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Rhinology Oct 2023Patients with septal deviation and/or turbinal hypertrophy may experience olfactory disfunction (OD). The aim of this study was to analyse the effect of septoplasty...
BACKGROUND
Patients with septal deviation and/or turbinal hypertrophy may experience olfactory disfunction (OD). The aim of this study was to analyse the effect of septoplasty and/or turbinoplasty on both lateralized and bilateral olfactory function.
METHODOLOGY
Prospective study of 47 patients with nasal obstruction secondary to septal deviation and/or turbinal hypertrophy and 20 healthy controls. The Barcelona Olfactory test (BOT-8), a new supraliminal orthonasal subjective olfactometry, was applied 3 times in a row (in each nostril separately and in both simultaneously). The 8 items were applied randomly to minimize the possible risk of learning. The test has not established the minimal clinically important difference (MCID). Anterior rhinomanometry and acoustic rhinometry were performed. All participants self-assessed smell loss and nasal obstruction using a visual analogue scale (VAS) and completed questionnaires for nasal obstruction (Nasal Obstruction Symptom Evaluation, NOSE) and for quality of life (QoL), using disease-specific (SinoNasal Outcome Test-22, SNOT-22) and generic (Short Form-12 Health Survey, SF-12) questionnaires. Nasal measurements and questionnaires were performed preoperatively and 12 months after surgery.
RESULTS
Before surgery, patients reported worse VAS on smell loss and on nasal obstruction compared to controls. Patients scored lower BOT-8 than controls. Lateralized preoperative olfactory function showed that all BOT-8 characteristics were lower at the narrow side than the wider one. Smell function and QoL improved significantly one year after surgery.
CONCLUSIONS
Nasal septal deviation and turbinal hypertrophy lead to an olfactory impairment on the obstructed nostril. Nasal surgery provides a positive outcome on olfactory function, as well as on subjective and objective outcomes.
Topics: Humans; Smell; Quality of Life; Nasal Obstruction; Prospective Studies; Anosmia; Treatment Outcome; Rhinoplasty; Nasal Septum; Nose Deformities, Acquired
PubMed: 37475674
DOI: 10.4193/Rhin22.461 -
PloS One 2021Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging...
BACKGROUND
Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell.
METHODS
We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020.
RESULTS
Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others.
CONCLUSIONS
Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people's sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.
Topics: Adult; Anosmia; COVID-19; Female; Humans; Male; Middle Aged; Olfactory Perception; SARS-CoV-2; Taste Disorders; Taste Perception; Time Factors
PubMed: 34559820
DOI: 10.1371/journal.pone.0256998 -
Brazilian Journal of Otorhinolaryngology 2022SARS-CoV-2 is the pathogen of COVID-19. The virus is composed of the spike, membrane and envelope. On physiological smell, odoriferous substances bind to proteins... (Review)
Review
INTRODUCTION
SARS-CoV-2 is the pathogen of COVID-19. The virus is composed of the spike, membrane and envelope. On physiological smell, odoriferous substances bind to proteins secreted by sustentacular cells in order to be processed by olfactory receptor neurons. Olfactory disorder is one of the main manifestations of COVID-19, however, research is still required to clarify the mechanism involved in SARS-CoV-2 induced anosmia.
OBJECTIVE
This article aims to analyze current scientific evidence intended to elucidate the pathophysiological relationship between COVID-19 and the cause of olfactory disorders.
METHODS
Pubmed, Embase, Scopus and ScienceDirect were used to compose this article. The research was conducted on November 24th, 2020. Original articles with experimental studies in human, animal and in vitro, short communications, viewpoint, published in the English language and between 2019 and 2020 were included, all related to the pathophysiological relationship between olfactory disorders and COVID-19 infection.
RESULTS
Both human cell receptors ACE2 and TMPRSS2 are essential for the SARS-CoV-2 entrance. These receptors are mostly present in the olfactory epithelium cells, therefore, the main hypothesis is that anosmia is caused due to damage to non-neuronal cells which, thereafter, affects the normal olfactory metabolism. Furthermore, magnetic resonance imaging studies exhibit a relationship between a reduction on the neuronal epithelium and the olfactory bulb atrophy. Damage to non-neuronal cells explains the average recovery lasting a few weeks. This injury can be exacerbated by an aggressive immune response, which leads to damage to neuronal cells and stem cells inducing a persistent anosmia. Conductive anosmia is not sufficient to explain most cases of COVID-19 induced anosmia.
