Potential pathogenesis of ageusia and anosmia in COVID‐19 patients

Vaira, Luigi Angelo; Salzano, Giovanni; Fois, Alessandro Giuseppe; Piombino, Pasquale; Riu, Giacomo De

doi:10.1002/alr.22593

Cited by 240 publications

(278 citation statements)

References 25 publications

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“…The damage SARS-CoV-2 in icts on taste and smell must be different from that of other viruses, but the pathophysiological mechanisms are largely unknown. Gilani et al [7] hypothesized that the mechanism of injury is similar to that of other coronaviruses infections that cause central and peripheral neurologic de cits, but we agree with Vaira et al [8] when they suggest that, given the high rate of rapid recovery, it is reasonable to hypothesize that the OD is not related to de nitive damage from the virus to the neuronal cells, and a damage to other cell types appears more likely. In case of SARS-CoV-2-induced anosmia, magnetic resonance imaging of the olfactory bulb did not show abnormal ndings regarding its volume or signal intensity [9].…”

Section: Resultssupporting

confidence: 77%

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: Resultssupporting

confidence: 77%

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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“…The continued improvement of chemosensory function during the whole observation period suggests a pathogenetic mechanism linked to interference of the virus on the taste and smell receptors or to local inflammatory phenomena, rather than central nervous system invasion and permanent neuronal damage. [22][23][24][25] We did not find any predictive factors for the persistence of chemosensitive disorders (Table 3), but our sample may be too small. Larger studies will be needed to determine whether there are predisposing factors for developing long-lasting severe chemosensitive disorders.…”

Section: Discussionmentioning

confidence: 65%

Smell and taste recovery in coronavirus disease 2019 patients: a 60-day objective and prospective study

et al. 2020

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Background The long-term recovery rate of chemosensitive functions in coronavirus disease 2019 patients has not yet been determined. Method A multicentre prospective study on 138 coronavirus disease 2019 patients was conducted. Olfactory and gustatory functions were prospectively evaluated for 60 days. Results Within the first 4 days of coronavirus disease 2019, 84.8 per cent of patients had chemosensitive dysfunction that gradually improved over the observation period. The most significant increase in chemosensitive scores occurred in the first 10 days for taste and between 10 and 20 days for smell. At the end of the observation period (60 days after symptom onset), 7.2 per cent of the patients still had severe dysfunctions. The risk of developing a long-lasting disorder becomes significant at 10 days for taste (odds ratio = 40.2, 95 per cent confidence interval = 2.204–733.2, p = 0.013) and 20 days for smell (odds ratio = 58.5, 95 per cent confidence interval = 3.278–1043.5, p = 0.005). Conclusion Chemosensitive disturbances persisted in 7.2 per cent of patients 60 days after clinical onset. Specific therapies should be initiated in patients with severe olfactory and gustatory disturbances 20 days after disease onset.

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“…A recent study by Brann et al 80 showed that ACE2 and a protease involved in the viral endocytosis called TMPRSS2 are expressed in the olfactory mucosa, but not (or weakly) in the olfactory receptors neurons. Additionally, anosmia symptoms usually disappear within 1–2 weeks, 81 which exclude neural damage as a cause of the lack of smell and suggest a non-neural cause of anosmia.…”

Section: Resultsmentioning

confidence: 99%

“…Other possibility of lack of taste may be attributable to the simultaneous manifestation of anosmia, as these two sensory systems are associated. 81 …”

Section: Resultsmentioning

confidence: 99%

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Pousa¹,

Mendonça²,

Oliveira³

et al. 2021

Jornal de Pediatria

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Objective The aim of this review was to summarize the most common extrapulmonary manifestations in pediatric patients with COVID-19, as well as to discuss clinical, epidemiological, and pathophysiological aspects of these clinical presentations in children. Source of data An extensive search of literature was performed in order to identify pediatric cases with extrapulmonary manifestations between January 1, 2020 and June 21, 2020. Generic keywords, such as “Novel coronavirus” or “Novel coronavirus 2019” or “2019 nCoV” or “COVID-19” or “SARS-CoV-2” were searched on PubMed database, associated either with age filters or generic pediatric terms. Summary of findings A total of 28 articles, including 199 patients, were considered suitable to review and data extraction. The main findings were summarized in tables. The main non-pulmonary manifestations in pediatric patients, in decreasing order of frequency, were gastrointestinal, renal, cardiovascular, neurological, hematological and lymphatic, cutaneous, hepatic, ocular, olfactory, and gustatory. Multisystem impairment and Kawasaki-like disease were also described. Conclusions Differences in immune response of children and variations of tissue expression of angiotensin converting enzyme 2, the virus receptor, are likely to influence clinical, epidemiological, and pathophysiological patterns of the disease.

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Potential pathogenesis of ageusia and anosmia in COVID‐19 patients

Cited by 240 publications

References 25 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

Smell and taste recovery in coronavirus disease 2019 patients: a 60-day objective and prospective study

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

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