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1.
Intern Med ; 61(11): 1757-1760, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1760074

ABSTRACT

Guillain-Barré syndrome (GBS) has occasionally occurred in people who have received coronavirus disease 2019 (COVID-19) vaccines. Dysgeusia is rare symptom of GBS. We herein report a rare case of sensory ataxic GBS with dysgeusia just after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Although autoantibodies against glycolipids were not detected, immunotherapy with intravenous immunoglobulin and methylprednisolone pulse therapy effectively ameliorated the symptoms. Our report suggests that the COVID-19 vaccine may induce various clinical subtypes of GBS, including a rare variant with sensory ataxia and dysgeusia.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Ataxia/etiology , COVID-19/complications , COVID-19 Vaccines/adverse effects , Dysgeusia/etiology , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/drug therapy , Guillain-Barre Syndrome/etiology , Humans , RNA, Messenger , SARS-CoV-2 , Vaccination
2.
Brain Behav Immun ; 87: 18-22, 2020 07.
Article in English | MEDLINE | ID: covidwho-1719333

ABSTRACT

Viral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system.


Subject(s)
Coronavirus Infections/physiopathology , Nervous System Diseases/physiopathology , Pneumonia, Viral/physiopathology , Betacoronavirus , COVID-19 , Consciousness Disorders/etiology , Consciousness Disorders/physiopathology , Coronavirus 229E, Human , Coronavirus Infections/complications , Coronavirus NL63, Human , Coronavirus OC43, Human , Dysgeusia/etiology , Dysgeusia/physiopathology , Encephalitis/etiology , Encephalitis/physiopathology , Encephalitis, Viral/etiology , Encephalitis, Viral/physiopathology , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/physiopathology , Humans , Middle East Respiratory Syndrome Coronavirus , Nervous System Diseases/etiology , Neurotoxicity Syndromes/etiology , Neurotoxicity Syndromes/physiopathology , Neurotoxicity Syndromes/virology , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Pandemics , Pneumonia, Viral/complications , Polyneuropathies/etiology , Polyneuropathies/physiopathology , SARS Virus , SARS-CoV-2 , Seizures/etiology , Seizures/physiopathology , Severe Acute Respiratory Syndrome/complications , Severe Acute Respiratory Syndrome/physiopathology , Stroke/etiology , Stroke/physiopathology
3.
Oral Maxillofac Surg ; 26(1): 105-111, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1680899

ABSTRACT

PURPOSE: Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. METHODS: This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients' registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant. RESULTS: Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. CONCLUSION: Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.


Subject(s)
COVID-19 , Olfaction Disorders , Anosmia , Cross-Sectional Studies , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Olfaction Disorders/epidemiology , Oral and Maxillofacial Surgeons , Pandemics , Retrospective Studies , SARS-CoV-2
4.
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
5.
Nutr Rev ; 80(5): 1086-1093, 2022 Apr 08.
Article in English | MEDLINE | ID: covidwho-1337279

ABSTRACT

Zinc supplementation is indicated for diarrhea and taste disorders, which are both features of COVID-19 . Nevertheless, this strategy has not been tested for the treatment of these secondary complications in the current pandemic. Through an updated review, a practical appraisal was considered as a means of providing a medical nexus of therapeutic zinc regimens as an adjunct in the management of COVID-19-related diarrhea and ageusia/dysgeusia. While diarrhea and taste disorders are consequences of COVID-19, zinc supplementation is useful for non-COVID-19 patients with these clinical problems. The overwhelming evidence for supplementing with zinc in diarrhea and pneumonia is associated with the treatment of children, while for taste disorders the use of supplementing with zinc is more examined in adults. Whereas COVID-19 is more prevalent in adults, precautions should be exercised not to translate the zinc dosage used for children with diarrhea and taste disorders into the current pandemic. Therapeutic doses of zinc used for adults (∼50-150 mg/day of elemental zinc) could be included in the treatment strategies for COVID-19, but this proposal should be examined through randomized studies.


