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1.
J Am Dent Assoc ; 153(3): 251-264, 2022 03.
Article in English | MEDLINE | ID: covidwho-1516988

ABSTRACT

BACKGROUND: Taste disorders in general, and dysgeusia in particular, are relatively common disorders that may be a sign of a more complex acute or chronic medical condition. During the COVID-19 pandemic, taste disorders have found their way into the realm of general as well as specialty dentistry, with significance in screening for patients who potentially may have the virus. TYPES OF STUDIES REVIEWED: The authors searched electronic databases (PubMed, Embase, Web of Science, Google Scholar) for studies focused on dysgeusia, ageusia, and other taste disorders and their relationship to local and systemic causes. RESULTS: The authors found pertinent literature explaining the normal physiology of taste sensation, proposals for suggested new tastes, presence of gustatory receptors in remote tissues of the body, and etiology and pathophysiology of taste disorders, in addition to the valuable knowledge gained about gustatory disorders in the context of COVID-19. Along with olfactory disorders, taste disorders are one of the earliest suggestive symptoms of COVID-19 infection. CONCLUSIONS: Gustatory disorders are the result of local or systemic etiology or both. Newer taste sensations, such as calcium and fat tastes, have been discovered, as well as taste receptors that are remote from the oropharyngeal area. Literature published during the COVID-19 pandemic to date reinforces the significance of early detection of potential patients with COVID-19 by means of screening for recent-onset taste disorders. PRACTICAL IMPLICATIONS: Timely screening and identification of potential gustatory disorders are paramount for the dental care practitioner to aid in the early diagnosis of COVID-19 and other serious systemic disorders.


Subject(s)
COVID-19 , Dysgeusia , COVID-19/complications , COVID-19/diagnosis , Dysgeusia/diagnosis , Dysgeusia/etiology , Humans , Pandemics , SARS-CoV-2 , Smell
2.
J Oral Biosci ; 63(4): 319-326, 2021 12.
Article in English | MEDLINE | ID: covidwho-1386086

ABSTRACT

BACKGROUND: Dysgeusia is a prevalent qualitative gustatory impairment that may affect food intake and quality of life. The facial (VII), glossopharyngeal (IX), and vagus (X) nerves are the three cranial nerves responsible for sensing taste. Typically, dysgeusia is considered a general term for all taste disorders. In addition, dysgeusia may be a symptom of underlying systemic conditions such as diabetes mellitus, chronic kidney disease, respiratory infections, and nutritional deficiencies. Various subjective and objective diagnostic approaches are available to aid clinicians, each with its own set of benefits and drawbacks. HIGHLIGHTS: Taste impairment can lead to a lack of enjoyment while eating, food aversion, and malnutrition, resulting in a decrease in the quality of life and loss of muscle mass. Therefore, the present review aims to address the probable etiologies, diagnostic aids, and management of dysgeusia. A broad search for studies was conducted using PubMed, Web of Science, Scopus, and Google Scholar. In addition, relevant studies found in the references of the selected articles were also studied. CONCLUSION: Oral health care providers should be aware of the possible etiologies of dysgeusia, diagnostic tools, and treatment options. Accurate diagnosis of the cause of taste dysfunction has a significant impact on the management of taste impairment.


Subject(s)
Dysgeusia , Quality of Life , Awareness , Dysgeusia/diagnosis , Humans , Taste , Taste Disorders
3.
J Med Virol ; 93(3): 1548-1555, 2021 03.
Article in English | MEDLINE | ID: covidwho-1196475

