks, or spoiled food, as well as hinder the quality of life related to social interactions and feelings of well-being. In the current study, a drug delivery composite was designed to cure anosmia and its efficiency in delivering transforming growth factor alpha (TGF-α) and transforming growth factor beta 1 (TGF-β1) to the nasal cavity was evaluated. Bovine serum albumin (BSA) was used as a model protein for encapsulation into Poloxamers 407 micelles. For the optimization of the BSA-micelle formulation, a two-parameter five-level central composite design (CCD) was applied. The BSA-micelle was optimized with a particle size of 41 nm, drug loading of 8%, and encapsulation efficiency of 74%. Further, the BSA-micelle was characterized by FESEM, TEM, and FTIR. The analysis of release profile suggested high-paced free BSA release compared to the gradual and prolonged release of BSA-micelle/hydrogel and BSA-micelles. The cytotoxicity assay demonstrated the safety of TGF-α and TGF-β1-micelles/hydrogel. Moreover, it was observed that TGF-α and TGF-β1 within the hydrogels promote cellular viability and human olfactory ectomesenchymal stem cell OE-MSCs proliferation. In conclusion, According to the results of our study, the TGF-α and TGF-β1-micelle/hydrogel-based delivery system provides a suitable alternative for anosmia treatment.
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Affiliation(s)
- Salah Moradi
- Department of Life Science Engineering, Faculty of New Science and Technology, University of Tehran, Tehran, Iran
| | - Rafieh Alizadeh
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Yazdian
- Department of Life Science Engineering, Faculty of New Science and Technology, University of Tehran, Tehran, Iran
| | - Mohammad Farhadi
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kamran Kamrava
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Simorgh
- Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
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ÇETİN H, ATEŞ AŞ, TAYDAŞ O, ELMAS B, GÜÇLÜ E. Magnetic resonance imaging findings in COVID-19-related anosmia. Turk J Med Sci 2022; 52:1506-1512. [PMID: 36422480 PMCID: PMC10395696 DOI: 10.55730/1300-0144.5490] [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: 04/12/2021] [Revised: 10/19/2022] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) mostly manifests with fever, shortness of breath, and cough, has also been found to cause some neurological symptoms, such as anosmia and ageusia. The aim of the study was to present the magnetic resonance imaging (MRI) findings of patients with anosmia-hyposmia symptoms and to discuss potential mechanisms in light of these findings. METHODS Of the 2412 patients diagnosed with COVID-19-related pneumonia (RT-PCR at least once + clinically confirmed) between March and December 2020, 15 patients underwent olfactory MRI to investigate the cause of ongoing anosmia/ hyposmia symptoms were included in the study. RESULTS Eleven (73.3%) patients were female and four (26.7%) were male. A total of eight patients (53.3%) showed thickening in the olfactory cleft region, where the olfactory epithelium is located. In nine patients (60%), enhancement was observed in the olfactory cleft region. Diffusion-weighted imaging showed restricted diffusion in three patients (20%) (corpus callosum splenium in one patient, thalamus mediodorsal nucleus in one patient, and mesencephalon in one patient). DISCUSSION This study revealed that there is a relationship between anosmia and MRI findings. Larger studies can enlighten the pathophysiological mechanism and shed light on both diagnosis and new treatments.
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Affiliation(s)
- Hüseyin ÇETİN
- Department of Radiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara,
Turkey
| | - Ayşe Şule ATEŞ
- Department of Chest Diseases, Sakarya University Training and Research Hospital, Sakarya,
Turkey
| | - Ogün TAYDAŞ
- Department of Family Medicine, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul,
Turkey
| | - Bahri ELMAS
- Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya,
Turkey
| | - Ertuğrul GÜÇLÜ
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sakarya University, Sakarya,
Turkey
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Wang L, Liu C, Yang B, Zhang H, Jiao J, Zhang R, Liu S, Xiao S, Chen Y, Liu B, Ma Y, Duan X, Guo Y, Guo M, Wu B, Wang X, Huang X, Yang H, Gui Y, Fang M, Zhang L, Duo S, Guo X, Li W. SARS-CoV-2 ORF10 impairs cilia by enhancing CUL2ZYG11B activity. J Biophys Biochem Cytol 2022; 221:213272. [PMID: 35674692 PMCID: PMC9184850 DOI: 10.1083/jcb.202108015] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/02/2022] [Accepted: 04/27/2022] [Indexed: 12/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causal pathogen of the ongoing global pandemic of coronavirus disease 2019 (COVID-19). Loss of smell and taste are symptoms of COVID-19, and may be related to cilia dysfunction. Here, we found that the SARS-CoV-2 ORF10 increases the overall E3 ligase activity of the CUL2ZYG11B complex by interacting with ZYG11B. Enhanced CUL2ZYG11B activity by ORF10 causes increased ubiquitination and subsequent proteasome-mediated degradation of an intraflagellar transport (IFT) complex B protein, IFT46, thereby impairing both cilia biogenesis and maintenance. Further, we show that exposure of the respiratory tract of hACE2 mice to SARS-CoV-2 or SARS-CoV-2 ORF10 alone results in cilia-dysfunction-related phenotypes, and the ORF10 expression in primary human nasal epithelial cells (HNECs) also caused a rapid loss of the ciliary layer. Our study demonstrates how SARS-CoV-2 ORF10 hijacks CUL2ZYG11B to eliminate IFT46 and leads to cilia dysfunction, thereby offering a powerful etiopathological explanation for how SARS-CoV-2 causes multiple cilia-dysfunction-related symptoms specific to COVID-19.
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Affiliation(s)
- Liying Wang
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Chao Liu
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Bo Yang
- Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Institute of Urology, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, China 5
| | - Haotian Zhang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China 2
| | - Jian Jiao
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China 9
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China 10
| | - Ruidan Zhang
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Shujun Liu
- Laboratory Animal Center, Institute of Zoology, Chinese Academy of Sciences, Beijing, China 3
| | - Sai Xiao
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Yinghong Chen
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Bo Liu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Yanjie Ma
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Xuefeng Duan
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China 6
| | - Yueshuai Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China 2
| | - Mengmeng Guo
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Bingbing Wu
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China 9
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China 10
| | - Xingxu Huang
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China 8
| | - Haitao Yang
- Shanghai Institute for Advanced Immunochemical Studies and School of Life Science and Technology, ShanghaiTech University, Shanghai, China 7
| | - Yaoting Gui
- Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Institute of Urology, Peking University Shenzhen Hospital, Shenzhen PKU-HKUST Medical Center, Shenzhen, China 5
| | - Min Fang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China 6
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China 9
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China 10
| | - Shuguang Duo
- Laboratory Animal Center, Institute of Zoology, Chinese Academy of Sciences, Beijing, China 3
| | - Xuejiang Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China 2
| | - Wei Li
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China 1
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Stem Cell and Regenerative Medicine Innovation Institute, Chinese Academy of Sciences, Beijing, China 4
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12
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Rodriguez-Sevilla JJ, Güerri-Fernádez R, Bertran Recasens B. Is There Less Alteration of Smell Sensation in Patients With Omicron SARS-CoV-2 Variant Infection? Front Med (Lausanne) 2022; 9:852998. [PMID: 35492353 PMCID: PMC9039252 DOI: 10.3389/fmed.2022.852998] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023] Open
Abstract
The ongoing pandemic Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of global concern in terms of public health Within the symptoms secondary to SARS-CoV-2 infection, hyposmia and anosmia have emerged as characteristic symptoms during the onset of the pandemic. Although many researchers have investigated the etiopathogenesis of this phenomenon, the main cause is not clear. The appearance of the new variant of concern Omicron has meant a breakthrough in the chronology of this pandemic, presenting greater transmissibility and less severity, according to the first reports. We have been impressed by the decrease in anosmia reported with this new variant and in patients reinfected or who had received vaccination before becoming infected. Based on the literature published to date, this review proposes different hypotheses to explain this possible lesser affectation of smell. On the one hand, modifications in the SARS-CoV-2 spike protein could produce changes in cell tropism and interaction with proteins that promote virus uptake (ACE-2, TMPRSS2, and TMEM16F). These proteins can be found in the sustentacular cells and glandular cells of the olfactory epithelium. Second, due to the characteristics of the virus or previous immunity (infection or vaccination), there could be less systemic or local inflammation that would generate less cell damage in the olfactory epithelium and/or in the central nervous system.
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Affiliation(s)
| | - Roberto Güerri-Fernádez
- Infectious Diseases Department, Hospital del Mar Institute of Medical Research (IMIM), Barcelona, Spain.,Facultad de Medicina y Ciencias de la Vida (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
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13
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Ghods K, Alaee A. Olfactory and Taste Disorders in Patients Suffering from Covid-19, a Review of Literature. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:1-6. [PMID: 35291682 PMCID: PMC8918638 DOI: 10.30476/dentjods.2021.87800.1284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/22/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
Corona virus epidemic has caused a widespread disaster around the world. In studies, there are pieces of evidence of olfactory and taste dysfunction in patients with Covid-19. These symptoms occur independently or can be associated with other symptoms such as dry cough. The mechanism of the above-mentioned disorders and their clinical features in patients are not yet known. The rate of incidence of olfactory dysfunction in patients has been varied from 29.64% to 75.23% and the rate of incidence of taste dysfunction among the people can be different from 20.46% to 68.95%. Therefore, clinicians including ENT specialists and dentists should pay attention to the symptoms of anosmia and ageusia in these patients to prevent delayed diagnosis and inappropriate treatments. In this review article, data have been collected by searching the available articles in the domestic and foreign journals using databases such as PubMed, PubMed Central, Medline, EBSCO, Google Scholar, and Embase with key words of Anosmia, Ageusia, Dysgeusia, Covid-19, and Coronavirus from 2019 to 2020. Among the relevant references, 38 authoritative articles were chosen. The data showed that it seems olfactory and taste function disorders are the obvious symptoms of Covid-19, which can occur independently or with other symptoms, but the pathogenesis is not well specified yet. Therefore, further studies are required to achieve a reliable result in this area.
