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Background: Functional Somatic Disorders (FSDs) are characterized by persistent physical symptoms that cannot be explained by other somatic or psychiatric conditions. Multiple Chemical Sensitivity (MCS) is a non-allergic FSD characterized by odour intolerance and various somatic symptoms being attributed to the influence of toxic environmental chemicals in low, usually harmless doses. The pathophysiology of FSDs are still not clear. Smell and taste complaints were also among the notable symptoms characterizing the covid epidemic and the latest evidence suggests overlaps between long COVID and FSDs. Method(s): The study includes advanced analysis of MRI-derived functional and structural connectomes acquired on a 3 T MR scanner. Furthermore, it includes questionnaires and paraclinical tests, e.g. the Sniffin' Stick olfactory test, Mini-Mental State Examination, and Sino-Nasal Outcome test 22. The pilot part of the project included 6 MCS patients who were compared with 6 matched healthy participants. Later follow-up included analysis of 8 multiorgan FSD and 4 post-COVID patients. Result(s): The MCS group showed important brain structural connectivity differences in 34 tracts. Notably, for MCS patients, the olfactory cortex (especially in the right hemisphere) showed decreased connectivity with regions in the emotional system. Conclusion(s): We plan to extend these findings with whole-brain modelling of the functional connectivity in the patient groups. Long-term this could be used as a 'fingerprint' which could help with diagnosis and treatment monitoring in FSDs as well as with new diagnoses such as long-COVID.Copyright © 2023
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Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants. Method(s): We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions. Result(s): Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of post-COVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of post-COVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant. Conclusion(s): The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased.Copyright © Korean Medical Association.
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Background: An emerging finding about COVID-19 is its effect on nutrition and weight loss. The COVID-19 symptoms of fatigue, altered taste or smell, and lack of appetite are well known. But COVID-19 may have a more profound effect on clinical nutrition status. Two recent studies have identified that approximately one-third of ambulatory COVID-19 patients are at risk of experiencing weight loss >= 5% (Anker, et al;di Filippo, et al). The case study presented here discusses home start total parenteral nutrition (TPN) in a patient recently diagnosed with COVID-19 at high risk for refeeding syndrome. Method(s): N/A Results: Case Study: A 92-year-old patient was diagnosed with COVID-19 on June 8, 2022. Over the next week, she was hospitalized twice to manage symptoms of acute mental status changes, lethargy, aphasia, hypotension, and loss of appetite. The patient received nirmatrelvir/ritonavir, remdesivir, and bebtelovimab to treat COVID-19 at different times between June 9, 2022, and June 18, 2022. She remained COVID positive and continued to deteriorate clinically. On June 20, 2022, the patient began receiving 24/7 homecare, including intravenous (IV) fluids of dextrose 5% in normal saline (D5NS) 1000 mL daily for three days. She continued to experience loss of appetite and had no bowel movement for 3 days. On June 23, 2022, she was referred to this specialty infusion provider to initiate TPN therapy in the home setting. The patient's BMI was 18.2 kg/m2. Lab results revealed potassium 3.0 mmol/L, phosphate 1.6 mg/dL, and magnesium 1.6 mg/dL. High risk of refeeding syndrome was identified by the level of hypophosphatemia and hypokalemia. The specialty infusion provider's registered dietitian recommended to discontinue D5NS and begin NS with added potassium, phosphate, and magnesium. Thiamine 200mg daily was added to prevent Wernicke's encephalopathy. The patient's clinical status and lab values were monitored closely each day until her electrolyte levels stabilized (Table 1). Home TPN therapy was initiated on June 28, 2022, with <10% dextrose and 50% calorie requirement with 85% protein and 1.0 g/kg lipids. Three-day calorie count and nutrition education were performed four days post TPN initiation. Oral intake met only 25% of estimated needs. Over several days, theTPN formula was gradually increased to goal calories and the infusion cycle was slowly decreased. The following week, the patient's oral intake improved to 60%-75% of estimated needs. Her constipation resolved, and she showed improvement in functional status and mobility. Her appetite drastically improved when the TPN was cycled. Another three-day calorie count was performed when TPN calories reached goals. Oral intake demonstrated 100% estimated calorie and protein needs. TPN therapy was ultimately discontinued on July 14, 2022. As of September 30, 2022, the patient has stabilized at her pre-COVID weight of 45 kg with full recovery of appetite, function, and cognition. Discussion(s): The ASPEN Consensus Recommendations for Refeeding Syndrome (da Silva, et al) describe the repletion of electrolyte levels before introducing calories to prevent end-organ damage associated with refeeding syndrome (respiratory muscle dysfunction, decreased cardiac contractility, cardiac arrhythmias, and encephalopathy). Conclusion(s): This case study highlights the successful initiation of home TPN therapy in a patient at high risk of refeeding syndrome post COVID-19 infection. Although home start TPN and the risk of refeeding syndrome are not new concepts, they must be considered in the setting of COVID-19. Given the effects COVID-19 has on taste, smell, and appetite and the recent finding that one-third of patients with COVID infection may experience weight loss of >= 5%, nutrition support and patient education are vital components of overall patient care. (Figure Presented).
