Study of Different Local Treatments of Post COVID-19 Smell Dysfunction.

Introduction: This study was designed to differentiate between the impact of the topical nasal spray of corticosteroids, antihistamines, a combination of them, and normal 0.2% saline in treating patients with post-coronavirus disease 2019 (COVID-19) smell dysfunction. Materials and Methods: Patients with hyposmia or anosmia (n = 240), who recently recovered from COVID-19, were enrolled in this trial and were randomly assigned to four parallel groups. Group I (G1) received a combination of topical corticosteroid and antihistamine nasal spray (n = 60). Group II (G2) received topical corticosteroid nasal spray (n = 60). Group III (G3) received antihistamine nasal spray (n = 60). Group IV (G4) received 0.2% normal nasal saline nasal spray (n = 60). The treatments were used in all groups for 3 weeks. The sense of smell was assessed using the butanol threshold and discrimination tests. The smell tests were evaluated weekly for 3 weeks. Results: The mean age of the patients was 51.9 ± 7.1 years; moreover, 83.8% and 16.2% were male and female, respectively. The results of the smell tests in the first week significantly improved with those in the third week (P< 0.001). The greatest degree of improvement was found in the first group, followed by the second, third, and fourth groups. Conclusions: The results suggest the ability of combination therapy of corticosteroid and antihistamine nasal spray to manage post-COVID-19 hyposmia or anosmia; however, this combination therapy was not superior to corticosteroid nasal spray. Trial registration ID: UMIN000043537.

Living with Smell Dysfunction: A Multi-sensory VR Experience

"Living with Smell Dysfunction"is a multi-sensory short film that introduces scents in Virtual Reality (VR) Experience. Through this first-person immersive film in VR, the participant will face daily adventure, confusion and danger as a patient with smell dysfunction. Olfactory disorders simulated in this film are anosmia (absence of smell), hyposmia (diminished sensitivity of smell), and dysosmia (distortion of normal smell). [Schiffman 2007] Olfactory dysfunction and disability are tend to be overlooked and invisible to vast population. This novel immersive experience could bring more discussion and attention to the treatment and daily lives of smell dysfunctional patients. © 2022 Owner/Author.

Olfactory dysfunction as a screening tool for mild and moderate cases of COVID-19: a single-center prevalence study of 646 patients in flu clinic

Background: To evaluate the prevalence of olfactory dysfunction (OD) in the Indian population and to establish olfactory dysfunction as a screening tool in COVID-19-positive patients. Data was collected using a questionnaire from laboratory-confirmed COVID-19 patients. The patient’s demographic and clinical details were analyzed to calculate the prevalence of olfactory dysfunction, general symptoms like fever, cough, malaise, diarrhea, along with the sinonasal symptoms. All the symptoms were self-reported, and no objective tests were carried out. Results: Out of 646 laboratory-confirmed cases of COVID-19 infection, olfactory dysfunction was self-reported by 465 (72%) patients and gustatory dysfunction (GD) was seen in 406 (62.8%) patients. The affected males (416) were proportionately more than females (230), with the mean age of our study population being 39.47 ± 13.85 (range 18–85 years). The most common symptoms were myalgia (n = 494, 76.5%), cough (n = 471, 72.9%), and fever (n = 444, 68.7%). Out of 465 patients with olfactory dysfunction, only 108 (23.2%) reported nasal obstruction. Five hundred thirty-three (82.5%) RT-PCR-positive patients did not give a history of smoking;however, co-morbidity was reported by 163 patients, of which 117 were found to have olfactory dysfunction. One hundred seventy (26.3%) patients gave a positive contact history. 13.6% reported olfactory dysfunction as their first symptom. A positive association was seen between olfactory dysfunction and gustatory dysfunction Conclusions: Our study demonstrates a high prevalence of 72% in the Indian population. We recommend that anosmia be used as a screening tool to identify mild to moderate cases of COVID-19. © 2021, The Author(s).

Prevalence of Smell or Taste Dysfunction Among Children With COVID-19 Infection: A Systematic Review and Meta-Analysis.

Background: Smell and taste dysfunctions are common and have been reported as an early indicator of COVID-19. The prevalence of smell and taste dysfunctions among children with COVID-19 varies greatly across studies, which remains to be summarized quantitatively. This review aimed at examining the pooled prevalence of smell or taste dysfunctions among children with COVID-19, summarizing possible causes of the inconsistencies in the current estimates. Methods: Systematic searches of databases were conducted for literature published until 12 January 2021. Statistical analyses were performed using R software, the pooled prevalence was combined using random effects model. The Loney criteria were used for quality assessment. Results: A total of 18 eligible studies were included. The results showed that the pooled prevalence of smell dysfunction among children with COVID-19 was 15.97% (95% CI: 8.18-23.77%), the pooled prevalence of taste dysfunction among children with COVID-19 was 9.20% (95% CI: 4.25-14.16%), the pooled prevalence of smell or taste dysfunction among children with COVID-19 was 15.50% (95% CI: 10.30-20.70%) and the pooled prevalence of smell and taste dysfunction among children with COVID-19 was 20.21% (95% CI: 14.14-26.28%). Higher smell or taste dysfunction rates were associated with being female, younger age, smaller sample size, patients in Asia, and with comorbidities. Conclusions: Evidence suggests that smell or taste dysfunctions were common among children with COVID-19. Further research is needed to identify effective strategies for preventing and treating smell and taste dysfunctions among children with COVID-19.