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Affiliation(s)
- Kimia Ghods
- Student of Dentistry, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arezoo Alaee
- Dept. of Oral Medicine, Membership of Dental Material Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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14
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Tavakolifard N, Moeini M, Haddadpoor A, Heidari K, Rezaee M, Amini Z. Clinical Symptoms of COVID-19 and Their Association with Disease Outcome. Adv Biomed Res 2022; 11:2. [PMID: 35284355 PMCID: PMC8906090 DOI: 10.4103/abr.abr_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/15/2021] [Accepted: 05/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND COVID-19 pandemic placed immense pressure on health systems. The current study aimed to evaluate the symptoms of COVID-19 in Isfahan province and their association with disease outcome. MATERIALS AND METHODS In this cross-sectional study, which was conducted on patients with a definite diagnosis of COVID-19, as a part of the investigations performed by the Deputy for Public Health of the Isfahan University of Medical Sciences, the frequency of underlying diseases, and general, respiratory, gastrointestinal, neurological, renal, cardiac, dermal, hearing symptoms are assessed using a checklist. The participants were followed up 1 month after definitive diagnosis, and the outcome of the disease (recovery or death) was recorded. RESULTS Of 300 patients, 143 (47.4%) were male and 157 (52.6%) were female. The mean age of patients was 43 ± 17.84 years. Muscle pain and fatigue were the most common early symptoms (63% and 60.3%, respectively). Age, sex, level of education, and occupation of patients and general, respiratory, and gastrointestinal symptoms and underlying diseases of respiratory disease showed a statistically significant association with the disease outcome (P < 0.05). CONCLUSION General, respiratory, and gastrointestinal symptoms were associated with an increased risk of death due to COVID-19. General, visual, and hearing symptoms, and diabetes, cardiovascular diseases, and respiratory disease had a statistically significant association with the hospitalization of patients.
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Affiliation(s)
- Negah Tavakolifard
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Moeini
- Vice Chancellery for Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asefeh Haddadpoor
- Vice Chancellery for Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamal Heidari
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Vice Chancellery for Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Rezaee
- Vice Chancellery for Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Amini
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Zahra Amini, Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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15
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Esmaeili M, Abdi F, Shafiee G, Asayesh H, Abdar ZE, Baygi F, Qorbani M. Olfactory and Gustatory Dysfunction in 2019 Novel Coronavirus: An Updated Systematic Review and Meta-analysis. Int J Prev Med 2022; 12:170. [PMID: 35070203 PMCID: PMC8724794 DOI: 10.4103/ijpvm.ijpvm_484_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/21/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Evidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients. Methods: In this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method. Results: Among 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively. Conclusions: Olfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.
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Affiliation(s)
- Marzieh Esmaeili
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Esmaeili Abdar
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Center of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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16
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Alrusayyis D, Aljubran H, Alshaibani A, Alsharhan S, AlSaied A, ALEnazi A, Alghamdi A, Alshahrani S, Salam A, Al Bar M. Patterns of Otorhinolaryngological Manifestations of Covid-19: A Longitudinal Questionnaire-Based Prospective Study in a Tertiary Hospital in Saudi Arabia. J Prim Care Community Health 2022; 13:21501319221084158. [PMID: 35311409 PMCID: PMC8941688 DOI: 10.1177/21501319221084158] [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] [Indexed: 11/25/2022] Open
Abstract
Objective: Many studied investigated the manifestations of COVID-19, yet few described
the pattern and severity of otolaryngological symptoms. We aim to describe
the picture of COVID-19-associated otorhinolaryngological manifestations and
recovery to explore individualized treatment, onward referral, and
complications prevention. Design: Prospective longitudinal questionnaire-based study. Setting: The online questionnaire was filled 3 times through a remote interview over a
period of 1 month from June 2020 to July 2020. Participants: Patients with confirmed COVID-19 by RT-PCR who were clinically stable. Main Outcome Measures: Date of diagnosis, sociodemographic data, and the presence of predictive
factors, such as nasal and paranasal disease, anosmia and dysgeusia.
Validated tools were used, such as Sino-nasal Outcome Test (SNOT-22), smell
test (medical academy screening tool), Voice Handicap Index (VHI), and
Reflux Symptoms Index (RSI). Result: The questionnaire was sent to 363 patients and the response rate was 70.80%
(n = 257). The mean age was 34.58 years (SD = 11.22) and the rate of male
participants was 60.7%. The most common otorhinolaryngological symptoms at
the time of enrollment was fever (48.6%), whilst the commonest severe
symptom was cough (57%). After 1 month, only 11 participants had persistent
severe symptoms, especially sleep and psychological symptoms (73%), and the
majority were female (63.6%). All of them had at least 1 comorbidity. There
was a significant difference between the mean age of participants with
severe symptoms (mean = 27.45, SD = 8.39) and without severe symptoms
(mean = 34.90, SD = 2.53, t(255) = 2.17,
P = .031). Conclusion: COVID-19 has a wide-ranged spectrum of presentations, with
otorhinolaryngological symptoms being the commonest and most serious.
Studying these symptoms is vital to advance management options.
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Affiliation(s)
| | | | | | - Salma Alsharhan
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Amal Alghamdi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Abdul Salam
- King Fahad Specialist Hospital, Dammam, Saudi Arabia.,King Khalid Medical City (KKMC), Saudi Arabia
| | - Mohammed Al Bar
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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17
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Wang Y, Zhang F, Byrd JB, Yu H, Ye X, He Y. Differential COVID-19 Symptoms Given Pandemic Locations, Time, and Comorbidities During the Early Pandemic. Front Med (Lausanne) 2022; 9:770031. [PMID: 35155491 PMCID: PMC8831795 DOI: 10.3389/fmed.2022.770031] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/04/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 pandemic is disaster to public health worldwide. Better perspective on COVID's features early in its course-prior to the development of vaccines and widespread variants-may prove useful in the understanding of future pandemics. Ontology provides a standardized integrative method for knowledge modeling and computer-assisted reasoning. In this study, we systematically extracted and analyzed clinical phenotypes and comorbidities in COVID-19 patients found at different countries and regions during the early pandemic using an ontology-based bioinformatics approach, with the aim to identify new insights and hidden patterns of the COVID-19 symptoms. RESULTS A total of 48 research articles reporting analysis of first-hand clinical data from over 40,000 COVID-19 patients were surveyed. The patients studied therein were diagnosed with COVID-19 before May 2020. A total of 18 commonly-occurring phenotypes in these COVID-19 patients were first identified and then classified into different hierarchical groups based on the Human Phenotype Ontology (HPO). This meta-analytic approach revealed that fever, cough, and the loss of smell and taste were ranked as the most commonly-occurring phenotype in China, the US, and Italy, respectively. We also found that the patients from Europe and the US appeared to have more frequent occurrence of many nervous and abdominal symptom phenotypes (e.g., loss of smell, loss of taste, and diarrhea) than patients from China during the early pandemic. A total of 22 comorbidities, such as diabetes and kidney failure, were found to commonly exist in COVID-19 patients and positively correlated with the severity of the disease. The knowledge learned from the study was further modeled and represented in the Coronavirus Infectious Disease Ontology (CIDO), supporting semantic queries and analysis. Furthermore, also considering the symptoms caused by new viral variants at the later stages, a spiral model hypothesis was proposed to address the changes of specific symptoms during different stages of the pandemic. CONCLUSIONS Differential patterns of symptoms in COVID-19 patients were found given different locations, time, and comorbidity types during the early pandemic. The ontology-based informatics provides a unique approach to systematically model, represent, and analyze COVID-19 symptoms, comorbidities, and the factors that influence the disease outcomes.
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Affiliation(s)
- Yang Wang
- Guizhou University School of Medicine, Guiyang, China
- NHC Key Laboratory of Immunological Diseases, Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People's Hospital and People's Hospital of Guizhou University, Guiyang, China
| | - Fengwei Zhang
- Guizhou University School of Medicine, Guiyang, China
| | - J. Brian Byrd
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Hong Yu
- Guizhou University School of Medicine, Guiyang, China
- NHC Key Laboratory of Immunological Diseases, Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People's Hospital and People's Hospital of Guizhou University, Guiyang, China
| | - Xianwei Ye
- Guizhou University School of Medicine, Guiyang, China
- NHC Key Laboratory of Immunological Diseases, Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People's Hospital and People's Hospital of Guizhou University, Guiyang, China
- *Correspondence: Xianwei Ye
| | - Yongqun He
- Unit for Laboratory Animal Medicine, Department of Microbiology and Immunology, Center for Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, United States
- Yongqun He
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18
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Alfallaj R, AlSkait G, Alamari N, Alfawzan L, Abualgasem M, Alotaibi NH, Sumaily I, Alarifi I, Alsaleh S. Incidence of Olfactory Dysfunction in Patients with COVID-19 in a Tertiary Hospital in Saudi Arabia. ALLERGY & RHINOLOGY (PROVIDENCE, R.I.) 2022; 13:21526575221140809. [PMID: 36452479 PMCID: PMC9703475 DOI: 10.1177/21526575221140809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2, a novel virus that emerged in China in December 2019. In many cases of COVID-19, olfactory dysfunction (OD) is the only symptom. OBJECTIVES This study aimed to examine the incidence of OD in patients with COVID-19 and identify an association between OD and COVID-19-related morbidity and admission. DESIGN This was a cross-sectional study. METHODS Real-time reverse transcription polymerase chain reaction-confirmed cases of COVID-19 from the Security Forces Hospital electronic registry from June 2020 to September 2020 were included in our study. Data on medical background, severity of the disease, and other related factors were collected through phone calls and electronic healthcare systems and analyzed to investigate OD in the participants. RESULTS Of the participants, 68% had OD, with a mean recovery time of 18 days and a mean follow-up time of 129 days (76-211 days). OD was negatively correlated with admission and morbidity. CONCLUSION OD is a common presentation of COVID-19 and is more prevalent in mild cases of infection.
