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Correlation Between Anosmia and Severity Along with Requirement of Tocilizumab in COVID-19 Patients.Indian Journal of Otolaryngology and... Sep 2021Anosmia with or without dysgeusia is frequently associated with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) SARS-CoV-2 infection. SARS-CoV-2 virus...
Anosmia with or without dysgeusia is frequently associated with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) SARS-CoV-2 infection. SARS-CoV-2 virus affects the olfactory system and thus represents neurotropic and neuro-invasive nature of the virus. We found that tocilizumab's role in reducing mortality in severe covid-19 infection is still questionable and aim of our study was correlation of anosmia and severity of covid-19 infection and requirement of tocilizumab in anosmia patients. To establish relationship between anosmia and severity of COVID-19 infection along with requirement of tocilizumab. This was a retrospective cum prospective cross sectional study done on COVID-19 patients who were admitted in normal COVID-19 ward and intensive care unit of Employee's State Insurance Corporation Hospital, Udaipur and Maharaja Bhupal Hospital of Ravindra Nath Medical College between September 2020 and 15 January 2021 age group of 18 to 92 years, both sexes. We had asked about anosmia in all COVID-19 positive patients and followed all patients in perspective of severity of disease and tocilizumab. value < 0.001 of prevalence of anosmia in COVID -19 patients who were isolated at home, admitted in ward and intensive care unit showed that anosmia is inversely related to severity of disease. Tocilizumab has no significant role in decreasing mortality in severe form of disease. Our study indicates that anosmia is related to the mildness of disease and there is no role of tocilizumab in decreasing the mortality in severe form of disease.
PubMed: 34178610
DOI: 10.1007/s12070-021-02679-6 -
Journal of the American Board of Family... 2022Our ability to smell and taste is dictated by 3 chemosensory systems with distinct physiologic mechanisms - olfaction, gustation, and chemesthesis. Although often... (Review)
Review
BACKGROUND
Our ability to smell and taste is dictated by 3 chemosensory systems with distinct physiologic mechanisms - olfaction, gustation, and chemesthesis. Although often overlooked, dysfunction of these special senses may have broad implications on multiple facets of patients' lives -including safety, nutritional status, quality of life, mental health, and even cognitive function. As "loss of smell or taste" emerged as a common symptom of coronavirus disease 2019 (COVID-19), the importance of intact chemosensory function has been thrust into the spotlight. Despite the growing recognition of chemosensory dysfunction, this already highly prevalent condition will increasingly impact a larger and more diverse population, highlighting the need for improved awareness and care of these patients.
METHODS
Comtemporary review of chemosensory function and assessments.
CONCLUSIONS
Although patient-reported chemosensory function measures highlight the ease of screening of chemosensory dysfunction, self-reported measures underestimate both the prevalence and degree of chemosensory dysfunction and do not adequately distinguish between olfaction, gustation, and chemesthesis. Meanwhile, psychophysical assessment tools provide opportunities for more accurate, thorough assessment of the chemosenses when appropriate. Primary care providers are uniquely situated to identify patients burdened by chemosensory dysfunction and raise patient and provider awareness about the importance of chemosensory dysfunction. Identification of chemosensory dysfunction, particularly olfactory dysfunction, may raise suspicion for many underlying medical conditions, including early detection of neurodegenerative conditions. Furthermore, identification and awareness of patients with chemosensory dysfunction may help primary care providers to identify those who may benefit from additional therapeutic and safety interventions, or consultations with specialists for more detailed evaluations and management.
Topics: Anosmia; COVID-19; Humans; Olfaction Disorders; Quality of Life; Smell
PubMed: 35379730
DOI: 10.3122/jabfm.2022.02.210373 -
Vaccine Mar 2023This is a Brighton Collaboration case definition of anosmia to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the... (Review)
Review
This is a Brighton Collaboration case definition of anosmia to be used in the evaluation of adverse events following immunization, and for epidemiologic studies for the assessment of background incidence or hypothesis testing. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of SARS-CoV-2 vaccines. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and defined levels of certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network and by two expert reviewers prior to submission.
Topics: Humans; COVID-19 Vaccines; Anosmia; COVID-19; SARS-CoV-2; Immunization; Data Collection
PubMed: 36775774
DOI: 10.1016/j.vaccine.2022.11.022 -
PloS One 2022The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali,... (Observational Study)
Observational Study
INTRODUCTION
The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms.