ABSTRACT

During this coronavirus disease 2019 (COVID-19) pandemic, physicians have the important task of risk stratifying patients who present with acute respiratory illnesses. Clinical presentation of COVID-19, however, can be difficult to distinguish from other respiratory viral infections. Thus, identifying clinical features that are strongly associated with COVID-19 in comparison to other respiratory viruses can aid risk stratification and testing prioritization especially in situations where resources for virological testing and resources for isolation facilities are limited. In our retrospective cohort study comparing the clinical presentation of COVID-19 and other respiratory viral infections, we found that anosmia and dysgeusia were symptoms independently associated with COVID-19 and can be important differentiating symptoms in patients presenting with acute respiratory illness. On the other hand, laboratory abnormalities and radiological findings were not statistically different between the two groups. In comparing outcomes, patients with COVID-19 were more likely to need high dependency or intensive care unit care and had a longer median length of stay. With our findings, we emphasize that epidemiological risk factors and clinical symptoms are more useful than laboratory and radiological abnormalities in differentiating COVID-19 from other respiratory viral infections.


Subject(s)
Anosmia/pathology , COVID-19/diagnosis , COVID-19/pathology , Dysgeusia/pathology , Adult , Ageusia/diagnosis , Ageusia/virology , Anosmia/diagnosis , Anosmia/virology , COVID-19/epidemiology , Critical Care/statistics & numerical data , Dysgeusia/diagnosis , Dysgeusia/virology , Female , Humans , Intensive Care Units/statistics & numerical data , Length of Stay , Male , Middle Aged , Respiration, Artificial/statistics & numerical data , Retrospective Studies , Risk Factors , SARS-CoV-2
4.
Eur Rev Med Pharmacol Sci ; 25(2): 1114-1134, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1082737

ABSTRACT

OBJECTIVE: The novel coronavirus disease-19 (COVID-19) pandemic had intense social and economic effects. Patients infected with COVID-19 may present with a series of conditions. A considerable number of patients express taste and smell disturbances as a prodromal, coexistent, or as the only manifestation of COVID-19 infection. The objective of the present review is to review the hypothetical mechanisms of action and etiopathogenesis of dysgeusia in COVID-19 patients. MATERIALS AND METHODS: Multiple scientific databases were explored, including PubMed, Medline, Scopus, Cochrane-library, LILACS, Livivo and OpenGrey. All types of articles that discussed the pathogenesis of dysgeusia were included, while articles that described dysgeusia without detail about its mode of action were excluded. RESULTS: A total of 47 articles, with different designs, were included in this review. These articles suggested direct viral neural invasion to olfactory and gustatory nerves, viral cytotoxicity to taste buds, angiotensin II imbalance, augmented pro-inflammatory cytokines, and disturbances in salivary glands and sialic acid. COVID-19 induced-dysgeusia was also associated with systemic diseases, medications, zinc, chemicals, and disinfectants. CONCLUSIONS: The most likely cause of transient dysgeusia in COVID-19 is peripheral neurotropism and direct toxicity to taste buds or olfactory epithelium. Other factors may also play a contributory role in dysgeusia, such as a defect in the quality and quantity of saliva, pro-inflammatory cytokines, angiotensin II accumulation, systemic diseases, hypozincemia, and excessive use of chemicals.


Subject(s)
COVID-19/complications , COVID-19/metabolism , Dysgeusia/etiology , Dysgeusia/metabolism , Ageusia/diagnosis , Ageusia/etiology , Ageusia/metabolism , COVID-19/diagnosis , Dysgeusia/diagnosis , Humans , Olfaction Disorders/diagnosis , Olfaction Disorders/etiology , Olfaction Disorders/metabolism , Prospective Studies , Renin-Angiotensin System/physiology , Retrospective Studies , Smell/physiology , Taste/physiology
5.
Cornea ; 40(1): 123-124, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-998523

ABSTRACT

PURPOSE: To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms. METHODS: Case report. RESULTS: A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection.


