Olfactory epithelium histopathological findings in long-term coronavirus disease 2019 related anosmia

Vaira, Luigi Angelo; Hopkins, Claire; Sandison, Ann; Manca, Alessia; Machouchas, Nikolaos; Turilli, D; Lechien, Jérôme R.; Barillari, Maria Rosaria; Salzano, Giovanni; Cossu, Antonio; Saussez, Sven; Riu, Giacomo De

doi:10.1017/s0022215120002455

Cited by 77 publications

(87 citation statements)

References 37 publications

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“…It has been hypothesized that the higher prevalence in women and those of a younger age, reported by some authors, could be related to a more intense inflammatory response that occurs in these patients after the spread of the virus in the olfactory epithelium [ 2 , 42 , 43 , 44 , 45 ]. Note that these authors did not assess the olfactory function with objective testing, rendering the conclusion unreliable.…”

Section: Discussionmentioning

confidence: 99%

Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients

et al. 2021

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Background: The objective evaluation of the olfactory function of coronavirus disease 2019 patients is difficult because of logistical and operator-safety problems. For this reason, in the literature, the data obtained from psychophysical tests are few and based on small case series. Methods: A multicenter, cohort study conducted in seven European hospitals between March 22 and August 20, 2020. The Sniffin-Sticks test and the Connecticut Chemosensory Clinical Research Center orthonasal olfaction test were used to objectively evaluate the olfactory function. Results: This study included 774 patients, of these 481 (62.1%) presented olfactory dysfunction (OD): 280 were hyposmic and 201 were anosmic. There was a significant difference between self-reported anosmia/hyposmia and psychophysical test results (p = 0.006). Patients with gastroesophageal disorders reported a significantly higher probability of presenting hyposmia (OR 1.86; p = 0.015) and anosmia (OR 2.425; p < 0.001). Fever, chest pain, and phlegm significantly increased the likelihood of having hyposmia but not anosmia or an olfactory disturbance. In contrast, patients with dyspnea, dysphonia, and severe-to-critical COVID-19 were significantly more likely to have no anosmia, while these symptoms had no effect on the risk of developing hyposmia or an OD. Conclusions: Psychophysical assessment represents a significantly more accurate assessment tool for olfactory function than patient self-reported clinical outcomes. Olfactory disturbances appear to be largely independent from the epidemiological and clinical characteristics of the patients. The non-association with rhinitis symptoms and the high prevalence as a presenting symptom make olfactory disturbances an important symptom in the differential diagnosis between COVID-19 and common flu.

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Section: Discussionmentioning

confidence: 99%

Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients

et al. 2021

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“…Anosmia, a common presenting symptom, was shown to be associated with T2 hyperintensity and volume loss in the olfactory bulb on MRI, but it remains unclear whether these imaging findings relate to direct viral involvement or post-inflammatory changes (115,116). A recent report of olfactory epithelial biopsy highlighted its disruption, suggesting that direct neural invasion was not the primary culprit in anosmia (117).…”

Section: N P R E S Smentioning

confidence: 99%

COVID-19 Imaging: What We Know Now and What Remains Unknown

et al. 2021

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Essentials • The chest CT and CXR findings of COVID-19 pneumonia and the evolution of findings over time are well described. An organizing pneumonia pattern of lung injury is most common with some patients developing a pattern of diffuse alveolar damage. Patients with few or no symptoms may have normal imaging. • Extent of CXR and CT findings correlates with a variety of clinical indicators and severity of clinical course. However, imaging alone is insufficient to determine outcome. • Classification systems of CT findings related to COVID-19 have high interobserver agreement across levels of experience. Performance will depend on the local prevalence of COVID-19, and their role greatly depends on availability of RT-PCR testing. • AI has shown promise in both diagnosis and prognosis of COVID-19. Larger datasets and prospective studies are needed to assess performance and generalizability. • Cardiovascular complications of COVID-19 include thromboembolic disease, myocarditis, and MIS-C with coronary artery aneurysms. • Abdominal complications of COVID-19 may be the consequence of cardiovascular effects or critical illness rather than direct abdominal organ infection. • Neurologic complications of COVID-19 are not well defined and likely are the result of the cardiovascular effects and not direct CNS infection.

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“…The clinical evolution of loss of smell due to COVID-19 is still unclear as reports of recovery vary significantly, ranging from 4 to 89% a month after the onset of anosmia [ 1 , 2 ]. Studies relying on more reliable data, such as psychophysical testing, showed persistent abnormal olfactory scores in 37% to 52% of patients 5 weeks after onset [ 2 , 3 ]. Loss of smell due to COVID-19 may be more prevalent and severe than in other viral upper respiratory infections.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of oral corticosteroids and olfactory training in the management of COVID-19-related loss of smell

Bon

Konopnicki

Pisarski

et al. 2021

Eur Arch Otorhinolaryngol

113

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Olfactory epithelium histopathological findings in long-term coronavirus disease 2019 related anosmia

Cited by 77 publications

References 37 publications

Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients

Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients

COVID-19 Imaging: What We Know Now and What Remains Unknown

Efficacy and safety of oral corticosteroids and olfactory training in the management of COVID-19-related loss of smell

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