METHOD
This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy.
RESULTS
This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not.
CONCLUSION
A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.
Topics: Anosmia; C-Reactive Protein; COVID-19; Cough; Fatigue; Fever; Humans; Indonesia; Interleukin-6; Retrospective Studies; SARS-CoV-2
PubMed: 35687545
DOI: 10.1371/journal.pone.0269026 -
Human Brain Mapping Apr 2022To address the impact of COVID-19 olfactory loss on the brain, we analyzed the neural connectivity of the central olfactory system in recently SARS-CoV-2 infected...
To address the impact of COVID-19 olfactory loss on the brain, we analyzed the neural connectivity of the central olfactory system in recently SARS-CoV-2 infected subjects with persisting olfactory impairment (hyposmia). Twenty-seven previously SARS-CoV-2 infected subjects (10 males, mean age ± SD 40.0 ± 7.6 years) with clinically confirmed COVID-19 related hyposmia, and eighteen healthy, never SARS-CoV-2 infected, normosmic subjects (6 males, mean age ± SD 36.0 ± 7.1 years), were recruited in a 3 Tesla MRI study including high angular resolution diffusion and resting-state functional MRI acquisitions. Specialized metrics of structural and functional connectivity were derived from a standard parcellation of olfactory brain areas and a previously validated graph-theoretic model of the human olfactory functional network. These metrics were compared between groups and correlated to a clinical index of olfactory impairment. On the scanning day, all subjects were virus-free and cognitively unimpaired. Compared to control, both structural and functional connectivity metrics were found significantly increased in previously SARS-CoV-2 infected subjects. Greater residual olfactory impairment was associated with more segregated processing within regions more functionally connected to the anterior piriform cortex. An increased neural connectivity within the olfactory cortex was associated with a recent SARS-CoV-2 infection when the olfactory loss was a residual COVID-19 symptom. The functional connectivity of the anterior piriform cortex, the largest cortical recipient of afferent fibers from the olfactory bulb, accounted for the inter-individual variability in the sensory impairment. Albeit preliminary, these findings could feature a characteristic brain connectivity response in the presence of COVID-19 related residual hyposmia.
Topics: Adult; Anosmia; Brain; COVID-19; Female; Humans; Magnetic Resonance Imaging; Male; Nerve Net; Smell
PubMed: 35083823
DOI: 10.1002/hbm.25741 -
Ear, Nose, & Throat Journal Jun 2024To systematically review the cases of anosmia or ageusia after receiving the coronavirus disease 2019 (COVID-19) vaccine. A systematic search was conducted in... (Review)
Review
To systematically review the cases of anosmia or ageusia after receiving the coronavirus disease 2019 (COVID-19) vaccine. A systematic search was conducted in electronic databases, including Web of Science, Scopus, Embase, and PubMed, to identify any published study that evaluated the anosmia or ageusia after receiving the COVID-19 vaccine, including case reports, case series, letter to editor articles with reported cases regarding our topic, or observational studies with at least 1 eligible patient consisted with our criteria. We excluded the studies that reported anosmia or ageusia due to COVID-19 infection and non-COVID-19 vaccines. Five studies consisting of 11 patients were included in this systematic review. Of the 11 patients, 5 patients had received the Pfizer COVID-19 vaccine and 6 patients received the Oxford-AstraZeneca COVID-19 vaccine, of which 6 patients developed symptoms after the first dose of vaccination and 5 patients were symptomatic after the second vaccine dose. Most of the patients developed symptoms within 1 week after the vaccination. The disorders of the patients included partial or total anosmia, parosmia, phantosmia, hyposmia, ageusia, and dysgeusia. Also, the patients had symptoms other than smell or taste disorders, including arthralgia, fever, chills, rhinorrhea, myalgia, abdominal pain, fatigue, muscle weakness, altered bowel pattern, aural fullness, tinnitus, and headache. Most of the evaluated patients did not receive any treatment as for their disorders. However, in some cases, treatment with oral corticosteroids or dietary supplementation was required. Anosmia and ageusia are important symptoms of COVID-19 vaccination. These symptoms will resolve without any treatment in most cases, although some interventions may be needed in some patients.
