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1.
Indian J Otolaryngol Head Neck Surg ; : 1-7, 2022.
Article in English | PubMed | ID: covidwho-2175028

ABSTRACT

The World Health Organization announced on March 11, 2020 that COVID-19 could become a pandemic. COVID-19 is a contagious disease caused by the coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2). Viruses usually enter the body through the mouth or nose. The virus then enters the alveoli, which are small air sacs inside the lungs. Cough, fatigue, fever, shortness of breath or breathing difficulties, and loss of smell and taste are all symptoms of COVID-19. Anosmia, also known as smell blindness, is a condition in which the ability to detect one or more smells is lost. Olfaction uses chemoreceptors to create signals that are processed in the brain and form the sense of smell in anosmia. Anosmia is recognised as a COVID-19 symptom in many countries, and some have developed "smell tests" as potential screening tools. The first level of screening, which is currently used in India, is primarily based on temperature and can result in false positives and negatives (fever as a symptom has not yet been developed although infection). One of the methods for detecting COVID-19 is an intermediate level of screening based on assessing an olfactory function, depending on the usage. This paper provides an overview of COVID-19 and its effects on the human body, as well as an overview of anosmia and how it contributes to one of the symptoms of COVID-19.

2.
Clin Exp Allergy ; 2022 May 03.
Article in English | MEDLINE | ID: covidwho-2192451

ABSTRACT

BACKGROUND: The impact of anosmia on quality-of-life (QoL) for patients with aspirin-exacerbated respiratory disease (AERD) is poorly understood. We aimed to investigate how the severity of smell loss and olfactory dysfunction (OD) in patients with AERD affects their QoL, mental health and physical well-being. METHODS: Five validated QoL questionnaires (Sinonasal Outcome Test-22, Asthma Control Test, Healthy Days Core Module-4, Short Form-36 and Patient Health Questionnaire-4) and two newly developed questionnaires assessing severity and consequences of OD were electronically sent to all 2913 patients in the Brigham and Women's Hospital AERD registry. Responses were received from 853 participants for analysis. RESULTS: Overall, 85% of participants reported a present diminished sense of smell and/or taste, and 30% categorized their OD severity was, "as bad as it can be." There were significant relationships between the severity of self-reported OD and both psychological distress and general health scores, even after adjusting for asthma control. Additionally, incidence rates for physically and mentally unhealthy days in the prior month were higher for patients with moderate or severe OD than for normosmic patients. Patients with diminished smell responded that they could not identify spoiled food (86%), did not enjoy food (71%), felt unsafe (63%) and had encountered dangerous situations (51%) as consequences of their OD. CONCLUSIONS: Anosmia and hyposmia severely impact the physical, emotional and mental health of AERD patients, and lead to safety concerns in their daily lives. The importance of olfaction and the relevance of OD to patients' QoL should be acknowledged and evaluated by clinicians caring for these patients.

3.
Haseki Tip Bulteni ; 60(5):433-438, 2022.
Article in English | EMBASE | ID: covidwho-2163947

ABSTRACT

Aim: Some symptoms of coronavirus disease-2019 (COVID-19) are more common in patients without pulmonary involvement and in patients with a good prognosis. Although it is known that smelling disorders are more common in patients with a good prognosis, their relationship with pulmonary involvement is unknown. This study ianvestigated the relationship between smell disorders and pulmonary involvement in COVID-19. Method(s): This cross-sectional study was conducted between May 2022 and July 2022 and included 60 COVID-19 patients with pulmonary involvement and 60 COVID-19 patients without pulmonary involvement. Phone-call interviews were performed with all patients 1 month after the diagnosis of COVID-19 and their sense of smell was questioned with a questionnaire. The prevalence of smell disorders, type and severity of smell disorders were questioned, and participants were asked to grade their answers from 0 to 10. Result(s): In 58 (48.3%) of the patients, smell disorders were found to be present. Hyposmia was detected in 35 (60.34%), and anosmia was detected in 23 (39.66%) of these patients. Smell disorder was present in 20 (33.3%) patients with pulmonary involvement and in 38 (63.3%) patients without pulmonary involvement. The prevalence of smell disorders was significantly higher in patients without pulmonary involvement (p=0.001). Hyposmia in 15 patients (25%) and anosmia in 5 patients (8.3%) were found in patients with pulmonary involvement. Hyposmia in 20 patients (33.3%) and anosmia in 5 patients (8.3%) were found in patients without pulmonary involvement. The prevalence of anosmia was significantly higher in patients without pulmonary involvement (p=0.003). The smell disorders were significantly more severe in patients without pulmonary involvement (p=0.042). Conclusion(s): Smell disorders are seen more frequently and more severely in patients without pulmonary involvement due to COVID-19 than in patients with pulmonary involvement. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