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Aim. An online survey among social network users was conducted to assess the frequency of COVID-19 cases, the spectrum of medications used for treatment, and the subjective assessment of clinical manifestations of the disease. Material and methods. An anonymous online survey was conducted among users of various social networks using a questionnaire created on the SurveyMonkey survey and research platform. During the first month of December 2021, the survey included 23 questions regarding the clinical and demographic characteristics of respondents, the number of COVID-19 cases, clinical manifestations, and severity, as well as the need for medical help and medication. Results. 752 respondents took part in the online survey, more than 70% of them are under 50 years old. Among the respondents 59.73% had a new coronavirus infection (COVID-19). More than 40% of the participants had COVID-19 in the period from September 2020 to April 2021 (2nd wave in Russia). In 79.2% of people, the presence of a new coronavirus infection was confirmed by one of the diagnostic methods: polymerase chain reaction (PCR test), radiography, the presence of antibodies to Ig G/M, and took into account the presence of contact with infected SARS-CoV-2. 411 participants observed any clinical manifestations of the disease. Most often respondents who had COVID-19 indicated weakness, cough, dyspnea, disappearance or decrease in the acuity of smell and taste. The volume of lung tissue damage in 36.5% of cases was less than 25%. The disappearance of any clinical manifestations of the disease immediately after recovery was noted by 32.0% of respondents. Most of the patients (59.2%) sought medical help at the polyclinic, 38.9% had to self-medicate. 71.9% respondents indicated they had been vaccinated against COVID-19, but without specifying the timing and completeness of the course. Side effects after immunization (fever, weakness, soreness, and redness at the injection site) were subjectively assessed by 41.9% of respondents. Conclusion. Among the surveyed respondents, 62.7% of the disease symptoms were mild. The highest number of cases occurred in the 2nd and 4th waves of COVID-19 morbidity in Russia. Most often respondents indicated symptoms of acute respiratory infection. The complete disappearance of clinical manifestations of the disease immediately after recovery was noted by 32.0 % of respondents, and the persistence of symptoms for up to a year - 7.5. More than 70% of the participants in the online survey reported vaccination against COVID-19, but the questionnaire did not include questions about the timing of vaccinations (before or after COVID-19) and the completeness of the course.Copyright © Eco-Vector, 2023. All rights reserved.
