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1.
PLoS One ; 17(3): e0265686, 2022.
Article in English | MEDLINE | ID: covidwho-1785192

ABSTRACT

Olfactory and gustatory disorders are prominent symptoms of acute COVID-19. Although both senses recover in many patients within weeks to months, persistency has been described in up to 60%. However up to now most reports on the course of chemosensitive disorders after COVID-19 are not based on psychophysical testing but only on subjective patients' ratings. In this study we assessed both olfaction and gustation using psychophysical tests eight months after COVID-19. Validated psychophysical testing revealed hyposmia in 18% and hypogeusia in even 32% of 303 included patients. This shows that olfactory and especially gustatory disorders have to be seen as important chronic symptoms post-COVID-19. The high prevalence of gustatory dysfunction indicates that gustatory function does not recover or might even deteriorate in the months following the acute infection.


Subject(s)
COVID-19/complications , Feeding and Eating Disorders/complications , Olfaction Disorders/etiology , Taste , COVID-19/etiology , Female , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Surveys and Questionnaires , Taste Threshold
2.
ORL J Otorhinolaryngol Relat Spec ; : 1-6, 2022 Apr 12.
Article in English | MEDLINE | ID: covidwho-1784934

ABSTRACT

INTRODUCTION: COVID-19 can be associated with a variety of longer-lasting impairments that can have a significant impact on patients' quality of life (QoL). While this is well described in the literature for limitations in lung capacity or permanent headaches, there is little research on the impact of olfactory dysfunction in the context of COVID-19 on patients' QoL. METHODS: In 65 patients with a history of COVID-19, the present olfactory ability was assessed using the Sniffin' Sticks test. In addition, olfactory QoL was assessed by the Questionnaire of Olfactory Disorders. Self-assessment was performed with visual analogue scales. The data were compared with the results obtained in healthy individuals and in patients with hyposmia due to other viral infections. RESULTS: The QoL of COVID-19 patients was significantly lower compared to the healthy control group. Even recovered subjects whose olfaction had already returned to the normal range still had a reduced QoL. The severity of the olfactory impairment correlated with the reduction in QoL. However, the olfactory QoL of COVID-19 patients was not worse than that of patients' olfactory loss due to other viral infections. Patients with parosmia had reduced QoL and rated their situation worse than patients without parosmia. CONCLUSION: QoL appears to be impaired in patients with long-lasting COVID-19 olfactory disorders several months after overcoming acute symptoms, even if olfaction has normalized. However, the impairment is not more pronounced than in patients with other postviral olfactory disorders of the same duration.

3.
Pediatr Allergy Immunol ; 33(3): e13750, 2022 03.
Article in English | MEDLINE | ID: covidwho-1765018
4.
Life (Basel) ; 12(3)2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1753648

ABSTRACT

The aim of this study was to investigate whether COVID-associated olfactory impairment differs from olfactory disorders due to other upper respiratory tract infections. We investigated the frequency of a SARS-CoV-2 infection among subjects presenting with a subjective olfactory impairment to a corona outpatient clinic between October 2020 and March 2021. Olfactory and gustatory loss were tested psychophysically, and the type of infection, SARS-CoV-2 versus 14 other common cold viruses, was assessed with nasopharyngeal swabs. Differences between the smell impairment caused by the pathogens were compared. Out of the 2120 patients, 314 reported sudden smell and/or taste loss (14%). In 68.9% of them, olfactory and in 25.6%, gustatory dysfunction could be confirmed by psychophysical testing. Of those with a psychophysically determined loss of smell, 61% were tested positive for SARS-CoV-2. SARS-CoV-2 led to a significantly more severe loss of smell and more qualitative olfactory disorders than other pathogens. Apart from rhinorrhea, shortness of breath and sore throat accompanying cold symptoms do not differ significantly between the viruses indicating the particular importance of smell loss in the differential diagnosis of seasonal colds. Multiplex-PCR in non-COVID patients revealed that only 27% of them had rhinoviruses, whereas the remainder were no further identified pathogens. Olfactory screening significantly increases diagnostic accuracy in COVID-19 patients compared to subjective assessment of olfactory loss.