4.
Journal of Affective Disorders ; 2022.
Article in English | ScienceDirect | ID: covidwho-2159162

ABSTRACT

Background Coronavirus disease 2019 (COVID-19) often causes chemosensory impairment, and olfactory dysfunctions may have negative consequences on psychological distress. This study aimed at assessing which dimension of perceived olfactory disfunctions (i.e., subjective olfactory capability, smell-related problems, or olfactory-related quality of life [QoL]) was most associated with psychological distress in people diagnosed with COVID-19. Methods 364 participants (65 men and 299 women) diagnosed with COVID-19 on average 7 months prior to the beginning of the study were recruited between June 5 and 21, 2021, to take part in an online cross-sectional survey. Participants answered questions on demographics, clinical factors, perceived olfactory functioning, and psychological distress. Hierarchical multiple linear regression analysis was conducted, assessing the role of demographics, clinical factors, and perceived olfactory functioning dimensions on psychological distress. Results More than half of the participants met the cut-off for all perceived olfactory dysfunctions scales and psychological distress. Being women, smoker, with comorbidities, and greater severity of COVID-19 symptoms were associated with higher scores on psychological distress. Among perceived olfactory functioning scales, only impairment in olfaction QoL was associated with psychological distress. Limitations Limitations concerned the cross-sectional nature of the study and the unbalanced sample in terms of gender. Conclusions The study confirmed the core intertwining between mood, perceived QoL, and olfactory functioning, showing how impairments in olfactory processing are strongly correlated with psychological distress through the impact they have on the perceived QoL.

5.
Brain, Behavior, and Immunity ; 2022.
Article in English | ScienceDirect | ID: covidwho-2158471

ABSTRACT

Persistent olfactory dysfunction (OD) is one of the most complaining and worrying complications of long COVID-19 because of the potential long-term neurological consequences. While causes of OD in the acute phases of the SARS-CoV-2 infection have been figured out, reasons for persistent OD are still unclear. Here we investigated the activity of two inflammatory pathways tightly linked with olfaction pathophysiology, namely Substance P (SP) and Prokineticin-2 (PK2), directly within the olfactory neurons (ONs) of patients to understand mechanisms of persistent post-COVID-19 OD. ONs were collected by non-invasive brushing from ten patients with persistent post-COVID-19 OD and ten healthy controls. Gene expression levels of SP, Neurokinin receptor 1, Interleukin-1β (IL-1β), PK2, PK2 receptors type 1 and 2, and Prokineticin-2-long peptide were measured in ONs by Real Time-PCR in both the groups, and correlated with residual olfaction. Immunofluorescence staining was also performed to quantify SP and PK2 proteins. OD patients, compared to controls, exhibited increased levels of both SP and PK2 in ONs, the latter proportional to residual olfaction. This work provided unprecedented, preliminary evidence that both SP and PK2 pathways may have a role in persistent post-COVID-19 OD. Namely, if the sustained activation of SP, lasting months after infection's resolution, might foster chronic inflammation and contribute to hyposmia, the PK2 expression could instead support the smell recovery.