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Background: SARS-CoV-2 infection is accompanied by acute olfactory disturbance in as high as 70% of cases. This loss is associated with decreased olfactory bulb volume. As time passes, the anosmia tends to subside, but the OB volume decrease does not. Volume reductions in primary and secondary olfactory cortex are also seen following SARS-CoV-2 infection. Nevertheless, concurrent SARS-CoV-2 infection effects on olfactory discrimination, olfactory bulb volume, primary olfactory cortex and its targets have not been investigated. To explore this possibility, we measured olfactory discrimination, olfactory bulb volume, primary olfactory cortex and basal ganglia volume in patients who had SARS-CoV-2 infection more than 12 weeks previously, who were then divided into COVID and long-COVID groups on the basis of selfreported fatigue and concentration complaints. Method(s): This cross-sectional study included 25 post-infection and 19 demographically-matched, no-COVID control participants, we investigated effects on olfaction using NIH Toolbox Odor Identification Test and the Monell Smell Questionnaire. GM structure was assessed with voxel-based morphometry and manual delineation of high resolution (1mm3), T1- and T2-weighted MRI data. Linear regression was used to model group effects on GM structure, adjusting for age, sex, education and total intracranial volume. CAT12/SPM12 and R were used for image processing and statistical modeling. Result(s): Results. The NIH Toolbox Odor Identification Test failed to show differences among the groups. In contrast, the Monell Smell Questionnaire revealed persistently diminished and distorted smell in 50% of the long-COVID sample. Olfactory bulb volume was lower in the long-COVID group (p=0.02). Primary olfactory cortex volume was reduced in the long-COVID group (p=0.004). Caudate volume was also lower in the long-COVID group (p=0.04). Conclusion(s): Conclusions. In the absence of olfactory discrimination problems, long-COVID, but not COVID, patients experience persistent olfactory loss and distortion. These perceptual problems are associated with lower olfactory bulb, primary olfactory cortex, and caudate volume, suggesting that the effects of SARS-CoV-2 infection can extend beyond the olfactory periphery in some cases to affect central targets. (Figure Presented).
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Background: Previous longitudinal studies (n=6) of objective olfaction performance post-acute COVID-19 have a maximum follow-up of 6-month and do not often test biomarkers. Although olfactory dysfunction appears to improve within two months of symptom onset, 4/6 longitudinal studies show persistent olfactory impairment. Method(s): PCR-confirmed COVID-19 patients in the prospective ADAPT cohort (Sydney, Australia) were assessed across 18 acute symptoms and hospitalization status: 40% mild, 50% moderate, 10% severe/hospitalised - none deceased). Blood samples were taken 2 (N=179), 4 (N=148) and 12-month (N=118) post-diagnosis. The NIH Odor Identification Test (OIT) and the Cogstate brief cognitive battery were performed. 58 also had an olfaction test at 24-month. The OIT raw data were transformed into demographically-corrected T-scores. OIT's attrition was completely random and only initial age (40+/-15 versus 47+/-15) differed between patients lost to follow-up and those in the study at 24-month. We tested peripheral neurobiomarkers (NFL, GFAP, S100B, GM-CSF) and immune markers (Interleukin-IL panel: 1-beta, 1Ralpha, 4, 5, 6, 8, 10, 12p40, 12p70, 13, and MCP-1, TNF-alpha and INF-gamma), analyzed as Log transformed and elevated/normal range using published references. Our previous analyses had shown no relationship with the kynurenine pathway, but an association of impaired olfaction and impaired cognition at 2-month only. Linear mixed effect regressions with time effect (months) tested olfaction trajectories (random subject effect) and their association with the biomarkers (main and time interaction). Result(s): At 2 months post-diagnosis 30% had impaired olfaction and those who had acute severe disease were more likely to be impaired (54% versus 26%, p=.009). 21%, 31% and 37% had impaired olfaction at 4, 12 and 24-months. Olfactory performance declined over time (p< .0001), which was dependent on the initial performance (Fig 1). Neurobiomarkers were within the normal range. IFN-gamma, IL-1Ralpha, IL-13 and TNF-alpha increased across time, p< .03-p< .0005. TNF-alpha and IFN-gamma showed a time covariance with poorer olfaction performance. Conclusion(s): Post-acute mild to moderate COVID-19 is associated with a declining olfactory performance up to 2-yr post-diagnosis, especially when initially impaired with the provisio of attrition although random. Olfactory performance decline may be mediated by upregulated immune parameters which are distinct from those driving cognitive changes. (Figure Presented).
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The sense of smell-olfaction involves the natural processing of ambient information in real-time. This process allows humans to detect danger, identify familiarities, and form lasting memories. During the COVID-19 pandemic, researchers were presented with challenges related to conducting in-person olfactory-based user studies. In this paper, we explore user experience and perception during olfactory-based interactions (OBI). Based upon previous literature, we propose an approach to offer future researchers a methodology for conducting olfactory-based user studies remotely. In particular, we explored a paper prototyping medium as an olfactory display. This experiment demonstrates the remote investigation of a complex sensory functionality during high mental work-load levels while participants (N=12) engage in an online memory game. Furthermore, this work seeks to inspire further discussion of olfactory-based user studies that explore functions related to human moods, memory, and behavior.
