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The Journal of Craniofacial Surgery Sep 2020Many reports by physicians and patients during the 2019 to 2020 pandemic indicate that COVID-19 is associated with elevated levels of odor and taste perception disorders... (Review)
Review
Many reports by physicians and patients during the 2019 to 2020 pandemic indicate that COVID-19 is associated with elevated levels of odor and taste perception disorders (anosmia, hyposmia, ageusia, and/or dysgeusia). Recent increase in olfactory dysfunction in patients referred to ear nose and throat clinics and COVID-19 infection at the same time encouraged us to examine anosmic/hyposmic patients to establish any association between these signs. It has been shown that the COVID-19 virus exploits the uses angiotensin-converting enzyme 2 receptor to obtain cell entry. This result increases the interest to examine the expression of angiotensin-converting enzyme 2 in neurological tissue, and to assess the possible contribution of damage. This mini review provides fundamental knowledge on coincidence of COVID-19 infection and smell-taste perception disorders from an objective perspective.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Olfaction Disorders; Olfactory Perception; Pandemics; Pneumonia, Viral; SARS-CoV-2; Taste Disorders; Taste Perception
PubMed: 32398625
DOI: 10.1097/SCS.0000000000006601 -
Genes & Diseases Jun 2023Long COVID, also known for post-acute sequelae of COVID-19, describes the people who have the signs and symptoms that continue or develop after the acute COVID-19 phase.... (Review)
Review
Long COVID, also known for post-acute sequelae of COVID-19, describes the people who have the signs and symptoms that continue or develop after the acute COVID-19 phase. Long COVID patients suffer from an inflammation or host responses towards the virus approximately 4 weeks after initial infection with the SARS CoV-2 virus and continue for an uncharacterized duration. Anyone infected with COVID-19 before could experience long-COVID conditions, including the patients who were infected with SARS CoV-2 virus confirmed by tests and those who never knew they had an infection early. People with long COVID may experience health problems from different types and combinations of symptoms over time, such as fatigue, dyspnea, cognitive impairments, and gastrointestinal (GI) symptoms (, nausea, vomiting, diarrhea, decreased or loss of appetite, abdominal pain, and dysgeusia). The critical role of the microbiome in these GI symptoms and long COVID were reported in clinical patients and experimental models. Here, we provide an overall view of the critical role of the GI tract and microbiome in the development of long COVID, including the clinical GI symptoms in patients, dysbiosis, viral-microbiome interactions, barrier function, and inflammatory bowel disease patients with long COVID. We highlight the potential mechanisms and possible treatment based on GI health and microbiome. Finally, we discuss challenges and future direction in the long COVID clinic and research.
PubMed: 37362775
DOI: 10.1016/j.gendis.2023.03.034 -
Frontiers in Oncology 2021Lung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The...
INTRODUCTION
Lung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs' early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life.
OBJECTIVES
To systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area.
METHODS
Literature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms "Lung neoplasms","Dysgeusia", "Olfaction Disorders", "Carcinoma, Small Cell","Carcinoma, Non- Small-Cell Lung "Adenocarcinoma of Lung","Carcinoma, Large Cell", and non-MeSH terms "Parageusia", "Altered Taste", "Smell Disorder", "Paraosmia", "Dysosmia","Lung Cancer" and "Oat Cell Carcinoma".
RESULTS
Thirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naïve LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only.One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia.
CONCLUSIONS
This is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted.
PubMed: 34881185
DOI: 10.3389/fonc.2021.774081 -
CJEM Sep 2020To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and...
OBJECTIVES
To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms.
METHODS
A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre. We identified 1,345 patients (102 positive and 1,243 negative) who visited the assessment centre between March 16 and April 15, 2020. We randomly sampled negative patients in a 1:3 ratio. The primary outcome was the prevalence of self-reported anosmia/hyposmia and dysgeusia/ageusia. Logistic regression was performed to evaluate the association between COVID-19 positivity and loss of smell and taste.
RESULTS
Fifty-six of 102 (50%) positive patients and 72 of 306 (23.5%) negative patients completed the survey. Anosmia/hyposmia and dysgeusia/ageusia were more prevalent among COVID-19 positive patients (41.1% v. 4.2%, p < 0.001 for smell and 46.4% v. 5.6%, p < 0.001 for taste). Anosmia/hyposmia and dysgeusia/ageusia were independently highly associated with COVID-19 positivity (adjusted odds ratios 14.4 and 11.4 for smell and taste, respectively).
CONCLUSION
In this Canadian study, smell and taste loss may be key symptoms of COVID-19. This evidence can be helpful in the clinical diagnosis of COVID-19, particularly settings of limited testing capacity.
