Olfactory bulb and mucosa abnormalities in persistent COVID‐19‐induced anosmia: a magnetic resonance imaging study

Tsivgoulis, Georgios; Fragkou, Paraskevi C.; Lachanis, Stefanos; Palaiodimou, Lina; Lambadiari, Vaia; Papathanasiou, Matilda; Sfikakis, Petros P.; Voumvourakis, Konstantinos; Tsiodras, Sotirios

doi:10.1111/ene.14537

Cited by 47 publications

(66 citation statements)

References 5 publications

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“…Interestingly, SARS-CoV-2 can infect the olfactory epithelium 13, 14 , including olfactory sensory neurons, support cells and immune cells, that express the viral entry receptors ACE2 and TMPRSS2 13, 15, 16 . Here, the virus can persist long and induce local inflammation 14 and olfactory bulb abnormalities 17, 18, 19 . In agreement, the loss of smell and taste can persist in individuals even with RT-PCR SARS-CoV-2 negativity in the nasopharyngeal swab 14, 20 .…”

Section: Discussionmentioning

confidence: 99%

The antibody response to SARS-CoV-2 infection persists over at least 8 months in symptomatic patients

Levi

Ubaldi

Pozzi

et al. 2021

Preprint

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The factors involved in the persistence of antibodies to SARS-CoV-2 are unknown. We evaluated the antibody response to SARS-CoV-2 in personnel from 10 healthcare facilities and its association with individuals' characteristics and COVID-19 symptoms in an observational study. We enrolled 4735 subjects (corresponding to 80% of all personnel) over a period of 5 months when the spreading of the virus was drastically reduced. For each participant, we determined the rate of antibody increase or decrease over time in relation to 93 features analyzed in univariate and multivariate analyses through a machine learning approach. In individuals positive for IgG (>= 12 AU/mL) at the beginning of the study, we found an increase [p= 0.0002] in antibody response in symptomatic subjects, particularly with anosmia/dysgeusia (OR 2.75, 95% CI 1.753 - 4.301), in a multivariate logistic regression analysis. This may be linked to the persistence of SARS-CoV-2 in the olfactory bulb.

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Section: Discussionmentioning

confidence: 99%

The antibody response to SARS-CoV-2 infection persists over at least 8 months in symptomatic patients

Levi

Ubaldi

Pozzi

et al. 2021

Preprint

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“…It is suggested that viremia and invasion of brain and olfactory bulb leads to anosmia (159). Imaging studies of the olfactory bulb have revealed that olfactory cleft and olfactory bulb abnormalities are present in patients with persistent COVID-19 anosmia, and that a majority of such patients have olfactory bulb atrophy and degeneration (24,76). One-third of the COVID-19 survivors had cognitive and/or motor impairment at their discharge from hospital (167).…”

Section: -F) Neurologicmentioning

confidence: 99%

<strong>Long COVID, A Comprehensive Systematic Scoping Review</strong>

Akbarialiabad¹,

Taghrir²,

Abdollahi³

et al. 2021

Preprint

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Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute-COVID-19. The condition has heterogeneously been named as Chronic COVID syndrome, Post COVID-19 Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called “Long COVID” were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

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“…Available literature supports spontaneous improvement with a mean duration of 2-3 weeks [23,24]. However, cases with symptoms lasting more than 1 month, so called persistent anosmia, have also been reported [25][26][27]. Considering the fact that olfactory epithelium undergoes regeneration over 6-8 weeks, SARS-COV2 may result in anosmia longer than 2-3 weeks due to the epithelia damage caused [28].…”

Section: Clinical Features Of Covid-19 Anosmiamentioning

confidence: 99%

The temporal course of COVID-19 anosmia and relation to other clinical symptoms

Altundağ

Saatçi²,

Şanlı

et al. 2020

Eur Arch Otorhinolaryngol

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Objective This study aimed to define the clinical course of anosmia in relation to other clinical symptoms. Methods 135 patients with COVID-19 were reached by phone and subsequently included in the study. Olfactory functions were evaluated using a questionnaire for assessment of self-reported olfactory function. Patients were divided into four subgroups according to the presence of olfactory symptoms and temporal relationship with the other symptoms: group1 had only olfactory complaints (isolated, sudden-onset loss of smell); group2 had sudden-onset loss of smell, followed by COVID-19 related complaints; group3 initially had COVID-19 related complaints, then gradually developed olfactory complaints; and group4 had no olfactory complaints. Results In total, 59.3% of the patients interviewed had olfactory complaints during the disease course. The olfactory dysfunction severity during COVID-19 infection was significantly higher in group1 compared to groups 2 and 3. In groups1-3, the odor scores after recovery from COVID-19 disease were significantly lower compared to the status prior to disease onset. The residual olfactory dysfunction was similar between groups1 and 2, but was more evident than group3. Mean duration for loss of smell was 7.8 ± 3.1 (2-15) days. Duration of loss of smell was longer in groups1 and 2 than in group3. Odor scores completely returned back to the pre-disease values in 41 (51.2%) patients with olfactory dysfunction. Rate of complete olfactory dysfunction recovery was higher in group3 compared to groups1 and 2. Conclusion In isolated anosmia cases, anosmia is more severe, and complete recovery rates are lower compared to the patients who have other clinical symptoms. Level of evidence Level 4.

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Olfactory bulb and mucosa abnormalities in persistent COVID‐19‐induced anosmia: a magnetic resonance imaging study

Cited by 47 publications

References 5 publications

The antibody response to SARS-CoV-2 infection persists over at least 8 months in symptomatic patients

The antibody response to SARS-CoV-2 infection persists over at least 8 months in symptomatic patients

<strong>Long COVID, A Comprehensive Systematic Scoping Review</strong>

The temporal course of COVID-19 anosmia and relation to other clinical symptoms

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