Subject(s)
Ageusia , COVID-19 , Adult , Ageusia/complications , Ageusia/drug therapy , COVID-19/drug therapy , Child , Diarrhea/drug therapy , Dietary Supplements , Dysgeusia/drug therapy , Dysgeusia/etiology , Humans , Taste Disorders/complications , Taste Disorders/drug therapy , Zinc/therapeutic use
6.
Neurol Res ; 44(1): 1-6, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1313683

ABSTRACT

OBJECTIVE: We sought to evaluate neurologic symptoms and findings in patients with COVID-19 infection hospitalized in a ward and intensive care unit (ICU). METHODS: This study was designed as a prospective study. Hospitalized COVID-19 rRt-PCR positive patients in the ward and ICU were included in the study. A 54-item questionnaire was used to evaluate the patients. Patients were examined within 3 hours of hospitalization. RESULTS: A total of 379 patients were included in the study. The mean age of the patients was 56.1 ± 17.8. 89 of the patients were in intensive care. At least one general symptom was recorded in 95.5% of patients. The most common neurologic symptoms were myalgia (48.5%), headache (39.6%), anosmia (34.8%), and dysgeusia (34%). Neurological symptoms in ICU patients were higher than in the ward. 53.6% of patients had comorbidities. DISCUSSION: This study indicated that the prevalence of neurological symptoms was very high in patients with COVID-19. The percentage of neurological symptoms and findings was higher in patients hospitalized in ICU.


Subject(s)
Anosmia/etiology , COVID-19/complications , Dysgeusia/etiology , Headache/etiology , Myalgia/etiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged
7.
Oral Maxillofac Surg ; 26(1): 105-111, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1217439

ABSTRACT

PURPOSE: Dysgeusia and anosmia have been liked to COVID-19 infection. The aim of this study is to study the prevalence of dysgeusia and anosmia in COVID-19 patients treated at the University of Florida Health Center and establish the odds of having an olfactory and gustatory disorder with a confirmed COVID-19 infection. METHODS: This is a retrospective cross-sectional study utilizing the University of Florida Health Center patients' registry i2b2 platform to search for ICD 10 diagnoses of COVID-19 infection and taste and smell disturbances. We assessed the odds ratio for patients with dysgeusia and anosmia having a laboratory-confirmed COVID-19 infection using a logistic regression model adjusting for gender, race, age, and comorbidity conditions. P < 0.05 was deemed significant. RESULTS: Out of 889 individuals that tested positive for COVID-19, 12.88% were diagnosed with taste and smell disturbances. The odds ratio for COVID-19 for people with dysgeusia and anosmia was 39.107. After adjusting for sex, age, and race, it was 41.9, 37, and 34.2, respectively. CONCLUSION: Taste and smell disturbances in COVID-19 are not anecdotal. It is paramount that oral and maxillofacial surgeons include taste and smell disturbances in the history and physical examination as these symptoms are suspicious of active COVID-19 infection. Patients presenting with an olfactory and gustatory disorder should undergo further evaluations for COVID-19 infection and oral and maxillofacial surgeons should enhance the personal protective equipment used when treating these patients to prevent further spread of the infection and protect other healthcare members.


Subject(s)
COVID-19 , Olfaction Disorders , Anosmia , Cross-Sectional Studies , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Olfaction Disorders/epidemiology , Oral and Maxillofacial Surgeons , Pandemics , Retrospective Studies , SARS-CoV-2
8.
Rev Neurol ; 72(6): 203-212, 2021 03 16.
Article in English, Spanish | MEDLINE | ID: covidwho-1134737