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Affiliation(s)
- Rayan Alfallaj
- Otolaryngology—Head & Neck Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ghada AlSkait
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Alamari
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lama Alfawzan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Naif H. Alotaibi
- ENT Department, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
| | - Ibrahim Sumaily
- ENT Department, King Fahd Central Hospital, Jazan, Saudi Arabia
| | - Ibrahim Alarifi
- ENT Department, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Otolaryngology—Head & Neck Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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19
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Herrero Y, Pascuali N, Velázquez C, Oubiña G, Hauk V, de Zúñiga I, Peña MG, Martínez G, Lavolpe M, Veiga F, Neuspiller F, Abramovich D, Scotti L, Parborell F. SARS-CoV-2 infection negatively affects ovarian function in ART patients. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166295. [PMID: 34718118 PMCID: PMC8550892 DOI: 10.1016/j.bbadis.2021.166295] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 01/08/2023]
Abstract
Several organs, such as the heart, breasts, intestine, testes, and ovaries, have been reported to be target tissues of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To date, no studies have demonstrated SARS-CoV-2 infection in the female reproductive system. In the present study, we investigated the effects of SARS-CoV-2 infection on ovarian function by comparing follicular fluid (FF) from control and recovered coronavirus disease 2019 (COVID-19) patients and by evaluating the influence of these FF on human endothelial and non-luteinized granulosa cell cultures. Our results showed that most FFs (91.3%) from screened post COVID-19 patients were positive for IgG antibodies against SARS-CoV-2. Additionally, patients with higher levels of IgG against SARS-CoV-2 had lower numbers of retrieved oocytes. While VEGF and IL-1β were significantly lower in post COVID-19 FF, IL-10 did not differ from that in control FF. Moreover, in COV434 cells stimulated with FF from post COVID-19 patients, steroidogenic acute regulatory protein (StAR), estrogen-receptor β (Erβ), and vascular endothelial growth factor (VEGF) expression were significantly decreased, whereas estrogen-receptor α (ERα) and 3β-hydroxysteroid dehydrogenase (3β-HSD) did not change. In endothelial cells stimulated with post COVID-19 FF, we observed a decrease in cell migration without changes in protein expression of certain angiogenic factors. Both cell types showed a significantly higher γH2AX expression when exposed to post COVID-19 FF. In conclusion, our results describe for the first time that the SARS-CoV-2 infection adversely affects the follicular microenvironment, thus dysregulating ovarian function.
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Affiliation(s)
- Yamila Herrero
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina
| | - Natalia Pascuali
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina
| | - Candela Velázquez
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina
| | - Gonzalo Oubiña
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina
| | - Vanesa Hauk
- Immunopharmacology Laboratory, Institute of Biological Chemistry (IQUIBICEN), School of Exact and Natural Sciences, University of Buenos Aires-CONICET, Buenos Aires, Argentina
| | | | | | | | | | | | | | - Dalhia Abramovich
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina
| | - Leopoldina Scotti
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina; Centro de Investigaciones y Transferencia del Noroeste de la Provincia de Buenos Aires (CITNOBA) - CONICET - UNNOBA - UNSAdA, San Antonio de Areco, Argentina
| | - Fernanda Parborell
- Ovarian Pathophysiology Studies Laboratory, Institute of Experimental Biology and Medicine (IByME) - CONICET, Buenos Aires, Argentina.
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20
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Khodeir MM, Shabana HA, Rasheed Z, Alkhamiss AS, Khodeir M, Alkhowailed MS, Alharbi S, Alsoghair M, Alsagaby SA, Al Abdulmonem W. COVID-19: Post-recovery long-term symptoms among patients in Saudi Arabia. PLoS One 2021; 16:e0260259. [PMID: 34879074 PMCID: PMC8654233 DOI: 10.1371/journal.pone.0260259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND After recovery from acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients experience long-term symptoms in different body systems. The aim of the present study was to identify these symptoms, their severity, and their duration as a first step in building a system to classify post-recovery long-term symptoms of coronavirus disease 2019 (COVID-19). METHODS An online-based cross-sectional survey was administered between September and October 2020. Data regarding the severity of post-recovery symptoms and their duration were collected using an Arabic questionnaire divided into six categories encompassing the 20 most prevalent symptoms. RESULTS A total of 979 patients recovered from COVID-19 in Saudi Arabia in the study period, of whom 53% were male and 47% were female. The most common symptoms included general fatigue and weakness (73% each), with moderate severity of neurological symptoms including mood changes (41%) and insomnia (39%). Among the special senses, loss of smell and taste of marked severity were reported by 64% and 55% among respiratory symptoms, cough of mild severity (47%), and dyspnea of moderate severity (43%). Loss of appetite of moderate severity was reported in 42%, and diarrhea, abdominal pain, and nausea of mild severity were reported by 53%, 50%, and 44% of respondents, respectively. CONCLUSIONS Long-term symptoms after recovery from COVID-19 warrant patient follow-up. The authors propose a classification system as a starting point to guide the identification and follow-up of long-term symptoms post-recovery, and recommend larger-scale studies to broaden the definition of recovery from COVID-19, which appears to have two phases, acute and chronic.
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Affiliation(s)
- Mostafa M. Khodeir
- Faculty of Medicine, Department of Pathology, Cairo University, Cairo, Egypt
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Hassan A. Shabana
- Faculty of Medicine, Chest Diseases Department, Cairo University, Cairo, Egypt
| | - Zafar Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Abdullah S. Alkhamiss
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Mohamed Khodeir
- Psychiatric Department, Brook Hospital, Louisville, Kentucky, United States of America
| | - Mohammad S. Alkhowailed
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Sami Alharbi
- Pulmonary Department, King Fahad Specialist Hospital, Ministry of Health, Buraidah, Saudi Arabia
| | - Mansour Alsoghair
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Suliman A. Alsagaby
- Department of Medical Laboratories, Central Biosciences Research Laboratories, College of Science in Al Zulfi, Majmaah University, Al Majma’ah, Saudi Arabia
| | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
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21
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Alshammary AF, Al-Sulaiman AM. The journey of SARS-CoV-2 in human hosts: a review of immune responses, immunosuppression, and their consequences. Virulence 2021; 12:1771-1794. [PMID: 34251989 PMCID: PMC8276660 DOI: 10.1080/21505594.2021.1929800] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Laboratory findings from a significant number of patients with COVID-19 indicate the occurrence of leukocytopenia, specifically lymphocytopenia. Moreover, infected patients can experience contrasting outcomes depending on lymphocytopenia status. Patients with resolved lymphocytopenia are more likely to recover, whereas critically ill patients with signs of unresolved lymphocytopenia develop severe complications, sometimes culminating in death. Why immunodepression manifests in patients with COVID-19 remains unclear. Therefore, the evaluation of clinical symptoms and laboratory findings from infected patients is critical for understanding the disease course and its consequences. In this review, we take a logical approach to unravel the reasons for immunodepression in patients with COVID-19. Following the footprints of the virus within host tissues, from entry to exit, we extrapolate the mechanisms underlying the phenomenon of immunodepression.
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Affiliation(s)
- Amal F. Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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22
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Jha NK, Ojha S, Jha SK, Dureja H, Singh SK, Shukla SD, Chellappan DK, Gupta G, Bhardwaj S, Kumar N, Jeyaraman M, Jain R, Muthu S, Kar R, Kumar D, Goswami VK, Ruokolainen J, Kesari KK, Singh SK, Dua K. Evidence of Coronavirus (CoV) Pathogenesis and Emerging Pathogen SARS-CoV-2 in the Nervous System: A Review on Neurological Impairments and Manifestations. J Mol Neurosci 2021; 71:2192-2209. [PMID: 33464535 PMCID: PMC7814864 DOI: 10.1007/s12031-020-01767-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/27/2020] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an issue of global significance that has taken the lives of many across the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for its pathogenesis. The pulmonary manifestations of COVID-19 have been well described in the literature. Initially, it was thought to be limited to the respiratory system; however, we now recognize that COVID-19 also affects several other organs, including the nervous system. Two similar human coronaviruses (CoV) that cause severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratory syndrome (MERS-CoV) are also known to cause disease in the nervous system. The neurological manifestations of SARS-CoV-2 infection are growing rapidly, as evidenced by several reports. There are several mechanisms responsible for such manifestations in the nervous system. For instance, post-infectious immune-mediated processes, direct virus infection of the central nervous system (CNS), and virus-induced hyperinflammatory and hypercoagulable states are commonly involved. Guillain-Barré syndrome (GBS) and its variants, dysfunction of taste and smell, and muscle injury are numerous examples of COVID-19 PNS (peripheral nervous system) disease. Likewise, hemorrhagic and ischemic stroke, encephalitis, meningitis, encephalopathy acute disseminated encephalomyelitis, endothelialitis, and venous sinus thrombosis are some instances of COVID-19 CNS disease. Due to multifactorial and complicated pathogenic mechanisms, COVID-19 poses a large-scale threat to the whole nervous system. A complete understanding of SARS-CoV-2 neurological impairments is still lacking, but our knowledge base is rapidly expanding. Therefore, we anticipate that this comprehensive review will provide valuable insights and facilitate the work of neuroscientists in unfolding different neurological dimensions of COVID-19 and other CoV associated abnormalities.
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Affiliation(s)
- Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, 201310, UP, India.
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, PO Box - 17666, United Arab Emirates University, Al Ain, UAE
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, 201310, UP, India
| | - Harish Dureja
- Faculty of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Punjab, India
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute (HMRI), University of Newcastle, New Lambton Heights, Newcastle, NSW, 2305, Australia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura, Mahal Road, Jaipur, India
| | - Shanu Bhardwaj
- Department of Biotechnology, HIMT, CCS University, Greater Noida, UP, India
| | - Neeraj Kumar
- Department of Chemistry, University of Delhi, Delhi, 110007, India
| | - Madhan Jeyaraman
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, UP, 201310, Greater Noida, India
| | - Rashmi Jain
- School of Medical Sciences and Research, Sharda University, UP, 201310, Greater Noida, India
| | - Sathish Muthu
- Research Associate, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India
| | - Rohan Kar
- Indian Institute of Management Ahmedabad (IIMA), Gujarat, 380015, India
| | - Dhruv Kumar
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University Uttar Pradesh, Noida, 201313, India
| | - Vineet Kumar Goswami
- Department of Biological Sciences, School of Basic and Applied Sciences, G.D. Goenka University, G.D. Goenka Education City Sohna Gurugram Road, Haryana- 122103, India
| | - Janne Ruokolainen
- Department of Applied Physics, School of Science, Aalto University, 00076, Espoo, Finland
| | - Kavindra Kumar Kesari
- Department of Applied Physics, School of Science, Aalto University, 00076, Espoo, Finland
| | - Sandeep Kumar Singh
- Centre of Biomedical Research, SGPGI Campus, Lucknow, 226014, UP, India
- Indian Scientific Education and Technology Foundation, Lucknow, 226002, UP, India
| | - Kamal Dua
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute (HMRI), University of Newcastle, New Lambton Heights, Newcastle, NSW, 2305, Australia
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Post box no. 9, Solan, Himachal Pradesh, 173229, India
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Olfactory and Taste Dysfunction in Coronavirus Disease 2019 Pandemic. Indian J Otolaryngol Head Neck Surg 2021; 74:3159-3166. [PMID: 34631493 PMCID: PMC8487225 DOI: 10.1007/s12070-021-02871-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/14/2021] [Indexed: 12/13/2022] Open
Abstract
This study is done to raise awareness of olfactory and taste dysfunction association in coronavirus disease, urging early detection and isolation of coronavirus positive patients thus breaking the chain of transmission of disease. This is a retrospective observational study done in outpatient department of tertiary care hospital in Mumbai, west India from 1st May 2020 to 1st August 2020 on patients who were confirmed positive for COVID-19 by real-time reverse transcription polymerase chain reaction (rRT-PCR) and having olfactory dysfunction and/or taste disorders. In study population, anosmia and ageusia occurred in 88% and 83.33% respectively. In control population, anosmia and ageusia occurred in 93% and 85.71% respectively. The mean duration of anosmia was around 2 weeks and 3 weeks for study and control group respectively. In study population 94.6% recovered from anosmia, whereas in control population 64.3% recovered from anosmia. Anosmia gradually improved to hyposmia. In the study population 94.3% hyposmia patients showed recovery, while in control population 85.2% showed recovery. Ageusia collaborated with the duration of anosmia. Recovery from taste dysfunction was 88.6% and 63.9% in study and control population respectively. Olfactory and taste dysfunction are very important clinical features of coronavirus positive patients with anosmia being the most prominent symptom. All patients presenting with smell and or taste dysfunction should be screened for coronavirus disease, helping in early detection in asymptomatic patients.