Topics: Humans; Ageusia; Anosmia; COVID-19; COVID-19 Vaccines; Female; Male; Vaccination; SARS-CoV-2; Middle Aged; Adult; BNT162 Vaccine; Aged
PubMed: 38411125
DOI: 10.1177/01455613241233098 -
The Cochrane Database of Systematic... Sep 2022Olfactory dysfunction is a common consequence of COVID-19 infection and persistent symptoms can have a profound impact on quality of life. At present there is little... (Review)
Review
BACKGROUND
Olfactory dysfunction is a common consequence of COVID-19 infection and persistent symptoms can have a profound impact on quality of life. At present there is little guidance on how best to treat this condition. A variety of interventions have been suggested to promote recovery, including medication and olfactory training. However, it is uncertain whether any intervention is of benefit. This is an update of the 2021 review with one additional study added. OBJECTIVES: 1) To evaluate the benefits and harms of any intervention versus no treatment for people with persisting olfactory dysfunction due to COVID-19 infection. 2) To keep the evidence up-to-date, using a living systematic review approach. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the latest search was 20 October 2021. SELECTION CRITERIA: We included randomised controlled trials (RCTs) in people with COVID-19 related olfactory disturbance that had persisted for at least four weeks. We included any intervention compared to no treatment or placebo. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were the recovery of sense of smell, disease-related quality of life and serious adverse effects. Secondary outcomes were the change in sense of smell, general quality of life, prevalence of parosmia and other adverse effects (including nosebleeds/bloody discharge). We used GRADE to assess the certainty of the evidence for each outcome.
MAIN RESULTS
We included two studies with 30 participants. The studies evaluated the following interventions: systemic corticosteroids plus intranasal corticosteroid/mucolytic/decongestant and palmitoylethanolamide plus luteolin. Systemic corticosteroids plus intranasal corticosteroid/mucolytic/decongestant compared to no intervention We included a single RCT with 18 participants who had anosmia for at least 30 days following COVID-19 infection. Participants received a 15-day course of oral corticosteroids combined with nasal irrigation (consisting of an intranasal corticosteroid/mucolytic/decongestant solution) or no intervention. Psychophysical testing was used to assess olfactory function at 40 days. This is a single, small study and for all outcomes the certainty of evidence was very low. We are unable to draw meaningful conclusions from the numerical results. Palmitoylethanolamide plus luteolin compared to no intervention We included a single RCT with 12 participants who had anosmia or hyposmia for at least 90 days following COVID-19 infection. Participants received a 30-day course of palmitoylethanolamide and luteolin or no intervention. Psychophysical testing was used to assess olfactory function at 30 days. This is a single, small study and for all outcomes the certainty of evidence was very low. We are unable to draw meaningful conclusions from the numerical results.
AUTHORS' CONCLUSIONS
There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified a number of ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available.
Topics: Adrenal Cortex Hormones; Anosmia; COVID-19; Expectorants; Humans; Luteolin; Nasal Decongestants; Randomized Controlled Trials as Topic; Smell
PubMed: 36062970
DOI: 10.1002/14651858.CD013876.pub3 -
ORL; Journal For Oto-rhino-laryngology... 2022The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia.
INTRODUCTION
The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia.
METHODS
This study consisted of PCR-proven COVID-19 patients. Cases with COVID-19-related anosmia constituted Group 1 and cases without any olfactory dysfunction (OD) throughout COVID-19 infection or after recovery constituted Group 2. A total of 50 patients were included in the study, comprising 24 cases in Group 1 and 26 cases in Group 2. Group 1 patients underwent a 4-item-odor identification test during active symptoms and a Sniffin' Sticks test after reconversion of PCR results to negative. All patients in Group 2 also underwent the Sniffin' Stick test to document normosmia. All cases had paranasal sinus CT performed. Olfactory cleft widths and olfactory volumes were measured. The differences in width and volume between groups and the correlation with odor test scores (threshold-discrimination-identification [TDI]) were calculated. In addition, regression analyzes analysis was performed for cleft widths, volumes, and TDI scores according to age.
RESULTS
Olfactory cleft widths and olfactory volumes were significantly higher in Group 1 than those in Group 2 (p = 0.001; p < 0.01). There was a significant negative correlation between total TDI scores and olfactory cleft widths and total olfactory volumes (r = -0.665; r = -0.731, respectively). Patients younger than 40 years of age had significantly higher right olfactory cleft width, left olfactory cleft width, and olfactory cleft volume than those in patients older than 40 years of age (p = 0.004, p = 0.005, p = 0.003; p < 0,01, respectively). However, patients younger than 40 years of age had a significantly lower total TDI score and in all other values individually (t-d-i) than those in patients older than 40 years of age (p = 0.004; p < 0.01).