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The olfactory system is unique as a special sensory system in its developmental neuroanatomy and function. Neonatal olfactory reflexes can be detected in the fetus from 30 weeks gestation and can be tested in term and preterm neonates and older children. Most efferent axons from the olfactory bulb terminate in the anterior olfactory nucleus within the olfactory tract, with secondary projections to the amygdala, hypothalamus, hippocampus, and entorhinal cortex (parahippocampal gyrus), with tertiary projections also to the insula and other cortical regions. The olfactory bulb and tract incorporate an intrinsic thalamic equivalent. The olfactory bulb may be primary in generating olfactory auras in some cases of temporal lobe epilepsy. Developmental malformations may involve the olfactory bulb and tract, isolated or as part of complex cerebral malformations and genetic syndromes. Primary neural tumors may arise in the olfactory bulb or nerve. Impaired olfaction occurs in neonatal hypoxic/ischemic and some metabolic encephalopathies. Loss of sense of smell are early symptoms in some neurodegenerative diseases and in some viral respiratory diseases including coronavirus disease 2019. Testing cranial nerve I is easy and reliable at all ages, and is recommended in selected neonates with suspected brain malformations or encephalopathy.
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Case report Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequent comorbidity in severe asthma in adults. Both diseases share key pathophysiological mechanisms that can involve type-2 inflammatory pathways. However, this is an uncommon presentation in pediatric patients. Dupilumab, a fully human monoclonal antibody against IL-4Ralpha, inhibits IL-4/ IL-13 signaling, which are key drivers of type-2 inflammation and interfere with both eosinophilic and allergic pathways. It is approved for patients >= 12-year- old with moderate to severe uncontrolled asthma, but its approval in CRSwNP is limited to adults. We report a case of a 12-year- old boy with severe uncontrolled asthma and highly symptomatic CRSwNP referred to our center in May 2021. He was sensitized to house dust mite and pollens, and a specific immunotherapy had been tried previously. He was treated with high dose inhaled corticosteroid, long-acting beta agonist, long-acting muscarinic antagonist, montelukast and daily intra-nasal corticosteroids. Furthermore, a bilateral endoscopic sinus surgery with polypectomy was performed in April 2021. Despite adherence to medication and surgical treatment, both diseases were uncontrolled with frequent exacerbations requiring unscheduled visits and multiple systemic corticosteroid courses. This led to failure to thrive and several missed school days. Oral corticosteroid (OCS) tapering was unachieved due to symptoms rebound and so maintenance therapy with prednisolone 10mg daily was attempted, with only a slight improvement. High levels of eosinophils (1010 cells/muL), FeNO (122 ppb) and IgE (2255 kU/L) were present. Treatment with subcutaneous dupilumab was started in July 2021. A clinical and analytical improvement was evident at the 3-month evaluation (Table 1). He was able to stop prednisolone, and no clinically relevant exacerbations occurred. He also was fully vaccinated and had an asymptomatic COVID-19 infection in December 2021. Patients with CRSwNP and comorbid asthma have a higher disease burden than patients with each disease alone. In this adolescent, dupilumab was effective as an add-on treatment, for both severe asthma and CRSwNP. It led to disease control, OCS withdrawal, reduced eosinophilic inflammation, improved lung function, smell recovery and absence of exacerbations during follow-up. Dupilumab, targeting the type 2 inflammatory process, may allow a better management of pediatric patients >=12 years old with severe CRSwNP and comorbid asthma. (Table Presented).
