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Kim KS, Kwak IY, Min HJ. Factors associated with impaired psychophysical gustatory function. Clin Otolaryngol 2024; 49:306-313. [PMID: 38199861 DOI: 10.1111/coa.14143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/10/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To investigate the clinical characteristics associated with measured gustatory dysfunction in patients with chemosensory (smell and taste) discomfort. STUDY DESIGN Retrospective study. DESIGN Hospital-based cohort. SETTING The clinical characteristics associated with the measured diagnosis of gustatory dysfunction were statistically analysed. PARTICIPANTS Patients who underwent all the psychophysical olfactory and chemical gustatory function tests (YSK olfactory function test and chemical gustometry exam) and the subjective questionnaires between October 2021 and February 2023. MAIN OUTCOME MEASURES YSK olfactory function test and chemical gustometry results, subjective questionnaire score about chemosensory (smell and taste) functions. The Medical records of patients who visited the smell and taste centre in a tertiary. RESULTS A total of 219 patients were enrolled; 180 were diagnosed as having normal gustatory function, and 39 were diagnosed as having gustatory dysfunction. Subjective recognition of gustatory function was not associated with the measured gustatory function. Age, sex, measured olfactory function and the threshold and discrimination scores for the olfactory function test were significant factors in the multivariate analysis. When the patients were further divided according to age, the threshold test scores rather than other subsets in the olfactory function test were significantly associated with measured gustatory dysfunction in patients 60 and older. CONCLUSION In older adult male patients with olfactory dysfunction, gustatory function should be considered regardless of subjective gustatory dysfunction.
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Affiliation(s)
- Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Il-Youp Kwak
- Department of Applied Statistics, Chung-Ang University, Seoul, South Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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Sakata KI, Hashimoto A, Kambe T, Sato J, Ohga N, Yamazaki Y, Koyachi M, Tatsuki I, Okada M, Taro O, Hikasa H, Kitagawa Y. Expression analysis of zinc-metabolizing enzymes in the saliva as a new method of evaluating zinc content in the body: two case reports and a review of the literature. J Med Case Rep 2024; 18:198. [PMID: 38570871 PMCID: PMC10993550 DOI: 10.1186/s13256-024-04463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/16/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The activity level of alkaline phosphatase, a zinc-requiring enzyme in the serum, is used to indicate zinc nutritional status; however, it does not correlate with serum zinc levels or subjective symptoms of taste disorder in many cases. Hence, this study focused on the total activity of alkaline phosphatase, a zinc-requiring enzyme. The total alkaline phosphatasa activity level in the saliva was measured before and after zinc supplementation, and the results were compared with serum zinc levels. CASE PRESENTATION This study included patients with hypozincemia, specifically a patient with zinc-deficient taste disorder (patient 1: a 69-year-old Japanese woman) and a patient with glossodynia with zinc deficiency (patient 2: an 82-year-old Japanese woman). Saliva samples were collected, and blood tests were performed before and after zinc supplementation. Subjective symptoms and serum zinc levels were simultaneously evaluated. Zinc supplementation was performed using zinc acetate hydrate or Polaprezinc. CONCLUSIONS Total alkaline phosphatase activity levels were found to be associated with serum zinc levels and subjective symptoms. A further study with a higher number of patients is necessary to confirm whether total alkaline phosphatase activity levels more accurately reflect the amounts of zinc in the body than serum zinc levels.
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Affiliation(s)
- Ken-Ichiro Sakata
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Ayako Hashimoto
- Department of Food and Nutrition, Faculty of Home Economics, Kyoto Women's University, Kyoto, Japan
| | - Taiho Kambe
- Department of Applied Molecular Biology, Division of Integrated Life Science, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Jun Sato
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Noritaka Ohga
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yutaka Yamazaki
- Department of Gerodontology, Division of Oral Health Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Masahide Koyachi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Itagaki Tatsuki
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Mai Okada
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Okura Taro
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Hikasa
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshimasa Kitagawa
- Department of Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Daskalou D, Hsieh JW, Hugentobler M, Macario S, Sipione R, Voruz F, Coppin G, Rimmer J, Landis BN. Predictive factors of involuntary weight loss in patients with smell and taste disorders. Rhinology 2024; 62:163-171. [PMID: 37943027 DOI: 10.4193/rhin23.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Chemosensory dysfunction (olfaction, taste, and trigeminal) affects quality of life, potentially impacting eating behaviors. We investigated which factors are associated with weight loss in patients with smell and taste disorders. METHODS Retrospective study of consecutive adult patients seen in the smell and taste clinic during a 10-year period. Patients were asked about smell, flavor and taste impairment. Psychophysically, smell was assessed with Sniffin' Sticks, flavor with a retronasal test, and taste with Taste Strips. RESULTS A total of 554 patients (313 females) were included with a median age of 51 years (IQR 23). Seventy-six (13.7%) reported involuntary weight loss (median 6 kg, IQR 6) due to chemosensory disorders. The odds of losing weight were 2.1 times higher when patients reported subjective changes in flavor perception. Parosmia was a significant predictor of weight loss. Patients with symptoms lasting longer than two years were less likely to present with weight loss. Post-traumatic chemosensory dysfunction was a significant predictor of losing weight. On psychophysical testing, the probability of a patient losing weight increased by 8% for every 1-unit reduction in Taste Strips score. CONCLUSION Factors associated with weight loss were self-reported changes in flavor perception, parosmia, duration of symptoms for less than two years, head injury, and psychophysically measured low Taste Strips score. These data help to identify patients at risk of weight loss from smell or taste impairment.
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Affiliation(s)
- D Daskalou
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland; The inner ear and olfaction neurosensory laboratory, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - J W Hsieh
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland; The inner ear and olfaction neurosensory laboratory, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - M Hugentobler
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - S Macario
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - R Sipione
- The inner ear and olfaction neurosensory laboratory, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - F Voruz
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - G Coppin
- Department of Psychology, UniDistance Suisse, Swiss Center for Affective Sciences, and Laboratory for the Study of Emotion Elicitation and Expression, Department of Psychology, University of Geneva, Switzerland
| | - J Rimmer
- Department of Otolaryngology-Head and Neck Surgery, Monash Health, Department of Otolaryngology-Head and Neck Surgery, St Vincent’s Hospital Melbourne, and Department of Surgery, Monash University, Melbourne, Australia
| | - B N Landis
- Rhinology-Olfactology Unit, Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland; The inner ear and olfaction neurosensory laboratory, University of Geneva, Faculty of Medicine, Geneva, Switzerland
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Kwak IY, Kim KS, Min HJ. Association of gustatory dysfunction and Alzheimer. Rhinology 2024; 62:130-142. [PMID: 37943054 DOI: 10.4193/rhin23.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Chemosensory dysfunction has been reported to be involved in the pathogenesis of Alzheimer’s disease (AD). Compared with olfaction, gustatory dysfunction in AD has not been evaluated in depth. We reviewed previously published studies regarding gustatory dysfunction in patients with AD compared with healthy controls. METHODS A systematic review was conducted by searching the MEDLINE, Cochrane Library, Embase, and PubMed databases covering publications from January 2000 to February 2023. The search was performed using the keyword "Alzheimer* AND (gustatory OR taste OR gustation)." Only studies that performed gustatory function testing and compared the results between patients with AD and healthy controls were included. A random-effects meta-analysis was performed. RESULTS Twelve articles were finally included, and various gustatory tests including taste strips, the taste disk test, taste solutions, and subjective questionnaires were applied. Overall gustatory function based on the taste strip test was significantly decreased in patients with AD compared with controls in two out of three papers. The overall gustatory function of patients with AD was significantly decreased in all studies based on the taste disk and taste solution tests. We also found that the sweet taste test showed low heterogeneity across all the included studies, and there was low publication bias. In studies using subjective questionnaires, gustatory function was not significantly different between patients with AD and healthy controls in the meta-analysis. CONCLUSIONS Based on these studies, gustatory dysfunction diagnosed by gustatory function testing was closely related to AD. However, the results of subjective questionnaires were not significantly different between patients with AD and healthy controls in the current meta-analysis. As the number of studies and enrolled subjects was limited and unified gustatory function testing was lacking, further studies are needed to confirm this relationship.
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Affiliation(s)
- I-Y Kwak
- Department of Applied Statistics, Chung-Ang University, Heukseok-dong, Dongjak-gu, Seoul, South Korea
| | - K S Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Heukseok-dong, Dongjak-gu, Seoul, South Korea
| | - H J Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Heukseok-dong, Dongjak-gu, Seoul, South Korea
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Mastinu M, Grzeschuchna LS, Mignot C, Guducu C, Bogdanov V, Hummel T. Time-frequency analysis of gustatory event related potentials (gERP) in taste disorders. Sci Rep 2024; 14:2512. [PMID: 38291123 PMCID: PMC10827706 DOI: 10.1038/s41598-024-52986-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/25/2024] [Indexed: 02/01/2024] Open
Abstract
In taste disorders, the key to a correct diagnosis and an adequate treatment is an objective assessment. Compared to psychophysical tests, EEG-derived gustatory event-related potentials (gERP) could be used as a less biased measure. However, the responses identified using conventional time-domain averaging show a low signal-to-noise ratio. This study included 44 patients with dysgeusia and 59 healthy participants, who underwent a comprehensive clinical examination of gustatory function. gERPs were recorded in response to stimulation with two concentrations of salty solutions, which were applied with a high precision gustometer. Group differences were examined using gERP analyzed in the canonical time domain and with Time-Frequency Analyses (TFA). Dysgeusic patients showed significantly lower scores for gustatory chemical and electrical stimuli. gERPs failed to show significant differences in amplitudes or latencies between groups. However, TFA showed that gustatory activations were characterized by a stronger power in controls than in patients in the low frequencies (0.1-4 Hz), and a higher desynchronization in the alpha-band (8-12 Hz). Hence, gERPs reflect the altered taste sensation in patients with dysgeusia. TFA appears to enhance the signal-to-noise ratio commonly present when using conventional time-domain averaging, and might be of assistance for the diagnosis of dysgeusia.
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Affiliation(s)
- Mariano Mastinu
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany.
| | - Lisa Sophie Grzeschuchna
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany
| | - Coralie Mignot
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany
| | - Cagdas Guducu
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany
- Dokuz Eylül University Faculty of Medicine Department of Biophysics, 35320, Balçova, Izmir, Turkey
| | - Vasyl Bogdanov
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell & Taste Clinic, Technische Universität Dresden, Dresden, Germany
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Gudziol H, Bitter T, Schade U, Laute K, Guntinas-Lichius O. [Subjective and objectified smell and taste disorders from an ENT post-Covid-19 consultation]. Laryngorhinootologie 2023; 102:933-943. [PMID: 37339661 DOI: 10.1055/a-2092-3913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
INTRODUCTION Olfactory disorders are among the four most common post-COVID-19 complaints. The aim of our prospective study from a university ENT post-COVID consultation (PCS) was to substantiate the symptoms with psychophysical test results. METHODS After an ENT examination, 60 post-COVID-19 patients (41 women) were asked in writing about their medical history. Their ability to smell was tested using the extended Sniffin' Sticks test battery and their ability to taste was determined using the 3-drop test. From these data, three quantitative olfactory (RD) and gustatory (SD) diagnoses could be defined from normal value tables. Every second patient took part in a control examination. RESULTS Up to the first examination, 60 patients reported smell and 51 taste disorders; their average duration was 11 months in both cases. Objectified pathologic RD and SD had 87% and 42% of the total cohort, respectively. Every third patient suffered from an objectified combination of olfactory and gustatory damage. About every second patient complained of parosmia. Parosmic patients with two visits came earlier for a check-up. Six months after the initial examination, the detection thresholds, the TDI and the RD had improved in these patients. The self-assessment of olfactory ability had not changed. CONCLUSIONS Objectified pathologic RD persisted in our PCS for a mean of 1.5 years from the onset of infection. Parosmics had a better prognosis. For the healthcare system and especially for the patients affected, they continue to be a burden even after the pandemic.
