Olfactory Dysfunction in COVID-19 Patients Who Do Not Report Olfactory Symptoms: A Pilot Study with Some Suggestions for Dentists

Favero, Riccardo; Hajrulla, Silva; Bordin, Anna; Mucignat‐Caretta, Carla; Gaudioso, Piergiorgio; Scarpa, Bruno; Favero, Lorenzo; Ottaviano, Giancarlo

doi:10.3390/ijerph19031036

Cited by 5 publications

(5 citation statements)

References 48 publications

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“…Likely, the subjective perception of olfactory impairment (i.e., using VAS for smell) may lead to poor or absent correlation with the results of olfactory tests [ 16 , 17 ], so a smell test should always be associated with a PROM for smell in order to better define the presence of dysosmia and its severity [ 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab

Ottaviano

Corso

Cantone

et al. 2023

JPM

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Chronic rhinosinusitis with nasal polyps (CRSwNP) in the most severe forms is associated with a poor quality of life. Dupilumab has been suggested as an add-on treatment option for severe CRSwNP. Severe CRSwNP patients treated with dupilumab in different rhinological units were followed up at 1, 3, 6 and 12 months from the first administration and were considered for this study. At baseline (T0) and at each follow-up, patients underwent nasal endoscopy and completed the sinonasal outcome test (SNOT)-22, a visual analogue scale (VAS) for smell/nasal obstruction, peak nasal inspiratory flow (PNIF) and the Sniffin’ Sticks identification test (SSIT). The aim of the present study was to evaluate the effects of dupilumab in patients with severe uncontrolled CRSwNP on recovering nasal obstruction and smell impairment. Moreover, the method between PNIF and SSIT with the highest correlation with patients’ response to dupilumab was evaluated. One hundred forty-seven patients were included. All parameters improved during treatment (p < 0.001). At T0, no correlations were found between PNIF and nasal symptoms. Nevertheless, during the following evaluations significant correlations between PNIF changes and both nasal symptoms and NPS were observed (p < 0.05). At T0, SSIT did not correlate with SNOT-22. Similarly to PNIF, during the follow-up SSIT changes significantly correlated with nasal symptom and NPS (p < 0.05). Comparing PNIF and SSIT correlations with SNOT-22 and NPS, PNIF showed a higher correlation with both. Dupilumab improves nasal obstruction and the sense of smell. PNIF and SSIT are effective tools in monitoring patients’ response to dupilumab.

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Section: Introductionmentioning

confidence: 99%

Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab

Ottaviano

Corso

Cantone

et al. 2023

JPM

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“…Some of the latter patients might have had OD in addition to other more severe neurological symptoms. Moreover, since the olfactory loss was self-reported and not assessed by any objective test, OD prevalence might have been underestimated, as reported in previous studies [ 9 , 36 ]. Our results, along with a previous study finding no difference in OB volume between COVID-19 patients with and without self-reported olfactory loss [ 37 ], suggest that OB atrophy may be associated with the neurological sequelae of COVID-19, even without leading to (self-perceivable) olfactory loss, supporting the hypothesis of SARS-CoV-2 using the olfactory pathway as a gateway to the brain.…”

Section: Discussionmentioning

confidence: 97%

MRI evidence of olfactory system alterations in patients with COVID-19 and neurological symptoms

et al. 2023

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Background and objective Despite olfactory disorders being among the most common neurological complications of coronavirus disease 2019 (COVID-19), their pathogenesis has not been fully elucidated yet. Brain MR imaging is a consolidated method for evaluating olfactory system’s morphological modification, but a few quantitative studies have been published so far. The aim of the study was to provide MRI evidence of olfactory system alterations in patients with COVID-19 and neurological symptoms, including olfactory dysfunction. Methods 196 COVID-19 patients (median age: 53 years, 56% females) and 39 controls (median age 55 years, 49% females) were included in this cross-sectional observational study; 78 of the patients reported olfactory loss as the only neurological symptom. MRI processing was performed by ad-hoc semi-automatic processing procedures. Olfactory bulb (OB) volume was measured on T2-weighted MRI based on manual tracing and normalized to the brain volume. Olfactory tract (OT) median signal intensity was quantified on fluid attenuated inversion recovery (FLAIR) sequences, after preliminary intensity normalization. Results COVID-19 patients showed significantly lower left, right and total OB volumes than controls ( p < 0.05). Age-related OB atrophy was found in the control but not in the patient population. No significant difference was found between patients with olfactory disorders and other neurological symptoms. Several outliers with abnormally high OT FLAIR signal intensity were found in the patient group. Conclusions Brain MRI findings demonstrated OB damage in COVID-19 patients with neurological complications. Future longitudinal studies are needed to clarify the transient or permanent nature of OB atrophy in COVID-19 pathology. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s00415-023-11561-0.