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Kolethekkat AA, Al Abri R, Al Washahi M, Al Badaai Y, Balkhair AA. Clinical Characteristics of COVID-19 from the Otorhinolaryngologist's Perspective: First Report from Oman, Middle East. Indian J Otolaryngol Head Neck Surg 2021; 74:3104-3110. [PMID: 34458130 PMCID: PMC8385262 DOI: 10.1007/s12070-021-02829-w] [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: 05/06/2021] [Accepted: 08/14/2021] [Indexed: 12/15/2022] Open
Abstract
To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms such as nasal congestion, rhinorrhoea, sneezing, facial pain, etc. were present with less frequency. In more than half of the patients (61.5%), all the symptoms recovered within 5 days, in 12 (18.5%) between 5 and 8 days, and in 9 (13.8%), between 9 and14 days. However, in four patients, symptoms lasted for 28–30 days. In seven patients (10.7%), symptoms recurred after the period of isolation, however, the retest was negative. Fever, cough and or shortness of breath are the commonly reported prominent symptoms of COVID-19, however, there is a changing trend of clinical presentation towards variable otorhinolaryngologic manifestations. Pharyngodynia, taste and smell dysfunctions are common in patients with COVID-19, and could represent potential characters.
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Affiliation(s)
- Arif Ali Kolethekkat
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Rashid Al Abri
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Mohammed Al Washahi
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Yahya Al Badaai
- ENT Division, Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Al Khoud, P. O. Box 35, 123 Seeb, Oman
| | - Abdullah A Balkhair
- Infectious Disease Unit, Department of Medicine, Sultan Qaboos University Hospital, Seeb, Oman
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25
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Ghannoum MA, Ford M, Bonomo RA, Gamal A, McCormick TS. A Microbiome-Driven Approach to Combating Depression During the COVID-19 Pandemic. Front Nutr 2021; 8:672390. [PMID: 34504858 PMCID: PMC8421528 DOI: 10.3389/fnut.2021.672390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/30/2021] [Indexed: 12/18/2022] Open
Abstract
The significant stressors brought about and exacerbated by COVID-19 are associated with startling surges in mental health illnesses, specifically those related to depressive disorders. Given the huge impact of depression on society, and an incomplete understanding of impactful therapeutics, we have examined the current literature surrounding the microbiome and gut-brain axis to advance a potential complementary approach to address depression and depressive disorders that have increased during the COVID-19 pandemic. While we understand that the impact of the human gut microbiome on emotional health is a newly emerging field and more research needs to be conducted, the current evidence is extremely promising and suggests at least part of the answer to understanding depression in more depth may lie within the microbiome. As a result of these findings, we propose that a microbiome-based holistic approach, which involves carefully annotating the microbiome and potential modification through diet, probiotics, and lifestyle changes, may address depression. This paper's primary purpose is to shed light on the link between the gut microbiome and depression, including the gut-brain axis and propose a holistic approach to microbiome modification, with the ultimate goal of assisting individuals to manage their battle with depression through diet, probiotics, and lifestyle changes, in addition to offering a semblance of hope during these challenging times.
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Affiliation(s)
- Mahmoud A. Ghannoum
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
- University Hospitals Cleveland Medical Center, Cleveland, OH, United States
- BIOHM Health LLC, Cleveland, OH, United States
| | | | - Robert A. Bonomo
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, United States
| | - Ahmed Gamal
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
| | - Thomas S. McCormick
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University, Cleveland, OH, United States
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He Y, Bai X, Zhu T, Huang J, Zhang H. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med 2021; 19:363. [PMID: 34425827 PMCID: PMC8381866 DOI: 10.1186/s12967-021-03039-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. Results A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.
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Affiliation(s)
- Yuanyuan He
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Xiaojie Bai
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Tiantian Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Jialin Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Hong Zhang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China.
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27
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Barrantes FJ. The unfolding palette of COVID-19 multisystemic syndrome and its neurological manifestations. Brain Behav Immun Health 2021; 14:100251. [PMID: 33842898 PMCID: PMC8019247 DOI: 10.1016/j.bbih.2021.100251] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023] Open
Abstract
Although our current knowledge of the pathophysiology of COVID-19 is still fragmentary, the information so far accrued on the tropism and life cycle of its etiological agent SARS-CoV-2, together with the emerging clinical data, suffice to indicate that the severe acute pulmonary syndrome is the main, but not the only manifestation of COVID-19. Necropsy studies are increasingly revealing underlying endothelial vasculopathies in the form of micro-haemorrhages and micro-thrombi. Intertwined with defective antiviral responses, dysregulated coagulation mechanisms, abnormal hyper-inflammatory reactions and responses, COVID-19 is disclosing a wide pathophysiological palette. An additional property in categorising the disease is the combination of tissue (e.g. neuro- and vasculo-tropism) with organ tropism, whereby the virus preferentially attacks certain organs with highly developed capillary beds, such as the lungs, gastrointestinal tract, kidney and brain. These multiple clinical presentations confirm that the acute respiratory syndrome as described initially is increasingly unfolding as a more complex nosological entity, a multiorgan syndrome of systemic breadth. The neurological manifestations of COVID-19, the focus of this review, reflect this manifold nature of the disease.
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Affiliation(s)
- Francisco J. Barrantes
- Institute of Biomedical Research (BIOMED), UCA-CONICET, Av. Alicia Moreau de Justo 1600, C1107AFF, Buenos Aires, Argentina
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28
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Nayeri ND, Nadali J, Divani A, Basirinezhad MH, Meidani M. Clinical manifestation, laboratory and radiology finding, treatment and outcomes of COVID-19: A systematic review and meta-analysis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2021; 26:41. [PMID: 34484373 PMCID: PMC8383992 DOI: 10.4103/jrms.jrms_900_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/04/2020] [Accepted: 01/19/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Since December 2019, coronavirus (COVID-19) spread throughout the world. The high rate of infection and its unknown nature led specialists to report the condition of patients. The aim of this study is to systematically review of symptoms, laboratory and radiologic findings, treatment, and outcomes of patients with COVID-19. MATERIALS AND METHODS Databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and Cochrane were searched. Finally, 46 articles were appropriate for the aim of the study. After quality evaluation, the necessary data were extracted and meta-analysis was performed. RESULTS 4858 articles were retrieved until March 30, 2020. After screening, the full-text of 46 articles was assessed. Of the reported cases, 31.7% had no comorbidities, 21.4% had high blood pressure, 70.6% had fever, and lymphopenia was reported in 55.2% of patients. For 16% bilateral patchy shadowing in radiography and for 51% ground-glass opacity was reported. Outcomes were remarkable for recover to death. CONCLUSION COVID-19 leads to healthcare problems for countries. Nonspecific symptoms have made it difficult for differential diagnoses without computed tomography-scan or corona Test, but they are not available in many countries. Therefore, this systematic review can help health care staff to make decisions based on symptoms, treatments, and outcomes..
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Affiliation(s)
- Nahid Dehghan Nayeri
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Nadali
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Anahita Divani
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Meidani
- Department of Infectious Diseases and Tropical Medicine, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Prakash A, Singh H, Sarma P, Bhattacharyya A, Dhibar DP, Balaini N, Shree R, Goyal M, Modi M, Medhi B. nCoV-2019 infection induced neurological outcome and manifestation, linking its historical ancestor SARS-CoV and MERS-CoV: a systematic review and meta-analysis. Sci Rep 2021; 11:12888. [PMID: 34145351 PMCID: PMC8213856 DOI: 10.1038/s41598-021-92188-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/18/2021] [Indexed: 12/23/2022] Open
Abstract
The first systematic review and meta-analysis to help clinician to identify early signs and symptoms of neurological manifestation in COVID-19 positive patients which will further help in early management of patients. Present systematic review and meta-analysis aimed to discuss the prevalence of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 "SARS" and 2012 "MERS" pandemics. The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neurological signs and symptoms in SARS-COV-2 disease. For meta-analysis, we included 09 observational and cross-sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological signs and symptoms in COVID-19 patients with relation to SARS-2002 and MERS-2012. Data was analyzed by using the "MedCalc" Statistical Software version 19.2.6 and reported as pooled prevalence. Standard I2 test was used to analyze the heterogeneity. We have collected and screened about a total 2615articles, finally we have included 31articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence rate of neurological symptoms in COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which was further tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache to vague non-focal complaints to severe neurologic impairment associated with seizure or meningitis. Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication had primary or secondary objectives of searching neurological manifestations in the COVID-19 patients and the pathogenic mechanism which will subsequently strengthen the importance to start more prospective clinical trials. The prevalence of neurological signs and symptoms were taken as primary objective. Thereafter, the prevalence of each CNS/PNS symptoms was categorized and their prevalence studied. The selection of Bagheri et al., 2020 may be discussed because they have done the cross-sectional study with the neurological finding and correlated the data with prevalence of the COVID-19 positive patients. The proportion of patients presenting with neurological outcome and clinical/PCR positivity were done. We had searched and followed all the possible online/web source, still the data collection process may remain a limitation of work due to addition of several publications on COVID-19 every day. Due to lack of data of SARS-CoV and MERS-CoV, we have included the case reports, MERS and COVID-19 in CNS/PNS manifestations.