5.
J Allergy Clin Immunol Pract ; 2022 Mar 17.
Article in English | MEDLINE | ID: covidwho-1747846

ABSTRACT

The COVID-19 pandemic has raised awareness about olfactory dysfunction, although a loss of smell was present in the general population before COVID-19. Chronic rhinosinusitis (CRS) is a common upper airway chronic inflammatory disease that is also one of the most common causes of olfactory dysfunction. It can be classified into different phenotypes (ie, with and without nasal polyps) and endotypes (ie, type 2 and non-type 2 inflammation). However, scientific information regarding CRS within the context of COVID-19 is still scarce. This review focuses on (1) the potential effects of severe acute respiratory syndrome coronavirus 2 infection on CRS symptoms, including a loss of smell, and comorbidities; (2) the pathophysiologic mechanisms involved in the olfactory dysfunction; (3) CRS diagnosis in the context of COVID-19, including telemedicine; (4) the protective hypothesis of CRS in COVID-19; and (5) the efficacy and safety of therapeutic options for CRS within the context of COVID-19.

6.
Laryngoscope ; 132(5): 1082-1087, 2022 May.
Article in English | MEDLINE | ID: covidwho-1705743

ABSTRACT

OBJECTIVE: Gustatory function during COVID-19 is self-reported by around 50% of patients. However, only a few studies assessed gustation using psychophysical testing during acute infection. The objective of this study is to test gustatory function on threshold tests in the very first days of COVID-19. METHODS: Psychophysical testing consisted of validated and blinded tests for olfaction (NHANES Pocket Smell Test) and gustation (Taste Strips Test). These test kits were sent to home-quarantined patients and self-administered using a detailed instruction sheet. RESULTS: A total of 51 patients were included in this study. Testing was performed 6.5 ± 2.7 days after sampling of respiratory swabs. At this time 37% of patients stated to currently experience a gustatory impairment. The mean Taste Strips score was 10.0 ± 3.4 with 28% scoring in the range of hypogeusia. Interestingly, no significant difference in the results of gustatory testing could be observed between the group with subjectively preserved gustation and the group with self-rated taste impairment. CONCLUSION: During the very first days of COVID-19, psychophysical gustatory testing revealed hypogeusia in 28%. This is far lower than patients' self-reports. Different from previous studies, we did not find clear evidence for an impairment of only certain taste qualities. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:1082-1087, 2022.


Subject(s)
Ageusia , COVID-19 , Olfaction Disorders , COVID-19/diagnosis , Dysgeusia , Humans , Nutrition Surveys , Smell , Taste , Taste Disorders/diagnosis , Taste Disorders/etiology
7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314259

ABSTRACT

Coronavirus disease 2019 (Covid-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a public health emergency recently, leading to fatal respiratory failure in a number of patients. The clinical manifestation of Covid-19 is manifold, cardio-respiratory symptoms and multiorgan failure being the most critical. Anosmia was reported to be an early symptom in a significant number of Covid-19 patients and is frequently the only symptom without underlying nasal congestion. Here we present neuropathological work-up of olfactory epithelium and associated olfactory nerves from two patients succumbing to Covid-19, one of which was anosmic. We show that SARS-CoV-2 infection is associated with inflammation in the olfactory epithelium and leads to axonal damage in olfactory structures of the CNS - potentially explaining anosmic symptoms.

9.
Int Forum Allergy Rhinol ; 12(2): 210-216, 2022 02.
Article in English | MEDLINE | ID: covidwho-1487435

ABSTRACT

Subjectively perceived impairment of taste is a common and distinct symptom of coronavirus disease 2019 (COVID-19). Large meta-analyses identified this symptom in approximately 50% of cases. However, this high prevalence is not supported by blinded and validated psychophysical gustatory testing, which showed a much lower prevalence in up to 26% of patients. This discrepancy may be due to misinterpretation of impaired retronasal olfaction as gustatory dysfunction. In addition, we hypothesized that COVID-19-associated hyposmia is involved in the decrease of gustatory function, as found for hyposmia of different origin. This indirect mechanism would be based on the central-nervous mutual amplification between the chemical senses, which fails in COVID-19-associated olfactory loss. However, further research is necessary on how severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) may directly impair the gustatory pathway as well as its subjective perception.


