Dysautonomia and Implications for Anosmia in Long COVID-19 Disease

Vallée, Alexandre

doi:10.3390/jcm10235514

Cited by 19 publications

(20 citation statements)

References 77 publications

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“…In the literature, there is no direct report available on the loss of these chemical senses in obese COVID-19 patients. However, the association between obesity and impairment of the oro-naso-sensory perception was reported in the literature [15]. Krams et al (2020) suggested that the obesity paradox provides a possible explanation for the observed population differences in COVID-19 infection and mortality rates between Europe, the USA, and Southeast Asia.…”

Section: Discussionmentioning

confidence: 99%

Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients

Algahtani

AlZarroug

Alghamdi

et al. 2022

IJERPH

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The Coronavirus Disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulted in a worldwide pandemic of a highly infectious disease. The difficulty of dealing with COVID-19 is the broad spectrum of clinical manifestations that involves various pathophysiological mechanisms, severities, duration, and complications. This study aims to help emphasize the factors related to the persistence and duration of anosmia (loss of smell) and ageusia (loss of taste) as part of post-acute COVID-19 syndrome in Saudi COVID-19 patients via a retrospective cross-sectional design. Eight hundred and eighty-one participants were recruited between March and April 2021. Those participants were 18 years or older, recovered from the COVID-19 infection, and completed 14 days after the onset of the acute phase of the disease. Among the 881 recruited participants, 808 have submitted eligible responses and were included in data analyses. The most common persistent symptoms in post-acute COVID-19 syndrome were anosmia (33.8%) and ageusia (26.4%). The data also showed a significant association between female sex and the incidence and the persistence of anosmia and ageusia. In multivariable analysis, anosmia during the acute phase was associated with BMI, asthma and shortness of breath, while anosmia during the post-acute phase was associated with sex. Ageusia during the acute phase was associated with sex, myalgia and arthralgia, while ageusia in the post-acute phase was associated with sex.

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Section: Discussionmentioning

confidence: 99%

Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients

Algahtani

AlZarroug

Alghamdi

et al. 2022

IJERPH

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“…It is not clear whether infection-associated dysautonomia is the direct result of the action of the virus on autonomic nervous system (ANS) structures or a consequence of postinfectious immune-mediated processes ( 34 , 35 ).…”

Section: The Role Of Dysautonomia In the Clinical Course Of Covid-19mentioning

confidence: 99%

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

et al. 2022

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IntroductionOn March 11, 2020, the World Health Organization sounded the COVID-19 pandemic alarm. While efforts in the first few months focused on reducing the mortality of infected patients, there is increasing data on the effects of long-term infection (Post-COVID-19 condition). Among the different symptoms described after acute infection, those derived from autonomic dysfunction are especially frequent and limiting.ObjectiveTo conduct a narrative review synthesizing current evidence of the signs and symptoms of dysautonomia in patients diagnosed with COVID-19, together with a compilation of available treatment guidelines.ResultsAutonomic dysfunction associated with SARS-CoV-2 infection occurs at different temporal stages. Some of the proposed pathophysiological mechanisms include direct tissue damage, immune dysregulation, hormonal disturbances, elevated cytokine levels, and persistent low-grade infection. Acute autonomic dysfunction has a direct impact on the mortality risk, given its repercussions on the respiratory, cardiovascular, and neurological systems. Iatrogenic autonomic dysfunction is a side effect caused by the drugs used and/or admission to the intensive care unit. Finally, late dysautonomia occurs in 2.5% of patients with Post-COVID-19 condition. While orthostatic hypotension and neurally-mediated syncope should be considered, postural orthostatic tachycardia syndrome (POTS) appears to be the most common autonomic phenotype among these patients. A review of diagnostic and treatment guidelines focused on each type of dysautonomic condition was done.ConclusionSymptoms deriving from autonomic dysfunction involvement are common in those affected by COVID-19. These symptoms have a great impact on the quality of life both in the short and medium to long term. A better understanding of the pathophysiological mechanisms of Post-COVID manifestations that affect the autonomic nervous system, and targeted therapeutic management could help reduce the sequelae of COVID-19, especially if we act in the earliest phases of the disease.

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“…These constellations of symptoms may persist chronically and are termed "Long COVID", or formally, post-acute sequelae of SARS-CoV-2 (PASC) infection [3]. The incidence of PASC is 30% in symptomatic and 5% in asymptomatic patients with COVID-19 infection [4]. Compared to influenza, COVID-19 is reported to be associated with a higher prevalence of anosmia (53% vs. 17%) [5].…”

Section: Introductionmentioning

confidence: 99%

“…Compared to influenza, COVID-19 is reported to be associated with a higher prevalence of anosmia (53% vs. 17%) [5]. PASC patients with or without hospitalization have often reported anosmia and dysgeusia as one of the predominant and persisting symptoms [4].…”

Section: Introductionmentioning

confidence: 99%

“…One such theory implicates autonomic dysregulation or dysautonomia as the underlying mechanism behind anosmia [6]. In the case of Long COVID, dysautonomia could be induced by the autonomic nervous system's (ANS) response or maladaptation to pro-inflammatory cytokines leading to excessive sympathetic nervous system activity [4,6,7]. Sympathetic innervation of the head and neck consists of the cervical and upper thoracic sympathetic chain [8].…”

Section: Introductionmentioning

confidence: 99%

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Stellate Ganglion Block for Anosmia and Dysgeusia Due to Long COVID

Chauhan¹,

Upadhyay²,

Khanduja³

et al. 2022

Cureus

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Anosmia and parosmia refer to the loss or dysfunction of smell, respectively. Dysgeusia refers to taste disturbance. The coronavirus disease 2019 (COVID-19) pandemic and the subsequent phenomenon of Long COVID syndrome have been associated with an increased incidence of anosmia and dysgeusia. Smell and taste disturbances associated with COVID-19 are usually self-limiting but can persist for longer periods in some cases. Imbalances of the autonomic nervous system, especially dysregulation of the sympathetic system, are implicated in the persistence of anosmia and dysgeusia post-COVID-19 infection. Stellate ganglion block (SGB) can diminish the increased sympathetic activity and potentially resolve anosmia and dysgeusia occurring due to Long COVID. The authors report the successful resolution of persistent anosmia and dysgeusia due to Long COVID in a female patient after she underwent SGB.

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Dysautonomia and Implications for Anosmia in Long COVID-19 Disease

Cited by 19 publications

References 77 publications

Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients

Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

Stellate Ganglion Block for Anosmia and Dysgeusia Due to Long COVID

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