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Affiliation(s)
- Ajay Prakash
- Department of Pharmacology, Research Block: B, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Harvinder Singh
- Department of Pharmacology, Research Block: B, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Phulen Sarma
- Department of Pharmacology, Research Block: B, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Deba Prasad Dhibar
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Ritu Shree
- Department of Neurology, PGIMER, Chandigarh, India
| | - Manoj Goyal
- Department of Neurology, PGIMER, Chandigarh, India
| | - Manish Modi
- Department of Neurology, PGIMER, Chandigarh, India
| | - Bikash Medhi
- Department of Pharmacology, Research Block: B, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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Bin Abdulrahman KA, Bamosa AO, Aseri KS, Bukhari AI, Masuadi EM. Clinical Presentation of Asymptomatic and Mild SARS-CoV-2 Infection in Riyadh, Saudi Arabia. J Multidiscip Healthc 2021; 14:1341-1347. [PMID: 34135592 PMCID: PMC8197580 DOI: 10.2147/jmdh.s315718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/21/2021] [Indexed: 12/22/2022] Open
Abstract
Background There is substantial evidence that most SARS-CoV-2 infections are mild or even asymptomatic, yet they can transmit the virus to others. The current study described the clinical presentation of mild COVID-19 cases isolated in the ministry of health (MOH) quarantines in Riyadh, Saudi Arabia. Methods A cross-sectional study targeted the SARS-CoV-2 PCR +ve asymptomatic and mild COVID-19 patients isolated in the Saudi MOH quarantines in Riyadh city between July and December 2020. The confirmed COVID-19 patients were enrolled and interviewed by telephones after obtaining the informed consent. Results The study included 223 patients with a mean age of 32.5±10.7 years old. The majority were male 156 (70%). Only 27 [12.1%; 95% CI = (8.1–17.1%)] were asymptomatic. General fatigue was the most common reported symptom, 43.5%, followed by headache with 42.6%, and cough by 38.1%. Anosmia and ageusia were reported by 33.2% and 31.4%, respectively. The least common reported symptoms were vomiting, earache, and nausea with 1.8%, 4.0%, and 7.6%, respectively. Conclusion The top five clinical manifestations of mild COVID-19 cases were general fatigue, headache, cough, anosmia, and ageusia. Only 12% of confirmed COVID-19 cases were asymptomatic.
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Affiliation(s)
- Khalid A Bin Abdulrahman
- Department of Medical Education and Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah O Bamosa
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khaled S Aseri
- Department of Preventive Medicine, Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abdullah I Bukhari
- Department of Medicine, Infectious Diseases Division, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Emad M Masuadi
- Research Unit, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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31
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Mangal V, Murari T, Vashisht R, Iqbal SM, Meghana K, Gujrathi S, Ambade V, Tilak TVSVGK, Aggarwal V, Manrai M, Verma V, Srinath R, Goel N, Yadav NK, Menon A. Olfactory Dysfunction Among Asymptomatic Patients with SARS CoV2 Infection: A Case-Control Study. Indian J Otolaryngol Head Neck Surg 2021; 73:212-217. [PMID: 33585178 PMCID: PMC7873509 DOI: 10.1007/s12070-021-02366-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022] Open
Abstract
Olfactory dysfunction (hyposmia, anosmia) is a well-recognized symptom in patients with coronavirus disease-19 (COVID-19). Studies of olfactory dysfunction in asymptomatic patients have not been reported. We conducted a study looking for the presence of olfactory dysfunction with an objective assessment tool in asymptomatic Covid 19 and compared it with patients with mild COVID-19 and age-matched controls. We recruited 57 male patients each of Mild COVID-19, asymptomatic Covid 19, and healthy controls for the study. All participants underwent evaluation of smell threshold by Butanol Threshold test (BTT) and ability to distinguish common odors by Smell identification test. The scores of each test were recorded on a numerical scale. The participants in all three arms were matched for age, history of smoking, and pre-existing medical conditions. The mean scores of the Butanol Threshold test in Mild COVID-19, asymptomatic Covid 19 and controls were 2.95 ± 2.25 (0-7.5), 3.42 ± 2.23 (0-7.5), and 4.82 ± 1.86 (0-8), respectively. A one-way ANOVA showed a significant difference between groups (df 2, MS 53.78, F 11.94, p < 0.005). Intergroup differences using the student T-test showed significantly low BTT scores in Mild COVID-19 (p < 0.005) and asymptomatic (p < 0.005) as compared to control. BTT scores could not distinguish between asymptomatic patients and control. The smell threshold was impaired in asymptomatic Covid 19 and Mild COVID-19. Butanol Threshold Test score could not differentiate between asymptomatic Covid 19 and controls.
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Affiliation(s)
- Vishal Mangal
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - T. Murari
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Rohit Vashisht
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Shaik Mohammad Iqbal
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Kodavati Meghana
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Sagar Gujrathi
- Department of Otorhinolaryngology & Head and Neck Surgery, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Vivek Ambade
- Department of Biochemistry, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - TVSVGK Tilak
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Vivek Aggarwal
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Manish Manrai
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Vishesh Verma
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Rajagopal Srinath
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Nidhi Goel
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Navin Kumar Yadav
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Anil Menon
- Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra 411040 India
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Tiwari A, Patil MB, Nath J, Phukan AH, Aafaque S, Adika S, Kumari CM, Kumar S, Nayyar AS. Impairment of olfactory and gustatory sensations in severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease. J Family Med Prim Care 2021; 10:2153-2158. [PMID: 34322406 PMCID: PMC8284234 DOI: 10.4103/jfmpc.jfmpc_2438_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022] Open
Abstract
Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China, and since then, it has emerged as a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested impairment of olfactory and gustatory sensations associated with corona virus disease (COVID-19). Angiotensin-converting enzyme-2 is an important aspect for the manifestations seen in this deadly viral disease. The associated olfactory and gustatory dysfunction can also lead to partial and/or complete loss of the ability to smell and taste in the early stages of disease onset. Evidence has also suggested that the presence of SARS-CoV-2 nucleic acid in human saliva makes it the carrier of the infectious viral disease and aids in its diagnosis. The present review focuses on the listed clinical manifestations in the form of olfactory and gustatory impairment in SARS-CoV-2 virus disease.
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Affiliation(s)
- Anurag Tiwari
- Department of Orthodontics and Dentofacial Orthopedics, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Manisha B. Patil
- Department of Oral Pathology and Microbiology, Nanded Rural Dental College and Research Center, Nanded, Maharashtra, India
| | - Jishnu Nath
- Department of Periodontology and Oral Implantology, Government Dental College, Silchar, Assam, India
| | - Anuve H. Phukan
- Department of Paediatric and Preventive Dentistry, Government Dental College, Silchar, Assam, India
| | - Syed Aafaque
- Consultant Orthodontist, Madurai, Tamil Nadu, India
| | - Sandeep Adika
- Department of Orthodontics and Dentofacial Orthopaedics, Meghna Institute of Dental Sciences, Nizamabad, Telangana, India
| | - C. Meena Kumari
- Department of Restorative Dentistry, College of Dentistry, Majmaah University, Al Majma'ah, Kingdom of Saudi Arabia
| | - Sourya Kumar
- Former Intern, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| | - Abhishek S. Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
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Acute Loss of Smell or Taste Without Nasal Blockage Should Raise Suspicion for COVID-19 Infection. J Evid Based Dent Pract 2021; 21:101525. [PMID: 34051956 PMCID: PMC7834925 DOI: 10.1016/j.jebdp.2020.101525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Article Title and Bibliographic Information Taste and smell as chemosensory dysfunctions in COVID-19 infection. Passarelli PC, Lopez MA, Mastandrea Bonaviri GN, Garcia-Godoy F, D'Addona A.Am J Dent 2020;33(3):135-137. Source of Funding Information not available. Type of Study/Design Systematic review.
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Prem B, Liu DT, Besser G, Renner B, Mueller CA. Retronasal olfactory testing in early diagnosed and suspected COVID-19 patients: a 7-week follow-up study. Eur Arch Otorhinolaryngol 2021; 279:257-265. [PMID: 33987699 PMCID: PMC8118104 DOI: 10.1007/s00405-021-06826-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/14/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Olfactory dysfunction (OD) constitutes a major symptom in Coronavirus Disease 2019 (COVID-19). Yet, most data on smell loss rely on the evaluation of orthonasal olfactory performance. Therefore, we aimed to assess retronasal olfactory function (ROF) over a period of several weeks in proven and suspected COVID-19 patients. METHODS One hundred and one subjects with suspected or laboratory-proven COVID-19 participated in this study. In patients with OD no longer than 4 weeks after initial symptom onset, ROF was measured with the 7-item Candy Smell Test ten times over 7 weeks. RESULTS Olfactory function was decreased in the investigated patients and remained decreased over the course of 7 weeks. One-way repeated-measures ANOVA revealed no significant difference of ROF between different measurement time points. However, self-assessment of smell and flavour improved significantly (p = 0.013 and p = 0.043), but did not show complete recovery. CONCLUSION The current investigation revealed significant improvements in subjective smell and flavour perception over the course of 7 weeks in proven and suspected COVID-19 patients suffering from acute OD. However, objectively measured ROF based on a screening test revealed no improvements within the same time period.
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Affiliation(s)
- Bernhard Prem
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - David Tianxiang Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria
| | - Bertold Renner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.,Medical Faculty Carl Gustav Carus, Institute of Clinical Pharmacology, Technische Universität Dresden, Dresden, Germany
| | - Christian Albert Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Vienna General Hospital, Medical University of Vienna, 1090, Vienna, Austria.
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Alharbi H, You S, Katz J. Should anosmia and dysgeusia be a concern for oral and maxillofacial surgeons during the COVID-19 pandemic? Oral Maxillofac Surg 2021; 26:105-111. [PMID: 33954852 PMCID: PMC8099141 DOI: 10.1007/s10006-021-00965-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/18/2021] [Indexed: 12/18/2022]
Abstract
Purpose Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. Methods This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients’ registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant.
Results Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. Conclusion Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.
