The rapid recovery of smell and taste functions in COVID-19 patients could be attributed to a decrease in interleukin-6 levels rather than central nervous system ischemic injury or viral damage to neuronal cells. To correlate interleukin-6 levels in COVID-19 patients with olfactory or gustatory dysfunctions and to investigate the role of IL-6 in the onset of these disorders, this observational study investigated 67 COVID-19 patients with taste or smell disorders or both, who did not require intensive care admission, admitted at COVID Hospital of Policlinico of Bari from March to May 2020. Interleukin-6 was assayed in COVID-19 patients with taste or smell disturbances at the time of admission and at the time of swab negativization. At the same time, patients have been given a specific survey to evaluate the severity of taste and smell disturbances. Of 125 patients with smell or taste dysfunctions at onset of disease, 67 fulfilled the inclusion criteria, while 58 were excluded because 35 of them required intensive care admission, 5 were unable to answer, 5 died, 7 had finished chemotherapy recently, and 5 refused to participate. The evaluation of taste and smell disorders was carried out using a survey performed at the time of admission and at the time of swab negativization. Sinonasal outcome test 22 (SNOT-22) was used as a reference for olfactory function assessment, and Taste and Smell Questionnaire Section of the US NHANES 2011–2014 protocol (CDC 2013b) was used as reference for gustatory function assessment. A venous blood sample was taken for each patient to measure IL-6 levels upon entry and at swab negativization. Interleukin-6 levels in COVID-19 patients in relation to olfactory or gustatory disorders were correlated from the time of their admission to the time of swab negativization. Statistically significant correlations were obtained between the decrease of interleukin-6 levels and the improvement of smell ( p value < 0.05) and taste ( p = 0.047) functions at swab negativization. The acquired results demonstrate the key role of interleukin-6 in the pathogenesis of chemosensitive disorders in COVID-19 patients.

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SUMMARY The aim of the present study was to evaluate how the features of obstructive sleep apnoea (OSA) and the degree of mandibular advancement influence the outcomes of oral appliance therapy with a fully-customised mandibular advancement device (MAD) in an adult population. A total of 85 adult patients with mild to severe OSA were retrospectively selected. Polysomnography was taken before treatment and after 2 months treatment with overnight MAD. Treatment success was defined as a > 50% reduction in the Apnoea/Hypopnoea Index (AHI) with a residual AHI < 10. Binary logistic regression was used to evaluate the effects of AHI, oxygen desaturation index (ODI), gender and age on the success rate of MAD therapy. MAD therapy was successful in 77.7% of patients, and the ODI was a significant predictor of treatment success. OSA treatment with the MAD was successful in reducing the AHI in adult patients. An ODI value smaller than 33.3 was a significant predictor of treatment success.

Obstructive sleep apnea (OSA) is associated with a number of cardiovascular comorbidities, including hypertension, heart rate (HR) alterations, cardiac arrhythmias, endothelial dysfunction and atherosclerosis. HR, in particular, is an important sign correlated with cardiac stress and survival. Previous investigations on the effects of mandibular advancement device (MAD) therapy on HR resulted in contradictory findings. The aim of the present retrospective cohort study was to evaluate the effects of MAD therapy with a fully customizable appliance on respiratory and cardiovascular parameters. Fifty adult consecutive cases with mild to severe OSA underwent split-night polysomnography (SN-PSG) at baseline (T0) and after three months of MAD treatment (T1), after appropriate titration. The apnea/hypopnea index (AHI), 4% oxygen desaturation index (ODI) and HR (average, minimum and maximum) values are recorded at T0 and at T1 and statistically compared. The AHI and ODI values improved after three months of MAD treatment. The minimum HR increased after treatment, while the maximum HR decreased after treatment. MAD treatment with a fully customizable appliance was effective in improving breathing and cardiovascular parameters in adult patients with mild to severe OSA.

The term “sleep-related breathing disorders” (SRDB) comprehends a spectrum of pathologic conditions characterized by abnormal respiration during sleep, that can affect both adults and growing subjects. The expanding knowledge on this topic has revealed that impaired sleeping and breathing have profound effects on many systemic functions, therefore a modern approach requires the collaboration of different professionals like the otorhinolaryngologist, pneumologist, neurologist, cardiologist, psychologist, dentist, and many others. The real prevalence of such conditions is unknown, especially in children, even though a growing awareness can be found among Governments, researchers, and public opinion, especially for the social implications that SRDB can have. Moreover, recent studies have raised attention on comorbidities that can be associated with SRDB, influencing each other. Regarding the current international situation, it would be interesting to evaluate the progress of COVID-19 disease in SRDB patients. Defining the state-of-the-art knowledge on all the conditions orbiting around SRDB, from all points of view—aetiology, diagnosis, clinical management, interdisciplinarity, public health management—would be of great interest and impact to improve future research and the quality of life of SRDB patients.