Topics: Adult; COVID-19; COVID-19 Testing; Canada; Clinical Laboratory Techniques; Coronavirus Infections; Cross-Sectional Studies; Dysgeusia; Female; Humans; Incidence; Male; Middle Aged; Olfaction Disorders; Pandemics; Pneumonia, Viral; Reference Values; Risk Assessment; Self Report; Sensitivity and Specificity
PubMed: 32507123
DOI: 10.1017/cem.2020.420 -
International Journal of General... 2023This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients.
OBJECTIVE
This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients.
METHODS
This is a cross-sectional study. Patients diagnosed with COVID-19 between 1st October 2020 and 30th June 2021 were randomly selected from a national COVID-19 registry. COVID-19 cases were diagnosed using molecular testing method which measured the viral E gene. The Anosmia Reporting Tool, and a brief version of the questionnaire on olfactory disorders were used to measure the outcomes via telephone interviews. Data were analysed using SPSS 27 statistics software.
RESULTS
A total of 405 COVID-19 adults were included in this study, 220 (54.3%) were males and 185 (45.8%) were females. The mean±SD age of participants was 38.2 ± 11.3 years. Alterations in the sense of smell and taste were reported by 206 (50.9%), and 195 (48.1%) of the patients, respectively. Sex and nationality of participants were significantly associated with anosmia and dysgeusia (p < 0.001) and (p-value=0.001) respectively. Among patients who experienced anosmia and dysgeusia, alterations in eating habits (64.2%), impact on mental wellbeing (38.9%), concerns that the alterations were permanent (35.4%), and physical implications and difficulty performing activities of daily living (34%) were reported.
CONCLUSION
Anosmia and dysgeusia are prevalent symptoms of COVID-19 disease, especially among females. Although transient, anosmia and dysgeusia had considerable impact on patient's life. Neuropsychological implications of COVID-19 in acute infection phase and prognosis of anosmia and dysgeusia in COVID-19 are areas for further exploration.
PubMed: 37333880
DOI: 10.2147/IJGM.S408706 -
Brain Circulation 2023
PubMed: 37151791
DOI: 10.4103/bc.bc_65_22 -
Indian Journal of Otolaryngology and... Oct 2022Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We...
Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We aimed to evaluate the socio-clinical characteristics and outcome of various options of treatment of individuals with parosmia due to COVID-19 infection. The study was conducted at two main Hospitals in the Ramadi and Tikrit cities, Iraq, on patients with a chief complaint of parosmia due to COVID-19 disease. The study involved 7 months (August 2020-February 2021). Detailed demographic and clinical characteristics and treatment options with their outcome were recorded and analyzed. Out of 268 patients with parosmia, there were 197 (73.5%) females. The majority were from age group ≤ 30 years (n = 188, 70.1%), housewives (n = 150, 56%), non-smokers (n = 222, 82.8%), and associated with dysgeusia (n = 207, 77.2%) but not associated with nasal symptoms (n = 266, 99.3%). All patients have complained of anosmia (89.9%) or hyposmia (10.1%). Troposmia was reported in the majority of participants. The majority of the patients were suffering from severe parosmia (65.7%). Around 3 quarters of the cases were presented in ≤ 4 months. Altered quality of life (AQL) was presented in 91.8% of subjects, and there was a significant association with the presence of dysgeusia and type and severity of parosmia. The smoking habit didn't show a significant association with AQL, the severity of parosmia, and the recovery rate. Most of the odor group was the most triggering stimuli eliciting parosmia, while, the sewage was the response odor in above 50% of the cases. The recovery rate was poor with olfactory training plus either tonics or local and systemic steroids. Parosmia due to COVID-19 infection is a common problem with poor results in the short-term treatment and follow-up. The AQL was seen in a greater proportion of patients and strongly associated with the presence of dysgeusia, type, and severity of parosmia.
PubMed: 34055592
DOI: 10.1007/s12070-021-02630-9 -
Cancer Nov 2022Dysgeusia is a common but understudied complication in patients undergoing autologous hematopoietic cell transplantation (auto-HCT). We assessed the feasibility of using...
BACKGROUND
Dysgeusia is a common but understudied complication in patients undergoing autologous hematopoietic cell transplantation (auto-HCT). We assessed the feasibility of using chemical gustometry (CG) to measure dysgeusia and explored its associations with symptom burden, nutrition, chemotherapy pharmacokinetics (PK), and the oral microbiome.
METHODS
We conducted a single-center, prospective feasibility study (NCT03276481) of patients with multiple myeloma undergoing auto-HCT. CG was performed longitudinally testing five flavors (sweet, sour, salty, bitter, umami) to calculate a total taste score (maximum score, 30). We measured caloric intake and patient-reported symptoms, assessing their correlation with oral microbiota composition and salivary and blood melphalan PK exposure.