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Affiliation(s)
- Hilmar Gudziol
- Klinik für Hals-, Nasen- und Ohrenkrankheiten, Uniklinikum, Jena, Germany
| | - Thomas Bitter
- Klinik für Hals-, Nasen- und Ohrenkrankheiten, Universitätsklinikum Jena, Jena, Germany
| | - Ulrike Schade
- Klinik für Hals-, Nasen- und Ohrenkrankheiten, Universitätsklinikum Jena, Jena, Germany
| | - Kerstin Laute
- Klinik für Hals-Nasen-Ohrenkrankheiten, Universitätsklinikum Jena, Jena, Germany
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Boscolo-Rizzo P, Hummel T, Invitto S, Spinato G, Tomasoni M, Emanuelli E, Tofanelli M, Cavicchia A, Grill V, Vaira LA, Lechien JR, Borsetto D, Polesel J, Dibattista M, Menini A, Hopkins C, Tirelli G. Psychophysical assessment of olfactory and gustatory function in post-mild COVID-19 patients: A matched case-control study with 2-year follow-up. Int Forum Allergy Rhinol 2023; 13:1864-1875. [PMID: 36852674 DOI: 10.1002/alr.23148] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND The aim of this study was to psychophysically evaluate the prevalence of smell and taste dysfunction 2 years after mildly symptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection compared to that observed at 1-year follow-up and while considering the background of chemosensory dysfunction in the no-coronavirus disease 2019 (COVID-19) population. METHOD This is a prospective case-control study on 93 patients with polymerase chain reaction (PCR)-positive SARS-CoV-2 infection and 93 matched controls. Self-reported olfactory and gustatory dysfunction was assessed by 22-item Sino-Nasal-Outcome Test (SNOT-22), item "Sense of smell or taste." Psychophysical orthonasal and retronasal olfactory function and gustatory performance were estimated using the extended Sniffin' Sticks test battery, 20 powdered tasteless aromas, and taste strips test, respectively. Nasal trigeminal sensitivity was assessed by sniffing a 70% solution of acetic acid. RESULTS The two psychophysical assessments of chemosensory function took place after a median of 409 days (range, 366-461 days) and 765 days (range, 739-800 days) from the first SARS-CoV-2-positive swab, respectively. At 2-year follow-up, cases exhibited a decrease in the prevalence of olfactory (27.9% vs. 42.0%; absolute difference, -14.0%; 95% confidence interval [CI], -21.8% to -2.6%; p = 0.016) and gustatory dysfunction (14.0% vs. 25.8%; absolute difference, -11.8%; 95% CI, -24.2% to 0.6%; p = 0.098). Subjects with prior COVID-19 were more likely than controls to have an olfactory dysfunction (27.9% vs. 10.8 %; absolute difference, 17.2%; 95% CI, 5.2% to 28.8%) but not gustatory dysfunction (14.0% vs. 9.7%; absolute difference, 4.3%; 95% CI, -5.8% to 14.4% p = 0.496) still 2 years after the infection. Overall, 3.2% of cases were still anosmic 2 years after the infection. CONCLUSIONS Although a proportion of subjects recovered from long-lasting smell/taste dysfunction more than 1 year after COVID-19, cases still exhibited a significant excess of olfactory dysfunction 2 years after SARS-CoV-2 infection when compared to matched controls.
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Affiliation(s)
- Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany
| | - Sara Invitto
- INSPIRE LAB-Laboratory of Cognitive and Psychophysiological Olfactory Processes, DiSTeBA, University of Salento, Lecce, Italy
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
- Unit of Otolaryngology, Azienda Unità Locale Socio Sanitaria 2-Marca Trevigiana, Treviso, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Enzo Emanuelli
- Unit of Otolaryngology, Azienda Unità Locale Socio Sanitaria 2-Marca Trevigiana, Treviso, Italy
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Angelo Cavicchia
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Vittorio Grill
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Luigi Angelo Vaira
- Department of Medicine, Surgery and Pharmacy, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS. Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Michele Dibattista
- Department of Translational Biomedicine and Neuroscience, University of Bari A. Moro, Bari, Italy
| | - Anna Menini
- Neurobiology Group, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy
| | - Claire Hopkins
- Ear, Nose and Throat Department, Guy's and St Thomas' Hospitals, London, UK
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
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Kwak IY, Kim KS, Min HJ. Gustatory dysfunction is related to Parkinson's disease: A systematic review and meta-analysis. Int Forum Allergy Rhinol 2023; 13:1949-1957. [PMID: 36934313 DOI: 10.1002/alr.23158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Olfactory dysfunction has been reported to be involved in Parkinson's disease (PD) pathogenesis. However, gustatory dysfunction in PD has not been evaluated as in-depth as olfactory dysfunction. We reviewed the previously published studies regarding gustatory function in PD patients and suggested the possibility that gustatory dysfunction may also be associated with PD. METHODS MEDLINE, Cochrane Library, Embase, and PubMed databases were searched for studies evaluating gustatory function in PD patients. We used the standardized mean difference and a 95% confidence interval (CI) as the effect analysis index regarding the taste strip test. The relative risk and 95% CI were used as the effect analysis index for the questionnaires and propylthiouracil (PTU)/phenylthiocarbamide (PTC) perception test. Statistical heterogeneity was assessed using forest plots, Cochran's Q, and the I2 statistic; heterogeneity was considered high when I2 was over 75%. Publication bias was assessed by funnel plots and the Egger bias test. RESULTS We identified 19 articles that reported the results of gustatory function tests in PD patients and healthy controls. Most of these studies used various gustatory tests, including taste strips, questionnaires, taste solutions, PTU/PTC perception tests, and electrogustometry, and reported significantly lower gustatory function in PD patients than in the controls. However, several articles reported contradictory results. CONCLUSIONS Based on these studies, gustatory dysfunction is closely related to PD. However, the number of studies and enrolled subjects was small, and a unified gustatory function test was lacking. Therefore, further studies with larger populations and normalized gustatory function tests are needed.
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Affiliation(s)
- Il-Youp Kwak
- Department of Applied Statistics, Chung-Ang University, Dongjak-gu, Seoul, South Korea
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, South Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, South Korea
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Savard DJ, Ursua FG, Gaddey HL. Smell and Taste Disorders in Primary Care. Am Fam Physician 2023; 108:240-248. [PMID: 37725455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Disorders of smell and taste are reported by approximately one-fifth of people 40 years and older, and one-third of people 80 years and older. These disorders affect quality of life and the ability to identify smoke and toxins. Smell and taste disorders can be early signs of dementia or Parkinson disease and are associated with increased mortality. Dysfunction may be apparent or may develop insidiously. Screening questionnaires are available, but many patients are unaware of their disorder. Most smell and taste disorders are due to sinonasal disease but also could be caused by smoking, medications, head trauma, neurodegenerative disease, alcohol dependence, or less common conditions. The differential diagnosis should guide the evaluation and include anterior rhinoscopy and an examination of the oral cavity, head, and cranial nerves. Further investigation is often unnecessary, but nasal endoscopy and computed tomography of the sinuses may be helpful. Magnetic resonance imaging of the head with contrast should be performed if there is an abnormal neurologic examination finding or if trauma or a tumor is suspected. Olfactory testing is indicated in refractory cases or for patients with poor quality of life and disease associated with smell or taste dysfunction. Smell and taste disorders may resolve when reversible causes are treated, but improvement is less likely when they are due to trauma, age, or neurodegenerative disease. Olfactory training is a self-administered mindful exposure therapy that may improve olfactory function. Physicians should encourage patients to ensure that smoke and other alarms are operational and to adhere to food expiration dates.
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Affiliation(s)
- Dillon J Savard
- David Grant Medical Center, Travis Air Force Base, California
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Trache MC, Schipp JMH, Haack M, Adderson-Kisser C, Högerle C, Becker S, Betz CS. Characteristics of smell and taste disorders depending on etiology: a retrospective study. Eur Arch Otorhinolaryngol 2023; 280:4111-4119. [PMID: 37160463 PMCID: PMC10382332 DOI: 10.1007/s00405-023-07967-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study investigates the impact of etiology on the epidemiologic profile, disease severity, type of treatment and therapy outcome in smell and taste disorders. METHODS This is a retrospective analysis of 270 patients that presented with a smell or taste disorder in a specialized, tertiary care center. An established questionnaire was used to collect data from patients and physicians. Olfactometry was performed with the Sniffin' Sticks test kit, while gustometry was performed by taste strips. RESULTS Post-traumatic etiology was associated with young age (median 46 years) and male sex, and showed the most severe degrees of smell loss compared to other etiologies (64.3% anosmia). Postinfectious causes occurred more frequently in females (77.3%) and correlated with a history of pharyngeal surgery, suggesting a vulnerability for virally mediated sensory dysfunction following adenoid/tonsil removal. Parosmia also correlated with both postinfectious etiology (62.5%) and female sex. In sinunasal etiology, the presence of nasal polyps worsened the overall olfactory test score by approximately 50%. In particular, smell threshold and discrimination were reduced, while smell identification was not significantly impacted by nasal polyp obstruction. Sinunasal dysfunction was the only etiology to show significant improvement after therapy (73.9% improved). Finally, we could establish good correlations between the subjective impairment and objective dysfunction for each sensory modality. CONCLUSION Each etiology of chemosensory dysfunction shows particular distributions of variables like sex, age, comorbidities and operations, disease severity, sensory threshold, discrimination and identification. This paper offers a detailed account of the correlations between the cause and the characteristics of smell and taste loss.
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Affiliation(s)
- Mihnea Cristian Trache
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | | | - Mareike Haack
- Department of Otorhinolaryngology, Ludwig-Maximillian University Hospital (LMU), Munich, Germany
| | | | - Catalina Högerle
- Department of Otorhinolaryngology, Ludwig-Maximillian University Hospital (LMU), Munich, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, University Hospital Tübingen, Tübingen, Germany
| | - Christian Stephan Betz
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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11
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Smell and Taste Disorders. Am Fam Physician 2023; 108:Online. [PMID: 37725456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
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12
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Chen Y, Geng Y, Jiang J, Xiong G, Lei C. Smell and taste dysfunction in patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus-2. Acta Otolaryngol 2023; 143:489-494. [PMID: 37326433 DOI: 10.1080/00016489.2023.2223243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Smell and taste dysfunctions (STD) are frequently observed in patients with coronavirus disease (COVID-19). OBJECTIVES To investigate the clinical characteristics of STD in COVID-19 patients. MATERIAL AND METHODS One-hundred six COVID-19 adult patients with the Omicron variant were enrolled. The clinical features of patients with and without STD were compared using questionnaires, laboratory tests, and imaging examinations. RESULTS Of the 76 patients with smell and/or taste dysfunction, age (p = .002), vaccination time (p = .024), history of systemic diseases (p = .032), and smoking status (p = .044) were significantly different from those of the controls (n = 34). Fatigue (p = .001), headache (p = .004), myalgia (p = .047), and gastrointestinal discomfort (p = .001) were observed more frequently in these patients than in controls. The Hospital Anxiety and Depression Scale score of these patients was significantly higher than that of controls (p < .001). The taste visual assessment scale score of the STD group was significantly lower than that of the taste dysfunction group (p = .001), and perceptions of sour, sweet, and salty tastes were worse in the STD group than in the taste dysfunction group (p < .001). CONCLUSIONS AND SIGNIFICANCE COVID-19 patients had similar changes in smell and/or taste dysfunctions and worse emotional states, possibly correlated with some factors, including age and vaccination time.