Subject(s)
COVID-19 , Olfaction Disorders , Humans , Olfaction Disorders/epidemiology , Pandemics , SARS-CoV-2 , Smell , Taste
10.
Fortschritte der Neurologie, Psychiatrie ; 89(6):281-288, 2021.
Article in German | APA PsycInfo | ID: covidwho-1441626

ABSTRACT

In this review article, current information on the frequency and relevance of chemosensory disorders in Covid-19 was recorded, assigned pathophysiologically and statements on prognostic significance were derived. The results are based on a comprehensive literature search of all literature on this topic and our own experience in the treatment of patients with smell and taste disorders since the beginning of the pandemic. Current study results indicate that clinically less affected Covid-19 patients without inpatient treatment and who do not require ventilation often have disorders of the chemosensory system. In young patients and women in particular, they seem to be an indicator of a favorable prognosis for the course of the disease. Smell disorders can appear early, as the sole symptom or together with other symptoms of Covid-19 disease. It has not yet been clarified whether ageusia can occur independently or whether it is also felt in the context of anosmia. In the pandemic, the new occurrence of anosmia without congestion/obstruction/runny nose is probably an expression of an infection with SARS-CoV-2 and should always give rise to quarantine and testing for SARS-CoV-2. The smell disorder in Covid-19 mostly seems to be temporary;It is not yet possible to conclusively assess whether there is usually a full restitution. The therapeutic approaches already established for other postviral olfactory disorders (e. g. olfactory training) are also used here. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (German) In dieser Ubersichtsarbeit wurden aktuelle Angaben zu Haufigkeit und Relevanz chemosensorischer Storungen bei Covid-19 erfasst, pathophysiologisch zugeordnet und Aussagen zur prognostischen Bedeutung abgeleitet. Die Ergebnisse basieren auf einer umfassenden Literaturrecherche samtlicher Literatur zu diesem Thema und eigenen Erfahrungen in der Behandlung von Patienten mit Riech- und Schmeckstorungen seit dem Beginn der Pandemie. Bisherige Studienergebnisse deuten darauf hin, dass klinisch gering betroffene Covid-19-Patienten ohne stationare Behandlungs- und Beatmungspflicht haufig Storungen der Chemosensorik aufweisen. Insbesondere bei jungen Patienten und Frauen scheinen sie ein Indikator einer gunstigen Prognose des Krankheitsverlaufs zu sein. Riechstorungen konnen fruh, isoliert oder als eines von mehreren Symptomen einer Covid-19-Erkrankung auftreten. Ob eine Ageusie eigenstandig auftreten kann oder aber im Rahmen der Anosmie mit empfunden wird, ist noch nicht geklart. In der Pandemie ist das neue Auftreten einer Anosmie ohne Kongestion/Obstruktion/Schnupfen wahrscheinlich Ausdruck einer Infektion mit SARS-CoV-2 und sollte stets zu Quarantane und Testung auf SARS-CoV-2 Anlass geben. Die Riechstorung bei Covid- 19 scheint meist vorubergehend zu sein;ob es regelhaft zu einer vollstandigen Restitution kommt, kann noch nicht abschliesend beurteilt werden. Die bereits bei anderen postviralen Riechstorungen etablierten Therapieansatze (z. B. Riechtraining) kommen auch hier zum Einsatz. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

11.
Pneumologie ; 75(11): 869-900, 2021 Nov.
Article in German | MEDLINE | ID: covidwho-1392935

ABSTRACT

The German Society of Pneumology initiated the AWMFS1 guideline Post-COVID/Long-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendation describes current post-COVID/long-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an expilcit practical claim and will be continuously developed and adapted by the author team based on the current increase in knowledge.


Subject(s)
COVID-19 , Pulmonary Medicine , COVID-19/complications , Consensus , Humans , SARS-CoV-2
12.
Dtsch Arztebl Int ; 117(41): 689, 2020 10 09.
Article in English | MEDLINE | ID: covidwho-1383841
13.
Chem Senses ; 2020 May 22.
Article in English | MEDLINE | ID: covidwho-1343675

