Olfactory and gustatory disorders in COVID-19

Klimek, Ludger; Hagemann, Jan; Döge, Julia; Freudelsperger, Laura; Cuevas, Mandy; Klimek, Felix; Hummel, Thomas

doi:10.1007/s40629-022-00216-7

Cited by 26 publications

(37 citation statements)

References 111 publications

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“…One explanation could be the activation of X-chromosome-related toll-like receptors that could generate different inflammatory conditions and clinical courses following infection between men and women [ 50 ]. In contrast to these, and in agreement with other work [ 14 , 27 ], the results of our olfactory tests also showed that the effects of the virus on olfactory function is similar between sexes. Consequently, gender does not appear to be a bias for discriminating against asymptomatic individuals.…”

Section: Discussionsupporting

confidence: 93%

“…In the plethora of early signs of COVID-19, viral spread causes a multi-system disease, including impairments in the brain, olfactory, and/or gustatory, although all olfactory and/or gustatory dysfunctions are not caused solely by the ongoing virus [ 11 , 12 , 13 , 14 ]. The olfactory system may be the most suitable system for detecting infection in the early stages, before the onset of symptoms or even in asymptomatic people [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unmasking the ‘Asymptomatic’ COVID-19: A Nose Question

Mazzatenta

Anna

Novarria

et al. 2022

Life

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The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has high infectivity, often masked by asymptomatic carriers, which allows it to spread rapidly and become a pandemic. Attempts to slow the pandemic at this stage depend on the ability to unmask asymptomatic carriers. The rapid diagnosis of active coronavirus disease 2019 (COVID-19) infection is one of the cornerstones of pandemic control, as the nasal cavity is the main gateway for SARS-CoV-2 entry and altered sense of smell is a feature of the current virus. In the present study, we therefore tested the olfactory threshold coupled with heart–lung parameters in subjects undergoing traditional molecular testing, resulting in a significantly different score between asymptomatic subjects and healthy controls. In total, 82% of asymptomatic positives showed olfactory impairment; of these, 46% had severe hyposmia and 7% had anosmia, while in the control 9% had severe hyposmia and 0% had anosmia, respectively, which agrees with heart rate, breathing rate, and blood pressure parameter variations. The olfactory test coupled with physiological parameters may help to identify asymptomatic people. In conclusion, our results suggest that most asymptomatic individuals could be unmasked by mass olfactory rapid threshold screening and then referred to traditional slower diagnostic tests.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Unmasking the ‘Asymptomatic’ COVID-19: A Nose Question

Mazzatenta

Anna

Novarria

et al. 2022

Life

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“…The original SARS-CoV-2 (Wuhan) gave rise to different variants of concern (VoCs) in the first year of the pandemic (B.1.1.7, B.1.351, P.1), which were almost totally replaced by the VoC Delta (B1.617.2) in 2020, by the VoC Omicron/BA.1 (B.1.1.529) in 2021 and other Omicron lineages (BA.2, BA.4, BA.5) in 2022 (WHO, 2022). SARS-CoV-2 infects cells of the upper and lower airways, and COVID-19 manifests by a multitude of respiratory and extra-respiratory symptoms, including neurological manifestations, ranging from headache and dizziness to anosmia, ageusia and even stroke (Chou et al, 2021;Klimek et al, 2022;Paterson et al, 2020). The neuropathology of COVID-19 is currently considered to be a consequence of inflammation and hypoxia, rather than direct viral invasion into the CNS (Ruz-Caracuel et al, 2022;Thakur et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…SARS-CoV-2 infects cells of the upper and lower airways, and COVID-19 manifests by a multitude of respiratory and extra-respiratory symptoms, including neurological manifestations, ranging from headache and dizziness to anosmia, ageusia and even stroke (Chou et al, 2021; Klimek et al, 2022; Paterson et al, 2020). The neuropathology of COVID-19 is currently considered to be a consequence of inflammation and hypoxia, rather than direct viral invasion into the CNS (Ruz-Caracuel et al, 2022; Thakur et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Neuroinvasion and anosmia are independent phenomena upon infection with SARS-CoV-2 and its variants

Melo

Perraud

Alvarez

et al. 2022

Preprint

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Anosmia was identified as a hallmark of COVID-19 early in the pandemic, however, with the emergence of variants of concern, the clinical profile induced by SARS-CoV-2 infection has changed, with anosmia being less frequent. Several studies have focused on the neuropathogenesis of the original SARS-CoV-2, but little is known about the neuropathological potential of the variants. Here, we assessed the clinical, olfactory and inflammatory conditions of golden hamsters infected with the original SARS-CoV-2, its ORF7-deleted mutant, and three variants: Gamma, Delta and Omicron/BA.1. We show that infected animals developed a variant-dependent clinical disease, and that the ORF7 of SARS-CoV-2 contribute to causing olfactory disturbances. Conversely, all SARS-CoV-2 variants were found to be neuroinvasive, regardless of the clinical presentation they induce. With newly-generated nanoluciferase-expressing SARS-CoV-2, we validated the olfactory pathway as a main entry point towards the brain, confirming that neuroinvasion and anosmia are independent phenomena upon SARS-CoV-2 infection.

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“… 4 , 6 - 8 In addition to hyposmia and anosmia, persistent parosmia is reported with striking frequency. 9 , 10 Less surprising is that olfactory dysfunction is commonly associated with gustatory impairments. 11 - 13 …”

Section: Introductionmentioning

confidence: 99%

Treatment of Olfactory Disorders After SARS – CoViD 2 Virus Infection

Schmidt¹,

Azar²,

Goektas³

2023

Ear Nose Throat J

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Objective The benefit of a nasal corticosteroid in the treatment of persistent post-infectious smell disorders is not as clear in previous studies as is assumed for olfactory training. This study would therefore like to describe the treatment strategies using the example of a persistent olfactory dysfunction as a result of a proven infection with SARS-CoViD-2-virus. Methods Twenty patients (average age of 33.9 ± 11.9 years) with hyposmia were included in this study from December 2020 to July 2021. Every second patient received additionally a nasal corticosteroid. The two resulting randomized groups of equal size were screened with the TDI test, a 20-item taste powder test for the assessment of retronasal olfaction and otorhinolaryngological examination. The patients were asked to train twice daily using a standardized odor training kit and followed up after 2 months and 3 months, respectively. Results We documented a significant overall improvement in olfactory ability over the investigation period in both groups. While the TDI score steadily increased on average under the combination therapy, the rise under olfactory training alone was initially steeper. This short-term interaction effect over mean two months was not statistically significant. According to Cohen, however, a moderate effect (eta 2 = 0.055, Cohen`s d = 0.5) can still be assumed. This effect could be explained by a possibly higher compliance at the beginning of the sole olfactory training due to the lack of further drug treatment offers. When the training intensity decreases, the recovery of the sense of smell stagnates. Adjunctive therapy ultimately outweighs this short-term benefit. Conclusions The results reinforce the recommendation of early and consistent olfactory training on patients with dysosmia due to COVID-19. For continuous improvement of the sense of smell, an accompanying topical treatment seems at least to be worth consideration. The results should be optimized with larger cohorts and using new objective olfactometric methods.

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Olfactory and gustatory disorders in COVID-19

Cited by 26 publications

References 111 publications

Unmasking the ‘Asymptomatic’ COVID-19: A Nose Question

Unmasking the ‘Asymptomatic’ COVID-19: A Nose Question

Neuroinvasion and anosmia are independent phenomena upon infection with SARS-CoV-2 and its variants

Treatment of Olfactory Disorders After SARS – CoViD 2 Virus Infection

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