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Affiliation(s)
- Yanping Chen
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Yan Geng
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Juan Jiang
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Gaoyun Xiong
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Chenyang Lei
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Wang J, Chen Y, Huang J, Niu C, Zhang P, Yuan K, Zhu X, Jin Q, Ran S, Huang Z. Prevalence of taste and smell dysfunction in mild and asymptomatic COVID-19 patients during Omicron prevalent period in Shanghai, China: a cross-sectional survey study. BMJ Open 2023; 13:e067065. [PMID: 36944468 PMCID: PMC10032136 DOI: 10.1136/bmjopen-2022-067065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 02/23/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES COVID-19, which is caused by SARS-CoV-2, is a severe threat to human health and the economy globally. This study aimed to investigate the prevalence of taste and/or smell dysfunction and associated risk factors in mild and asymptomatic patients with Omicron infection in Shanghai, China.DesignThis was a questionnaire-based cross-sectional study. SETTING COVID-19 patients at the makeshift hospital in the Shanghai World Expo Exhibition and Convention Centre were recruited from March to April 2022. PARTICIPANTS In total, 686 COVID-19-infected patients who were defined as mild or asymptomatic cases according to the diagnostic criteria of New Coronavirus Pneumonia Prevention and Control Programme ninth edition (National Health Commission of China, 2022) were enrolled. MEASURES Data to investigate taste and smell loss and to characterise other symptoms were collected by the modified Chemotherapy-induced Taste Alteration Scale and Sino-Nasal Outcome Test-22 questionnaires. The risk factors for the severity of taste/smell dysfunction were analysed by binary logistic regression models. RESULTS 379 males (379/686, 55.2%) and 307 females (307/686, 44.8%) completed the questionnaires to record recent changes in taste and smell ability. A total of 302 patients (44%) had chemosensory dysfunction with Omicron infection, of which 22.7% (156/686) suffered from both taste and smell dysfunction. In addition, cough (60.2%), expectoration (40.5%), fever (33.2%) and sore throat (32.5%) were common symptoms during Omicron infection. The quality-of-life-related indicators were negatively associated with participants' self-reported taste and smell dysfunction. CONCLUSIONS The prevalence of taste or/and smell dysfunction in patients with Omicron infections was 44%. Individuals with chemosensory dysfunction had significantly higher rates of various upper respiratory influenza-like symptoms, xerostomia and bad breath. Moreover, smell dysfunction was a risk factor for the prevalence of taste dysfunction in patients with Omicron infection. TRIAL REGISTRATION NUMBER ChiCTR 2200059097.
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Affiliation(s)
- Jia Wang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenguang Niu
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pengfei Zhang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Keyong Yuan
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohan Zhu
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiaoqiao Jin
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shujun Ran
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Matosevic L, Friedrich H, Negoias S, Dür C, Caversaccio M, Dubach P. Taste Alteration in External Auditory Canal Cholesteatoma: Indicator of Impending N VII Affection. ORL J Otorhinolaryngol Relat Spec 2023; 85:177-185. [PMID: 36634634 DOI: 10.1159/000527886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 10/26/2022] [Indexed: 01/14/2023]
Abstract
INTRODUCTION External auditory canal cholesteatoma (EACC) is a rare disease, with an estimated incidence of approximately 1:1,000 adult and 1.6:1,000 pediatric otologic patients. Systematic studies of chronic ear disease and taste alteration prior to surgery are rare; in fact, there are no such studies for EACCs. Therefore, we describe chorda tympani nerve (CTN) dysfunction and the related clinical consequences in EACC patients. METHODS/STUDY DESIGN Between 1992 and 2021, we retrospectively analyzed the symptoms, signs, and radiological and intraoperative descriptions of CTN involvement in 73 patients. Liquid taste tests and, since 2009, Taste StripsTM as well as an olfactory screening test (Smell DiskettesTM) have been performed for all symptomatic patients and, when feasible, all other EACC patients. LEVEL OF EVIDENCE: 4 RESULTS Ten of 73 patients complained subjectively of dysfunction, and 8 showed abnormal taste test results. Four patients complained of olfactory dysfunction (3 cases with pathological taste tests). Gustatory dysfunction was most frequent in radiogenic EACC cases (n = 4), followed by postoperative EACC (n = 3). Two postoperative patients were asymptomatic despite abnormal test results. Rarely, patients with idiopathic (n = 2) and posttraumatic (n = 1) EACC showed acute taste dysfunction that was confirmed in each with abnormal test results. DISCUSSION/CONCLUSION CTN dysfunction often developed asymptomatically in chronic ears, except for idiopathic and posttraumatic EACCs under previous healthy middle ear conditions. Taste disturbance is not a cardinal symptom of EACC, but objective testing suggests that up to one out of 10 EACC patients with advanced disease may experience regional gustatory dysfunction prior to surgery. Especially in context of a new and acute presentation, regional taste dysfunction may alert the clinician of potential progressive EACC invasion and danger to the facial nerve.
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Affiliation(s)
- Lilia Matosevic
- ENT Department, Burgerspital Solothurn, Solothurn, Switzerland
| | | | - Simona Negoias
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Basel, Basel, Switzerland
| | - Cilgia Dür
- Department of ENT, Head and Neck Surgery, Inselspital Bern, University Hospital, Bern, Switzerland
| | - Marco Caversaccio
- Department of ENT, Head and Neck Surgery, Inselspital Bern, University Hospital, Bern, Switzerland
| | - Patrick Dubach
- ENT Department, Burgerspital Solothurn, Solothurn, Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern, University Hospital, Bern, Switzerland
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15
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Levesque-Boissonneault C, Bussière N, Roy-Côté F, Cloutier F, Caty MÈ, Frasnelli J. A quick test to objectify smell and taste dysfunction at home: a proof of concept for the validation of the chemosensory perception test. Chem Senses 2023; 48:bjad033. [PMID: 37586396 PMCID: PMC10746307 DOI: 10.1093/chemse/bjad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Indexed: 08/18/2023] Open
Abstract
Recent studies have shown the efficacy of a home test for the self-evaluation of olfactory and gustatory functions in quarantined coronavirus disease-2019 (COVID-19) patients. However, testing was often limited to COVID-19 participants, and the accuracy of home test kits was rarely compared to standardized testing. This study aims at providing proof of concept for the validation of the new Chemosensory Perception Test (CPT) developed to remotely assess orthonasal olfactory, retronasal olfactory, and gustatory functions in various populations using common North American household items. In the 2 experiments, a total of 121 participants irrespective of having olfactory and/or gustatory complaints from various causes (COVID-19, sinunasal, post-viral, idiopathic) were tested first, with one or many of the following tests: (i) a brief chemosensory questionnaire, (ii) an olfactory test-Sniffin' Sticks Test (SST) or University of Pennsylvania Smell Identification Test (UPSIT), and/or (iii) a gustatory test-Brief Waterless Empirical Taste Test (B-WETT). We then applied the CPT which yielded 3 different subscores, namely orthonasal, retronasal, and gustatory CPT scores. The orthonasal CPT score was significantly correlated with SST (ρ = 0.837, P < 0.001) and UPSIT (ρ = 0.364, P < 0.001) scores, and exhibited an excellent accuracy to identify olfactory dysfunction (OD) as compared to SST (area under the curve [AUC]: 0.923 [95% confidence interval {CI}, 0.822-1.000], P < 0.001). The retronasal CPT score but not the gustatory CPT score allowed to distinguish between participants with or without subjective gustatory complaint (AUC: 0.818 [95% CI, 0.726-0.909], P < 0.001). The CPT has the ability to identify OD and to quantify subjective gustatory complaints.
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Affiliation(s)
- Cindy Levesque-Boissonneault
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Department of Speech and Language Pathology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Nicholas Bussière
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Faculty of medicine, Université de Montreal, Montreal, QC, Canada
| | - Frédérique Roy-Côté
- Research Center of the Sacré-Cœur hospital, CIUSSS Nord-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Frank Cloutier
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Marie-Ève Caty
- Department of Speech and Language Pathology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Center of the Sacré-Cœur hospital, CIUSSS Nord-de-l’Île-de-Montréal, Montréal, QC, Canada
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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16
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 DOI: 10.1093/chemse/bjad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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17
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Reply: taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad012. [PMID: 37503715 PMCID: PMC10653024 DOI: 10.1093/chemse/bjad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
- Department of Public Health, University of California Merced, Merced, CA 95348, United States
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, United States
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Nguyen H, Albayay J, Höchenberger R, Bhutani S, Boesveldt S, Busch NA, Croijmans I, Cooper KW, de Groot JHB, Farruggia MC, Fjaeldstad AW, Hayes JE, Hummel T, Joseph PV, Laktionova TK, Thomas-Danguin T, Veldhuizen MG, Voznessenskaya VV, Parma V, Pepino MY, Ohla K. Covid-19 affects taste independent of taste-smell confusions: results from a combined chemosensory home test and online survey from a large global cohort. Chem Senses 2023; 48:bjad020. [PMID: 37350646 PMCID: PMC10396355 DOI: 10.1093/chemse/bjad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Indexed: 06/24/2023] Open
Abstract
People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with 10 household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 5,225 self-reported a respiratory illness and were grouped based on their reported COVID test results: COVID-positive (COVID+, N = 3,356), COVID-negative (COVID-, N = 602), and COVID unknown for those waiting for a test result (COVID?, N = 1,267). The participants who reported no respiratory illness were grouped by symptoms: sudden smell/taste changes (STC, N = 4,445), other symptoms excluding smell or taste changes (OthS, N = 832), and no symptoms (NoS, N = 416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% confidence interval (CI): 15-28%), 47% in smell (95% CI: 37-56%), and 17% in oral irritation (95% CI: 10-25%) intensity. There were medium to strong correlations between perceived intensities and self-reported abilities (r = 0.84 for smell, r = 0.68 for taste, and r = 0.37 for oral irritation). Our study demonstrates that COVID-19-positive individuals report taste dysfunction when self-tested with stimuli that have little to none olfactory components. Assessing the smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and may help to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.