CONCLUSION
Olfactory disorders such as anosmia and hyposmia can be caused by COVID-19, the main mechanism is associated with olfactory epithelium damage, targeting predominantly non-neuronal cells. However, neuronal cells can also be affected, worsening the condition of olfactory loss.
Topics: Angiotensin-Converting Enzyme 2; Animals; Anosmia; COVID-19; Humans; Olfaction Disorders; SARS-CoV-2; Smell
PubMed: 33965353
DOI: 10.1016/j.bjorl.2021.04.001 -
NeuroImage. Clinical 2023To explore the neuropsychological profile and the integrity of the olfactory network in patients with COVID-19-related persistent olfactory dysfunction (OD).
OBJECTIVES
To explore the neuropsychological profile and the integrity of the olfactory network in patients with COVID-19-related persistent olfactory dysfunction (OD).
METHODS
Patients with persistent COVID-19-related OD underwent olfactory assessment with Sniffin' Sticks and neuropsychological evaluation. Additionally, both patients and a control group underwent brain MRI, including T1-weighted and resting-state functional MRI (rs-fMRI) sequences on a 3 T scanner. Morphometrical properties were evaluated in olfaction-associated regions; the rs-fMRI data were analysed using graph theory at the whole-brain level and within a standard parcellation of the olfactory functional network. All the MR-derived quantities were compared between the two groups and their correlation with clinical scores in patients were explored.
RESULTS
We included 23 patients (mean age 37 ± 14 years, 12 females) with persistent (mean duration 11 ± 5 months, range 2-19 months) COVID-19-related OD (mean score 23.63 ± 5.32/48, hyposmia cut-off: 30.75) and 26 sex- and age-matched healthy controls. Applying population-derived cut-off values, the two cognitive domains mainly impaired were visuospatial memory and executive functions (17 % and 13 % of patients). Brain MRI did not show gross morphological abnormalities. The lateral orbital cortex, hippocampus, and amygdala volumes exhibited a reduction trend in patients, not significant after the correction for multiple comparisons. The olfactory bulb volumes did not differ between patients and controls. Graph analysis of the functional olfactory network showed altered global and local properties in the patients' group (n = 19, 4 excluded due to artifacts) compared to controls. Specifically, we detected a reduction in the global modularity coefficient, positively correlated with hyposmia severity, and an increase of the degree and strength of the right thalamus functional connections, negatively correlated with short-term verbal memory scores.
DISCUSSION
Patients with persistent COVID-19-related OD showed an altered olfactory network connectivity correlated with hyposmia severity and neuropsychological performance. No significant morphological alterations were found in patients compared with controls.
Topics: Female; Humans; Infant; Smell; Olfaction Disorders; Anosmia; COVID-19; Cognition; Cognitive Dysfunction
PubMed: 37104928
DOI: 10.1016/j.nicl.2023.103410 -
The Journal of Headache and Pain Jan 2022Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms...
BACKGROUND
Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms are related to one another.
OBJECTIVES
To determine whether there is an association between the neurological symptoms in patients with COVID-19, and to characterize the headache.
METHOD
This was a cross-sectional study. All hospital inpatients and health workers at the Hospital Universitario Oswaldo Cruz with a PCR-confirmed COVID-19 infection between March and June 2020 were considered for the study and were interviewed by telephone at least 2-months after the acute phase of the disease. These patients were identified by the hospital epidemiological surveillance department. A semi-structured questionnaire was used containing sociodemographic and clinical data and the ID-Migraine.
RESULTS
A total of 288 patients was interviewed; 53.1% were male; with a median age of 49.9 (41.5-60.5) years; 91.7% presented some neurological symptom; 22.2% reported some neurological symptom as the symptom that troubled them most during COVID-19. Neurological symptoms were: ageusia (69.8%), headache (69.1%), anosmia (67%), myalgia (44.4%), drowsiness (37.2%), agitation (20.8%); mental confusion (14.9%), syncope (4.9%) and epileptic seizures (2.8%). Females, those who presented with fever, sore throat, anosmia/ageusia and myalgia also presented significantly more with headache (logistic regression). The most frequent headache phenotype was a non-migraine phenotype, was of severe intensity and differed from previous headaches. This persisted for more than 30 days in 18% and for more than 90 days in 10% of patients. Thirteen percent of those with anosmia and 11% with ageusia continued with these complaints after more than 90 days of the acute phase of the disease. Aged over 50 years, agitation and epileptic seizures were significantly associated with mental confusion (logistic regression).