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Affiliation(s)
- Hamad Alharbi
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, FL 32603 USA
| | - Sijia You
- Department of Biostatistics, College of Public Health and Health Professionals, University of Florida, Gainesville, FL USA
| | - Joseph Katz
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL USA
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Bakhshaee M, Barzegar-Amini M, Motedayen Z, Khojasteh-Taheri R, Rafiee M, Amini M, Layegh P, Hashemzadeh K, Omidvar D, Hwang PH, Hosseinpoor M. Olfactory Dysfunction in Patients Infected with 2019 Novel Coronavirus. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:163-171. [PMID: 34222108 PMCID: PMC8231298 DOI: 10.22038/ijorl.2021.51614.2750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/14/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The current study aimed at investigating the occurrence and features of olfactory dysfunction in patients with confirmed coronavirus disease 2019 (COVID-19) infection. MATERIALS AND METHODS Patients with laboratory and clinically confirmed COVID-19 infection were enrolled in this longitudinal study. They were managed in either the inpatient or outpatient setting. The demographic, clinical, and outcome data were retrieved from patients' medical records. Olfactory dysfunction features, including the onset pattern, duration, and recovery time were investigated. The visual analog scale (VAS) was utilized as a self-rating subjective measurement of olfactory function. RESULTS According to the results, the mean age of the patients (n=502) was obtained at 46.8±18.5 years; moreover, 52.4% and 47.6% of cases were female and male, respectively. It was also revealed that 35.4% and 64.5% of the subjects were outpatients and hospitalized, respectively. Based on the findings, 178 (38.4%) subjects had olfactory dysfunction. The mean values of VAS in hyposmic patients were estimated at 2.5±2.5, 8.3 ±2.1, and 9.4±1.6 at the first evaluation, in 2 weeks, and after 1 month of follow-up (P<0.001). The onset of olfactory dysfunction was more suddenly (58.7%). The majority of cases experienced olfactory dysfunction at the same time as other symptoms 72(51.1%). Based on the results, 0.4% of subjects infected with COVID-19 had olfactory dysfunction as an isolated symptom. The olfactory dysfunction was recovered after 2 weeks in 18 (25.3%) anosmic and 37(46.8%) hyposmic patients. CONCLUSION Olfactory dysfunction seemed to be an important symptom of COVID-19 infection. The occurrence of this disturbance as a transient self-limited condition was significantly higher among female subjects.
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Affiliation(s)
- Mehdi Bakhshaee
- Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Zohreh Motedayen
- Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Roshanak Khojasteh-Taheri
- Department of Microbiology, Faculty of Science, Neyshaboor Branch, Islamic Azad University, Neyshaboor, Iran.
- Department of Research, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahdi Rafiee
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahnaz Amini
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Parvaneh Layegh
- Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Kamila Hashemzadeh
- Rheumatic Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Delaram Omidvar
- Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Peter H. Hwang
- Department of Rhinology & Endoscopic Skull Base Surgery, Stanford University School of Medicine, Palo Alto, California.
| | - Masoomeh Hosseinpoor
- Department of Otolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.
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Paz LES, Bezerra BJDS, Pereira TMDM, da Silva WE. COVID-19: the importance of physical therapy in the recovery of workers' health. Rev Bras Med Trab 2021; 19:94-106. [PMID: 33986786 PMCID: PMC8100758 DOI: 10.47626/1679-4435-2021-709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/02/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is likely to have a major impact on society and the economy since the illness is currently infecting a significant number of active workers in the industry and service sectors. The illness can have long-term consequences for patients, affecting their functional capacity and, consequently, their occupational performance. This study analyzed the effects of COVID-19 on occupational health, with a focus on the importance of physical therapy in rehabilitation. An integrative literature review was conducted based on articles retrieved from the PubMed, SciELO, and LILACS databases using the following keywords: COVID-19, physical therapy, rehabilitation, and occupational health. The search retrieved 1,308 studies, 15 of which met inclusion criteria for the review. A thorough assessment of the articles revealed four topics that corresponded to the results of this study: 1) effects of COVID-19 on occupational health; 2) physical therapy in mild and moderate cases without hospitalization; 3) physical therapy in hospitalized patients with COVID-19; 4) physical therapy in post-intensive care unit (ICU) recovery and after hospital discharge. The findings showed that COVID-19 can affect several physiological systems and have both short- and long-term effects on patients, including physical and psychological impairments. Physical therapists must be involved in the battle against this illness to help patients recover their physical function and return to work as quickly, safely, and effectively as possible.
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Affiliation(s)
| | | | | | - Welma Emidio da Silva
- Departamento de Fisioterapia, Faculdade de Integração do Sertão, Serra Talhada, PE, Brazil
- Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Recife, PE, Brazil
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Incidence of Sino-Nasal Symptoms in COVID-19 Patients. Indian J Otolaryngol Head Neck Surg 2021; 74:2941-2946. [PMID: 33937010 PMCID: PMC8080095 DOI: 10.1007/s12070-021-02569-x] [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: 09/21/2020] [Accepted: 04/12/2021] [Indexed: 12/03/2022] Open
Abstract
Corona virus disease was first reported in December 2019 in Wuhan, China and is spreading across the world in an alarming fashion. To contain the spread, it is very important to identify the subtle/not readily apparent symptoms of COVID-19 at the earliest. The aim of the study is to determine the incidence duration progress of sino-nasal symptoms in COV 2 positive patients using SNAQ scoring. Patients who tested positive for SARS-COV 2 by RT-PCR and admitted in our hospital under category A (n = 382) were included in the study. A detailed history was collected from all the patients and sino-nasal assessment questionnaire (SNAQ) was provided to the patient with complaints of sinonasal symptoms and they were asked to fill the forms on day 3, 7 and 14. To identify the characteristics of sinonasal symptoms in COVID-19 patients with a history of smoking, smoking history was also collected in detail and patients were classified based on Brinkman’s index into mild, moderate and severe smokers. In this study, the incidence of sinonasal symptoms was 24%. Average SNAQ scoring on day 3 was 30.09 and on day 7 was 12.9 and day 14 is 3.8. There was a decline in score on day 7 compared to day 3 indicating symptoms decrease by day7. Average SNAQ scoring in non-smokers and mild and moderate smokers was 20.18, 34.11, 57.5 respectively. The SNAQ scoring in smokers was more than that of non-smokers and was also persistent for a longer duration compared to non-smokers. Sino-nasal symptoms catch our eye because it is an important route for transmission. Viral shedding from sinonasal tract may be an important source for transmission. History and degree of smoking should also be considered while dividing COVID-19 patients into categories.
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Koyama S, Ueha R, Kondo K. Loss of Smell and Taste in Patients With Suspected COVID-19: Analyses of Patients' Reports on Social Media. J Med Internet Res 2021; 23:e26459. [PMID: 33788699 PMCID: PMC8064705 DOI: 10.2196/26459] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The year 2020 was the year of the global COVID-19 pandemic. The severity of the situation has become so substantial that many or even most of the patients with mild to moderate symptoms had to self-isolate without specific medical treatments or even without being tested for COVID-19. Many patients joined internet membership groups to exchange information and support each other. OBJECTIVE Our goal is to determine the benefits and limits of using social media to understand the symptoms of patients with suspected COVID-19 with mild to moderate symptoms and, in particular, their symptoms of anosmia (loss of the sense of smell) and ageusia (loss of the sense of taste). The voluntary reports on an internet website of a membership group will be the platform of the analyses. METHODS Posts and comments of members of an internet group known as COVID-19 Smell and Taste Loss, founded on March 24, 2020, to support patients with suspected COVID-19 were collected and analyzed daily. Demographic data were collected using the software mechanism called Group Insights on the membership group website. RESULTS Membership groups on social media have become rare sources of support for patients with suspected COVID-19 with mild to moderate symptoms. These groups provided mental support to their members and became resources for information on COVID-19 tests and medicines or supplements. However, the membership was voluntary, and often the members leave without notification. It is hard to be precise from the free voluntary reports. The number of women in the group (6995/9227, 75.38% as of October 12, 2020) was about three times more than men (2272/9227, 24.62% as of October 12, 2020), and the peak age of members was between 20-40 years in both men and women. Patients who were asymptomatic other than the senses comprised 14.93% (53/355) of the total patients. Recovery of the senses was higher in the patients who were asymptomatic besides having anosmia and ageusia. Most (112/123, 91.06%) patients experienced other symptoms first and then lost their senses, on average, 4.2 days later. Patients without other symptoms tended to recover earlier (P=.02). Patients with anosmia and ageusia occasionally reported distorted smell and taste (parosmia and dysgeusia) as well as experiencing or perceiving the smell and taste without the sources of the smell or taste (phantosmia and phantogeusia). CONCLUSIONS Our analysis of the social media database of suspected COVID-19 patients' voices demonstrated that, although accurate diagnosis of patients is not always obtained with social media-based analyses, it may be a useful tool to collect a large amount of data on symptoms and the clinical course of worldwide rapidly growing infectious diseases.
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Affiliation(s)
- Sachiko Koyama
- Department of Chemistry, Indiana University, Bloomington, IN, United States
| | - Rumi Ueha
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kondo
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Tabari A, Golpayegani G, Tabari A, Saedi B, Mahdkhah A, Amali A, Jazinizadeh S, Sahebi L, Saffarzadeh N, Sadrehosseini SM. Olfactory Dysfunction is Associated with More Severe Clinical Course in COVID-19. Indian J Otolaryngol Head Neck Surg 2021; 74:2894-2899. [PMID: 33747891 PMCID: PMC7954203 DOI: 10.1007/s12070-021-02507-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/02/2021] [Indexed: 12/26/2022] Open
Abstract
To perform a quantitative olfactory test in positive COVID19 RT-PCR admitted patients and asymptomatic ones, to evaluate the association between hyposmia and disease severity. This is a Cross sectional study. Ninety-one patients including 68 inpatients and 23 asymptomatic healthcare workers with positive COVID-19 RT-PCRs. Methods: Demographics and clinical characteristics were collected. Iran Smell Identification Test (IR-SIT), a highly accurate 6-odorant test was used to evaluate the reliability of self-reported hyposmia and determine the correlation of the measured olfactory dysfunction with disease severity. Twenty-two of 91 patients (24%) reported hyposmia, while 41/91 (45%) patients had measurable olfactory dysfunction (IR-SIT score 1–4, p < 0.05). Mean age of the 68 inpatients and 23 asymptomatic patients were 43.97 ± 16.13 years; M:F 43:25, and 43.87 ± 12.76 years; M:F 8:15 respectively. Of 68 patients, 20 were graded as severe, and 48/68 had mild course of disease. IR-SIT detected hyposmia in 80% of patients with severe disease, and 50% with mild disease, respectively. The risk of disease severity was significantly increased for patients with olfactory dysfunction and was detected 4 times higher when compared to patients with mild disease (OR 4, 95% CI: 1.166–13.728, p = 0.028). Olfactory Dysfunction was present in 80% of patients with severe course. The risk of disease severity is significantly increased with olfactory dysfunction in admitted patients.