7.
J Transl Med ; 20(1):569, 2022.
Article in English | PubMed | ID: covidwho-2153603

ABSTRACT

BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is characterized by persistent physical and mental fatigue. The post-COVID-19 condition patients refer physical fatigue and cognitive impairment sequelae. Given the similarity between both conditions, could it be the same pathology with a different precipitating factor? OBJECTIVE: To describe the cognitive impairment, neuropsychiatric symptoms, and general symptomatology in both groups, to find out if it is the same pathology. As well as verify if the affectation of smell is related to cognitive deterioration in patients with post-COVID-19 condition. METHODS: The sample included 42 ME/CFS and 73 post-COVID-19 condition patients. Fatigue, sleep quality, anxiety and depressive symptoms, the frequency and severity of different symptoms, olfactory function and a wide range of cognitive domains were evaluated. RESULTS: Both syndromes are characterized by excessive physical fatigue, sleep problems and myalgia. Sustained attention and processing speed were impaired in 83.3% and 52.4% of ME/CFS patients while in post-COVID-19 condition were impaired in 56.2% and 41.4% of patients, respectively. Statistically significant differences were found in sustained attention and visuospatial ability, being the ME/CFS group who presented the worst performance. Physical problems and mood issues were the main variables correlating with cognitive performance in post-COVID-19 patients, while in ME/CFS it was anxiety symptoms and physical fatigue. CONCLUSIONS: The symptomatology and cognitive patterns were similar in both groups, with greater impairment in ME/CFS. This disease is characterized by greater physical and neuropsychiatric problems compared to post-COVID-19 condition. Likewise, we also propose the relevance of prolonged hyposmia as a possible marker of cognitive deterioration in patients with post-COVID-19.

8.
B-Ent ; 18(4):284-290, 2022.
Article in English | EMBASE | ID: covidwho-2144692

ABSTRACT

Objective: Hyposmia and anosmia are the most frequent complaints of patients with COVID-19. It can disappear after a short time or can last for an unknown period. Finding a suitable treatment for restoring the patients' smell. The objective of this study is to review the effects of numerous types of corticoids on COVID-19-induced hyposmia and anosmia. Method(s): A narrative literature review was performed to analyze the effects of different forms of corticosteroids in various dosages for the treatment of COVID-19-induced hyposmia and anosmia. Result(s): There is not a lot of data on the effects of corticosteroids on COVID-19-induced hyposmia and anosmia;however, despite little evidence for the efficacy of these drugs in hyposmia and anosmia caused by COVID-19, their effect in improving these symptoms whether in oral or nasal spray forms has been reported in recent literature. Most of the studies show that corticosteroids, whether nasal or systemic, are not as effective as they are thought to be. Conclusion(s): Using topical corticosteroids as nasal sprays or systemic corticosteroids cannot help to improve the patient's ability to smell. These methods were sometimes mixed with other methods such as olfactory training to improve the patient's olfactory sense. However, the results of the studies showed diversity in the efficacies of each treatment plan. In most of the studies which used olfactory training along with corticosteroid therapy as a therapy for hyposmia/anosmia induced by COVID-19, olfactory training showed a better result. Copyright@Author(s).

9.
Multiple Sclerosis Journal ; 28(3 Supplement):487-488, 2022.
Article in English | EMBASE | ID: covidwho-2138849

ABSTRACT

Background: Long-term outcome after COVID-19 in patients with multiple sclerosis (pwMS) is scarcely studied and controlled data are lacking. Objective(s): To describe long-term outcome after COVID-19 in pwMS in comparison to a matched control group of pwMS. Method(s): From the AutMuSC registry, we included pwMS with PCR-confirmed diagnosis of COVID-19 and >=6 months of follow- up available. As a control group, we recruited pwMS from the Vienna MS database (VMSD) matched for age, sex, disability level (Expanded Disability Status Scale [EDSS]) and diseasemodifying treatment type (no vs. immunomodulatory vs. immunosuppressive DMT). Result(s): Of 142 pwMS with COVID-19 (mean age 43.2 years [SD 11.8], 63.4% female, median EDSS 1.5 [range: 0-7.5], 54.2%immunomodulatory DMT, 20.4% immunosuppressive DMT), 90.1% initially had a mild COVID-19 course not requiring hospitalization. Three months (M3) afterCOVID-19, 76% had recovered completely, 84% after 6 months (M6) and 92% after 12 months (M12). Most frequent residual symptoms were new or worsened fatigue (M3: 18.4%, M6: 12.8%, M12: 7.8%), new or worsened hyposmia (M3: 8.5%, M6: 4.3%, M12: 1.4%) and new or worsened dyspnea (M3: 7.1%, M6: 6.4%, M12: 2.8%). Compared to matched controls (fatigue: 7.1%, hyposmia: 0.7%, dyspnea: 1.4%), fatigue and hyposmia were significantly more frequent only at M3, while dyspnea remained increased until M6.Occurrence of relapse (8.6% vs. 7.0%) and EDSS progression (5.6% vs. 4.2%) were not significantly increased in pwMS with COVID-19 compared to control group during the observation period.Employment status remained unchanged in 96.5% after COVID-19 and 97.9% in controls. Conclusion(s): Long-term outcome of COVID-19 is favourable in a large majority of pwMS with only a small proportion of patients suffering from persistent fatigue, hyposmia or dyspnea, usually resolving after 3-6 months.Against the background of a closely matched control group, COVID-19 is neither associated with increased risk of relapse or EDSS progression nor a persistent increase in fatigue.