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Affiliation(s)
- Ha Nguyen
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Javier Albayay
- Centro Interdipartimentale Mente/Cervello, Università degli Studi di Trento, Rovereto, Italy
| | | | - Surabhi Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Niko A Busch
- Institute for Psychology, University of Münster, Münster, Germany
| | - Ilja Croijmans
- Department of Language and Communication, Radboud University, Nijmegen, Netherlands
| | - Keiland W Cooper
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | | | - Michael C Farruggia
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alexander W Fjaeldstad
- Department of Otorhinolaryngology, Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Gødstrup Regional Hospital, Herning, Denmark
| | - John E Hayes
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
| | - Thomas Hummel
- Department of Otorhinolaryngology, University of Dresden Medical School, Smell & Taste Clinic, Dresden, Germany
| | - Paule V Joseph
- National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, DIBCR, Section of Sensory Science and Metabolism, Bethesda, MD, USA
| | | | | | | | | | | | - M Yanina Pepino
- Department of Food Science and Human Nutrition, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kathrin Ohla
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
- Experimental Psychology Unit, Helmut-Schmidt-University/University of the Armed Forces Hamburg, Hamburg, Germany
- Science & Research, dsm-firmenich, Satigny, Switzerland
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19
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Jiang RS, Wang JJ. Validation of the clinical applicability of the brief self-administered waterless empirical taste test during the era of COVID-19. J Chin Med Assoc 2022; 85:1136-1144. [PMID: 35972324 PMCID: PMC9749949 DOI: 10.1097/jcma.0000000000000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study was performed to test the clinical applicability of a new taste test, the Brief Self-Administered Waterless Empirical Taste Test (B-WETT) in the era of COVID-19. METHODS Sixty healthy volunteers and 60 patients experiencing gustatory dysfunction were enrolled. All subjects received both the Self-Administered WETT and the new B-WETT which are comprised of disposable plastic strips containing sucrose, citric acid, sodium chloride, caffeine, and monosodium glutamate tastants to evaluate taste function. The healthy volunteers were re-tested with the WETT and B-WETT after an inter-test interval of at least 7 days to measure retest reliability. RESULTS The sum scores of five tastants of the first test were 25.7 for males and 29.5 for females in WETT, and 12.4 for males and 15.2 for females in B-WETT. There were significant differences in the sum scores between males and females whether in WETT or B-WETT. The sum scores strongly correlated between WETT and B-WETT, whether in healthy volunteers or in patients with gustatory dysfunction (r >0.7). There was also a strong correlation between the first and second tests of B-WETT for the sum scores. CONCLUSION This study shows that B-WETT is a valid and reliable taste test, and is convenient for use in the era of COVID-19 to evaluate the taste function of patients.
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Affiliation(s)
- Rong-San Jiang
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Department of Otolaryngolog, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Address correspondence. Dr. Rong-San Jiang, Department of Medical Research, Taichung Veterans General Hospital, 1650, Section 4, Taiwan Boulevard, Taichung 407, Taiwan, ROC. E-mail address: (R.-S. Jiang)
| | - Jing-Jie Wang
- Department of Otolaryngolog, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
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20
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Li Z, Stolper S, Draf J, Haehner A, Hummel T. Smell, taste and trigeminal function: similarities and differences between results from home tests and examinations in the clinic. Rhinology 2022; 60:293-300. [PMID: 35926120 DOI: 10.4193/rhin21.430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND This study aimed to examine an easy-to-conduct home chemosensory test as a screening tool prior to clinical testing and to investigate the associations between home and clinical tests. METHODS We examined 200 participants who performed a chemosensory test including subjective ratings as well as psychophysical smell, taste and trigeminal function tests at their homes. Following that, they were invited to the clinic for standardized testing using the Sniffin sticks test for assessment of olfactory function, taste sprays and strips for taste function, and a lateralization test for trigeminal function. RESULTS The home smell test correlated well with the Sniffin sticks test. The home test had acceptable sensitivity for detecting smell loss (sensitivity of 67% at a specificity of 92%). The home test could distinguish between patients with olfactory loss and healthy controls. In contrast, the home tests for taste and trigeminal function did not provide valid results. When comparing home and clinical smell and taste tests older age and olfactory loss were the most influencing confounders in various models, while participants who had olfactory loss and admitted to drink alcohol regularly were more likely to have consistency between home and clinical smell measurements. CONCLUSIONS Although the standardized psychophysical tests are valid and reliable and should be recommended, simple methods used at home could reflect the patients' information to some degree and provide useful data prior to clinical testing. The present home chemosensory test allows motivated individuals to screen their olfactory function in a simple way at home. Results from smell tests, but not from tests of taste or trigeminal function, obtained at home correlate with tests obtained at the clinic. Moreover, tests conducted at home or in the clinic have confounders that should be considered by researchers and clinicians.
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Affiliation(s)
- Z Li
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - S Stolper
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - J Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Univeristy Dresden, Dresden, Germany
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Nanjo Y, Okuma T, Kuroda Y, Hayakawa E, Shibayama K, Akimoto T, Murashima R, Kanamori K, Tsutsumi T, Suzuki Y, Namba Y, Makino F, Nagashima O, Sasaki S, Takahashi K. Multiple Types of Taste Disorders among Patients with COVID-19. Intern Med 2022; 61:2127-2134. [PMID: 35527025 PMCID: PMC9381347 DOI: 10.2169/internalmedicine.9065-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective Based on the increasing incidence of smell and taste dysfunction among coronavirus disease 2019 (COVID-19) patients, such issues have been considered an early symptom of infection. However, few studies have investigated the type of taste components that are most frequently affected in COVID-19 patients. This study investigated the difference in frequencies of the types of taste component disorders among hospitalized COVID-19 patients. Methods In this retrospective, single-center, observational study, patients' background characteristics, clinical course, laboratory and radiological findings, and details on taste and/or smell disorders were collected and analyzed from medical records. Patients A total of 227 COVID-19 patients were enrolled, among whom 92 (40.5%) complained of taste disorders. Results Multiple types of taste disorders (hypogeusia/ageusia and hypersensitivity, or hypersensitivity and changing tastes) were reported in 10 patients. In particular, 23 patients reported hypersensitivity to at least 1 type of taste, and 2 patients complained of a bitter taste on consuming sweet foods. Impairment of all taste components was found in 48 patients (52.2%). The most frequent taste disorder was salty taste disorder (81 patients, 89.0%). Hypersensitivity to salty taste was most frequently observed (19 patients, 20.9%). Conclusion Patients with COVID-19 develop multiple types of taste disorders, among which salty taste disorder was the most frequent, with many patients developing hypersensitivity to salty taste. As smell and taste are subjective senses, further studies with the combined use of objective examinations will be required to confirm the findings.
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Affiliation(s)
- Yuta Nanjo
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Tomoko Okuma
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yumi Kuroda
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Eri Hayakawa
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Kohei Shibayama
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Takashi Akimoto
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Ryoko Murashima
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Koichiro Kanamori
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Takeo Tsutsumi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yohei Suzuki
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yukiko Namba
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Fumihiko Makino
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Osamu Nagashima
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Shinichi Sasaki
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
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22
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Caretta A, Mucignat-Caretta C. Not Only COVID-19: Involvement of Multiple Chemosensory Systems in Human Diseases. Front Neural Circuits 2022; 16:862005. [PMID: 35547642 PMCID: PMC9081982 DOI: 10.3389/fncir.2022.862005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Chemosensory systems are deemed marginal in human pathology. In appraising their role, we aim at suggesting a paradigm shift based on the available clinical and experimental data that will be discussed. Taste and olfaction are polymodal sensory systems, providing inputs to many brain structures that regulate crucial visceral functions, including metabolism but also endocrine, cardiovascular, respiratory, and immune systems. Moreover, other visceral chemosensory systems monitor different essential chemical parameters of “milieu intérieur,” transmitting their data to the brain areas receiving taste and olfactory inputs; hence, they participate in regulating the same vital functions. These chemosensory cells share many molecular features with olfactory or taste receptor cells, thus they may be affected by the same pathological events. In most COVID-19 patients, taste and olfaction are disturbed. This may represent only a small portion of a broadly diffuse chemosensory incapacitation. Indeed, many COVID-19 peculiar symptoms may be explained by the impairment of visceral chemosensory systems, for example, silent hypoxia, diarrhea, and the “cytokine storm”. Dysregulation of chemosensory systems may underlie the much higher mortality rate of COVID-19 Acute Respiratory Distress Syndrome (ARDS) compared to ARDSs of different origins. In chronic non-infectious diseases like hypertension, diabetes, or cancer, the impairment of taste and/or olfaction has been consistently reported. This may signal diffuse chemosensory failure, possibly worsening the prognosis of these patients. Incapacitation of one or few chemosensory systems has negligible effects on survival under ordinary life conditions but, under stress, like metabolic imbalance or COVID-19 pneumonia, the impairment of multiple chemosensory systems may lead to dire consequences during the course of the disease.
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Affiliation(s)
- Antonio Caretta
- National Institute for Biostructures and Biosystems (NIBB), Rome, Italy
- Department of Food and Drug Science, University of Parma, Parma, Italy
| | - Carla Mucignat-Caretta
- National Institute for Biostructures and Biosystems (NIBB), Rome, Italy
- Department of Molecular Medicine, University of Padova, Padua, Italy
- *Correspondence: Carla Mucignat-Caretta,
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23
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Bhutani S, Coppin G, Veldhuizen MG, Parma V, Joseph PV. COVID-19 related chemosensory changes in individuals with self-reported obesity. Rhinology 2022; 60:128-138. [PMID: 35191431 PMCID: PMC11036347 DOI: 10.4193/rhin21.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Self-reported smell loss is a prominent symptom of COVID-19 infection and a potentially useful clinical tool for remote pre-screening of this disease. However, pre-existing chemosensory dysfunction with obesity may diminish the usefulness of self-reported smell loss in this vulnerable group. Here we aim to compare COVID-19 related chemosensory alterations in participants with and without obesity and determine if self-reported smell loss is predictive of lab-based COVID-19 diagnosis in both groups in the context of restrictive clinical data collection. SUBJECTS/METHODS In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to have obesity (C19+; n = 433, C19-; n = 86) or not. RESULTS Participants with obesity and without obesity reported a similar decline in smell, taste, and chemesthesis during illness. In C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory and GI symptoms. Critically, we found that the model previously proposed also predicts C19+ diagnosis in participants with obesity. CONCLUSIONS We conclude that COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity. In both groups self-reported chemosensory symptoms are similarly predictive of COVID-19 infection, thus highlighting the potential of collecting self-report of symptoms and comorbidities remotely when clinical observations are restrictive.
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Affiliation(s)
- S Bhutani
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - G Coppin
- Department of Psychology, Formation Universitaire Distance (UniDistance), Brig, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - M G Veldhuizen
- Department of Anatomy, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - V Parma
- Department of Psychology, Temple University, Monell Chemical Senses Center, Philadelphia, PA, USA
| | - P V Joseph
- National Institutes of Alcohol Abuse and Alcoholism and National Institute of Nursing Research, Bethesda, MD, USA
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24
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M L, N AG. A Comparative Study to Assess Utility of Olfactory and Gustatory Dysfunctions in the Diagnosis of Covid-19. J Assoc Physicians India 2022; 70:11-12. [PMID: 35443555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 is a global pandemic which has infected more than 100 million individuals and having taken a big toll on the world in terms of morbidity and mortality. The disease may progress in some patients from an influenza like illness to sever acute respiratory illness. Diagnosis of COVID 19 by RTPCR supported by radiological evidence, Material: In this prospective observational study, 60 COVID- 19 positive patients and 60 COVID negative/ suspect patients respectively were enrolled from march 2020 to July 2020 in Bowring and lady Curzon Hospital, Bangalore and they were assessed for taste and smell sensations based on SQOD- NS and questions based on smell and taste component of NHNE survey, symptomatic patients were followed up and duration needed for recovery of symptoms was analysed for P value, chi-square value, other relevant blood and radiological investigations were done. Observation: 1. To compare the olfactory and gustatory dysfunctions in COVID suspects and patients with laboratory-confirmed COVID-19 infection. 2. To assess utility of hypoguesia and hyposmia as discriminant clinical features that might be used for the diagnosis of COVID-19 in patients with ILI. Conclusion: We concluded that patients with COVID 19 positive status had severe spectrum of olfactory dysfunction like anosmia, hyposmia and they will have long recovery time compared to COVID negative /suspect patients .Taste perception was more impaired in COVID positive patients compared to COVID negative /suspects.Covid positive patients had higher sQOD-NS score compared to COVID negative patients and significant associations are seen.