Subject(s)
COVID-19/diagnosis , Endothelium, Corneal/pathology , Graft Rejection/diagnosis , Keratoconus/surgery , Keratoplasty, Penetrating , SARS-CoV-2 , Acute Disease , Adult , COVID-19/etiology , COVID-19 Testing , Dysgeusia/diagnosis , Female , Graft Rejection/etiology , Humans , Polymerase Chain Reaction , Reoperation , Visual Acuity/physiology
6.
J Formos Med Assoc ; 120(1 Pt 2): 311-317, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-880538

ABSTRACT

BACKGROUND/PURPOSE: To investigate the characteristics of dysosmia and dysgeusia among patients diagnosed with coronavirus disease 2019 (COVID-19) in Taiwan. METHODS: Prospective data collection between January 22, 2020 to May 7, 2020 of nucleic acid confirmed COVID-19 hospitalized patients in northern Taiwan by the Taiwan Centers for Disease Control were analyzed. RESULTS: Of 217 patients enrolled, 78 (35.9%) reported dysosmia (n = 73, 33.6%) and/or dysgeusia (n = 62, 28.6%). The median duration of COVID-19 associated symptom-onset to development of dysosmia and/or dysgeusia was <1 days (interquartile range [IQR], <1-6 days) and 53 of 78 (67.9%) patients developed dysosmia and/or dysgeusia as one of the initial symptoms of COVID-19. Of 59 closely monitored patients, 41 (69.5%) patients recovered within 3 weeks after symptoms onset and the median time to recovery was 12 days (IQR, 7-20 days). Only 6 of the 59 (10.2%) patients reported persistent dysosmia and/or dysgeusia before discharge from hospitals. Multivariate analysis showed that younger individuals (adjusted hazard ratio [AHR], 0.93 per one-year increase; 95% confidence interval [95% CI], 0.89-0.97; P = 0.001), women (AHR, 2.76; 95% CI, 1.05-7.25; P = 0.04) and travel to North America (AHR, 2.35; 95% CI, 1.05-5.26; P = 0.04) were the significant factors associated with dysosmia and/or dysgeusia. CONCLUSION: Dysosmia and/or dysgeusia are common symptoms and clues for the diagnosis of COVID-19, particularly in the early stage of the disease. Physicians should be alerted to these symptoms to make timely diagnosis and management for COVID-19 to limit spread.


Subject(s)
COVID-19/complications , Dysgeusia/virology , Olfaction Disorders/virology , Adult , COVID-19/diagnosis , COVID-19 Testing , Case-Control Studies , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Early Diagnosis , Female , Hospitalization , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Prognosis , Prospective Studies , Risk Factors , Taiwan
7.
CJEM ; 22(5): 595-602, 2020 09.
Article in English | MEDLINE | ID: covidwho-834800

ABSTRACT

OBJECTIVES: To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms. METHODS: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre. We identified 1,345 patients (102 positive and 1,243 negative) who visited the assessment centre between March 16 and April 15, 2020. We randomly sampled negative patients in a 1:3 ratio. The primary outcome was the prevalence of self-reported anosmia/hyposmia and dysgeusia/ageusia. Logistic regression was performed to evaluate the association between COVID-19 positivity and loss of smell and taste. RESULTS: Fifty-six of 102 (50%) positive patients and 72 of 306 (23.5%) negative patients completed the survey. Anosmia/hyposmia and dysgeusia/ageusia were more prevalent among COVID-19 positive patients (41.1% v. 4.2%, p < 0.001 for smell and 46.4% v. 5.6%, p < 0.001 for taste). Anosmia/hyposmia and dysgeusia/ageusia were independently highly associated with COVID-19 positivity (adjusted odds ratios 14.4 and 11.4 for smell and taste, respectively). CONCLUSION: In this Canadian study, smell and taste loss may be key symptoms of COVID-19. This evidence can be helpful in the clinical diagnosis of COVID-19, particularly settings of limited testing capacity.