ABSTRACT

In response to the COVID-19 pandemic, countries have implemented various strategies to reduce and slow the spread of the disease in the general population. For countries that have implemented restrictions on its population in a step-wise manner, monitoring of COVID-19 prevalence is of importance to guide decision on when to impose new, or when to abolish old, restrictions. We are here determining whether measures of odor intensity in a large sample can serve as one such measure. Online measures of how intense common household odors are perceived and symptoms of COVID-19 were collected from 2440 Swedes. Average odor intensity ratings were then compared to predicted COVID-19 population prevalence over time in the Swedish population and were found to closely track each other (r=-0.83). Moreover, we found that there was a large difference in rated intensity between individuals with and without COVID-19 symptoms and number of symptoms was related to odor intensity ratings. Finally, we found that individuals progressing from reporting no symptoms to subsequently reporting COVID-19 symptoms demonstrated a large drop in olfactory performance. These data suggest that measures of odor intensity, if obtained in a large and representative sample, can be used as an indicator of COVID-19 disease in the general population. Importantly, this simple measure could easily be implemented in countries without widespread access to COVID-19 testing or implemented as a fast early response before wide-spread testing can be facilitated.

14.
Current Opinion in Food Science ; 2021.
Article in English | ScienceDirect | ID: covidwho-1284014

ABSTRACT

Olfactory disorders in individuals are common. In general, 15% to 22% of the general population are estimated to have low olfactory function, and their prevalence rate has increased during the coronavirus disease 2019 (COVID-19) pandemic, raising global awareness as to how olfactory disorders can affect our quality of life. Notably, the most frequent issues reported by individuals with olfactory disorders are observed in food-related experiences. Because previous studies have advanced conflicting results in this regard, this review deals with current perspectives on the impacts of olfactory disorders on food perception, food enjoyment, food-evoked emotions, and dietary patterns. The strategies suggested in this review will provide a better understanding of how to improve eating-related quality of life among individuals with olfactory disorders.

16.
Int Forum Allergy Rhinol ; 11(7): 1041-1046, 2021 07.
Article in English | MEDLINE | ID: covidwho-1136915

ABSTRACT

The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.


Subject(s)
Adrenal Cortex Hormones/pharmacology , COVID-19 , Medication Therapy Management/statistics & numerical data , Olfaction Disorders , COVID-19/complications , COVID-19/physiopathology , Drug-Related Side Effects and Adverse Reactions/diagnosis , Drug-Related Side Effects and Adverse Reactions/etiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Global Health , Humans , Medication Therapy Management/standards , Needs Assessment , Olfaction Disorders/drug therapy , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfactory Mucosa/drug effects , Olfactory Mucosa/virology , Remission, Spontaneous , Research Design , SARS-CoV-2/pathogenicity
17.
Fortschr Neurol Psychiatr ; 89(6): 281-288, 2021 Jun.
Article in German | MEDLINE | ID: covidwho-1096360

ABSTRACT

In this review article, current information on the frequency and relevance of chemosensory disorders in Covid-19 was recorded, assigned pathophysiologically and statements on prognostic significance were derived. The results are based on a comprehensive literature search of all literature on this topic and our own experience in the treatment of patients with smell and taste disorders since the beginning of the pandemic.Current study results indicate that clinically less affected Covid-19 patients without inpatient treatment and who do not require ventilation often have disorders of the chemosensory system. In young patients and women in particular, they seem to be an indicator of a favorable prognosis for the course of the disease. Smell disorders can appear early, as the sole symptom or together with other symptoms of Covid-19 disease. It has not yet been clarified whether ageusia can occur independently or whether it is also felt in the context of anosmia. In the pandemic, the new occurrence of anosmia without congestion / obstruction/runny nose is probably an expression of an infection with SARS-CoV-2 and should always give rise to quarantine and testing for SARS-CoV-2. The smell disorder in Covid-19 mostly seems to be temporary; It is not yet possible to conclusively assess whether there is usually a full restitution. The therapeutic approaches already established for other postviral olfactory disorders (e. g. olfactory training) are also used here.


Subject(s)
COVID-19 , Olfaction Disorders , Female , Humans , Olfaction Disorders/epidemiology , Pandemics , SARS-CoV-2 , Taste Disorders
18.
J Allergy Clin Immunol ; 147(5): 1704-1719, 2021 05.
Article in English | MEDLINE | ID: covidwho-1096022

ABSTRACT

BACKGROUND: Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD). OBJECTIVE: Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists. METHODS: A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. RESULTS: The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction. CONCLUSIONS: The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options.