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Funding: None. Synopsis: 61-year-old male who initially presented to an outside facility with streptococcal pneumoniae meningitis and bacteremia. Of note, he had history of COVID-19 pneumonia a month prior. On hospital day 15, he reported sudden onset lower back pain prompting imaging which demonstrated a contained rupture of an infrarenal aortic aneurysm that had significantly evolved in comparison to admission imaging where his infrarenal aorta had the largest dimension measuring 2.9cm. We present the successful application of neoaortoiliac system (NAIS). Method(s): Proceeding with midline laparotomy we encountered dense adhesive disease due to his history of surgery for colon cancer. After adhesiolysis, we exposed the aorta and aneurysm with severe surrounding inflammatory changes. 20cm of femoral vein was harvested, reversed, and joined for a span of 4cm using an Endo GIA 45mm vascular load to create our neoaorta. Proximal and distal clamp zones were developed. Upon entering the aneurysm, a foul smell was encountered, revealing that the noxious process had destroyed the posterior wall of the aorta and paraspinal tissues. Our neoaorta was anastomosed in end-to-end fashion to the infrarenal aorta and subsequently to the common iliac arteries. Flow was initially restored to the hypogastric arteries and then the external iliac arteries. The retroperitoneum was closed over our repair and covered with omentum. Result(s): On post-operative day 2, he had hematochezia;intraoperatively, the IMA was noted to be 1mm in size, though had brisk back-bleeding and was ultimately ligated. A flexible sigmoidoscopy revealed ischemic sloughing of the sigmoid colon near his previous anastomosis from his colon cancer resection though no transmural necrosis. He remains on high-dose ceftriaxone to complete a 6-week course and metronidazole for 10 days due to his sigmoid mucosal ischemia per infectious disease recommendations. He is now post-operative day 10 and remains in the ICU. Conclusion(s): Mycotic aortic aneurysms constitute 1-1.8% of aortic aneurysms. The standard of treatment is aggressive debridement of involved aortic wall and periaortic tissue, in-situ or extra-anatomic reconstruction, coverage with an omental flap and long-term antibiotic therapy. NAIS is resistant to infection and aneurysmal dilation, however, is a time-consuming procedure with a mean completion time of 8 hours. Dorweiler et al. demonstrated that vascular reconstruction with femoral vein in infected aortoiliofemoral fields has a mortality of 9-10% with negligible rate of late complications (graft stenosis, thrombosis, and dilation) and that venous morbidity after femoral vein harvest is well tolerated. Clagett et al. demonstrated that NAIS fashioned from greater saphenous vein had a failure rate requiring intervention of 64% compared to 0% for those constructed with deep femoral vein. Lastly, it is important to note that our patient was previously COVID-19 positive. This case demonstrates that the sequela of COVID-19 may have been a significant factor in our patient's pathophysiology. As we continue to learn about the effects of COVID-19 on vascular pathology, we must keep a large repertoire of operative techniques at hand in order to treat complex presentations of vascular emergencies. [Formula presented] [Formula presented] [Formula presented] Institution: Orlando Health, Orlando, FLCopyright © 2022
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Millions of people will now suffer from long-term smell loss as a result of infection with the SARS-CoV-2 virus. Smell is an integral component of the flavor of foods, which is one of the primary drivers of ingestive behavior. When individuals lose their sense of smell, they find food to be less flavorful and less enjoyable, which negatively impacts their quality of life. To compensate, many individuals alter their diet by focusing on tastes, chemesthesis (e.g., chili pepper heat, menthol cooling), and the texture of foods to make it more palatable. Some diet alterations, such as increasing salt use, can result in a lower diet quality, and an increased risk for chronic disease. Sensory nutrition is an area of research that focuses on how the chemical senses (e.g. taste, smell, chemesthesis) and oral somatosensation) affect dietary choices and health. Sensory nutrition strategies designed for individuals with smell loss may help improve the flavor and liking of foods while improving diet quality, and are a necessary area of future research to help improve health and quality of life in the growing population with smell loss.Copyright © 2022 The Author(s)
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Objective: During the coronavirus disease 2019 (COVID-19) pandemic, the N95 mask is an essential piece of protective equipment for healthcare workers. However, the N95 mask may inhibit air exchange and odor penetration. Our study aimed to determine whether the use of N95 masks affects the odor discrimination ability of healthcare workers. Methods: In our study, all the participants were asked to complete three olfactory tests. Each test involved 12 different odors. The participants completed the test while wearing an N95 mask, a surgical mask, and no mask. The score for each olfactory test was documented. Results: The olfactory test score was significantly lower when the participants wore N95 masks than when they did not wear a mask (7 vs. 10, p < 0.01). The score was also lower when the participants wore N95 masks than surgical masks (7 vs. 8, p < 0.01). Conclusion: Wearing N95 masks decreases the odor discrimination ability of healthcare workers. Therefore, we suggest that healthcare workers seek other clues when diagnosing disease with a characteristic odor.