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic is a major worldwide health disorder. There is an increasing number of neurological complications recognized with COVID-19 including patients with GBS and its variants. DEVELOPMENT: A review of the clinical cases of GBS associated to COVID-19 infection published in the last months has been developed. We included 48 patients (31 men, mean age 56.4 years). The most common COVID-19 symptoms were cough (60.4%) and fever (56.3%). Mean time from COVID-19 symptoms to neurologic manifestations was 12.1 days, but in nine patients (18.8%) developed GBS within seven days. Eleven patients (22.9%) presented cranial nerve involvement in the absence of muscle weakness; 36 presented the classic sensory motor variant (75%) and one had a pure motor variant (2.1%). The electrodiagnostic pattern was considered demyelinating in 82.4% of the generalized variants. The presence of hyposmia/dysgeusia was associated with a latency shorter than seven days to GBS onset of symptoms (30% vs 15.6%), and cranial nerve involvement in the absence of weakness (30.8% vs 17.1%). Most patients (87.5%) were treated with intravenous immunoglobulin. Neurological outcome was favorable in 64.6%; 29.2% had respiratory failure and 4.2% died shortly after being admitted. CONCLUSIONS: GBS in patients with SARS-CoV-2 infection resembles clinically and electrophysiology the classical forms. Further studies are necessary to understand whether GBS frequency is actually increased due to SARS-CoV-2 infection and explore pathogenic mechanisms.


TITLE: Síndrome de Guillain-Barré asociado a infección por COVID-19: revisión de casos publicados.Introducción. La pandemia por la enfermedad por coronavirus 2019 (COVID-19) es un importante problema para la salud mundial. Hay un incremento en las complicaciones neurológicas reconocidas por la COVID-19, incluyendo el síndrome de Guillain-Barré (SGB) y sus variantes. Desarrollo. Se realizó una revisión de los casos publicados en los últimos meses de SGB asociado a infección por COVID-19. Incluimos a 48 pacientes (31 hombres; edad media: 56,4 años). Los síntomas de COVID-19 más comunes fueron tos (60,4%) y fiebre (56,3%). El tiempo promedio entre los síntomas de COVID-19 y el SGB fue de 12,1 días, pero nueve pacientes (18,8%) desarrollaron SGB en menos de siete días. Once pacientes (22,9%) presentaron afectación de los nervios craneales en ausencia de debilidad muscular, 36 presentaron la variante clásica sensitivomotora (75%) y uno tuvo una variante motora pura (2,1%). El patrón electrofisiológico se consideró desmielinizante en el 82,4% de las variantes generalizadas. La presencia de hiposmia/disgeusia estuvo asociada con una latencia menor a los siete días hasta el inicio de los síntomas del SGB (30 frente a 15,6%) y a la afectación de los nervios craneales en ausencia de debilidad (30,8 frente a 17,1%). La mayoría de los pacientes (87,5%) fueron tratados con inmunoglobulina endovenosa. La evolución neurológica fue favorable en el 64,6%, el 29,2% tuvo insuficiencia respiratoria y hubo un 4,2% de muertes. Conclusiones. El SGB en pacientes con infección por SARS-CoV-2 es similar clínica y electrofisiológicamente a las formas clásicas. Se requieren más estudios para comprender si la frecuencia del SGB realmente aumentó debido a la pandemia por COVID-19 y explorar los mecanismos patógenos involucrados.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/etiology , Pandemics , SARS-CoV-2 , Adolescent , Adult , Aged , Anosmia/etiology , Autoantibodies/blood , Autoantibodies/immunology , Autoantigens/immunology , Cranial Nerve Diseases/etiology , Dysgeusia/etiology , Female , Gangliosides/immunology , Guillain-Barre Syndrome/cerebrospinal fluid , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Middle Aged , Plasmapheresis , Respiratory Insufficiency/etiology , Retrospective Studies , Symptom Assessment , Treatment Outcome , Young Adult
9.
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
10.
Int J Pediatr Otorhinolaryngol ; 142: 110626, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065193

ABSTRACT

OBJECTIVES: To study the prevalence, clinical course and outcomes of olfactory and taste dysfunction in COVID-19 positive adolescents. METHODS: This prospective study was carried out from May to August 2020. The adolescents, aged 10-19 years, who were detected COVID-19 positive by RT-PCR with mild to moderate disease were included in the study. The following epidemiological and clinical outcomes were studied: age, sex, general symptoms, olfactory and taste dysfunction. RESULTS: Out of 141 patients included in the study, there were 83 males (58.9%) and 58 females (41.1%). The age varied from 10 to 19 years with an average of 15.2 years. Forty patients (28.4%) had olfactory or taste dysfunction. Out of these 40 patients, 28 patients (19.8%) had both olfactory and taste dysfunction. Of the 34 patients (24.1%) who complained of olfactory dysfunction, 16 patients complained of hyposmia and 18 patients complained of anosmia. Dysgeusia was reported by 34 patients (24.1%). The duration of OTD varied from 2 to 15 days with an average of 5.7 days. CONCLUSION: Loss of smell and taste are common symptoms in COVID-19 positive adolescents. It recovers spontaneously within a few weeks, along with the resolution of other symptoms.