CONCLUSION
Headache is frequent in COVID-19, is associated with other symptoms such as fever, sore throat, anosmia, ageusia, and myalgia, and may persist beyond the acute phase of the disease.
Topics: Aged; Ageusia; Anosmia; COVID-19; Cross-Sectional Studies; Female; Headache; Humans; Male; Middle Aged; SARS-CoV-2
PubMed: 34979899
DOI: 10.1186/s10194-021-01367-8 -
Journal of Medical Virology Jul 2021Epidemiological data shows a discrepancy in COVID-19 susceptibility and outcomes with some regions being more heavily affected than others. However, the factors that... (Review)
Review
Epidemiological data shows a discrepancy in COVID-19 susceptibility and outcomes with some regions being more heavily affected than others. However, the factors that determine host susceptibility and pathogenicity remain elusive. An increasing number of publications highlight the role of Transmembrane Serine Protease 2 (TMPRSS2) in the susceptibility of the host cell to SARS-CoV-2. Cleavage of viral spike protein via the host cell's TMPRSS2 enzyme activity mediates viral entry into the host cell. The enzyme synthesis is regulated by the TMPRSS2 gene, which has also been implicated in the entry mechanisms of previously reported Coronavirus infections. In this review, we have investigated the pathogenicity of SARS-CoV-2 and disease susceptibility dependence on the TMPRSS2 gene as expressed in various population groups. We further discuss how the differential expression of this gene in various ethnic groups can affect the SARS-CoV-2 infection and Coronavirus disease (COVID)-19 outcomes. Moreover, promising new TMPRSS2 protease blockers and inhibitors are discussed for COVID-19 treatment.
Topics: Anosmia; COVID-19; Female; Genetic Predisposition to Disease; Humans; Male; SARS-CoV-2; Serine Endopeptidases; Spike Glycoprotein, Coronavirus; Virus Internalization; COVID-19 Drug Treatment
PubMed: 33638460
DOI: 10.1002/jmv.26911 -
European Journal of Neurology May 2023Acute health events, including infections, can trigger the onset of functional neurological disorder (FND). It was hypothesized that a proportion of people with long... (Review)
Review
BACKGROUND AND PURPOSE
Acute health events, including infections, can trigger the onset of functional neurological disorder (FND). It was hypothesized that a proportion of people with long COVID might be experiencing functional symptoms.
METHODS
A systematic review of studies containing original data on long COVID was performed. The frequency and characteristics of neurological symptoms were reviewed, looking for positive evidence suggesting an underlying functional disorder and the hypothesized causes of long COVID.
RESULTS
In all, 102 studies were included in our narrative synthesis. The most consistently reported neurological symptoms were cognitive difficulties, headaches, pain, dizziness, fatigue, sleep-related symptoms and ageusia/anosmia. Overall, no evidence was found that any authors had systematically looked for positive features of FND. An exception was three studies describing temporal inconsistency. In general, the neurological symptoms were insufficiently characterized to support or refute a diagnosis of FND. Moreover, only 13 studies specifically focused on long COVID after mild infection, where the impact of confounders from the general effects of severe illness would be mitigated. Only one study hypothesized that some people with long COVID might have a functional disorder, and another eight studies a chronic-fatigue-syndrome-like response.
DISCUSSION
Neurological symptoms are prevalent in long COVID, but poorly characterized. The similarities between some manifestations of long COVID and functional disorders triggered by acute illnesses are striking. Unfortunately, the current literature is plagued by confounders, including the mixing of patients with initial mild infection with those with severe acute medical complications. The hypothesis that long COVID might in part correspond to a functional disorder remains untested.
Topics: Humans; Post-Acute COVID-19 Syndrome; COVID-19; Conversion Disorder; Anosmia; Fatigue
PubMed: 36719069
DOI: 10.1111/ene.15721 -
Turkish Journal of Medical Sciences Oct 2022The coronavirus disease 2019 (COVID-19) mostly manifests with fever, shortness of breath, and cough, has also been found to cause some neurological symptoms, such as...