CONCLUSION
Patients with COVID-19-related OD had larger olfactory cleft width and volumes than those without OD in this study. Total TDI score was found to be inversely correlated with cleft width and volume.
Topics: Adult; Anosmia; COVID-19; Humans; Olfaction Disorders; SARS-CoV-2; Smell
PubMed: 34569549
DOI: 10.1159/000518672 -
Medicina (Kaunas, Lithuania) Aug 2023: Hypo/anosmia is a characteristic symptom of COVID-19 infection. The aim of this study is to investigate the time of smell recovery and to identify a possible order of... (Observational Study)
Observational Study
: Hypo/anosmia is a characteristic symptom of COVID-19 infection. The aim of this study is to investigate the time of smell recovery and to identify a possible order of perception recovery of different odors in COVID-19 patients. : A prospective observational study was conducted on not hospitalized COVID-19 patients, selected according to eligible criteria. The study was approved by the Ethical Committee. A questionnaire formulated by our team was submitted to patients in order to know the duration of the hypo/anosmia and hypo/ageusia and the order of odor recovery: vanillin (mixed olfactory/gustatory substances), phenyl ethyl alcohol (rosewater) (pure olfactory substances), eucalyptol (mixed olfactory/trigeminal substances), and eugenol (mixed olfactory/trigeminal/gustatory substances). : 181 patients were included. Hypo/ageusia and hypo/anosmia lasted on average 10.25 (±8.26) and 12.8 (±8.80) days, respectively. The most frequent odor recovery sequence was: (1) phenyl ethyl alcohol; (2) eucalyptol; (3) vanillin; and (4) eugenol. In COVID-19 patients, hypo/anosmia occurs more often in women and at a young age. : This preliminary investigation highlighted novel data: there is a chronological order in perception recovery of different olfactory substances and, therefore, in the restoration of the various sensitive nerve pathways involved in the sense of smell.
Topics: Humans; Female; Smell; Anosmia; Ageusia; Eucalyptol; Eugenol; COVID-19; Phenylethyl Alcohol
PubMed: 37763630
DOI: 10.3390/medicina59091511 -
Parkinsonism & Related Disorders May 2024Olfactory dysfunction and REM sleep behavior disorder (RBD) are associated with distinct cognitive trajectories in the course of Parkinson's disease (PD). The underlying...
INTRODUCTION
Olfactory dysfunction and REM sleep behavior disorder (RBD) are associated with distinct cognitive trajectories in the course of Parkinson's disease (PD). The underlying neurobiology for this relationship remains unclear but may involve distinct patterns of neurodegeneration. This study aimed to examine longitudinal cortical atrophy and thinning in early-stage PD with severe olfactory deficit (anosmia) without and with concurrent probable RBD.
METHODS
Longitudinal MRI data over four years of 134 de novo PD and 49 healthy controls (HC) from the Parkinson Progression Marker Initiative (PPMI) cohort were analyzed using a linear mixed-effects model. Patients were categorized into those with anosmia by the University of Pennsylvania Smell Identification Test (UPSIT) score ≤ 18 (AO+) and those without (UPSIT score > 18, AO-). The AO+ group was further subdivided into AO+ with probable RBD (AO+RBD+) and without (AO+RBD-) for subanalysis.
RESULTS
Compared to subjects without baseline anosmia, the AO+ group exhibited greater longitudinal declines in both volume and thickness in the bilateral parahippocampal gyri and right transverse temporal gyrus. Patients with concurrent anosmia and RBD showed more extensive longitudinal declines in cortical volume and thickness, involving additional brain regions including the bilateral precuneus, left inferior temporal gyrus, right paracentral gyrus, and right precentral gyrus.
CONCLUSIONS
The atrophy/thinning patterns in early-stage PD with severe olfactory dysfunction include regions that are critical for cognitive function and could provide a structural basis for previously reported associations between severe olfactory deficit and cognitive decline in PD. Concurrent RBD might enhance the dynamics of cortical changes.
Topics: Humans; Parkinson Disease; Male; Female; Aged; Middle Aged; Longitudinal Studies; Magnetic Resonance Imaging; REM Sleep Behavior Disorder; Olfaction Disorders; Atrophy; Anosmia; Disease Progression; Brain
PubMed: 38430690
DOI: 10.1016/j.parkreldis.2024.106072