Anosmia: Differential Diagnosis, Evaluation, and Management

Scangas, George A.; Bleier, Benjamin S.

doi:10.2500/ajra.2017.31.4403

Cited by 46 publications

(60 citation statements)

References 83 publications

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“…One clue could be that angiotensin-converting-enzyme (ACE)-inhibitors can cause OD [10]. SARS-CoV-2 enters host cells by binding (then down-regulating it) the ACE2 receptor [11]: ACE2 receptor and TMPRSS2 proteases, crucial for S protein priming, are both expressed by non-neuronal cells of the olfactory epithelium [12], and ACE2 is diffusely expressed on the mucous membrane of the oral cavity, particularly on the tongue [13].…”

Section: Discussionmentioning

confidence: 99%

Olfactory and Gustatory Dysfunctions In 100 Patients Hospitalized For Covid-19: Sex Differences and Recovery Time In Real-Life

Meini

Suardi

Busoni

et al. 2020

Preprint

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Purpose. COVID-19 displays a variety of clinical manifestations; in pauci-symptomatic patients olfactory (OD) and gustatory dysfunctions (GD) may represent the first or only symptom. To date, literature addressing these disorders is scarce. Aim of this study is to investigate the timing of recovery from OD and GD in a real-life COVID-19 population.Methods. We followed up by a phone interview the first 100 patients discharged a month earlier from three Italian non-intensive care wards.Results. All patients were Caucasian, mean age was 65 years, 60% were males. OD and GD were early symptoms reported by 29% and 41% of patients, respectively. Among the 42 symptomatic patients, the male/female ratio was 2:1; 83% reported an almost resolved dysfunction at follow-up. The recovery rate was not significantly different between males and females. The mean duration of OD and GD was 18 and 16 days, respectively. The mean recovery time from OD or GD resulted significantly longer for females than for males (26 vs 14 days, p=0.009). Among the 42 symptomatic, the mean age of males was significantly higher than that of females (66 vs 57 years, p=0.04), while the opposite was observed in the 58 asymptomatic patients (60 vs 73 years, p=0.0018).Conclusions. Recovery from OD or GD was rapid, occurring within 4 weeks in most patients. Chemosensory dysfunctions in women was less frequent, but longer lasting. The value of our study is its focus on a significantly older population than those previously described, and to add further data on gender differences.

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Section: Discussionmentioning

confidence: 99%

Olfactory and Gustatory Dysfunctions In 100 Patients Hospitalized For Covid-19: Sex Differences and Recovery Time In Real-Life

Meini

Suardi

Busoni

et al. 2020

Preprint

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“…-Sinonasal diseases, such as allergic rhinitis or rhinosinusitis, can cause conductive and inflammatory disorders to arise from anatomic barriers that prevent odorants from reaching the olfactory epithelium and receptors [5,17].…”

Section: Loss Of Smell Etiologymentioning

confidence: 99%

Olfactory Dysfunction in the COVID-19 Outbreak

Izquierdo-Domínguez¹,

Rojas-Lechuga²,

Mullol³

et al. 2020

J Investig Allergol Clin Immunol

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The first cases of coronavirus 2019 (COVID-19) occurred in Wuhan, China, and rapidly become a public health emergency of international proportions. The disease may cause mild-to-severe acute respiratory syndrome (SARS) and is caused by a SARS-CoV-2 coronavirus infection. The clinical manifestations of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, sore throat, and headache. This article is a narrative review with the aim of analyzing the current literature on postviral olfactory dysfunction (OD) related to SARS-CoV-2 pandemics. Since the initial anecdotal reports from China, international reports on COVID-19 patients have been increasing, describing a 5% to 85% range of loss of smell. To date, the literature is widely heterogeneous regarding the loss of smell; therefore, we advise home isolation measures and/or social distancing, and to carry out diagnostic tests for SARS-CoV-2 when possible in those patients with sudden and severe loss of smell who cannot be promptly evaluated.neurons nor the olfactory bulb neurons express specific genes that are instead expressed in support cells, stem cells, and perivascular cells. These findings suggest that infection of non-neuronal cell types leads to anosmia and related disturbances in odour perception in patients [7,8]

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“… 123 It is also a strong antioxidant 1 , 119 , 124 , 125 and anti-inflammatory 109 , 119 , 125 agent capable of activating and modulating signal transduction pathways, 109 , 119 , 126 upregulating the expression of nerve growth factor, and augmenting the conduction velocity of motor nerves. 127 …”

Section: α-Lipoic Acid L -Carnitine and Butyratementioning

confidence: 99%

A New Approach to Treating Neurodegenerative Otologic Disorders

Moos

Faller

Glavas

et al. 2018

BioResearch Open Access

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Hearing loss, the most common neurological disorder and the fourth leading cause of years lived with disability, can have profound effects on quality of life. The impact of this “invisible disability,” with significant consequences, economic and personal, is most substantial in low- and middle-income countries, where >80% of affected people live. Given the importance of hearing for communication, enjoyment, and safety, with up to 500 million affected globally at a cost of nearly $800 billion/year, research on new approaches toward prevention and treatment is attracting increased attention. The consequences of noise pollution are largely preventable, but irreversible hearing loss can result from aging, disease, or drug side effects. Once damage occurs, treatment relies on hearing aids and cochlear implants. Preventing, delaying, or reducing some degree of hearing loss may be possible by avoiding excessive noise and addressing major contributory factors such as cardiovascular risk. However, given the magnitude of the problem, these interventions alone are unlikely to be sufficient. Recent advances in understanding principal mechanisms that govern hearing function, together with new drug discovery paradigms designed to identify efficacious therapies, bode well for pharmaceutical intervention. This review surveys various causes of loss of auditory function and discusses potential neurological underpinnings, including mitochondrial dysfunction. Mitochondria mitigate cell protection, survival, and function and may succumb to cumulative degradation of energy production and performance; the end result is cell death. Energy-demanding neurons and vestibulocochlear hair cells are vulnerable to mitochondrial dysfunction, and hearing impairment and deafness are characteristic of neurodegenerative mitochondrial disease phenotypes. Beyond acting as cellular powerhouses, mitochondria regulate immune responses to infections, and studies of this phenomenon have aided in identifying nuclear factor kappa B and nuclear factor erythroid 2-related factor 2/antioxidant response element signaling as targets for discovery of otologic drugs, respectively, suppressing or upregulating these pathways. Treatment with free radical scavenging antioxidants is one therapeutic approach, with lipoic acid and corresponding carnitine esters exhibiting improved biodistribution and other features showing promise. These compounds are also histone deacetylase (HDAC) inhibitors, adding epigenetic modulation to the mechanistic milieu through which they act. These data suggest that new drugs targeting mitochondrial dysfunction and modulating epigenetic pathways via HDAC inhibition or other mechanisms hold great promise.

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Anosmia: Differential Diagnosis, Evaluation, and Management

Cited by 46 publications

References 83 publications

Olfactory and Gustatory Dysfunctions In 100 Patients Hospitalized For Covid-19: Sex Differences and Recovery Time In Real-Life

Olfactory and Gustatory Dysfunctions In 100 Patients Hospitalized For Covid-19: Sex Differences and Recovery Time In Real-Life

Olfactory Dysfunction in the COVID-19 Outbreak

A New Approach to Treating Neurodegenerative Otologic Disorders

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