Subject(s)
Coronavirus Infections/diagnosis , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Pneumonia, Viral/diagnosis , Adult , COVID-19 , COVID-19 Testing , Canada , Clinical Laboratory Techniques/methods , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Reference Values , Risk Assessment , Self Report , Sensitivity and Specificity
9.
J Laryngol Otol ; 134(8): 710-716, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-728953

ABSTRACT

OBJECTIVE: A study was carried out to evaluate the relationship between anosmia and hospital admission in coronavirus disease 2019 patients. METHODS: The clinical data of 1534 patients with confirmed coronavirus disease 2019 virus were analysed. The study was conducted with medical records of 1197 patients (78 per cent). The basic characteristics of patients and symptoms related to otolaryngology practice were examined. The patients were divided into two groups according to their follow up: an out-patient group and an in-patient group. RESULTS: The majority of patients presented with anosmia (44.2 per cent), dysgeusia (43.9 per cent) and fever (38.7 per cent). Anosmia was observed in 462 patients (47 per cent) in the out-patient group, and in only 67 patients (31.2 per cent) in the in-patient group. Younger age (odds ratio = 1.05, 95 per cent confidence interval = 1.03-1.06) and the presence of anosmia (odds ratio = 2.04, 95 per cent confidence interval = 1.39-3) were significantly related to out-patient treatment. CONCLUSION: Anosmia could be a symptom in the clinical presentation of the coronavirus disease 2019 infection.


Subject(s)
Coronavirus Infections/complications , Hospitalization/statistics & numerical data , Olfaction Disorders/diagnosis , Otolaryngology/standards , Pneumonia, Viral/complications , Adult , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , COVID-19 , Case-Control Studies , Comorbidity , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Female , Fever/diagnosis , Fever/epidemiology , Hospitalization/trends , Humans , Inpatients/statistics & numerical data , Male , Middle Aged , Olfaction Disorders/etiology , Olfaction Disorders/virology , Outpatients/statistics & numerical data , Pandemics , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Turkey/epidemiology
11.
Microbes Infect ; 22(9): 481-488, 2020 10.
Article in English | MEDLINE | ID: covidwho-599130

ABSTRACT

Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sounds (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/diagnosis , Influenza A virus/pathogenicity , Influenza B virus/pathogenicity , Influenza, Human/diagnosis , Pneumonia, Viral/diagnosis , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Diagnosis, Differential , Diarrhea/diagnosis , Diarrhea/physiopathology , Diarrhea/virology , Dysgeusia/diagnosis , Dysgeusia/physiopathology , Dysgeusia/virology , Dyspnea/diagnosis , Dyspnea/physiopathology , Dyspnea/virology , Female , France , Headache/diagnosis , Headache/physiopathology , Headache/virology , Humans , Influenza, Human/physiopathology , Influenza, Human/virology , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/physiopathology , Olfaction Disorders/virology , Pandemics , Pharyngitis/diagnosis , Pharyngitis/physiopathology , Pharyngitis/virology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Vomiting/diagnosis , Vomiting/physiopathology , Vomiting/virology
13.
Eur Arch Otorhinolaryngol ; 277(9): 2637-2640, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-343393

ABSTRACT

PURPOSE: To estimate the prevalence of smell or taste impairment in household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. METHODS: Cross-sectional study based on ad hoc questions. RESULTS: Of 214 mildly symptomatic COVID-19 patients managed at home under self-isolation, 179 reported to have at least one household contact, with the total number of no study participants contacts being 296. Among 175 household contacts not tested for SARS-CoV-2 infection, 67 (38.3%) had SARS-CoV-2 compatible symptoms, 39 (22.3%) had loss of smell or taste with 7 (4.0%) having loss of smell or taste in the absence of other symptoms. The prevalence of smell or taste impairment was 1.5% in patients tested negative compared to 63.0% of those tested positive for SARS-CoV-2 (p < 0.001). CONCLUSION: Smell or taste impairment are quite common in not-tested household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. This should be taken into account when estimating the burden of loss of sense of smell and taste during COVID-19 pandemic, and further highlights the value of loss of sense of smell and taste as a marker of infection.