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Affiliation(s)
- Azin Tabari
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Goli Golpayegani
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Azadeh Tabari
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA USA
| | - Babak Saedi
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Aydin Mahdkhah
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Amin Amali
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Saber Jazinizadeh
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
| | - Leyla Sahebi
- Family Health Research Institute, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Negin Saffarzadeh
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mousa Sadrehosseini
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran
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Sbrana MF, Fornazieri MA, Bruni-Cardoso A, Avelino-Silva VI, Schechtman D, Voegels RL, Malnic B, Glezer I, de Rezende Pinna F. Olfactory Dysfunction in Frontline Health Care Professionals During COVID-19 Pandemic in Brazil. Front Physiol 2021; 12:622987. [PMID: 33767631 PMCID: PMC7985267 DOI: 10.3389/fphys.2021.622987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/20/2021] [Indexed: 12/31/2022] Open
Abstract
Upper respiratory viral infections can decrease the sense of smell either by inflammatory restriction of nasal airflow that carries the odorant molecules or through interference in olfactory sensory neuron function. During the coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), worldwide reports of severe smell loss (anosmia/hyposmia) revealed a different type of olfactory dysfunction associated with respiratory virus infection. Since self-reported perception of smell is subjective and SARS-CoV-2 exposure is variable in the general population, we aimed to study a population that would be more homogeneously exposed to the virus. Here, we investigated the prevalence of olfactory loss in frontline health professionals diagnosed with COVID-19 in Brazil, one of the major epicenters of the disease. We also analyzed the rate of olfactory function recovery and the particular characteristics of olfactory deficit in this population. A widely disclosed cross-sectional online survey directed to health care workers was developed by a group of researchers to collect data concerning demographic information, general symptoms, otolaryngological symptoms, comorbidities, and COVID-19 test results. Of the 1,376 health professionals who completed the questionnaire, 795 (57.8%) were working directly with COVID-19 patients, either in intensive care units, emergency rooms, wards, outpatient clinics, or other areas. Five-hundred forty-one (39.3%) participants tested positive for SARS-CoV-2, and 509 (37%) were not tested. Prevalence of olfactory dysfunction in COVID-19-positive subjects was 83.9% (454 of 541) compared to 12.9% (42 of 326) of those who tested negative and to 14.9% (76 of 509) of those not tested. Olfactory dysfunction incidence was higher in those working in wards, emergency rooms, and intensive care units compared to professionals in outpatient clinics. In general, remission from olfactory symptoms was frequent by the time of responses. Taste disturbances were present in 74.1% of infected participants and were significantly associated with hyposmia. In conclusion, olfactory dysfunction is highly correlated with exposure to SARS-CoV-2 in health care professionals, and remission rates up to 2 weeks are high.
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Affiliation(s)
- Mariana Ferreira Sbrana
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marco Aurélio Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifical Catholic University of Paraná, Londrina, Brazil
| | - Alexandre Bruni-Cardoso
- Department of Biochemistry, Institute of Chemistry, Universidade de São Paulo, São Paulo, Brazil
| | - Vivian I. Avelino-Silva
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Deborah Schechtman
- Department of Biochemistry, Institute of Chemistry, Universidade de São Paulo, São Paulo, Brazil
| | - Richard Louis Voegels
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bettina Malnic
- Department of Biochemistry, Institute of Chemistry, Universidade de São Paulo, São Paulo, Brazil
| | - Isaias Glezer
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fabio de Rezende Pinna
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Veronese S, Sbarbati A. Chemosensory Systems in COVID-19: Evolution of Scientific Research. ACS Chem Neurosci 2021; 12:813-824. [PMID: 33559466 PMCID: PMC7885804 DOI: 10.1021/acschemneuro.0c00788] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
COVID-19 disease induced by coronavirus SARS-CoV-2 presents among its symptoms alterations of the chemosensory functions. In the first studies on the Chinese population, this symptomatology was not particularly relevant, and hyposmia and hypogeusia were excluded from the symptoms to be evaluated to diagnose the disease. With the pandemic spread of the illness, there has been an augment in reports on chemosensory dysfunctions among patients. The first data analysis showed the presence of these disorders mainly in paucisymptomatic and asymptomatic patients. The interest in chemosensory systems therefore increased considerably, because the olfactory and gustatory symptoms could be the key to stop the infection spread. Furthermore, the degree of alert and attention grew, considering that these types of dysfunctions are prognostic symptoms of serious neurodegenerative diseases. About 9 months have passed since the first anecdotal reports on the involvement of the olfactory and gustatory systems in the COVID-19 pathology. For this reason, a careful review of the literature was conducted to understand if it is clearer which people present chemosensory symptoms and if these are related to the severity of the disease. Furthermore, we have identified which aspects still remain to be clarified.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience,
Biomedicine and Movement Sciences, University
of Verona, 37134 Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience,
Biomedicine and Movement Sciences, University
of Verona, 37134 Verona, Italy
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Brandão Neto D, Fornazieri MA, Dib C, Di Francesco RC, Doty RL, Voegels RL, Pinna FDR. Chemosensory Dysfunction in COVID-19: Prevalences, Recovery Rates, and Clinical Associations on a Large Brazilian Sample. Otolaryngol Head Neck Surg 2021; 164:512-518. [PMID: 32867582 PMCID: PMC7464054 DOI: 10.1177/0194599820954825] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Our study aimed to measure the percentage of reported olfactory or taste losses and their severity, recovery time, and association with other features in a large cohort of patients with COVID-19. STUDY DESIGN Prospective survey. SETTING Quaternary medical center and online survey. METHODS The perceived chemosensory capacities of 655 patients with confirmed COVID-19 were assessed with 11-point category rating scales (0, no function; 10, normal function). Patients were contacted in hospital, by phone calls, or by internet regarding their ability to smell or taste, and 143 were interviewed by phone 1 to 4 months later to assess the recovery of their chemosensory abilities. RESULTS The prevalence of self-reported olfactory, general taste, and taste quality-specific disturbances (sweet, sour, bitter, and salty) in the patients with COVID-19 were 82.4% (95% CI, 79.5%-85.3%), 76.2% (95% CI, 72.9%-79.4%), and 52.2% (95% CI, 48.3%-56.1%), respectively. The majority reported anosmia (42.9%). The presence of chemosensory symptoms was not associated with COVID-19 severity. At a median time >2 months after the onset of symptoms, rates of total and partial olfaction recovery were 53.8% and 44.7%, while complete or partial return to previous taste function was 68.3% and 27.6%. Less than 5% of the patients reported no chemosensory function improvement at all. CONCLUSION The prevalence of self-reported chemosensory dysfunction is high among patients with COVID-19. Almost all patients seem to recover a significant part of their smell and taste abilities in the first 4 months after the onset of symptoms.
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Affiliation(s)
| | - Marco Aurélio Fornazieri
- Department of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
- Department of Surgery, Londrina State University, Londrina, Brazil
- Department of Medicine, Pontifical Catholic University of Paraná, Londrina, Brazil
- Smell and Taste Center, Department of Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Caroline Dib
- Department of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
| | | | - Richard L. Doty
- Smell and Taste Center, Department of Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Safari Z, Fouladi-Fard R, Vahidmoghadam R, Hosseini MR, Mohammadbeigi A, Omidi Oskouei A, Rezaali M, Ferrante M, Fiore M. Awareness and Performance towards Proper Use of Disinfectants to Prevent COVID-19: The Case of Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2099. [PMID: 33670033 PMCID: PMC7926505 DOI: 10.3390/ijerph18042099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 02/06/2023]
Abstract
This study aimed to assess the awareness and performance of Qom citizens towards using disinfectants and compared its relationship with geographical distribution of COVID-19 outbreak in Qom, Iran. The study was conducted by a researcher-made questionnaire during April and May, 2020. COVID-19 incidence data for each district of city was obtained from health department of Qom province. Data were analyzed using Excel, SPSS and ArcView (GIS) softwares. It was found that the highest level of citizens' awareness (52%) was in the weak range while their performance (56%) was in the good range. According to Spearman's correlation analysis, there was a strong correlation (rho 0.95) between the total mean of awareness and performance (p < 0.01). The highest incidence rate of COVID-19 was in district 7 which had the lowest mean score in both awareness and performance. In addition, the results of ANOVA (LSD-least significant difference) showed that there was a significant difference (p < 0.05) between district 7-with lower mean scores in awareness and performance-and other districts. Overall, it is concluded that citizens' awareness level was lower than that of their performance. This conclusion not only calls for more training programs to be implemented in public places, schools, universities and governmental offices, but it also necessitates maintaining a proper and timely training about using disinfectants.
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Affiliation(s)
- Zahra Safari
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom 3715614566, Iran; (Z.S.); (R.V.)
- Student Research Committee, Qom University of Medical Sciences, Qom 3715614566, Iran;
| | - Reza Fouladi-Fard
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom 3715614566, Iran; (Z.S.); (R.V.)
| | - Razieh Vahidmoghadam
- Research Center for Environmental Pollutants, Department of Environmental Health Engineering, Faculty of Health, Qom University of Medical Sciences, Qom 3715614566, Iran; (Z.S.); (R.V.)
| | | | - Abolfazl Mohammadbeigi
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom 3715614566, Iran; (A.M.); (A.O.O.)
| | - Alireza Omidi Oskouei
- Department of Public Health, Faculty of Health, Qom University of Medical Sciences, Qom 3715614566, Iran; (A.M.); (A.O.O.)
| | | | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 87-95123 Catania, Italy;
| | - Maria Fiore
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 87-95123 Catania, Italy;
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Callejon-Leblic MA, Moreno-Luna R, Del Cuvillo A, Reyes-Tejero IM, Garcia-Villaran MA, Santos-Peña M, Maza-Solano JM, Martín-Jimenez DI, Palacios-Garcia JM, Fernandez-Velez C, Gonzalez-Garcia J, Sanchez-Calvo JM, Solanellas-Soler J, Sanchez-Gomez S. Loss of Smell and Taste Can Accurately Predict COVID-19 Infection: A Machine-Learning Approach. J Clin Med 2021; 10:570. [PMID: 33546319 PMCID: PMC7913595 DOI: 10.3390/jcm10040570] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 outbreak has spread extensively around the world. Loss of smell and taste have emerged as main predictors for COVID-19. The objective of our study is to develop a comprehensive machine learning (ML) modelling framework to assess the predictive value of smell and taste disorders, along with other symptoms, in COVID-19 infection. A multicenter case-control study was performed, in which suspected cases for COVID-19, who were tested by real-time reverse-transcription polymerase chain reaction (RT-PCR), informed about the presence and severity of their symptoms using visual analog scales (VAS). ML algorithms were applied to the collected data to predict a COVID-19 diagnosis using a 50-fold cross-validation scheme by randomly splitting the patients in training (75%) and testing datasets (25%). A total of 777 patients were included. Loss of smell and taste were found to be the symptoms with higher odds ratios of 6.21 and 2.42 for COVID-19 positivity. The ML algorithms applied reached an average accuracy of 80%, a sensitivity of 82%, and a specificity of 78% when using VAS to predict a COVID-19 diagnosis. This study concludes that smell and taste disorders are accurate predictors, with ML algorithms constituting helpful tools for COVID-19 diagnostic prediction.