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Affiliation(s)
- Lokesh M
- Bangalore Medical College, Bangalore
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25
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Lee SH, Yeoh ZX, Sachlin IS, Gazali N, Soelar SA, Foo CY, Low LL, Syed Alwi SB, Tengku Kamalden TMI, Shanmuganathan J, Zaid M, Wong CY, Chua HH, Yusuf S, Muhamad D, Devesahayam PR, Ker HB, Salahuddin Z, Mustafa M, Sawali H, Lee HG, Din S, Misnan NA, Mohamad A, Ismail MN, Periasamy C, Chow TS, Krishnan EK, Leong CL, Lim LPF, Zaidan NZ, Ibrahim MZ, Abd Wahab S, Mohd Hashim SS. Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia. Sci Rep 2022; 12:2111. [PMID: 35136124 PMCID: PMC8826975 DOI: 10.1038/s41598-022-06029-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/21/2022] [Indexed: 01/08/2023] Open
Abstract
Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.
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Affiliation(s)
- Shen-Han Lee
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia.
| | - Zhi Xiang Yeoh
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Ida Sadja'ah Sachlin
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Norzi Gazali
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | | | - Chee Yoong Foo
- Real World Insights, IQVIA Asia Pacific, Petaling Jaya, Malaysia
| | - Lee Lee Low
- Department of Medicine, Hospital Sultanah Bahiyah, Kedah, Malaysia
| | | | | | | | - Masliza Zaid
- Department of Medicine, Hospital Sultanah Aminah, Johor, Malaysia
| | - Chun Yiing Wong
- Department of Otorhinolaryngology, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Hock Hin Chua
- Department of Medicine, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Suhaimi Yusuf
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | - Dzawani Muhamad
- Department of Medicine, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | | | - Hong Bee Ker
- Department of Medicine, Hospital Raja Permaisuri Bainun, Perak, Malaysia
| | - Zulkiflee Salahuddin
- Department of Otorhinolaryngology, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Mahiran Mustafa
- Department of Medicine, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Halimuddin Sawali
- Department of Otorhinolaryngology, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Heng Gee Lee
- Department of Medicine, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Sobani Din
- Department of Otorhinolaryngology, Hospital Sungai Buloh, Selangor, Malaysia
| | | | - Amran Mohamad
- Department of Otorhinolaryngology, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | - Mohd Noor Ismail
- Department of Medicine, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | | | - Ting Soo Chow
- Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia
| | | | - Chee Loon Leong
- Department of Medicine, Hospital Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | | | - Mohd Zambri Ibrahim
- Department of Otorhinolaryngology, Hospital Tuanku Fauziah, Perlis, Malaysia
| | | | - Siti Sabzah Mohd Hashim
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
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Overdevest JB, Irace AL, Mazzanti V, Oh EJ, Joseph PV, Devanand DP, Bitan ZC, Hod EA, Gudis DA, Chiuzan C. Chemosensory deficits are best predictor of serologic response among individuals infected with SARS-CoV-2. PLoS One 2022; 17:e0274611. [PMID: 36516124 PMCID: PMC9750016 DOI: 10.1371/journal.pone.0274611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Smell and taste alteration are closely linked to infection with SARS-CoV-2 and may be associated with a more indolent disease course. Serologic response rates among individuals with mild disease remains limited. We sought to identify whether chemosensory changes associated with COVID-19 were predictive of a serologic response. STUDY DESIGN Cross-sectional study. METHODS The sample consisted of 306 adults (≥18 years old) volunteering for convalescent plasma donation following perceived COVID-19 illness from April-June 2020. Documentation of COVID-19 PCR status, clinical symptoms at time of illness, and treatment course occurred at the time of serologic analysis, where we assessed chemosensory function using patient-perceived deficits. We implemented previously validated ELISA screening to determine serologic status regarding anti-Spike immunoglobulins. Statistical analysis using stepwise logistic models were employed to identify predictive factors of serologic response. RESULTS Of 306 patients undergoing serologic and chemosensory evaluation, 196 (64.1%) and 195 (63.7%) reported subjective olfactory and taste dysfunction, respectively, during the first two weeks of COVID-19 infection. In unadjusted models, the odds of developing suprathreshold IgG antibody titers were 1.98 times higher among those who reported altered smell (95% CI 1.14-3.42, p = 0.014) and 2.02 times higher among those with altered taste (95% CI 1.17-3.48, p = 0.011) compared to those with normal smell and taste. Multivariable logistic models adjusting for sex, age, race/ethnicity, symptom duration, smoking status and comorbidities index demonstrated that altered smell and taste remained significant predictors of positive anti-spike IgG response (smell OR = 1.90, 95% CI 1.05-3.44, p = 0.033; taste OR = 2.01, 95% CI = 1.12-3.61, p = 0.019). CONCLUSION Subjective chemosensory dysfunction, as self-reported smell or taste deficiency, is highly predictive of serologic response following SARS-CoV-2 infection. This information may be useful for patient counseling. Additional longitudinal research should be performed to better understand the onset and duration of the serologic response in these patients.
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Affiliation(s)
- Jonathan B. Overdevest
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, NY, United States of America
- * E-mail:
| | - Alexandria L. Irace
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Valeria Mazzanti
- Department of Biostatistics, Columbia University, New York, NY, United States of America
| | - Eun Jeong Oh
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Paule V. Joseph
- National Institute of Alcohol Abuse and Alcoholism, Section of Sensory Science and Metabolism & National Institute of Nursing Research, Bethesda, MD, United States of America
| | - Davangere P. Devanand
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States of America
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY, United States of America
| | - Zachary C. Bitan
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - Eldad A. Hod
- Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America
| | - David A. Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Codruta Chiuzan
- Department of Biostatistics, Columbia University, New York, NY, United States of America
- Institute of Health System Science Feinstein Institutes for Medical Research Northwell Health, New York, NY, United States of America
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27
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Myshchenko I, Ostrovskyy M, Kolhanov A, Makoida I, Hrechukh L. PREVALENCE OF SENSORY DYSFUNCTIONS IN ADULT UKRAINIAN POPULATION WITH LABORATORY CONFIRMED COVID-19. Wiad Lek 2022; 75:670-677. [PMID: 35522877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim: To analyse the structure of sensory impairments, associated with COVID-19. To identify terms of recovery periods depending on severity of disease, age and gender of the patients. PATIENTS AND METHODS Materials and methods: Within two weeks, 2225 patients with confirmed COVID-19 completed a questionnaire, created by Google Forms. General complaints, peculiarities of sensory impairments and recovery time were specified. After exclusion criteria application, data of 2108 patients were analyzed by R Statistics Package, Student's t-test, Wilcoxon rank-sum test, Fisher's exact test, Spearman's rank test. RESULTS Results: Among patients enrolled (973 males and 1135 females, mean age 28.6±0.18) the most frequent were olfactory (91.32%) and gustatory (66.03%) dysfunctions. Olfactory manifestations were usually accompanied by gustatory disorders (73.72%). Average duration of olfactory dysfunction was 15.46±0.45 days, gustatory - 11.3±0.33, hearing - 4.3±0.16, and visual - 6.53±0.23 days. It was found a correlation between duration of olfactory and gustatory impairments (r=0.65; p < 0.001), hearing and visual disorders (r=0.49; p < 0.05). CONCLUSION Conclusions: Olfactory and gustatory disorders are prevalent symptoms in Ukrainian population. 7.87% of respondents who had impairment of all four sensory functions had the longest recovery time. Duration of sensory impairments did not depend on age, type of treatment and severity of disease, which rises the question about the neurogenic pathway of virus.
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Affiliation(s)
- Iryna Myshchenko
- DEPARTMENT HYGIENE AND ECOLOGY, IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE; ACCREDITED LABORATORY OF OCCUPATIONAL HEALTH AND SAFETY, WROCLAW UNIVERSITY OF SCIENCE TECHNOLOGY, WROCLAW, POLAND
| | - Mykola Ostrovskyy
- DEPARTMENT OF PHTHISIOLOGY AND PULMONOLOGY WITH COURSE OF OCCUPATIONAL DISEASES, IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Anatolii Kolhanov
- DEPARTMENT HYGIENE AND ECOLOGY, IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Iryna Makoida
- DEPARTMENT OF PHTHISIOLOGY AND PULMONOLOGY WITH COURSE OF OCCUPATIONAL DISEASES, IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Lidiia Hrechukh
- DEPARTMENT HYGIENE AND ECOLOGY, IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
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Vaira LA, Calvo-Henriquez C, Mayo-Yanes M, Hoch CC, Lechien JR. Olfactory and gustatory dysfunctions are difficult to evaluate in hospitalized COVID-19 patients. Am J Otolaryngol 2021; 42:103169. [PMID: 34352674 PMCID: PMC8323548 DOI: 10.1016/j.amjoto.2021.103169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/31/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Luigi A Vaira
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy; PhD School of Biomedical Sciences, Biomedical Sciences Department, University of Sassari, Italy.
| | - Christian Calvo-Henriquez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Mayo-Yanes
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otolaryngology - Hospital Complex of A Coruña, A Coruña, Spain
| | - Cosima C Hoch
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Jerome R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
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Lechien JR, Saussez S, Maniaci A, Vaira LA. The study of recovery rates of COVID-19 olfactory and gustatory dysfunctions requires psychophysical evaluations. Am J Otolaryngol 2021; 42:103168. [PMID: 34339959 PMCID: PMC8320430 DOI: 10.1016/j.amjoto.2021.103168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 05/25/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Jerome R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Sven Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Antonino Maniaci
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Medical and Surgical Sciences and Advanced Technologies G.F. Ingrassia, ENT Section, University of Catania, Catania, Italy
| | - Luigi A Vaira
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy; Biomedical Science PhD School, Biomedical Science Department, University of Sassari, Italy
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30
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Biadsee A, Biadsee A. Commentary on Letter to the Editor regarding "Eight-month follow-up of olfactory and gustatory dysfunction in recovered COVID-19 patients". Am J Otolaryngol 2021; 42:103190. [PMID: 34488185 PMCID: PMC8410223 DOI: 10.1016/j.amjoto.2021.103190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Ameer Biadsee
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ameen Biadsee
- Department of Otorhinolaryngology - Head and Neck Surgery, Meir Medical Center, Kfar-Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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31
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Petrocelli M, Cutrupi S, Salzano G, Maglitto F, Salzano FA, Lechien JR, Saussez S, Boscolo-Rizzo P, De Riu G, Vaira LA. Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study. J Laryngol Otol 2021; 135:436-441. [PMID: 33888166 PMCID: PMC8111201 DOI: 10.1017/s002221512100116x] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. METHODS Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. RESULTS A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. CONCLUSION Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance.
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Affiliation(s)
- M Petrocelli
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, Italy
| | - S Cutrupi
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Dentistry Operative Unit, Bellaria and Maggiore Hospital, AUSL of Bologna, Italy
| | - G Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F Maglitto
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F A Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitan, University of Salerno, Italy
| | - J R Lechien
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - S Saussez
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - P Boscolo-Rizzo
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - G De Riu
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Department of Medical, Surgical and Experimental Sciences, Italy
| | - L A Vaira
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Biomedical Science Department, Biomedical Science PhD School, University of Sassari, Italy
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Abstract
During the COVID-19 pandemic, it became clear that smell and taste (chemosensory) disturbance is very common in the early stages of disease. This article addresses (i) why COVID-19 specifically targets the modalities of smell and possibly taste and what is the mechanism, (ii) what is the frequency of smell and taste loss and (iii) what is the overall prognosis. It is suggested that mouth-breathers may be at particular risk of COVID-19. Symptom-based questionnaires are likely to under-estimate the prevalence of chemosensory impairment by as much as 50%. The prevalence of smell loss is so high that a person who has normal olfaction on formal testing is unlikely to be infected significantly with Cov-2. Furthermore, someone without symptoms who has an abnormal smell test could still be infected and liable to spread the disease. Brief, low-cost, olfactory tests are available that would permit a high throughput in field stations and airports. A normal result might obviate the need for a nasopharyngeal swab for the Cov-2 virus.