RESULTS
Among all 45 patients, 39 (87%) completed at least four (>60%) and 22 (49%) completed all six CG assessments. Median total CG scores remained stable over time but were lowest at day +7 (27, range 24-30) with recovery by day +100. Symptom burden was highest by day +10 (area under the curve, 2.9; range, 1.0-4.6) corresponding with the lowest median overall caloric intake (1624 kcal; range, 1345-2267). Higher serum/salivary melphalan levels correlated with higher patient-reported dysgeusia and lower caloric intake. Oral microbiota α-diversity was stable early and increased slightly by day +100.
CONCLUSIONS
Assessment of dysgeusia by CG is feasible after auto-HCT. Most dysgeusia, symptom burden, and lowest caloric intake occurred during the blood count nadir. Higher melphalan concentrations correlated with more dysgeusia and poorer caloric intake. Future studies will aim to modulate melphalan exposure by PK-targeted dosing and characterize patient taste preferences to personalize diets for improved nutritional intake.
LAY SUMMARY
Taste changes after cancer treatments are very common. We used chemical gustometry (taste testing) to study taste changes and to better understand why patients with multiple myeloma experience this symptom after autologous hematopoietic cell transplantation. We found that taste testing was feasible, taste changes peaked when blood counts were lowest, and most patients recovered their taste by 100 days after transplantation. Taste changes correlated with lower food intake and with higher levels of chemotherapy in the body. Future work will focus on using personalized chemotherapy doses to reduce taste changes and to match patients' individual taste preferences with their diets.
Topics: Dysgeusia; Hematopoietic Stem Cell Transplantation; Humans; Melphalan; Multiple Myeloma; Prospective Studies; Transplantation, Autologous
PubMed: 36041227
DOI: 10.1002/cncr.34444 -
Therapeutic Advances in Ophthalmology 2019The objective of this article is to review the pharmacology, efficacy, and safety of lifitegrast and determine its role relative to other agents in the management of dry... (Review)
Review
The objective of this article is to review the pharmacology, efficacy, and safety of lifitegrast and determine its role relative to other agents in the management of dry eye disease. A PubMed search (1946 to December 2018) using the terms and was conducted to identify relevant articles. or evaluations of lifitegrast published in the English language were eligible for inclusion. Phase II and III trials were selected for review of efficacy and safety. Four randomized controlled trials evaluated the efficacy and safety of lifitegrast 0.5% ophthalmic solution for 12 weeks, and 1 additional trial assessed safety for 1 year. In a majority of the trials, lifitegrast caused statistically significant improvements in inferior corneal fluorescein staining scores and eye dryness scores. The most common adverse effects were eye irritation, dysgeusia, and reduced visual acuity, and most were mild to moderate in severity. Lifitegrast has a novel mechanism of action and is safe and effective for the treatment of dry eye disease. At this time, lifitegrast may be considered as an option for patients who have an inadequate response to artificial tears.
PubMed: 31489402
DOI: 10.1177/2515841419870366 -
Handbook of Experimental Pharmacology 2022This review summarizes our understanding of ATP signaling in taste and describes new directions for research. ATP meets all requisite criteria to be considered a... (Review)
Review
This review summarizes our understanding of ATP signaling in taste and describes new directions for research. ATP meets all requisite criteria to be considered a neurotransmitter: (1) presence in taste cells, as in all cells; (2) release upon appropriate taste stimulation; (3) binding to cognate purinergic receptors P2X2 and P2X3 on gustatory afferent neurons, and (4) after release, enzymatic degradation to adenosine and other nucleotides by the ectonucleotidase, NTPDase2, expressed on the Type I, glial-like cells in the taste bud. Importantly, double knockout of P2X2 and P2X3 or pharmacological inhibition of P2X3 abolishes transmission of all taste qualities. In Type II taste cells (those that respond to sweet, bitter, or umami stimuli), ATP is released non-vesicularly by a large conductance ion channel composed of CALHM1 and CALHM3, which form a so-called channel synapse at areas of contact with afferent taste nerve fibers. Although ATP release has been detected only from Type II cells, it is also required for the transmission of salty and sour stimuli, which are mediated primarily by the Type III taste cells. The source of the ATP required for Type III cell signaling to afferent fibers is still unclear and is a focus for future experiments. The ionotropic purinergic receptor, P2X3, is widely expressed on many sensory afferents and has been a therapeutic target for treating chronic cough and pain. However, its requirement for taste signaling has complicated efforts at treatment since patients given P2X3 antagonists report substantial disturbances of taste and become non-compliant.
Topics: Adenosine Triphosphate; Humans; Receptors, Purinergic; Signal Transduction; Taste; Taste Buds
PubMed: 34435233
DOI: 10.1007/164_2021_518