Subject(s)
Anosmia/epidemiology , COVID-19/physiopathology , Dysgeusia/epidemiology , Adolescent , Anosmia/etiology , Anosmia/physiopathology , COVID-19/complications , Child , Disease Progression , Dysgeusia/etiology , Dysgeusia/physiopathology , Female , Humans , India/epidemiology , Male , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Prevalence , Prospective Studies , Recovery of Function , SARS-CoV-2 , Taste Disorders/epidemiology , Taste Disorders/etiology , Taste Disorders/physiopathology , Young Adult
11.
J Laryngol Otol ; 135(1): 45-49, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1023804

ABSTRACT

OBJECTIVE: This study aimed to evaluate the association between serum D-dimer, ferritin and vitamin D levels, and dysgeusia symptoms, in patients with coronavirus disease 2019. METHODS: The present study was conducted with the medical records of 300 patients positive for coronavirus disease 2019, hospitalised between 28 March and 15 August 2020. The patients were divided into two groups regarding the presence or absence of dysgeusia symptoms. RESULTS: Fever and sore throat rates, and the mean D-dimer level, were considerably higher in the dysgeusia group than in the non-dysgeusia group (32.1 vs 21.6 per cent, p = 0.04; 43.6 vs 20.7 per cent, p < 0.001; and 0.54 ± 0.32 vs 0.49 ± 0.51 mg/l FEU, p = 0.008, respectively). The mean age was significantly lower in the dysgeusia group than in the non-dysgeusia group (42.83 ± 12.31 vs 50.51 ± 13.67 years, p < 0.001). CONCLUSION: Younger age, fever and shortness of breath could be observed in patients with dysgeusia symptoms. In addition, the D-dimer level was significantly higher in the dysgeusia group.


Subject(s)
COVID-19/blood , COVID-19/complications , Dysgeusia/complications , Dysgeusia/etiology , Ferritins/blood , Fibrin Fibrinogen Degradation Products/analysis , Vitamin D/blood , Adult , COVID-19/diagnosis , Female , Humans , Male , Middle Aged
12.
Int J Infect Dis ; 100: 117-122, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-959799

ABSTRACT

BACKGROUND: New loss of smell or taste was not included as common symptoms of COVID-19 until March 2020 when the pandemic started in Western countries. We want to describe the prevalence and features of anosmia and dysgeusia in COVID-19 patients. METHODS: We retrospectively investigated the clinical features of confirmed cases of COVID-19 in Nord Franche-Comté Hospital, Trevenans, France, between March, 1st and March, 14th 2020. We used SARS-CoV-2 real time RT-PCR in respiratory samples to confirm the cases. RESULTS: Of 70 patient enrolled, the mean age was 57.0 years and 29 patients (41%) were men. Median Charlson comorbidity index was 1.70(±2.5). Twenty-seven (39%) patients had pneumonia. Fatigue (93% [65]), cough (80% [55]) and fever (77% [54]) were the three main symptoms. Neurologic symptoms were present in more than half of the patients: anosmia (53% [37]) and dysgeusia (48% [34]). The mean duration of anosmia was 7.4 (±5, [1-21]) days, 51% (36/70) recovered before 28 days of evolution. Only one patient with anosmia had not recovered at the end of the follow-up. Patients with anosmia had less often a pneumonia (10/37 vs 17/33, p = 0.036), were less often hospitalized (13/37 vs 20/33, p = 0.033) and needed less often oxygen therapy (6/37 vs 17/33, p = 0.002) than patients without anosmia. There were no statistically differences for viral load between patients with anosmia and patients without anosmia (5.5 [2.0-8.6] vs 5.3 [2.1-8.5] log copies/ml respectively, p = 0.670). The fatality of COVID-19 in our study was 6% with four deaths. CONCLUSIONS: Anosmia and dysgeusia are present in half of COVID-19 patients. The mean duration of anosmia was 7 days and the outcome seems favorable in less than 28 days.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Dysgeusia/etiology , Olfaction Disorders/etiology , Pneumonia, Viral/complications , Adult , COVID-19 , Coronavirus Infections/epidemiology , Female , France/epidemiology , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , Retrospective Studies , SARS-CoV-2 , Time Factors
14.
Int J Environ Res Public Health ; 17(21)2020 11 01.
Article in English | MEDLINE | ID: covidwho-902535