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Affiliation(s)
- Christopher H Hawkes
- Blizard Institute, Queen Mary University of London, 4 Newark St, London, E1 2AT, UK
- To whom correspondence should be addressed.
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34
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Catamo E, Tornese G, Concas MP, Gasparini P, Robino A. Differences in taste and smell perception between type 2 diabetes mellitus patients and healthy controls. Nutr Metab Cardiovasc Dis 2021; 31:193-200. [PMID: 33500104 DOI: 10.1016/j.numecd.2020.08.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS The senses of taste and smell are essential determinants of food choice, which in turn may contribute to the development of chronic diseases, including diabetes. Although past studies have evaluated the relationship between type 2 diabetes mellitus (DM2) and senses disorders, this relationship remains controversial. In this study, we evaluated taste and smell perception in DM2 patients and healthy controls (HC). Moreover, we analyzed the association of chemosensory impairments with anthropometric and clinical outcomes (e.g. Body Mass Index (BMI), Fasting blood glucose (FBG), drugs, cardiovascular diseases (CVD), and hypertension) in DM2 patients. METHODS AND RESULTS The study included 94 DM2 patients and 244 HC. Taste recognition for 6-n-propylthiouracil (PROP), quinine, citric acid, sucrose, and sodium chloride (NaCl) compounds was assessed using a filter paper method, while smell recognition of 12 odorants was performed using a Sniffin' sticks test. We found that a higher percentage of DM2 patients showed identification impairment in salt taste (22% vs. 5%, p-value<0.0009) and smell recognition (55% vs. 27%, p-value = 0.03) compared to HC. We also observed that 65% of hypertensive DM2 subjects presented smell identification impairment compared to 18% of non-hypertensive patients (p-value = 0.019). Finally, patients with impairments in both taste and smell showed elevated FBG compared to patients without impairment (149.6 vs.124.3 mg/dL, p-value = 0.04). CONCLUSION The prevalence of taste and smell identification impairments was higher in DM2 patients compared to HC, and a possible relationship with glycemic levels emerged.
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Affiliation(s)
- Eulalia Catamo
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Gianluca Tornese
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Maria P Concas
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Paolo Gasparini
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy; Department of Medical Sciences, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
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35
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Cazzolla AP, Lovero R, Lo Muzio L, Testa NF, Schirinzi A, Palmieri G, Pozzessere P, Procacci V, Di Comite M, Ciavarella D, Pepe M, De Ruvo C, Crincoli V, Di Serio F, Santacroce L. Taste and Smell Disorders in COVID-19 Patients: Role of Interleukin-6. ACS Chem Neurosci 2020; 11:2774-2781. [PMID: 32786309 PMCID: PMC7437448 DOI: 10.1021/acschemneuro.0c00447] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022] Open
Abstract
The rapid recovery of smell and taste functions in COVID-19 patients could be attributed to a decrease in interleukin-6 levels rather than central nervous system ischemic injury or viral damage to neuronal cells. To correlate interleukin-6 levels in COVID-19 patients with olfactory or gustatory dysfunctions and to investigate the role of IL-6 in the onset of these disorders, this observational study investigated 67 COVID-19 patients with taste or smell disorders or both, who did not require intensive care admission, admitted at COVID Hospital of Policlinico of Bari from March to May 2020. Interleukin-6 was assayed in COVID-19 patients with taste or smell disturbances at the time of admission and at the time of swab negativization. At the same time, patients have been given a specific survey to evaluate the severity of taste and smell disturbances. Of 125 patients with smell or taste dysfunctions at onset of disease, 67 fulfilled the inclusion criteria, while 58 were excluded because 35 of them required intensive care admission, 5 were unable to answer, 5 died, 7 had finished chemotherapy recently, and 5 refused to participate. The evaluation of taste and smell disorders was carried out using a survey performed at the time of admission and at the time of swab negativization. Sinonasal outcome test 22 (SNOT-22) was used as a reference for olfactory function assessment, and Taste and Smell Questionnaire Section of the US NHANES 2011-2014 protocol (CDC 2013b) was used as reference for gustatory function assessment. A venous blood sample was taken for each patient to measure IL-6 levels upon entry and at swab negativization. Interleukin-6 levels in COVID-19 patients in relation to olfactory or gustatory disorders were correlated from the time of their admission to the time of swab negativization. Statistically significant correlations were obtained between the decrease of interleukin-6 levels and the improvement of smell (p value < 0.05) and taste (p = 0.047) functions at swab negativization. The acquired results demonstrate the key role of interleukin-6 in the pathogenesis of chemosensitive disorders in COVID-19 patients.
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Affiliation(s)
- Angela P. Cazzolla
- Department of Clinical and
Experimental Medicine, Università degli Studi di
Foggia, Foggia 71122,
Italy
| | - Roberto Lovero
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Clinical Pathology Unit, Bari 70124, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and
Experimental Medicine, Università degli Studi di
Foggia, Foggia 71122,
Italy
| | - Nunzio F. Testa
- Department of Clinical and
Experimental Medicine, Università degli Studi di
Foggia, Foggia 71122,
Italy
| | - Annalisa Schirinzi
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Clinical Pathology Unit, Bari 70124, Italy
| | | | - Pietro Pozzessere
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Emergency Medicine and Surgery Unit, Bari 70124,
Italy
| | - Vito Procacci
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Emergency Medicine and Surgery Unit, Bari 70124,
Italy
| | - Mariasevera Di Comite
- Department of Basic Medical Sciences,
Neurosciences and Sensory Organs, Human Anatomy Section,
Università degli Studi di
Bari, Bari 70124, Italy
| | - Domenico Ciavarella
- Department of Clinical and
Experimental Medicine, Università degli Studi di
Foggia, Foggia 71122,
Italy
| | - Maria Pepe
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Clinical Pathology Unit, Bari 70124, Italy
| | - Caterina De Ruvo
- Maugeri Clinical Research
Institutes IRCCS of Bari, Bari 70124,
Italy
| | - Vito Crincoli
- Department of Basic Medical Sciences,
Neurosciences and Sensory Organs, Human Anatomy Section,
Università degli Studi di
Bari, Bari 70124, Italy
| | - Francesca Di Serio
- AOU Policlinico
Consorziale di Bari - Ospedale Giovanni XXIII,
Clinical Pathology Unit, Bari 70124, Italy
| | - Luigi Santacroce
- Ionian Department (DJSGEM),
Microbiology and Virology Lab, Università degli
Studi di Bari, Bari 70124,
Italy
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36
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Jacquot L, Bereau M. [Aging and disorders of taste and smell]. Soins Gerontol 2020; 25:18-21. [PMID: 32988482 DOI: 10.1016/j.sger.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Compared with other sensory modalities, age-related alterations in taste and smell are less known and less investigated in clinical practice. In fact, the elderly with a loss of smell or taste may not always report it or be aware of it. In addition, the clinical evaluation of taste and smell by specific tests is rarely performed.
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Affiliation(s)
- Laurence Jacquot
- Laboratoire de neurosciences intégratives et cliniques, EA 481, université de Bourgogne Franche-Comté, 19 rue Ambroise-Paré, 25030 Besançon cedex, France.
| | - Matthieu Bereau
- Laboratoire de neurosciences intégratives et cliniques, EA 481, université de Bourgogne Franche-Comté, 19 rue Ambroise-Paré, 25030 Besançon cedex, France; Service de neurologie, centre hospitalier régional universitaire Jean-Minjoz, 3 boulevard Alexandre-Fleming, 25000 Besançon, France
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37
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Sayin İ, Yaşar KK, Yazici ZM. Taste and Smell Impairment in COVID-19: An AAO-HNS Anosmia Reporting Tool-Based Comparative Study. Otolaryngol Head Neck Surg 2020; 163:473-479. [PMID: 32513096 PMCID: PMC7284454 DOI: 10.1177/0194599820931820] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To identify the taste and smell impairment in coronavirus disease 2019 (COVID-19)-positive subjects and compare the findings with COVID-19-negative subjects using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Anosmia Reporting Tool. SETTING Tertiary referral center/COVID-19 pandemic hospital. STUDY DESIGN Comparative study. SUBJECTS AND METHODS After power analysis, 128 subjects were divided into 2 groups according to real-time polymerase chain reaction (RT-PCR) COVID-19 testing results. Subjects were called via telephone, and the AAO-HNS Anosmia Reporting Tool was used to collect responses. RESULTS The mean age of the study group was 38.63 ± 10.08 years. At the time of sampling, rhinorrhea was significantly high in the COVID-19-negative group, whereas those complaints described as "other" were significantly high in the COVID-19-positive group. There was a significant difference in the smell/taste impairment rates of the groups (n = 46% [71.9%] for the COVID-19-positive group vs n = 17 [26.6%] for the COVID-19-negative group, P = .001). For subjects with a smell impairment, anosmia rates did not differ between the groups. The rates of hyposmia and parosmia were significantly high in the COVID-19-positive group. For the subjects with taste impairment, ageusia rates did not differ between groups. The rate of hypogeusia and dysgeusia was significantly high in the COVID-19-positive group. Logistic regression analysis indicates that smell/taste impairment in COVID-19-positive subjects increases the odds ratio by 6.956 (95% CI, 3.16-15.29) times. CONCLUSION COVID-19-positive subjects are strongly associated with smell/taste impairment.
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Affiliation(s)
- İbrahim Sayin
- Department of Otolaryngology Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey
| | - Kadriye Kart Yaşar
- Department of Infectious Diseases, Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey
| | - Zahide Mine Yazici
- Department of Otolaryngology Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey
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Agyeman AA, Chin KL, Landersdorfer CB, Liew D, Ofori-Asenso R. Smell and Taste Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis. Mayo Clin Proc 2020; 95:1621-1631. [PMID: 32753137 PMCID: PMC7275152 DOI: 10.1016/j.mayocp.2020.05.030] [Citation(s) in RCA: 253] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To estimate the prevalence of olfactory and gustatory dysfunctions (OGDs) among patients infected with novel coronavirus disease 2019 (COVID-19). METHODS A systematic review was conducted by searching MEDLINE, EMBASE, and the preprint server MedRxiv from their inception until May 11, 2020, using the terms anosmia or hyposmia or dysosmia or olfactory dysfunction or olfaction disorder or smell dysfunction or ageusia or hypogeusia or dysgeusia or taste dysfunction or gustatory dysfunction or neurological and COVID-19 or 2019 novel coronavirus or 2019-nCoV or SARS-CoV-2. The references of included studies were also manually screened. Only studies involving patients with diagnostic-confirmed COVID-19 infection were included. Random-effects meta-analysis was performed. RESULTS Twenty-four studies with data from 8438 patients with test-confirmed COVID-19 infection from 13 countries were included. The pooled proportions of patients presenting with olfactory dysfunction and gustatory dysfunction were 41.0% (95% CI, 28.5% to 53.9%) and 38.2% (95% CI, 24.0% to 53.6%), respectively. Increasing mean age correlated with lower prevalence of olfactory (coefficient = -0.076; P=.02) and gustatory (coefficient = -0.073; P=.03) dysfunctions. There was a higher prevalence of olfactory dysfunctions with the use of objective measurements compared with self-reports (coefficient = 2.33; P=.01). No significant moderation of the prevalence of OGDs by sex was observed. CONCLUSION There is a high prevalence of OGDs among patients infected with COVID-19. Routine screening for these conditions could contribute to improved case detection in the ongoing COVID-19 pandemic. However, to better inform population screening measures, further studies are needed to establish causality.