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COVID-19 , Respiratory Protective Devices , Humans , N95 Respirators , COVID-19/prevention & control , SARS-CoV-2 , Controlled Before-After Studies , Odorants , Health PersonnelABSTRACT
Background and Purpose: Effects of COVID-19 in pregnancy are controversial.1-3 Some studies have found that a high viral load (VL) yields more symptoms,3,4 while others have found no significant differences.5 Some studies have shown pregnant women are not more likely to have a serious illness,2,6,7 while others say pregnancy is at risk for severe disease. 8,9 The purpose of our study is to compare VL values of polymerase chain reaction (PCR) tests between COVID-19 positive pregnant and nonpregnant women. Our secondary aim is to compare the asymptomatic rates among these two groups. Method(s): This case-control study identified women with COVID-19 confirmed by PCR between April-November, 2020. Cycle threshold (Ct), the number of cycles run on PCR to detect COVID-19, is inversely proportional to VL. Each pregnant woman was matched, by BMI and age, to two nonpregnant controls. Statistical analyses included Independent T-Test, Cochran's Q test and repeated measures ANOVA. Result(s): Sixty-four pregnant women were matched to 128 nonpregnant female controls. Race did not differ between the two groups. Ct in asymptomatic cases (Ct=24.1, SD=5.9) was higher (lower viral load) than symptomatic cases (Ct=12.5, SD=7.3) (p<0.001). Ct did not differ between pregnant and non-pregnant females, regardless of symptoms. Symptomatic infection among pregnant women was 54% compared to 87.7% in nonpregnant women (p<0.001). Fever, cough and fatigue were less common in pregnancy, at rates of 20.3% vs 40.7% (p=0.03), 39.1% vs 61.7% (p=0.02), and 4.7% vs 19.6% (p=0.02), respectively. Rates of shortness of breath, loss of taste and/or smell were similar in the two groups. Conclusion(s): Pregnancy did not yield higher viral load than nonpregnancy. VL is higher in symptomatic women than asymptomatic women, which holds true in pregnancy as well. Of all hospital admissions, pregnant women were less symptomatic than nonpregnant women. Correlation between VL and severity of disease needs further investigation.
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The online environment has long been a sensory interaction between a brand or product and its consumers through visual imagery and sonic elements. While newer technologies have developed that cater to a customer's more psychological need for haptics (touch), gestation, and olfaction, brands have not explored its true potential. Immersions and other forms of Human-Computer interaction have vastly developed and present scope for more than just a single sense for online consumers. While brands are employing these multisensory interfaces (vs. single-sensory) in certain product categories, it remains to be seen whether customers who unknowingly experience sensations online want to adapt to it. Several product categories could find multisensory elements beneficial. This study aims to delve deeper and understand the motivations of such behavior and identify the need for a customer to engage all its senses beyond the traditional visuals and sound while interacting with brands virtually for a more holistic experience. While external environmental factors such as pandemics have resulted in the inevitable loss of physical touchpoints, the aim is to determine whether sensory elements beyond images and sounds will benefit customer engagement.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.