ABSTRACT

Coronavirus (SARS-CoV-2) emerged in China in December 2019 and rapidly caused a global health pandemic. Current evidence seems to suggest a possible link with ecosystem disequilibrium and even air pollution. The primary manifestations affect respiratory and circulatory systems, but neurological features are also being reported through case reports and case series. We summarize neurological symptoms and complications associated with COVID-19. We have searched for original articles published in PubMed/Medline, PubMed Central and Google Scholar using the following keywords: "COVID-19", "Coronavirus", "pandemic", "SARS-COV-2", "neurology", "neurological", "complications" and "manifestations". We found around 1000 publications addressing the issue of neurological conditions associated with COVID-19 infection. Amongst those, headache and dizziness are the most common reported symptoms followed by encephalopathy and delirium, while the most frequent complications are cerebrovascular accidents, Guillain-Barré syndrome, acute transverse myelitis, and acute encephalitis. Specific symptoms affecting the peripheral nervous system such as hyposmia and dysgeusia are the most common manifestations recorded in the selected studies. Interestingly, it was noted that these kinds of neurological symptoms might precede the typical features, such as fever and cough, in COVID patients. Neurological symptoms and complications associated with COVID-19 should be considered as a part of the clinical features of this novel global pandemic.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Dizziness/etiology , Dysgeusia/etiology , Headache/etiology , Nervous System Diseases/physiopathology , Pandemics , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , COVID-19 , China/epidemiology , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Humans , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology , Nervous System Diseases/psychology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS-CoV-2
15.
Nutrients ; 12(11)2020 Oct 27.
Article in English | MEDLINE | ID: covidwho-895390

ABSTRACT

Our sense of taste arises from the sensory information generated after compounds in the oral cavity and oropharynx activate taste receptor cells situated on taste buds. This produces the perception of sweet, bitter, salty, sour, or umami stimuli, depending on the chemical nature of the tastant. Taste impairments (dysgeusia) are alterations of this normal gustatory functioning that may result in complete taste losses (ageusia), partial reductions (hypogeusia), or over-acuteness of the sense of taste (hypergeusia). Taste impairments are not life-threatening conditions, but they can cause sufficient discomfort and lead to appetite loss and changes in eating habits, with possible effects on health. Determinants of such alterations are multiple and consist of both genetic and environmental factors, including aging, exposure to chemicals, drugs, trauma, high alcohol consumption, cigarette smoking, poor oral health, malnutrition, and viral upper respiratory infections including influenza. Disturbances or loss of smell, taste, and chemesthesis have also emerged as predominant neurological symptoms of infection by the recent Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus strain 2 (SARS-CoV-2), as well as by previous both endemic and pandemic coronaviruses such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and SARS-CoV. This review is focused on the main causes of alteration, reduction, and loss of taste and their potential repercussion on dietary habits and health, with a special focus on the recently developed hypotheses regarding the mechanisms through which SARS-CoV-2 might alter taste perception.