Subject(s)
Dysgeusia/etiology , Olfaction Disorders/etiology , Taste Disorders/etiology , Taste/physiology , Betacoronavirus , COVID-19 , Contact Tracing , Coronavirus Infections , Cross-Sectional Studies , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Family , Female , Humans , Male , Olfaction Disorders/diagnosis , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral , Prevalence , SARS-CoV-2 , Smell , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Taste Disorders/virology
14.
Int Forum Allergy Rhinol ; 10(8): 955-962, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-265881

ABSTRACT

BACKGROUND: Olfactory (OD) and gustatory (GD) dysfunction have been proven to be a typical symptom of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. However, their prevalence in different patient populations still needs to be clarified. METHODS: A cross-sectional study was performed from March 27 to April 1, 2020, in Northern Italy. Physicians administered a survey-based questionnaire to SARS-CoV-2-positive patients with the aim of assessing symptoms, focusing on OD and GD. Two groups were studied: group A, patients hospitalized at Azianda Socio Sanitaria Territoriale (ASST) Spedali Civili University Hospital of Brescia; and group B, home-quarantined subjects. RESULTS: A total of 508 patients were enrolled: 295 in group A and 213 in group B. Mean age ± standard deviation (SD) was 55 ± 15 years; 56% were men. Overall, OD and GD were present in 56% (95% confidence interval [CI], 51% to 60%) and 63% (95% CI, 59% to 67%) of cases, respectively. In group A, the prevalence of OD and GD was 44% (95% CI, 38% to 50%) and 52% (95% CI, 46% to 58%), respectively. In group B, the prevalence of OD and GD was 72% (95% CI, 65% to 79%) and 79% (95% CI, 73% to 84%), respectively. In the entire cohort, total loss of olfaction and taste was reported in 64% and 60% of cases, respectively. OD and GD occurred as the first symptom in 10% and 11% of cases, respectively; in the remaining cases, they occurred after a mean of 4 ± 3 days following the first symptom. At the time of the questionnaire, complete resolution of OD and GD was reported in 52% and 55% of cases, respectively (mean duration, 9 ± 5 days in both). CONCLUSION: OD and GD are more prevalent in home-quarantined subjects, and they are independently associated with younger age and female gender.


Subject(s)
Coronavirus Infections , Dysgeusia , Olfaction Disorders , Pandemics , Pneumonia, Viral , Age Factors , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Cross-Sectional Studies , Dysgeusia/diagnosis , Dysgeusia/epidemiology , Dysgeusia/etiology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Prevalence , Recovery of Function , SARS-CoV-2 , Sex Factors , Smell , Symptom Assessment/methods
16.
Rhinology ; 58(4): 402-403, 2020 Aug 01.
Article in English | MEDLINE | ID: covidwho-143920

ABSTRACT

Since the outbreak of the pandemic, anecdotal observations have been accumulating rapidly that sudden anosmia and dysgeusia are peculiar symptoms associated with the COVID-19 infection. Prof C. Hopkins, as President of British Rhinological Society, published a letter describing "the loss of sense of smell as a marker of COVID-19 infection" and proposed that adults presenting with anosmia but no other symptoms should self-isolate for seven days. The Hopkins team published the first case report and case series as well as other evidence that isolated sudden onset anosmia (ISOA), should be considered highly suspicious for SARS-CoV-2(1). Subsequently, a larger series of 2428 patients presenting with new onset anosmia during the COVID-19 pandemic has been reported, of whom 16% report loss of sense of smell as an isolated symptom. Only 51% reported the recognized symptoms of cough or fever. A major limitation of this series however, was a lack of access to testing to confirm the COVID-19 status of the patients(2); in the 80 who had been tested 74% were positive. In the same way, the American Academy of Otolaryngology-head and neck surgery (AA0-HNS) proposed "that anosmia could be added to the list of screening tools for possible COVID-19 infection. More, they warrant serious consideration for self-isolation and testing those patients".


Subject(s)
Coronavirus Infections/complications , Dysgeusia/virology , Olfaction Disorders/virology , Pneumonia, Viral/complications , Adult , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Dysgeusia/diagnosis , Humans , Olfaction Disorders/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , Public Health , SARS-CoV-2
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