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Background: Coronavirus disease (COVID-19) is spreading rapidly at an unprecedented scale across continents and has emerged as the single biggest risk the world has faced in modern times. Some scientists are comparing it to Spanish flu that created havoc around a century ago. The fear of death by COVID-19 looms large in the world today. The disease has reached devastating proportions since its first reports in December 2019. Doctors are having a difficult time dealing with this challenge and the microbiologists are having sleepless nights to bring about an effective vaccine for this disease. Method(s): A number of research and review articles have been exhaustively reviewed. The collected data has been meticulously analyzed and documented. Conclusion(s): This paper reviews the different types of coronaviruses, the structure of SARS-CoV-2 re-sponsible for COVID-19, its transmission, and virulence. Further, the article discusses the diagnosis, signs and symptoms like fever, breathlessness, cough, potential loss of taste or smell, sneezing, runny nose, fatigue, headache, sore throat and different treatment approaches including drug repurposing being tried by doctors around the globe that may come handy in the management of disease symptoms. The article describes the use of remdesivir, ribavarin, lopinavir, favipiravir, hydoxychloroquine, chloroquine, and tocilizumab among others in treating COVID-19.Copyright © 2021 Bentham Science Publishers.
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From the start of the COVID-19 pandemic evidence emerged that children were less affected by SARS-CoV- 2 PCR DNA COVID-19 positive infections with increasing evidence showing immunosuppressed children were less at risk compared to immunosuppressed adults. The aim of our study was to investigate how COVID-19 infections affected paediatric renal transplant recipients in the UK. Methods Questionnaires regarding patient demographics renal transplant information COVID-19 infection data and care of patients during the COVID-19 pandemic were sent out to all 13 UK paediatric nephrology centres. Results 54 patients (69% male;50% Black Asian and minority ethnic [BAME];57% living donors) aged 4-19 (median 11) years and between 2 months - 15 years (median 3 years 1 month) post-transplantation from nine centres tested positive for SARS-CoV-2 PCR DNA. Four centres had no positive patients. 48% presented with the classical COVID-19 symptoms (37% fever 11% continuous cough and 4% loss of sense of taste or smell);atypical presentations included diarrhoea (13%) and headache (8%). 37% of patients were asymptomatic. 28% were hospitalised (median stay 2 days) which included asymptomatic patients admitted for other reasons. Of those admitted one patient required oxygen;however, no patients required ventilation or intensive care admission. One child had a rejection episode as a complication of the infection and one adolescent had ongoing cardiorespiratory symptoms for six months. There was evidence of AKI with renal transplant dysfunction in 31% of patients, with increase in mean baseline plasma creatinine from 80.6mmol/l to 171.7mmol/l but no patients required CVVH or dialysis. Conclusion 9% of the UK paediatric renal transplantation population have had documented SARS-CoV-2 PCR DNA infections with 28% required hospitalisation. There was increased prevalence of AKI particularly after the first wave of the COVID-19 pandemic possibly due to different variants, although there is no specific virological data to support this.
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Background: Long COVID-19 is a multisystem syndrome that may start 12 weeks after the acute illness. About 10% of the recoverees will have at least one symptom during this period. We lack information about the rate of various symptoms and persistence beyond six months, especially after mild disease without hospitalisation. Research question: Characterisation of the long-term symptoms of COVID-19 patients in Israel. Method(s): A nationwide telephone survey was conducted using a structured questionnaire on 714 post COVID-19 participants aged 18 or over, 12 weeks or more after virological defined recovery. Patients were randomly selected from approximately 80,000 COVID-19-recovered patients at Leumit Health Service in Israel. Result(s): About 14% of convalescents had at least one symptom 12 weeks or more from recovery. The most common symptoms were memory or concentration disturbances (10%), muscle aches (8.5%), muscle weakness (7.6%), loss of taste or smell (5.9%) and headaches (3.8%). Six months after recovery, the incidence of most symptoms decreased, but memory or concentration problems (9.2%), muscle pain (7.8%) and muscle weakness (6.6%) remained common. In patients with fever or muscle aches at the time of COVID-19 and in patients with chronic diseases, the rate of prolonged symptoms (>6 months) was higher. Older age and hospitalisation during the course of the disease were not predictive of prolonged symptoms. Conclusion(s): In a large sample of recovering patients, most of them with mild, community-managed, the most common long-term complaints were disturbances in memory and concentration and muscle pain.