Subject(s)
Ageusia/etiology , Coronavirus Infections/complications , Dysgeusia/etiology , Feeding Behavior , Pneumonia, Viral/complications , Taste Perception , Taste , Appetite , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Smell
16.
Laryngoscope ; 131(6): 1254-1265, 2021 06.
Article in English | MEDLINE | ID: covidwho-866144

ABSTRACT

OBJECTIVES/HYPOTHESIS: The objective of this meta-analysis was to look at the pooled prevalence of symptoms, laboratory tests, and imaging of all COVID-19 infected patients. This will allow better identification of potential COVID-19 patients and take appropriate precautions. STUDY DESIGN: Meta analysis. METHODS: We searched three databases, PubMed, EMBASE, and Ovid to identify studies published between Dec-2019 and May-2020. All studies reporting upper-aerodigestive symptoms of COVID-19 infection were included. The meta-analysis was conducted following meta-analyses of observational studies in epidemiology (MOOSE) guidelines, which have evaluated the pooled prevalence of 14 symptoms and nine laboratory investigations. RESULTS: Based on inclusion criteria, 67 publications consisting of 8302 patients were included. Among adults, the pooled proportion of hypertensive and diabetic patients was 18% and 7%. Cough (53% [0.46-0.61]), anosmia (38% [0.19-0.58]), loss/distortion of taste (31% [0.17-0.45]), and nasal obstruction (26% [0.12-0.39]) were the most common ear, nose & throat (ENT) symptoms. Fever (69% [0.62-0.76]) and fatigue (31% [0.26-0.37]) were the commonest generalized symptoms. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were raised in 56% (0.41-0.71) and 49% (0.21-0.77), respectively. Interestingly, lymphopenia (41% [0.30-0.53]) and leucopenia (22% [0.16-0.29]) were more common than lymphocytosis (33% [0.02-0.64]) and leucocytosis (12% [0.09-0.16]). Fever (69% vs. 44%), cough (53% vs. 33%), and dyspnea (20% vs. 4%) were more common in adults as compared to the pediatric population. Diarrhea was more common among the pediatric cases (12%) versus (9%). The pooled estimate of fatality was 4%. CONCLUSIONS: The most commonly experienced ENT symptom was cough followed by anosmia and dysguesia. Raised ESR and CRP with leukopenia and lymphopenia are common laboratory findings. Majority of the infected patients had abnormal computed tomography findings. COVID infection is less severe in pediatric patients. Laryngoscope, 131:1254-1265, 2021.


Subject(s)
COVID-19/diagnosis , Clinical Laboratory Techniques , Adult , Anosmia/epidemiology , Anosmia/etiology , COVID-19/epidemiology , Child , Cough/epidemiology , Cough/etiology , Cross-Sectional Studies , Databases, Bibliographic , Diagnosis, Differential , Dysgeusia/epidemiology , Dysgeusia/etiology , Humans , Tomography, X-Ray Computed
20.
Int Forum Allergy Rhinol ; 10(11): 1255-1257, 2020 11.
Article in English | MEDLINE | ID: covidwho-734214

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has been identified as the pathogen causing the outbreak of coronavirus disease-2019 (COVID-19) commencing in Wuhan, China, in December 2019. Multiple reports have shown subjective loss of taste and smell as an early and hallmark symptom for COVID-19. METHODS: A retrospective study was performed in our clinical practice during July 2020 on patients positive for SARS-CoV-2 via polymerase chain reaction. All patients were categorized into 3 groups (supertasters, tasters, and nontasters) via taste sensitivity to phenylthiocarbamide, thiourea, and sodium benzoate with taste strip testing. The results of the taste strip tests were correlated with clinical course. RESULTS: A total of 100 patients (mean, 51 [range, 24-82] years of age; 44 [44%] women) were assessed. We found that 21 of 100 (21%) were nontasters, 79 of 100 (79%) were tasters, and 0 of 100 (0%) were supertasters (p < 0.001). Twenty-one of 21 (100%) (p < 0.001) of the patients requiring inpatient admission were classified as nontasters. All 79 (100%) (p < 0.001) of the patients who displayed mild to moderate symptoms not requiring admission were classified as tasters. CONCLUSION: Our results show objective data that taste disturbance, specifically global loss of taste, appears to correlate with the clinical course specific to each individual, because 100% of the patients requiring inpatient admission were classified as nontasters.


Subject(s)
Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Receptors, G-Protein-Coupled/metabolism , Taste/physiology , Adult , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Dysgeusia/epidemiology , Dysgeusia/etiology , Dysgeusia/physiopathology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , Phenotype , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
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