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Affiliation(s)
- Akosua Adom Agyeman
- Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Melbourne, Victoria, Australia
| | - Ken L Chin
- Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia; Monash University, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Cornelia B Landersdorfer
- Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Melbourne, Victoria, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia
| | - Richard Ofori-Asenso
- Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia; Department of Pharmacy, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.
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39
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Vaira LA, Hopkins C, Petrocelli M, Lechien JR, Chiesa-Estomba CM, Salzano G, Cucurullo M, Salzano FA, Saussez S, Boscolo-Rizzo P, Biglioli F, De Riu G. Smell and taste recovery in coronavirus disease 2019 patients: a 60-day objective and prospective study. J Laryngol Otol 2020; 134:703-709. [PMID: 32782030 PMCID: PMC7471571 DOI: 10.1017/s0022215120001826] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The long-term recovery rate of chemosensitive functions in coronavirus disease 2019 patients has not yet been determined. METHOD A multicentre prospective study on 138 coronavirus disease 2019 patients was conducted. Olfactory and gustatory functions were prospectively evaluated for 60 days. RESULTS Within the first 4 days of coronavirus disease 2019, 84.8 per cent of patients had chemosensitive dysfunction that gradually improved over the observation period. The most significant increase in chemosensitive scores occurred in the first 10 days for taste and between 10 and 20 days for smell. At the end of the observation period (60 days after symptom onset), 7.2 per cent of the patients still had severe dysfunctions. The risk of developing a long-lasting disorder becomes significant at 10 days for taste (odds ratio = 40.2, 95 per cent confidence interval = 2.204-733.2, p = 0.013) and 20 days for smell (odds ratio = 58.5, 95 per cent confidence interval = 3.278-1043.5, p = 0.005). CONCLUSION Chemosensitive disturbances persisted in 7.2 per cent of patients 60 days after clinical onset. Specific therapies should be initiated in patients with severe olfactory and gustatory disturbances 20 days after disease onset.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
| | - C Hopkins
- ENT Department, King's College, London, UK
| | - M Petrocelli
- Maxillofacial Surgery Operative Unit, Bellaria-Maggiore Hospital, Un'azienda Sanitaria Locale (‘AUSL’) Bologna, Italy
| | - J R Lechien
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
- Department of Human and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (‘UMons’), Belgium
| | - C M Chiesa-Estomba
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
- Department of Otorhinolaryngology, Osakidetza, Donostia University Hospital, Biodonostia Health Research Institute, San Sebastian, Spain
| | - G Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples ‘Federico II’, Italy
| | - M Cucurullo
- Maxillofacial Surgery Department, San Paolo Hospital, Azienda Socio Sanitaria Territoriale (‘ASST’) Santi Paolo e Carlo, University of Milan, Italy
| | - F A Salzano
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, ‘Scuola Medica Salernitana’, University of Salerno, Italy
| | - S Saussez
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
| | - P Boscolo-Rizzo
- Department of Neurosciences, Section of Otolaryngology, University of Padua, Treviso, Italy
| | - F Biglioli
- Maxillofacial Surgery Department, San Paolo Hospital, Azienda Socio Sanitaria Territoriale (‘ASST’) Santi Paolo e Carlo, University of Milan, Italy
| | - G De Riu
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
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Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, Ganesh S, Varsavsky T, Cardoso MJ, El-Sayed Moustafa JS, Visconti A, Hysi P, Bowyer RCE, Mangino M, Falchi M, Wolf J, Ourselin S, Chan AT, Steves CJ, Spector TD. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med 2020; 26:1037-1040. [PMID: 32393804 PMCID: PMC7751267 DOI: 10.1038/s41591-020-0916-2] [Citation(s) in RCA: 829] [Impact Index Per Article: 207.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
A total of 2,618,862 participants reported their potential symptoms of COVID-19 on a smartphone-based app. Among the 18,401 who had undergone a SARS-CoV-2 test, the proportion of participants who reported loss of smell and taste was higher in those with a positive test result (4,668 of 7,178 individuals; 65.03%) than in those with a negative test result (2,436 of 11,223 participants; 21.71%) (odds ratio = 6.74; 95% confidence interval = 6.31-7.21). A model combining symptoms to predict probable infection was applied to the data from all app users who reported symptoms (805,753) and predicted that 140,312 (17.42%) participants are likely to have COVID-19.
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Affiliation(s)
- Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
| | - Ana M Valdes
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
- Academic Rheumatology, Clinical Sciences, Nottingham City Hospital, Nottingham, UK
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Carole H Sudre
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Long H Nguyen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David A Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Thomas Varsavsky
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | | | - Alessia Visconti
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Pirro Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
- NIHR Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, UK
| | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
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Vaira LA, Hopkins C, Salzano G, Petrocelli M, Melis A, Cucurullo M, Ferrari M, Gagliardini L, Pipolo C, Deiana G, Fiore V, De Vito A, Turra N, Canu S, Maglio A, Serra A, Bussu F, Madeddu G, Babudieri S, Giuseppe Fois A, Pirina P, Salzano FA, De Riu P, Biglioli F, De Riu G. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study. Head Neck 2020; 42:1560-1569. [PMID: 32437022 PMCID: PMC7280583 DOI: 10.1002/hed.26269] [Citation(s) in RCA: 200] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Objective data on chemosensitive disorders during COVID-19 are lacking in the Literature. METHODS Multicenter cohort study that involved four Italian hospitals. Three hundred and forty-five COVID-19 patients underwent objective chemosensitive evaluation. RESULTS Chemosensitive disorders self-reported by 256 patients (74.2%) but the 30.1% of the 89 patients who did not report dysfunctions proved objectively hyposmic. Twenty-five percentage of patients were seen serious long-lasting complaints. All asymptomatic patients had a slight lowering of the olfactory threshold. No significant correlations were found between the presence and severity of chemosensitive disorders and the severity of the clinical course. On the contrary, there is a significant correlation between the duration of the olfactory and gustatory symptoms and the development of severe COVID-19. CONCLUSIONS Patients under-report the frequency of chemosensitive disorders. Contrary to recent reports, such objective testing refutes the proposal that the presence of olfactory and gustatory dysfunction may predict a milder course, but instead suggests that those with more severe disease neglect such symptoms in the setting of severe respiratory disease.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative UnitUniversity Hospital of SassariSassariItaly
| | | | - Giovanni Salzano
- Maxillofacial Surgery UnitUniversity Hospital of Naples “Federico II”NaplesItaly
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit; Bellaria and Maggiore Hospital, AUSLBolognaItaly
| | - Andrea Melis
- Otolaryngology Operative UnitUniversity Hospital of SassariSassariItaly
| | - Marco Cucurullo
- Maxillofacial Surgery Department, San Paolo Hospital, ASST Santi Paolo e CarloUniversity of MilanMilanItaly
| | - Mario Ferrari
- Maxillofacial Surgery Department, San Paolo Hospital, ASST Santi Paolo e CarloUniversity of MilanMilanItaly
| | - Laura Gagliardini
- Otolaryngology Operative Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health SciencesUniversity of MilanMilanItaly
| | - Carlotta Pipolo
- Otolaryngology Operative Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health SciencesUniversity of MilanMilanItaly
| | - Giovanna Deiana
- Department of Medical, Surgical and Experimental SciencesUniversity of SassariSassariItaly
| | - Vito Fiore
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Andrea De Vito
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Nicola Turra
- Otolaryngology Operative UnitUniversity Hospital of SassariSassariItaly
| | - Sara Canu
- Respiratory Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Angelantonio Maglio
- Respiratory Diseases Operative Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoBaronissiSalernoItaly
| | - Antonello Serra
- Surveillance and Prevention DepartmentUniversity Hospital of SassariSassariItaly
| | - Francesco Bussu
- Otolaryngology Operative UnitUniversity Hospital of SassariSassariItaly
| | - Giordano Madeddu
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Sergio Babudieri
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | | | - Pietro Pirina
- Respiratory Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Francesco A. Salzano
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoBaronissiSalernoItaly
| | | | - Federico Biglioli
- Maxillofacial Surgery Department, San Paolo Hospital, ASST Santi Paolo e CarloUniversity of MilanMilanItaly
| | - Giacomo De Riu
- Maxillofacial Surgery Operative UnitUniversity Hospital of SassariSassariItaly
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Kodama H, Tanaka M, Naito Y, Katayama K, Moriyama M. Japan's Practical Guidelines for Zinc Deficiency with a Particular Focus on Taste Disorders, Inflammatory Bowel Disease, and Liver Cirrhosis. Int J Mol Sci 2020; 21:ijms21082941. [PMID: 32331308 PMCID: PMC7215354 DOI: 10.3390/ijms21082941] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/31/2020] [Accepted: 04/08/2020] [Indexed: 12/12/2022] Open
Abstract
Zinc deficiency is common in Japan, yet awareness on this disorder is lacking. The Japanese Society of Clinical Nutrition recently issued the Japan’s Practical Guideline for Zinc Deficiency 2018 setting forth criteria for diagnosing zinc deficiency, i.e., (a) one or more symptoms of zinc deficiency or low serum alkaline phosphatase, (b) ruling out other diseases, (c) low serum zinc, and (d) alleviation of symptoms upon zinc administration. Serum zinc <60 μg/dL and 60–80 μg/dL indicate zinc deficiency and marginal deficiency, respectively. Zinc deficiency symptoms vary and include dermatitis and taste disorders among others. Zinc administration improves taste in 50–82% of patients suffering from taste disorders (a common symptom of zinc deficiency). Effects of zinc administration do not appear immediately, and therapy should be continued for at least three months. Zinc deficiency often accompanies various diseases and conditions. Here, we focus on inflammatory bowel diseases and liver cirrhosis. As zinc deficiency enhances intestinal inflammation via macrophage activation, we discuss the pathological mechanism for inflammation and zinc deficiency in the context of IBD. Zinc deficiency can also lead to a nitrogen metabolic disorder in patients with liver cirrhosis. Zinc supplementation can improve not only the ammonia metabolism, but also the protein metabolism. We also discuss directions for future studies of zinc deficiency.
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Affiliation(s)
- Hiroko Kodama
- Department of Health and Dietetics, Faculty of Health and Medical Sciences, Teikyo Heisei University, 2-51-4, Higashiikebukuro, Toshima-ku, Tokyo 170-8445, Japan
- Correspondence: ; Tel.: +81-3-5843-3111; Fax: +81-3-5843-3153
| | - Makoto Tanaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan;
| | - Yuji Naito
- Department of Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 620-8566, Japan;
| | - Kazuhiro Katayama
- Department of Hepato-Biliary and Pancreatic Oncology, International Cancer Institute, Osaka 541-8567, Japan;
| | - Mitsuhiko Moriyama
- Department of Internal Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610 Japan;
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Fjaeldstad A, Stankovic J, Onat M, Stankevice D, Ovesen T. Patients and experiences from the first Danish flavour clinic. Dan Med J 2020; 67:1-5. [PMID: 33576332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Chemosensory dysfunction is common. Although patients complain of taste loss, the most common cause of a diminished taste experience is olfactory dysfunction. METHODS Since January 2017, patients with complaints about smell and/or taste loss have been referred to the Flavour Clinic by ear, nose and throat (ENT) practitioners. Prior to referral, CT, endoscopy of the nasal cavity and allergy testing were required. Patients underwent full olfactory and gustatory testing, complete ENT and neurological examination and review of medicine and medical history. Patients also completed different questionnaires such as the Mini Mental Status Examination, the Sino-Nasal Outcome Test and the Major Depression Inventory. RESULTS Among 515 patients, 97% complained of olfactory loss and 82% complained of taste loss. While 89% had a measurable olfactory deficit, only 22% were found to have a gustatory deficit. CONCLUSIONS An accurate distinction between smell and taste requires application of validated chemosensory tests and specialised knowledge. As this is not readily available in all ENT clinics, sensory loss without a clear aetiology should be referred to a more specialisedcentre. FUNDING none. TRIAL REGISTRATION not relevant.