10.
Cureus ; 14(10): e29939, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2145084

ABSTRACT

Introduction Olfactory dysfunction (OD) is often a devaluated sensorial affection. The objective evaluation of this dysfunction doesn't evaluate its compromise in patients' daily life. Therefore, the use of a Portuguese-validated tool is of uttermost importance to objectively scale the pathology presented by these patients. Objective We aim to validate and cross-culturally adapt the Olfactory Disorders Questionnaire (ODQ) in the Portuguese language. Methods A prospective study was carried out to evaluate and compare 56 consecutive patients who had olfactory disorders and 54 asymptomatic controls. A cross-cultural adaptation process was taken into account in order to transform the original English tool into a valid Portuguese version. We explored the psychometric properties of the European-Portuguese version of the Portuguese version of ODQ (PT-ODQ) concerning its internal consistency, reproducibility, feasibility, and discriminatory validity. Results Cronbach alpha for the tool was 0.924 showing strong internal consistency. We also found a statistically significant difference in PT-ODQ between patients with olfactory disorders and patients without olfactory disorders, according to the Mann-Whitney test. Conclusions The PT-ODQ seems to be a valid tool for assessing the individual effect of olfactory disorders on patients' quality of life and, therefore, could be applied in olfactory disorders research and daily practice.

11.
Front Med (Lausanne) ; 9: 1038938, 2022.
Article in English | MEDLINE | ID: covidwho-2142063

ABSTRACT

Background: Olfactory dysfunction is a common neurological symptom of Corona Virus Disease 2019(COVID-19). Little is known about hyposmia after COVID-19 infection with Omicron variant in Chinese population. Objective: To investigate the incidence, clinical characteristics and recovery of hyposmia in hospitalized non-severe COVID-19 patients with Omicron variant in Shanghai, China. Methods: Three hundred and forty-nine Chinese non-severe COVID-19 patients with Omicron variant were consecutively enrolled in a designated hospital to investigate the incidence of hyposmia in hospitalization and the recovery rate 1 month later. The visual assessment scale (VAS) was used to evaluate the severity of hyposmia. We compared the demographic, clinical features and treatment outcomes, as well as laboratory parameters between patients with and without hyposmia. Results: The cross-sectional survey showed that 22 (6.3%) hospitalized patients with non-severe COVID-19 had hyposmia. Patients with hyposmia were younger (61.5 vs. 72.0, p = 0.002), had more related clinical symptoms (sore throat, cough, poor appetite, diarrhea, myalgia and taste impairment, etc.), a higher proportion of moderate clinical type (31.8 vs. 13.5%, p = 0.028) and longer duration of hospitalization (11 vs. 8 days, p = 0.027) than those without hyposmia. Whereas, there were no significant differences regarding gender, comorbidity and nucleic acid conversion time between the two groups. Laboratory subgroup analyses demonstrated that patients with hyposmia had slightly low serum IL-6 and TNF-α levels. However, both of the levels were not associated with hyposmia occurrence in multivariate regression analyses. Further follow-up study disclosed that 16 of 22 (72.7%) hyposmia patients had recovered olfaction 1 month later. Serum IL-6 and TNF-α levels were similar between hyposmia recovered patients and those with persistent hyposmia. Conclusion: Although the incidence of hyposmia after Omicron variant infection is relatively low and the short-term recovery rate is quite high, patients with hyposmia are prone to have a higher proportion of both upper and lower respiratory tract involvements, gastrointestinal and neurological symptoms, contributing to a longer duration of hospitalization.

