Background and Objectives: Neurological manifestations of Coronavirus Disease 2019 (COVID-19) such as olfactory and gustatory disturbance have been reported among convalescent COVID-19 patients. However, scientific data on the prevalence of smell and taste disturbance are lacking. Therefore, we present findings on the degree of smell and taste disturbances among the Armenian population. Methods: Study participants were randomly recruited and then categorized into two groups based on their course of the disease. A cross-sectional study was performed to assess participants’ sensitivity to smell triggered by the olfactory and the trigeminal nerves; their ability to differentiate between various odors; and to evaluate their gustatory perception. Results: The smell test revealed that the degree of olfactory nerve disturbance was different by 30.7% in those participants of the early group as compared to those of the late group, and the degree of trigeminal nerve disturbance was different by 71.3% in the early group as compared to the late group. A variation of the differentiating ability among the participants of the early and late groups was detected. Gustatory disturbances for all flavors were also found to be different in both the groups. A moderate positive correlation (0.51) was found between the overall sensitivity of smell and the ability to differentiate between various odors as cumulatively stimulated by both the olfactory and trigeminal nerves. Also, a moderate positive correlation (0.33) was found between headache and smell sensitivity through the olfactory nerve and a high negative correlation (−0.71) was found between headache and smell sensitivity through the trigeminal nerve. Conclusion: Pathological changes in the olfactory and trigeminal perceptive abilities caused disturbances in smell sensation, with the trigeminal nerve being more affected. The capacity to differentiate fragrances did not improve with time and the disturbance severity of bitter taste perception was higher among the study participants.

e13013 Background: The treatment prospects for Human Epidermal Growth Factor Receptor 2 positive (HER2p) breast cancer (BC) patients are continuously evolving, however, BC remains a major public health problem. Multiple therapeutic and biological strategies are already in function, and specifically the anti-HER2 therapy (trastuzumab, pertuzumab, lapatinib, and ado-trastuzumab emtansine) remains a mainstream clinically approved treatment method. Implementation of the anti-HER2 therapy has substantially strengthened the prognosis for HER2p patients. This has remarkably improved the 5-year survival rates upto 80% in high-income countries, 60% in middle-income countries and 40% in low-income countries by establishing anti-HER2 therapy. Barriers to anti-HER2p therapies in low- and middle-income countries (LMICs) can be minimized by further instigation and licensing of the bio-similar drugs as a low-cost alternative treatment. Bio-similar drugs will also potentially result in a considerable savings for patients and eventually lessen the burden on the health care systems of LMICs as the usual cancer treatment regimen includes multiple systemic therapies for an extended time period, which are highly expensive. The aim of the study is to identify the barriers to accessibility of targeted therapy for BC, among patients seeking BC treatment in Yerevan, Armenia. Methods: The qualitative study assessed the out-of-pocket (OOP) payment burden among patients and their opinions about the quality of treatment using an interview guide with probe questions, adapted to the Armenian context. The study participants were patients seeking BC treatment at Hematology Center and Mikhaelyan Medical Center. Results: All the study participants were satisfied with the quality of health care and health care providers, however, majority of the study participants paid OOP for the examination, analysis and therapeutic drugs. Most participants were sponsored by family members and stated being financially vulnerable. Conclusions: The study provides evidence for the development and implementation of biosimilar drugs, implementation of mandatory health insurance to increase the access to targeted therapy, enhance collaboration with international funding agencies and strengthen diaspora support.