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Högerle C. [Smell and taste dysfunction in the elderly population - what the general practitioner needs to know]. MMW Fortschr Med 2019; 161:48-52. [PMID: 31587200 DOI: 10.1007/s15006-019-0962-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Catalina Högerle
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Klinikum der Universität München, Marchioninistr. 15, D-81377, München, Deutschland.
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Abstract
OBJECTIVES We developed an edible taste film test that can be stored easily as a kit. This study was conducted to confirm the agreement between the results of the edible taste film kit test and the conventional taste solution test. DESIGN Prospective, randomised, controlled trial. SETTING Single tertiary hospital. PARTICIPANTS Sixty-two healthy volunteers with no self-described taste problems. INTERVENTIONS A randomisation scheme was used to determine the order of use of the edible taste film kit and the taste solution test for each subject. The taste solution test was performed using a cotton swab. In the taste film kit test, an edible taste film was placed on the tongue, and the subject detected the taste after the film was dissolved by saliva. OUTCOME MEASURES For each test, we measured the taste identification threshold, taste detection time and total test time. RESULTS We confirmed the consistency of the taste identification thresholds of the two tests, and the results were consistent with each other except for the bitter taste results, which used coffee in the edible taste film kit and quinine in the taste solution test. Although the detection time for each taste quality was faster for the taste solution test, the mean total time was significantly shorter for the taste film kit test than for the taste solution test (6.16±2.27 min vs 7.04±1.98 min, respectively; p=0.004). CONCLUSIONS The edible taste film kit along with the taste solution test will be useful for quantitative taste testing. TRIAL REGISTRATION NUMBER KCT0002865.
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Affiliation(s)
- Ji-Sun Kim
- Otorhinolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Dong-Hyun Kim
- Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Eun-Ju Jeon
- Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Byung Guk Kim
- Otorhinolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Jeongjun Yu
- Ancors R&D Center, Seoul, The Republic of Korea
| | - Hyun-Il Shin
- Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
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Rasmussen VF, Vestergaard ET, Hejlesen O, Andersson CUN, Cichosz SL. Prevalence of taste and smell impairment in adults with diabetes: A cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES). Prim Care Diabetes 2018; 12:453-459. [PMID: 29903679 DOI: 10.1016/j.pcd.2018.05.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/30/2018] [Accepted: 05/18/2018] [Indexed: 11/26/2022]
Abstract
AIM This study investigates the prevalence of smell and taste impairment in adults with diabetes and potential risk factors for sense deterioration and its influence of daily food intake. METHODS Data from the NHANES 2013-2014 were analyzed. Smell impairment was defined as failing to identify ≥3 of 8 odors in NHANES Pocket Smell Test. Taste impairment was defined as being unable to identify quinine or NaCl in NHANES Tongue Tip and Whole-mouth Test. RESULTS A total of 3204 people (428 patients with diabetes, 2776 controls) were suitable to be included. The prevalence of smell impairment in patients with diabetes was higher compared to the controls: 22% versus 15% (p<0.001). The difference prevailed after adjustment for age, BMI, alcohol misuse and smoking status. Taste was not impaired in patients with diabetes (p=0.29). Patients with diabetes and smell impairment had a lower daily calorie intake compared to patients with diabetes and normal smell function. The duration of diabetes, diabetic complications and other potential risk factors were not associated with smell dysfunction. CONCLUSIONS Smell dysfunction appears with a higher prevalence in patients with diabetes, and this seems to negatively affect daily food intake.
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Affiliation(s)
| | - Esben Thyssen Vestergaard
- Department of Pediatrics, Randers Regional Hospital, Denmark; Department of Pediatrics, Aarhus University Hospital, Denmark
| | - Ole Hejlesen
- Department of Health Science and Tecnology, Aalborg University, Denmark
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Liu YH, Huang Z, Vaidya A, Li J, Curhan GC, Wu S, Gao X. A longitudinal study of altered taste and smell perception and change in blood pressure. Nutr Metab Cardiovasc Dis 2018; 28:877-883. [PMID: 29858155 PMCID: PMC6428580 DOI: 10.1016/j.numecd.2018.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/03/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Previous studies suggest that olfactory receptors, which mediate smell chemosensation, are located in the kidney and involved in blood pressure regulation. Mammalian epithelial sodium channels located in taste receptor cells are also found to participate in blood pressure regulation. However, there is currently no human study that has examined the association between taste and smell function and blood pressure. We thus conducted a longitudinal study to examine whether participants with altered taste and smell perception had larger increases in blood pressure compared with those without altered perception in a community-based cohort. METHODS AND RESULTS The study included 5190 Chinese adults (4058 men and 1132 women) who were normotensive at baseline. Taste and smell perception were assessed via questionnaire in 2012 (baseline). Blood pressure was measured in 2012 and 2014 to determine relative change in blood pressure. Mean differences of 2-year blood pressure change and 95% confidence intervals (CIs) across four categories of taste and smell perception were calculated after adjusting for known risk factors for hypertension. After adjusting for potential confounders, individuals with altered taste and smell perception had larger increases in systolic blood pressure (adjusted mean difference = 5.1 mmHg, 95% CI: 0.1-10.0, p-value: 0.04) and mean arterial pressure (adjusted mean difference = 3.8 mmHg, 95% CI: 0.4-7.1, p-value: 0.03) after two years of follow-up compared with those having neither altered taste nor altered smell perception. No significant association was observed in individuals with altered taste or smell perception only. CONCLUSION Our results suggest an association between chemosensory function and blood pressure.
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Affiliation(s)
- Y-H Liu
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Z Huang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - A Vaidya
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - J Li
- Department of Nephrology, Kailuan Hospital, Tangshan, China
| | - G C Curhan
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - S Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China.
| | - X Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States.
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Abstract
PURPOSE OF REVIEW This article aims to educate clinical neurologists on the importance of taste and smell disorders in clinical neurology. These disorders commonly occur in head trauma, multiple sclerosis, seizure disorders, and neurodegenerative diseases such as idiopathic Parkinson disease and dementia, mild cognitive impairment, and Alzheimer disease, just to name a few. This article covers the basic anatomy of smell and taste, notes the important points of taking a proper history, and discusses smell and taste testing, which are inexpensive, minimally time-consuming procedures. Recurrent bad smells and tastes are not uncommon in these disorders, which cause major impairment in quality of life, including loss of appetite, decreased eating, and weight loss. The diagnosis and treatment of these disorders will also be discussed. RECENT FINDINGS Despite past widespread negative prognoses of taste and smell disorders, more recent work in the last 10 years has shown an improved prognosis for smell and taste recovery in most disorders, and recommendations for changes in food preparation have helped many patients enjoy their food and increase their appetite. Recent experimental evidence has shown that smell loss and testing can assist in separating idiopathic Parkinson disease from other parkinsonian syndromes, can suggest which patients with rapid eye movement (REM) sleep behavior disorder will more likely develop Parkinson disease, and can be predictive of the progression of cognitive impairment and Alzheimer dementia. SUMMARY This article discusses the common smell and taste disorders that a clinical neurologist will encounter in practice. The anatomy and function of smell and taste will be reviewed, followed by office evaluation and testing. The common disorders will be reviewed, along with their prognosis and management.
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49
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Fjaeldstad A, Fernandes H, Nyengaard JR, Ovesen T. [The sense of taste in a clinical setting]. Ugeskr Laeger 2018; 180:V08170627. [PMID: 29720344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As a gatekeeper, taste buds forage chemicals to identify both nutrition and toxins. This can be the decisive difference between initiating the swallow reflex or spitting out the oral contents. In addition to this simple function the sense of taste takes part in more complex relations such as reflexes vs learning, perception vs expectation, and pleasure vs disgust. All relations, which can be perturbed into unbalance, create great discomfort in patients suffering from a dysfunctional sense of taste. This review discusses the most important mechanisms of taste function and dysfunction as well as the possible avenues for treatment of the disorders.
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50
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Yazla S, Özmen S, Kıyıcı S, Yıldız D, Haksever M, Gencay S. Evaluation of olfaction and taste function in type 2 diabetic patients with and without peripheral neuropathy. Diabetes Metab Res Rev 2018; 34. [PMID: 29232497 DOI: 10.1002/dmrr.2973] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 09/15/2017] [Accepted: 11/20/2017] [Indexed: 11/07/2022]
Abstract
AIMS Olfaction and gustation in patients with diabetes mellitus have great significance on quality of life, and their impairment may result in possible hazards. A limited number of studies have been performed to determine the alteration of both gustatory and olfactory function in type 2 diabetic patients with diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether type 2 diabetic patients, with and without DPN, exhibit major olfactory and gustatory dysfunction using validated and dependable techniques. METHODS An observational-analytical case-control study was conducted. Sixty patients with type 2 diabetes mellitus (T2DM) and 30 healthy control subjects with a mean age of 57.1 ± 8.4 were included in the study. Patients with T2DM were recruited from the endocrinology outpatient clinic. After clinical evaluation and electromyography examination, patients with T2DM were divided into the 2 groups, with and without DPN. After a 10-hour fasting period, blood samples were taken for the measurement of serum creatinine, lipids, and HbA1c. For the quantitative assessment of olfactory function, all participants underwent butanol threshold test and odour identification test. Gustatory function was tested administering a whole-mouth above-threshold test using sucrose solutions. RESULTS The control subjects showed significantly higher Sniffin' sticks and butanol threshold scores than the diabetic patients without DPN (P = .001 and P = .009). No significant difference was found in the gustatory function test between these 2 groups (P = .116). Diabetic patients with DPN had lower Sniffin' sticks scores, butanol threshold scores, and higher sucrose thresholds compared to the controls (P < .001, P < .001, and P = .002). There were no significant differences between diabetic patients with or without DPN regarding Sniffin' sticks scores, butanol threshold, and sucrose thresholds (P = .302, P = .181, and P = .118). CONCLUSION In conclusion, this study demonstrates that T2DM is associated with olfactory and gustatory dysfunction. The fact that there was no difference between the diabetic patients with and without DPN elicits the idea of central neuropathy. This novel finding might facilitate the addition of olfactory and gustatory tests to the methodological spectrum of afferent pathway investigations.
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Affiliation(s)
- Semih Yazla
- Department of Otorhinolaryngology, Şırnak Public Hospital, Şırnak, Turkey
| | - Süay Özmen
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Otorhinolaryngology, University of Health Sciences, Bursa, Turkey
| | - Sinem Kıyıcı
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Endocrinology, University of Health Sciences, Bursa, Turkey
| | - Demet Yıldız
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Neurology, University of Health Sciences, Bursa, Turkey
| | - Mehmet Haksever
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Otorhinolaryngology, University of Health Sciences, Bursa, Turkey
| | - Sündüz Gencay
- Bursa Yüksek İhtisas Training and Research Hospital, Department of Otorhinolaryngology, University of Health Sciences, Bursa, Turkey
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