12.
Pakistan Journal of Medical and Health Sciences ; 16(9):138-140, 2022.
Article in English | EMBASE | ID: covidwho-2113892

ABSTRACT

Aim: To assess the neurological and mental health responses to pandemic Covid-19. Study design: Cohort study Place and duration of study: Department of Medicine, Chandka Medical College Hospital Larkana and Department of Medicine, Khairpur Medical College Hospital Khairpur Mir's from 1st October 2021 to 31st March 2022. Methodology: Two hundred patients who suffered Covid-19 infection and 200 who had any other life event except Covid-19 were enrolled. All patients who were above 18 years of age and were positive for Covid-19 through reverse transcriptase PCR were included in the study.Global Psych trauma Screening was done by enlisting twenty-two items which assessed trauma related symptoms while five items only assessed the factors increasing risks. Result(s): There were 112 (56%) females and 88 (44%) males in Covid-19 patients and 150 (75%) females and 50 (25%) males in non-Covid patients. The mean age of the Covid-19 patients was 49.65+/-15.5 year while of non Covid patients was 39.02+/-12.01 years. A significant increase in post-traumatic stress disorder (PTSD) cases probability was noted in the Covid-19 cases than non Covid-19 related events. Neurological responses showed that patients who had suffered from Covid 19 infections had a generalized weakness with hyposmia formation. Conclusion(s): Covid-19 is related with high level of depression, anxiety, hyposmia and other mental and neurological responses. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

13.
Front Allergy ; 3: 1019274, 2022.
Article in English | MEDLINE | ID: covidwho-2119580

ABSTRACT

Educational objective: To investigate the impact of SARS-CoV-2 on sinonasal quality of life, olfaction, and cognition at different stages of viral infection and evaluate the association between olfaction and cognition in this population cohort. Objectives: While olfactory dysfunction (OD) is a frequently reported symptom of COVID-19 (98% prevalence), neurocognitive symptoms are becoming more apparent as patients recover from infection. This study aims to address how different stages of infection [active infection (positive PCR test, symptomatic) vs. recovered (7 days post-symptoms)] compared to healthy control patients influence sinonasal quality of life, olfactory function, and cognition. Study design: Prospective, longitudinal, case-control. Methods: Participants completed the SNOT-22, University of Pennsylvania Smell Identification Test (UPSIT) and validated cognitive examinations to assess degree of smell loss and neurocognitive function at baseline and at 1 and 3 months for the active group and 3 months for the recovered group. Self-reported olfactory function and overall health metrics were also collected. Results: The recovered group had the lowest average UPSIT score of 27.6 compared to 32.7 (active) and 32.6 (healthy control). 80% (n = 24) of the recovered patients and 56.3% (n = 9) of the active patients suffered from smell loss. In follow-up, the active group showed improvement in UPSIT scores while the recovered group scores worsened. In terms of neurocognitive performance, recovered patients had lower processing speed despite an improving UPSIT score. Conclusion: SARS-CoV-2 infection was found to impact olfactory function in a delayed fashion with significant impact despite recovery from active infection. Although olfactory function improved, decrements in cognitive processing speed were detected in our cohort.