BACKGROUND
The coronavirus disease 2019 (COVID-19) mostly manifests with fever, shortness of breath, and cough, has also been found to cause some neurological symptoms, such as anosmia and ageusia. The aim of the study was to present the magnetic resonance imaging (MRI) findings of patients with anosmia-hyposmia symptoms and to discuss potential mechanisms in light of these findings.
METHODS
Of the 2412 patients diagnosed with COVID-19-related pneumonia (RT-PCR at least once + clinically confirmed) between March and December 2020, 15 patients underwent olfactory MRI to investigate the cause of ongoing anosmia/ hyposmia symptoms were included in the study.
RESULTS
Eleven (73.3%) patients were female and four (26.7%) were male. A total of eight patients (53.3%) showed thickening in the olfactory cleft region, where the olfactory epithelium is located. In nine patients (60%), enhancement was observed in the olfactory cleft region. Diffusion-weighted imaging showed restricted diffusion in three patients (20%) (corpus callosum splenium in one patient, thalamus mediodorsal nucleus in one patient, and mesencephalon in one patient).
DISCUSSION
This study revealed that there is a relationship between anosmia and MRI findings. Larger studies can enlighten the pathophysiological mechanism and shed light on both diagnosis and new treatments.
Topics: Humans; Male; Female; Anosmia; COVID-19; Olfaction Disorders; Magnetic Resonance Imaging; Corpus Callosum
PubMed: 36422480
DOI: 10.55730/1300-0144.5490 -
Saudi Medical Journal Nov 2023To assess the frequency of olfactory dysfunction (OD) among individuals afflicted with coronavirus disease of 2019 (COVID-19).
OBJECTIVES
To assess the frequency of olfactory dysfunction (OD) among individuals afflicted with coronavirus disease of 2019 (COVID-19).
METHODS
A comprehensive literature search was carried out across several bibliographical databases (PubMed, Scopus, Google Scholar, and Web of Science) to extract publications in the English language between January 2020 and December 2021 to report the incidence of OD alone or together with gustatory dysfunction (GD) among COVID-19 patients.
RESULTS
Based on eligibility criteria, 84 articles were included from 27 countries, comprising 36,903 patients, of whom 58.1% were females. The generality rates of olfactory impairment alone was 34.60% and in conjunction with GD was 11.36%. Patients with OD were subclassified into various categories, and the prevalence of anosmia was 20.85%, 5.04% for hyposmia, 8.88% for anosmia or hyposmia, 1.84% for parosmia, 0.78% for phantosmia, and 0.02% for hyperosmia, among COVID-19 patients.
CONCLUSION
Clinical features associated with OD, either isolated or in combination with GD, are common in patients with COVID-19 and consider important signs of COVID-19 that may guide clinicians in the early phase of the disease..
Topics: Female; Humans; Male; Anosmia; COVID-19; Olfaction Disorders; Language; Patients
PubMed: 37926445
DOI: 10.15537/smj.2023.44.11.20230264 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment and recovery. The peculiarity of pediatric COVID-19 anosmia is due to children accounting for very low percentage of COVID-19 patients (comparing to one in adults), mostly with milder course of the disease. Awareness of anosmia and its proper diagnostics is crucial in children and adolescents, considering it can be the only manifestation in COVID-19 positive pediatric patients.
PATIENTS AND METHODS
Materials and Methods: In order to achieve this goal a meta-analysis of information from databases followed by statistical processing and generalisation of the obtained data was carried out.
CONCLUSION
Conclusions: Publications on COVID-19 anosmia in children and adolescents are less numerous than those concerning adult patients, so it is important to use every single trustworthy one. Anosmia/ageusia may be the only symptom, early identifier and the strongest predictor of COVID-19 infection in pediatric patients. Prospects for further scientific researches. Further researches regarding differential diagnostics of COVID-19 and other infections, including seasonal influenza, manifesting with both olfactory and taste dysfunction as well as anosmia diagnostics in children and adolescents with autistic spectrum and different types of mental disorders are possible.
Topics: Adolescent; Adult; Child; Humans; Ageusia; Anosmia; COVID-19; Olfaction Disorders; SARS-CoV-2
PubMed: 38431815
DOI: 10.36740/WLek202401114