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Affiliation(s)
- María A Callejon-Leblic
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain
| | - Ramon Moreno-Luna
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Alfonso Del Cuvillo
- Rhinology and Asthma Unit, ENT Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain
| | - Isabel M Reyes-Tejero
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Miguel A Garcia-Villaran
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Marta Santos-Peña
- COVID-19 Unit, Infectious Disease Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain; (M.S.-P.); (J.M.S.-C.)
| | - Juan M Maza-Solano
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Daniel I Martín-Jimenez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Jose M Palacios-Garcia
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Carlos Fernandez-Velez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Jaime Gonzalez-Garcia
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
| | - Juan M Sanchez-Calvo
- COVID-19 Unit, Infectious Disease Department, The University Hospital of Jerez, 11407 Jerez de la Frontera, Cadiz, Spain; (M.S.-P.); (J.M.S.-C.)
| | - Juan Solanellas-Soler
- Rhinology Unit, Department of Otolaryngology, Virgen de Valme University Hospital, 41014 Seville, Spain; (I.M.R.-T.); (M.A.G.-V.); (J.S.-S.)
| | - Serafin Sanchez-Gomez
- Rhinology Unit, Department of Otolaryngology, Head and Neck Surgery, Virgen Macarena University Hospital, 41009 Seville, Spain; (M.A.C.-L.); (R.M.-L.); (J.M.M.-S.); (D.I.M.-J.); (J.M.P.-G.); (C.F.-V.); (J.G.-G.); (S.S.-G.)
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Mehraeen E, Behnezhad F, Salehi MA, Noori T, Harandi H, SeyedAlinaghi S. Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence. Eur Arch Otorhinolaryngol 2021; 278:307-312. [PMID: 32556781 PMCID: PMC7297932 DOI: 10.1007/s00405-020-06120-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION It is reported that coronavirus disease (COVID-19) can affect the sense of smell and taste of infected people. The pathobiology of this virus is still incompletely known, and it is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions. We aimed to review current evidence on olfactory and gustatory dysfunctions caused by COVID-19. METHODS This study was a narrative review performed in 2020 to investigate the olfactory and gustatory dysfunctions of the COVID-19. We searched eight keywords in six databases to determine the related documents on the main objective of the study. To discover studies meeting the inclusion criteria, the authors screened the titles and abstracts of the identified articles. The appropriate studies were included and their results were discussed to make the final selection. RESULTS We have studied 24 current articles on the olfactory and gustatory dysfunctions due to COVID-19. A review of current studies has shown that we have a surge in the spread of olfactory and gustatory dysfunctions that happened during the epidemic of COVID-19 infection. Most studies (95.8%) have confirmed the symptoms of anosmia in patients with SARS-CoV-2 infection. A review of current studies showed that, in addition to anosmia, evidence of ageusia and dysgeusia (parageusia) was also seen in patients with COVID-19. CONCLUSION The results of our study support recent reports that SARS-CoV-2 may infect oral and nasal tissues and cause olfactory and gustatory dysfunctions. These findings may aid future research on the diagnosis, prevention, and treatment of COVID-19 consequences.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Noori
- Department of Health Information Technology, School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran
| | - Hamid Harandi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
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Thepmankorn P, Bach J, Lasfar A, Zhao X, Souayah S, Chong ZZ, Souayah N. Cytokine storm induced by SARS-CoV-2 infection: The spectrum of its neurological manifestations. Cytokine 2021; 138:155404. [PMID: 33360025 PMCID: PMC7832981 DOI: 10.1016/j.cyto.2020.155404] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
The new coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can trigger a hyperinflammatory state characterized by elevated cytokine levels known as hypercytokinemia or cytokine storm, observed most often in severe patients. Though COVID-19 is known to be a primarily respiratory disease, neurological complications affecting both the central and peripheral nervous systems have also been reported. This review discusses potential routes of SARS-CoV-2 neuroinvasion and pathogenesis, summarizes reported neurological sequelae of COVID-19, and examines how aberrant cytokine levels may precipitate these complications. Clarification of the pathogenic mechanisms of SARS-CoV-2 is needed to encourage prompt diagnosis and optimized care. In particular, identifying the presence of cytokine storm in patients with neurological COVID-19 manifestations will facilitate avenues for treatment. Future investigations into aberrant cytokine levels in COVID-19 patients with neurological symptoms as well as the efficacy of cytokine storm-targeting treatments will be critical in elucidating the pathogenic mechanisms and effective treatments of COVID-19.
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Affiliation(s)
- Parisorn Thepmankorn
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - John Bach
- Department of Physical Medicine and Rehab, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Ahmed Lasfar
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Xilin Zhao
- Department of Microbiology, Biochemistry, & Molecular Genetics, Public Health Research Institute Center, Rutgers New Jersey Medical School, Newark, NJ, United States,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Sami Souayah
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Zhao Zhong Chong
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Nizar Souayah
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States,Corresponding author at: Department of Neurology, Rutgers New Jersey Medical School, Doctor's Office Center (DOC), 90 Bergen Street Room Suite 8100, Newark, NJ 07101, United States
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48
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Cameron EL, Møller P, Karn KS. Effects of COVID-19 on Sense of Smell: Human Factors/Ergonomics Considerations. HUMAN FACTORS 2021:18720821990162. [PMID: 33517793 PMCID: PMC7902264 DOI: 10.1177/0018720821990162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE We review the effects of COVID-19 on the human sense of smell (olfaction) and discuss implications for human-system interactions. We emphasize how critical smell is and how the widespread loss of smell due to COVID-19 will impact human-system interaction. BACKGROUND COVID-19 reduces the sense of smell in people who contract the disease. Thus far, olfaction has received relatively little attention from human factors/ergonomics professionals. While smell is not a primary means of human-system communication, humans rely on smell in many important ways related to both quality of life and safety. METHOD We briefly review and synthesize the rapidly expanding literature through September 2020 on the topic of smell loss caused by COVID-19. We interpret findings in terms of their relevance to human factors/ergonomics researchers and practitioners. RESULTS Since March 2020 dozens of articles have been published that report smell loss in COVID-19 patients. The prevalence and duration of COVID-19-related smell loss is still under investigation, but the available data suggest that it may leave many people with long-term deficits and distortions in sense of smell. CONCLUSION We suggest that the human factors/ergonomics community could become more aware of the importance of the sense of smell and focus on accommodating the increasing number of people with reduced olfactory performance. APPLICATION We present examples of how olfaction can augment human-system communication and how human factors/ergonomics professionals might accommodate people with olfactory dysfunction. While seemingly at odds, both of these goals can be achieved.
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Affiliation(s)
| | - Per Møller
- Per Møller Consulting, Bagsværd, Denmark
| | - Keith S. Karn
- Human Factors in Context LLC, Philadelphia, Pennsylvania, USA
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Equils O, Lekaj K, Wu A, Fattani S, Liu G, Rink L. Intra-nasal zinc level relationship to COVID-19 anosmia and type 1 interferon response: A proposal. Laryngoscope Investig Otolaryngol 2021; 6:21-24. [PMID: 33614925 PMCID: PMC7883601 DOI: 10.1002/lio2.513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/02/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022] Open
Abstract
Anosmia is common among COVID-19 patients and anosmia assessment is proposed to be useful in the early diagnosis and prognosis of patients. Data on the pathogenesis of anosmia during COVID-19 suggest potential olfactory nerve involvement. Zinc is an essential micronutrient that regulates the immune responses, and zinc deficiency is known to induce anosmia and ageusia. We previously proposed that a drop in nasal zinc level is a normal nasal immune response to acute viral infections, including SARS-CoV-2 infection, and play a role in the pathogenesis of anosmia. The drop in the local zinc level in response to SARS-CoV-2 may lead to lower type 1 interferons and shift toward Th2 immune responses; if prolonged, it may lead to increased viral replication and more severe disease. In people who are at risk for baseline systemic zinc deficiency, such as the elderly and those with chronic diseases such as, chronic lung disease, diabetes, cardiovascular disease, and cancer, SARS-CoV-2 infection-induced drop in nasal zinc level may be more severe and prolonged and lead to an insufficient anti-viral nasal immune response and control the spread of the virus systemically and to the lungs. A better understanding of the clinical implications of baseline systemic zinc deficiency on anosmia and nasal immune responses may allow the development of new treatment strategies to slow down or stop the systemic invasion of SARS-CoV-2.
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Affiliation(s)
- Ozlem Equils
- MiOra, Public Health Education Foundation California Los Angeles USA
| | - Klaudi Lekaj
- MiOra, Public Health Education Foundation California Los Angeles USA
| | - Arthur Wu
- Cedars-Sinai Medical Center Division of Otolaryngology California Los Angeles USA
| | - Sahar Fattani
- MiOra, Public Health Education Foundation California Los Angeles USA
| | - Gene Liu
- Cedars-Sinai Medical Center Division of Otolaryngology California Los Angeles USA
| | - Lothar Rink
- Institute of Immunology RWTH Aachen University Hospital Aachen Germany
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50
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Abstract
Due to the rapid spread of the SARS-CoV-2 virus, many health systems worldwide are overwhelmed, leading to the triggering of the scarcity of medical resources. The identification of indicators that require hospital admission help in the efficient allocation of medical resources. Olfactory impairment is also one of the indicators of COVID-19 infection. Many studies have analyzed olfactory dysfunction in COVID-19 with a variable prevalence rate but underreporting of this problem is very much likely as the problem is considered benign. Many scientific societies have stated that olfactory dysfunction is a frequent symptom of COVID-19 and have published recommendations for it.
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