14.
ORL J Otorhinolaryngol Relat Spec ; : 1-9, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2098087

ABSTRACT

INTRODUCTION: To date, little is known about predisposing factors for persistent COVID-19-induced olfactory dysfunction (pCIOD). The objective was to determine whether olfactory cleft (OC) measurements associate with pCIOD risk. MATERIAL AND METHODS: Three subgroups were recruited: group A included patients with pCIOD, group B included patients without olfactory dysfunction following SARS-CoV-2 infection (ntCIOD), and group C consisted in controls without past history of SARS-CoV-2 infection (noCOVID-19). Olfactory perception threshold (OPT) and visual analog scale for olfactory impairment (VAS-olf) were obtained. OC measurements were obtained through computed tomography scans. Results were subsequently compared. RESULTS: A total of 55 patients with a mean age of 39 ± 10 years were included. OPT was significantly lower in pCIOD patients (group A: 4.2 ± 2.1 vs. group B: 12.3 ± 1.8 and group C: 12.2 ± 1.5, p < 0.001). VAS-olf was significantly higher in pCIOD (group A: 6 ± 2.6 vs. group B: 1.7 ± 1.6 and group C: 1.6 ± 1.5, p < 0.001). OC length was significantly higher in group A (42.8 ± 4.6) compared to group B (39.7 ± 3.4, p = 0.047) and C (39.8 ± 4, p = 0.037). The odd of pCIOD occurring after COVID-19 infection increased by 21% (95% CI [0.981, 1.495]) for a one unit (mm) increase in OC length. The odd of pCIOD occurring was 6.9 times higher when OC length >40 mm. CONCLUSION: Longer OC may be a predisposing factor for pCIOD. This study is expected to encourage further research on OC morphology and its impact on olfactory disorders.

15.
Transl Neurosci ; 13(1): 349-353, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-2065199

ABSTRACT

Introduction: Rare and mild adverse effects on cranial nerves have been reported after vaccination. Here, we report a singular case of smell and taste disorder associated with tinnitus that occurred after Oxford-AstraZeneca vaccination together with a review of the available literature. Case presentation: A 76-year-old patient experienced smell disorder, ear fullness and tinnitus 2 days after the first dose of Oxford-AstraZeneca vaccine. The patient then underwent a complete audiological and Ear, Nose and Throat evaluation, nasal endoscopy, Sniffin'Sticks battery, audiometric test battery, and cerebral magnetic resonance imaging (MRI). The exams revealed hyposmia and bilateral reduction of the volume of the olfactory bulbs (OB). At the follow-up, tinnitus was completely resolved while olfactory dysfunction only partially reduced. Review of the literature: A PubMed search was conducted on olfactory and gustatory dysfunctions after COVID-19 vaccination resulting in four case reports with a total of 10 patients. The main symptoms were hyposmia, parosmia, and dysgeusia developed after 1-9 days from vaccination with complete resolution occurring within 1 month. Notably, none of the considered articles reported reduction of OB volumes at cerebral MRI. Discussion: So far, no definitive cause-effect relationship has been established between anti-COVID19 vaccination and otolaryngologic adverse reactions. The persistence of hyposmia in our patient could possibly be explained by the reduction in OB volume, even though also the advanced age of the patient needs to be taken into account. This is a first indication of a cause-effect relation between hyposmia and Covid19 vaccination, even though a more robust study is needed to confirm the autoimmunological mechanisms responsible for these rare adverse reactions. However, it is worth highlighting that benefits of the anti-COVID-19 vaccination clearly outweigh the risk of rare adverse events.

16.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P147, 2022.
Article in English | EMBASE | ID: covidwho-2064494

ABSTRACT

Introduction: Olfactory dysfunction (OD) is a prevalent and characteristic symptom among individuals with COVID-19 infection. Although most patients with COVID-19-related OD experience a significant recovery, there exists a substantial population of patients with persistent OD with limited therapeutic options. Method(s): Patients with laboratory-confirmed or clinically suspected COVID-19 infection and self-reported new onset OD from March 2020 to October 2021 were prospectively recruited for a randomized, placebo-controlled, doubleblinded clinical trial. Patients with evidence of quantitative OD, defined as a Brief Smell Identification Test (BSIT) score of 9 or less, were eligible for study inclusion. The experimental group received 2 g of omega-3 fatty acid (O3FA) supplementation, including 1366-mg eicosapentaenoic acid and 504-mg docosahexaenoic acid, while the control group received an identical placebo, each to be taken daily for 6 weeks. The primary outcome was change in BSIT score from initial test to a 6-week follow-up BSIT. Result(s): A total of 117 patients were included in analysis, including 57 patients in the O3FA group and 60 in the placebo group. The mean duration of OD prior to study enrollment was 200.1 days with no significant difference between groups (P=.685). Patients receiving O3FA supplementation demonstrated a mean BSIT improvement of 1.12+/-1.99 compared with 0.68+/-0.86 in the placebo group (P=.385). Among those with severe hyposmia, defined as a BSIT score of 7 or less, patients in the O3FA group (n=23) demonstrated a BSIT improvement of 2.30+/-0.77 compared with 1.63+/-1.82 among those in the placebo group (n=16, P=.255). Conclusion(s): Our study showed a trend toward improved olfactory recovery among COVID-19-related OD patients receiving high doses of O3FA supplementation at a 6-week follow-up time point. Future work will be needed to better define the effectiveness and durability of O3FA supplementation as a treatment for COVID-19-related OD.