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“…We have previously reported that taste test results remain consistent across different ages for both males and females. Recent reports have highlighted cases demonstrating anomalies in the sense of taste and smell due to the COVID-19 epidemic [7][8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…Other researchers have reported a decline in the sense of smell and taste as an early symptom of Alzheimer's dementia [6]. Additionally, other researchers have reported that having COVID-19 affects one's sense of smell and taste [7][8][9][10][11][12][13][14][15][16]. This time, we decided to compare the data of the same participants in the health checkup for residents of Yakumo Town, Hokkaido, Japan, which we have been conducting for many years, to examine whether the sense of taste and smell changed before and after the COVID-19 epidemic.…”

Section: Introductionmentioning

confidence: 99%

Comparison of The Salty Taste Test Results, The Olfactory Test Results, and Questionnaire Survey Results before the COVID-19 Epidemic (2019) and after the COVID-19 Epidemic (2022) in The Medical Examination for Residents of Yakumo Town, Hokkaido, Japan in the Same 100 Participants

Katayama

2023

J Health Care and Research

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Since 2005, we have conducted a questionnaire survey on taste and olfaction, the salty taste test, and the olfactory test in Yakumo Town, Hokkaido, Japan. However, due to the COVID-19 epidemic, resident screening was canceled in 2020 and 2021. We investigated the potential impact of COVID-19 by comparing results from the salty taste test, olfactory tests, and questionnaire surveys. Data were analyzed for a total of 100 individuals, 42 males, and 58 females, who underwent screening in both 2019 and 2022. The questionnaire survey included items regarding the subjective presence or absence of dizziness, tinnitus, headache, taste, smell, and saliva secretion. Furthermore, we obtained results from a salty taste test using the Solsave kit (manufactured by Advantech) and olfactory test results using the smell stick kit (manufactured by Daiichi Kogyo Co., Ltd.). Consequently, when comparing the results of the olfactory test between 2019 and 2022 for 42 males, a statistically significant difference (p = 0.004) emerged. The ability to understand odors was more challenging in 2022 compared to 2019. Specifically, distinguishing between the odors of perfume (p = 0.044), menthol (p = 0.032), mandarin orange (p = 0.032), and fried garlic (p = 0.019) proved to be difficult. Similarly, in the comparison of 2019 and 2022 for 58 females, there was a statistically significant difference (p = 0.033) in olfactory test results, indicating that comprehending odors was more difficult in 2022 than in 2019. Particularly, distinguishing between the odors of perfume (p = 0.026), mandarin orange (p = 0.026), and condensed milk (p = 0.018) presented challenges. There was no statistically significant difference in the results of the salty taste test and questionnaire survey for both males and females. To determine whether the observed changes in olfactory sense are due to aging changes over the three years or the effects of COVID-19, ongoing investigation is crucial. It is necessary to continue assessing whether this diminished sense of smell will recover in the future.

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Olfactory Dysfunction in COVID-19 Patients Who Do Not Report Olfactory Symptoms: A Pilot Study with Some Suggestions for Dentists

Cited by 5 publications

References 48 publications

Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab

Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab

MRI evidence of olfactory system alterations in patients with COVID-19 and neurological symptoms

Comparison of The Salty Taste Test Results, The Olfactory Test Results, and Questionnaire Survey Results before the COVID-19 Epidemic (2019) and after the COVID-19 Epidemic (2022) in The Medical Examination for Residents of Yakumo Town, Hokkaido, Japan in the Same 100 Participants

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