Characteristics of COVID-19 smell and taste dysfunction in hospitalized patients.

The effects of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) exist on a spectrum. Clinical symptoms of smell and taste dysfunction are prominent features of COVID-19. The objective of this study was to elucidate the factors associated with smell and taste dysfunction amongst hospitalized COVID-19 patients. A retrospective review of a multi-hospital health network's COVID-19 database between March and June 2020 was performed. Patients with self-reported smell or taste loss were included. Demographic information, patient comorbidities, and mortality data was obtained. There were 2892 patients included in this analysis and 117 reported smell or taste loss (4.0%, 95% confidence interval [CI]: 3.4%-4.8%). The proportion of females with smell or taste loss was significantly higher than males (6.3% vs. 2.5%, P < 0.001), whereas no differences existed between ethnicity or smoking status. When compared with age of 30-40 years, the age group of 10-20 years were most likely to present with smell or taste dysfunction (odds ratio [OR] 6.59, 95% CI 1.32-26.12; P = 0.01). The majority of specific comorbidities were not associated with increased incidence of smell or taste dysfunction. Outpatient healthcare workers were more likely to present with smell or taste loss (OR 3.2, CI 1.8-5.47; P < 0.001). The mortality rate among COVID-19 patients with smell or taste dysfunction was significantly lower than those without (0% vs. 20.3%; P < 0.001). Smell or taste loss is more prevalent in women, younger age groups, and healthier individuals. It may be associated with lower mortality and a milder disease trajectory compared to the overall cohort.

High frequency of smell and taste dysfunctions in allergy health care professionals suffering from COVID-19.

BACKGROUND AND OBJECTIVE: Since the first stages of the novel coronavirus 2019 (SARS-CoV-2) outbreak smell and/or taste dysfunction (STD), has been described from 5% to 88% in COVID-19 patients. Objective: we aimed to assess STD in healthcare professionals (HCP), mainly allergists, affected with COVID-19, by means of a survey, and to evaluate the association of STD and their severity with demographic characteristics, symptoms, comorbidities, and hospital admission. METHODS: A 15-item questionnaire was designed including different sections as follows: demographics, diagnostic characteristics, STD patterns, medication use as well as comorbidities. The questionnaire was developed using Google forms, implemented and distributed to members of the Spanish Society of Allergology and Clinical Immunology (SEAIC) and spread via Social Media to be completed by HCP affected with COVID-19. RESULTS: HCP (n=234), 76.5% ≤55 yrs, 73.5% female, completed the survey. There was STD in up to 74.4% of the respondents, 95.6% reporting a moderate-severe impairment. Mean recovery time of taste dysfunction was 21.6±24.0 days in HCP ≤55 yrs and 33.61±26.2 days in >55 yrs (p=0.019). Stratified analysis by severity of STD showed that more than a half of COVID-19 subjects presented severe loss of smell. An older age (>55 yrs) was associated with fever, anorexia, less headache and with a longer persistence of taste dysfunction. CONCLUSIONS: STD is a common symptom in COVID-19, even as a unique or preceding symptom. HCP who declared smell dysfunction (SD) were younger than those not affected with STD. Taste dysfunction (TD) may imply more systemic involvement in COVID-19-positive HCP.

A Systematic Review of the Neuropathologic Findings of Post-Viral Olfactory Dysfunction: Implications and Novel Insight for the COVID-19 Pandemic.

BACKGROUND: Post-viral olfactory dysfunction is a common cause of both short- and long-term smell alteration. The coronavirus pandemic further highlights the importance of post-viral olfactory dysfunction. Currently, a comprehensive review of the neural mechanism underpinning post-viral olfactory dysfunction is lacking. OBJECTIVES: To synthesize the existing primary literature related to olfactory dysfunction secondary to viral infection, detail the underlying pathophysiological mechanisms, highlight relevance for the current COVID-19 pandemic, and identify high impact areas of future research. METHODS: PubMed and Embase were searched to identify studies reporting primary scientific data on post-viral olfactory dysfunction. Results were supplemented by manual searches. Studies were categorized into animal and human studies for final analysis and summary. RESULTS: A total of 38 animal studies and 7 human studies met inclusion criteria and were analyzed. There was significant variability in study design, experimental model, and outcome measured. Viral effects on the olfactory system varies significantly based on viral substrain but generally include damage or alteration in components of the olfactory epithelium and/or the olfactory bulb. CONCLUSIONS: The mechanism of post-viral olfactory dysfunction is highly complex, virus-dependent, and involves a combination of insults at multiple levels of the olfactory pathway. This will have important implications for future diagnostic and therapeutic developments for patients infected with COVID-19.