17.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P144-P145, 2022.
Article in English | EMBASE | ID: covidwho-2064489

ABSTRACT

Introduction: Olfactory dysfunction is a common symptom associated with COVID-19 infection. While often transient, nearly 1 in 8 patients experience persistent dysfunction after initial infection resolution. Given the known association between impaired olfaction and mild cognitive impairment (MCI), this persistent COVID-19 olfactory dysfunction may impede early detection of cognitive decline. Method(s): Patients with confirmed COVID-19-associated hyposmia (n=73), MCI (n=58), and normal controls (n=86) were prospectively enrolled. Demographic data were collected alongside formal olfactory testing via AROMA (Affordable Rapid Olfaction Measurement Assay) at time of initial enrollment. MCI was assessed via MoCA (Montreal Cognitive Assessment). Multivariate logistic regressions were utilized to evaluate for associations between variables and etiology of olfactory dysfunction. Result(s): After controlling for age and gender, when compared against normal controls, the inability to smell licorice, cinnamon, and lemon at the lowest 3 concentrations increased odds of COVID-19 hyposmia by 10.8 (95% CI, 4.6-25.6), 5.7 (95% CI, 2.7-11.7), and 5.3 (95% CI, 2.6-10.8), respectively. While the inability to smell coffee (9.9 odds ratio [OR];95% CI, 2.02-48.1), eucalyptus (6.7 OR;95% CI, 2.2-20.0), and rose (4.0 OR;95% CI, 1.7-9.7) were associated with MCI, decreased ability to smell licorice, cinnamon, and lemon were not. When combined into a composite score and compared against controls, decreased detection of licorice, cinnamon, and lemon was associated with a 16.5 OR (95% CI, 6.6-41.3) for COVID-19 hyposmia. This composite score was not significantly associated with MCI (1.2 OR;95% CI, 0.6-2.2) and, as such, performed well at discriminating between COVID-19 and MCI patients (receiver operating characteristic area under the curve=0.76). Conclusion(s): Distinct patterns of impaired olfaction were noted for COVID-19. We show that this etiology-specific phenotype has good discriminative performance when differentiating from MCI-associated hyposmia, which may allow for continued utilization of olfactory screening for MCI even among those with previous COVID-19 infection.

18.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P151, 2022.
Article in English | EMBASE | ID: covidwho-2064487

ABSTRACT

Introduction: Olfactory dysfunction (OD) affects more than 3 million US adults. The number of patients with post viral olfactory dysfunction (PVOD) is expected to increase secondary to the worldwide COVID-19 pandemic. Preliminary studies have demonstrated the efficacy of platelet-rich plasma (PRP) in restoration of smell in both animals and humans. To date, human studies have utilized injectable PRP only. We describe our pilot study investigating the use of topical PRP as a novel delivery method for smell restoration and contribute to existing literature demonstrating the promise of PRP as a therapeutic. Method(s): Pilot study from September 2020 to January 2022. Patients >18 years with hyposmia diagnosed via Brief Smell Identification Test (B-SIT) score <8 were included. PRPimpregnated Surgifoam was placed into bilateral olfactory clefts monthly for at least 3 months. Patients completed the B-SIT at baseline and 1 month after each treatment. Result(s): Eight patients underwent at least 3 treatments and completed the B-SIT at month 4. Average age was 56.3 years;mean smell loss duration was 19.3 months. Etiologies included PVOD, post-COVID (5), and idiopathic. Mean change in B-SIT after 3 treatments was +1.06. Of patients, 62.5% had achieved the minimal clinically significant difference of >1 on B-SIT after treatments 2 and 3. Patients with smell loss <12 months demonstrated greater B-SIT scores at 4 months (+1.6 vs +0.2). Two patients achieved B-SIT >8 after 3 treatments. Of patients who have returned thus far for a fourth treatment, 1 additional patient scored >8. Conclusion(s): We present the largest pilot study to date for the use of PRP in treatment of OD and the first study to develop methods for topical delivery in human subjects. Topical PRP may serve as a less invasive, efficacious therapy for patients. Further, randomized control trials are warranted to investigate the required number of topical PRP treatments for smell restoration.