Subject(s)
COVID-19 , Olfaction Disorders , SARS-CoV-2/immunology , Steroids/therapeutic use , Vitamin A/therapeutic use , COVID-19/complications , COVID-19/drug therapy , COVID-19/epidemiology , COVID-19/immunology , Consensus , Evidence-Based Medicine , Olfaction Disorders/drug therapy , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfaction Disorders/immunology , Practice Guidelines as Topic
19.
Eur Arch Otorhinolaryngol ; 278(1): 101-108, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1064481

ABSTRACT

PURPOSE: To evaluate the evolution of chemosensation via extended psychophysical testing in patients who suffered from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19). Additionally, this study sought to determine whether odor threshold testing provided additional information on olfactory loss due to COVID-19 compared to the more common odor identification testing. METHODS: Prospective cohort study of patients with sudden chemosensory loss since February 2020 and confirmed COVID-19 infection via RT-PCR or serology testing. Olfactory function was tested extensively using the "Sniffin Sticks" test battery. In addition, we screened gustatory perception and nasal cooling sensations using psychophysical tests. RESULTS: Seventy-two patients completed the study. After a mean of 37 days, 37% of patients showed olfactory dysfunction, 7% were dysgeusic, and 48% showed signs of low sensitivity for cooling sensation. A longer duration of anosmia before smell improvement was correlated with lower olfactory function at 5 weeks. Odor threshold detection was more affected by COVID-19 compared to odor identification. CONCLUSION: Five weeks after developing sudden chemosensory loss due to COVID-19, a high proportion of patients were dysosmic and showed signs of low nasal cooling sensitivity, whereas most of them had normal taste function. SARS-CoV-2 affected mainly odor thresholds, possibly suggesting that the major cause of loss of smell lies at the level of the olfactory neuroepithelium, rather than in the central nervous system.


Subject(s)
Anosmia/etiology , COVID-19/diagnosis , COVID-19/psychology , Olfaction Disorders/etiology , Smell/physiology , Adult , Anosmia/psychology , COVID-19/complications , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Odorants , Prospective Studies , SARS-CoV-2 , Symptom Assessment/methods
20.
Laryngoscope ; 131(5): 1095-1100, 2021 05.
Article in English | MEDLINE | ID: covidwho-1009082

ABSTRACT

OBJECTIVE/HYPOTHESIS: With the COVID-19 pandemic, chemosensory dysfunction are among the most prevalent symptoms. Most reports are subjective evaluations, which have been suggested to be unreliable. The objective is to test chemosensory dysfunction and recovery based on extensive psychophysical tests in COVID-19 during the course of the disease. STUDY DESIGN: Prospective cohort study. METHODS: A total of 111 patients from four centers participated in the study. All tested positive for SARS-COV-2 with RT-PCR. They were tested within 3 days of diagnosis and 28 to 169 days after infection. Testing included extensive olfactory testing with the Sniffin' Sticks test for threshold, discrimination and identification abilities, and with the Taste Sprays and Taste Strips for gustatory function for quasi-threshold and taste identification abilities. RESULTS: There was a significant difference in olfactory function during and after infection. During infection 21% were anosmic, 49% hyposmic, and 30% normosmic. After infection only 1% were anosmic, 26% hyposmic, and 73% normosmic. For gustatory function, there was a difference for all taste qualities, but significantly in sour, bitter, and total score. Twenty-six percent had gustatory dysfunction during infection and 6.5% had gustatory dysfunction after infection. Combining all tests 22% had combined olfactory and gustatory dysfunction during infection. After infection no patients had combined dysfunction. CONCLUSIONS: Chemosensory dysfunction is very common in COVID-19, either as isolated smell or taste dysfunction or a combined dysfunction. Most people regain their chemosensory function within the first 28 days, but a quarter of the patients show persisting dysfunction, which should be referred to specialist smell and taste clinics for rehabilitation of chemosensory function. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1095-1100, 2021.


Subject(s)
COVID-19/complications , Olfaction Disorders/physiopathology , Psychophysics/methods , Taste Disorders/physiopathology , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Humans , Male , Middle Aged , Olfaction Disorders/rehabilitation , Olfaction Disorders/virology , Olfactory Perception/physiology , Prospective Studies , Recovery of Function/physiology , SARS-CoV-2/genetics , Taste Disorders/rehabilitation , Taste Disorders/virology , Taste Perception/physiology
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