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The sense of smell plays an essential role in the sensory evaluation of coffee. However, a precise sensory evaluation also requires good memory and the ability to stay focused and concentrated. This study aimed to investigate the effect of an online sensory and cognitive training program on the odor recognition of 36 coffee aromas. A total of 44 coffee professionals participated in a randomized crossover trial. It consisted of an online training program with different sensory and cognitive tasks over two periods of 6 weeks. The participants were divided into three study groups for data analysis purposes: a Control-first group (n = 16), a matching Intervention-first group (n = 16), and a second Intervention-first-residual group (n = 12) to check for repeatability of the test results. On average, the participants improved their odor recognition score by 15% after 6 weeks of training (p <.01) and maintained a high-performance level after the control period. A positive correlation between completed training and improvement was observed (p <.001). The participants significantly improved their ability to detect the 36 Le Nez du Café aromas commonly used in the Specialty Coffee Association (SCA) and the Coffee Quality Institute (CQI) exam systems. Practical Applications: The new online training program is a promising tool for improving the odor recognition of coffee professionals. The sensory training can easily be accomplished as it is executable off-site, is self-instructive, and does not require any supervision. A further generalization of this new odor-training program for noncoffee professionals may potentially train people with prolonged loss in olfactory function, such as observed in coronavirus disease 2019 patients. © 2023 The Authors. Journal of Sensory Studies published by Wiley Periodicals LLC.
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Quantifying olfactory impairments can facilitate early detection of Coronavirus disease 2019 (COVID-19). Despite being a debated topic, many reports provide evidence for the neurotropism of SARS-CoV-2. However, a sensitive, specific, and accurate non-invasive method for quantifying persistent neurological impairments is missing to date. To quantify olfactory detectabilities and neurocognitive impairments in symptomatic COVID-19 patients during and post-infection periods, we used a custom-built olfactory-action meter (OAM) providing accurate behavioral readouts. Ten monomolecular odors were used for quantifying olfactory detectabilities and two pairs of odors were employed for olfactory matching tests. We followed cohorts of healthy subjects, symptomatic patients, and recovered subjects for probing olfactory learning deficits, before the Coronavirus Omicron variant was reported in India. Our method identifies severe and persistent olfactory dysfunctions in symptomatic patients during COVID-19 infection. Symptomatic patients and recovered subjects showed significant olfactory learning deficits during and post-infection periods, 4-18 months, in comparison to healthy subjects. On comparing olfactory fitness, we found differential odor detectabilities and olfactory function scores in symptomatic patients and asymptomatic carriers. Our results indicate probable long-term neurocognitive deficits in COVID-19 patients imploring the necessity of long-term tracking during post-infection period. Differential olfactory fitness observed in symptomatic patients and asymptomatic carriers demand probing mechanisms of potentially distinct infection routes.
ABSTRACT
BACKGROUND: Remote medical scent detection of cancer and infectious diseases with dogs and rats has been an increasing field of research these last 20 years. If validated, the possibility of implementing such a technique in the clinic raises many hopes. This systematic review was performed to determine the evidence and performance of such methods and assess their potential relevance in the clinic. METHODS: Pubmed and Web of Science databases were independently searched based on PRISMA standards between 01/01/2000 and 01/05/2021. We included studies aiming at detecting cancers and infectious diseases affecting humans with dogs or rats. We excluded studies using other animals, studies aiming to detect agricultural diseases, diseases affecting animals, and others such as diabetes and neurodegenerative diseases. Only original articles were included. Data about patients' selection, samples, animal characteristics, animal training, testing configurations, and performances were recorded. RESULTS: A total of 62 studies were included. Sensitivity and specificity varied a lot among studies: While some publications report low sensitivities of 0.17 and specificities around 0.29, others achieve rates of 1 sensitivity and specificity. Only 6 studies were evaluated in a double-blind screening-like situation. In general, the risk of performance bias was high in most evaluated studies, and the quality of the evidence found was low. CONCLUSIONS: Medical detection using animals' sense of smell lacks evidence and performances so far to be applied in the clinic. What odors the animals detect is not well understood. Further research should be conducted, focusing on patient selection, samples (choice of materials, standardization), and testing conditions. Interpolations of such results to free running detection (direct contact with humans) should be taken with extreme caution. Considering this synthesis, we discuss the challenges and highlight the excellent odor detection threshold exhibited by animals which represents a potential opportunity to develop an accessible and non-invasive method for disease detection.