19.
J Intern Med ; 2022 Aug 24.
Article in English | MEDLINE | ID: covidwho-2063842

ABSTRACT

OBJECTIVE: To investigate the prevalence and recovery of olfactory dysfunction (OD) in COVID-19 patients 24 months after the infection. METHODS: From 22 March 2020 to 5 June 2022, 251 COVID-19 patients were followed in three European medical centres. Olfactory function was assessed with subjective patient-reported outcome questionnaires and odour identification tests at baseline, 6, 12, 18 and 24 months postinfection. The predictive values of epidemiological and clinical data were investigated with multivariate analysis. RESULTS: One hundred and seventy-one patients completed the evaluations. The odour identification test revealed that 123 patients (50.8%) had OD at baseline. The prevalence of persistent psychophysical abnormalities at 6, 12, 18 and 24 months post-COVID-19 was 24.2%, 17.9%, 5.8% and 2.9%, respectively (p = 0.001). Parosmia occurred in 40 patients (23.4%) and lasted 60 ± 119 days. At 2 years, 51 patients (29.8%) self reported that their olfaction was unnormalised. Older patients had better odour identification evaluations at baseline (p < 0.001) but those with OD reported lower odour identification test scores at the end of the follow-up. Parosmia occurred more frequently in young patients. The olfactory training was significantly associated with higher values of Sniffin' Sticks tests at 18 months postinfection (rs = 0.678; p < 0.001). CONCLUSION: Two years post-COVID-19, 29.8% of patients reported persistent OD, but only 2.9% had abnormal identification psychophysical evaluations.

20.
Laryngoscope ; 132(12): 2445-2452, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2047822

ABSTRACT

OBJECTIVES: Persistent olfactory dysfunction (OD) after 6 months caused by SARS-CoV-2 infection has been reported with a variable prevalence worldwide. This study aimed to determine the prevalence of long-term OD and identify predisposing factors. METHODS: A prospective cohort study was conducted on 100 adults with COVID-19. Olfactory function was assessed with the University of Pennsylvania Smell Identification Test and a symptom survey at the onset of disease and 30 days later. Patients with persistent quantitative OD at the second assessment were reevaluated after 1 year. Demographic variables, symptoms, and the degree of smell loss were analyzed. RESULTS: Participants included 100 patients. The mean age was 42.2 ± 15.6 years, 55 (55%) were female, and 56 (56%) were outpatients. Baseline smell loss was identified in 75/100 (75%) patients, decreasing to 39/95 (40%) after 1 month, and persisting in 29 patients after 1 year. Phantosmia at baseline was the only risk factor identified for persistent OD after 1 year (relative risk 2.51; 95% confidence interval 1.53-4.12; p < 0.001). Regardless of the outcome in smell function, a significant decline in olfaction was associated with the presence of phantosmia at 1 month (ß = -12.39; 95% CI -19.82 to -4.95; p < 0.01). CONCLUSIONS: SARS-CoV-2 (2019-2020 variants) produced a highly frequent OD that persisted in 29% of the patients after 1 year. The presence of phantosmia at baseline and 1 month was associated with a worse evolution, but phantosmia may interfere with the performance in an identification smell test. A longer follow-up is required in these patients. LEVEL OF EVIDENCE: 2 Laryngoscope, 132:2445-2452, 2022.


Subject(s)
COVID-19 , Olfaction Disorders , Adult , Humans , Female , Middle Aged , Male , COVID-19/complications , COVID-19/epidemiology , Smell , SARS-CoV-2 , Anosmia/epidemiology , Anosmia/etiology , Prospective Studies , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfaction Disorders/diagnosis
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