COVID-19-associated anosmia: Difference between revisions

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* [[COVID-19]] ([[SARS-CoV-2]]) [[outbreak]] initiated in December, 2019 in Wuhan, Hubei Province, China.<ref name="pmid32563019">{{cite journal |vauthors=Meng X, Deng Y, Dai Z, Meng Z |title=COVID-19 and anosmia: A review based on up-to-date knowledge |journal=Am J Otolaryngol |volume=41 |issue=5 |pages=102581 |date=June 2020 |pmid=32563019 |pmc=7265845 |doi=10.1016/j.amjoto.2020.102581 |url=}}</ref>
* [[COVID-19]] ([[SARS-CoV-2]]) [[outbreak]] initiated in December, 2019 in Wuhan, Hubei Province, China.<ref name="pmid32563019">{{cite journal |vauthors=Meng X, Deng Y, Dai Z, Meng Z |title=COVID-19 and anosmia: A review based on up-to-date knowledge |journal=Am J Otolaryngol |volume=41 |issue=5 |pages=102581 |date=June 2020 |pmid=32563019 |pmc=7265845 |doi=10.1016/j.amjoto.2020.102581 |url=}}</ref>
*In April 17, 2020 Moein et al. demostrated a pronounced relation of [[olfactory]] [[dysfunction]] in patients with [[COVID-19]] [[infection]].<ref name="MoeinHashemian20202">{{cite journal|last1=Moein|first1=Shima T.|last2=Hashemian|first2=Seyed MohammadReza|last3=Mansourafshar|first3=Babak|last4=Khorram‐Tousi|first4=Ali|last5=Tabarsi|first5=Payam|last6=Doty|first6=Richard L.|title=Smell dysfunction: a biomarker for COVID‐19|journal=International Forum of Allergy & Rhinology|year=2020|issn=2042-6976|doi=10.1002/alr.22587}}</ref>
*In April 17, Shweta et al. used [[Artificial intelligence systems integration|artificial intelligence]] with the most advanced deep neural networks technology at the time, and proved that there was a 28.6-fold probability of having [[anosmia]] in [[COVID-19]]-positive than those negative, and that [[anosmia]]/[[dysgeusia]] was one of the earliest signatures of [[COVID-19]].<ref name="url[2004.09338] Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis">{{cite web |url=https://arxiv.org/abs/2004.09338 |title=[2004.09338] Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis |format= |work= |accessdate=}}</ref><ref name="pmid32563019" />
*In April 22, 2020 a study made by Beltrán-Corbellini et al. proved that the [[incidence]] rate of [[anosmia]] was significantly higher in individuals with [[COVID-19]] (39.2%) patients than those with [[influenza]] (12.5%).<ref name="Beltrán‐CorbelliniChico‐García20202">{{cite journal|last1=Beltrán‐Corbellini|first1=Á.|last2=Chico‐García|first2=J. L.|last3=Martínez‐Poles|first3=J.|last4=Rodríguez‐Jorge|first4=F.|last5=Natera‐Villalba|first5=E.|last6=Gómez‐Corral|first6=J.|last7=Gómez‐López|first7=A.|last8=Monreal|first8=E.|last9=Parra‐Díaz|first9=P.|last10=Cortés‐Cuevas|first10=J. L.|last11=Galán|first11=J. C.|last12=Fragola‐Arnau|first12=C.|last13=Porta‐Etessam|first13=J.|last14=Masjuan|first14=J.|last15=Alonso‐Cánovas|first15=A.|title=Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study|journal=European Journal of Neurology|year=2020|issn=1351-5101|doi=10.1111/ene.14273}}</ref>


==Classification==
==Classification==
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*The [[genome]] sequence of (COVID-19) <nowiki/>[[SARS-CoV-2]] is a 29,903 bp single-stranded [[RNA]].<ref name="pmid32563019" /><ref name="pmid32167747">{{cite journal |vauthors=Baig AM, Khaleeq A, Ali U, Syeda H |title=Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms |journal=ACS Chem Neurosci |volume=11 |issue=7 |pages=995–998 |date=April 2020 |pmid=32167747 |pmc=7094171 |doi=10.1021/acschemneuro.0c00122 |url=}}</ref>
*The [[genome]] sequence of (COVID-19) <nowiki/>[[SARS-CoV-2]] is a 29,903 bp single-stranded [[RNA]].<ref name="pmid32563019" /><ref name="pmid32167747">{{cite journal |vauthors=Baig AM, Khaleeq A, Ali U, Syeda H |title=Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms |journal=ACS Chem Neurosci |volume=11 |issue=7 |pages=995–998 |date=April 2020 |pmid=32167747 |pmc=7094171 |doi=10.1021/acschemneuro.0c00122 |url=}}</ref>
*[[Pathogenicity]], [[virology]], and predi<nowiki/>lection for [[infection]] site are different for every [[virus]]. The main pathogenic site for [[COVID-19]] is [[throat]] and [[nose]].<ref name="pmid32303590">{{cite journal |vauthors=Rockx B, Kuiken T, Herfst S, Bestebroer T, Lamers MM, Oude Munnink BB, de Meulder D, van Amerongen G, van den Brand J, Okba NMA, Schipper D, van Run P, Leijten L, Sikkema R, Verschoor E, Verstrepen B, Bogers W, Langermans J, Drosten C, Fentener van Vlissingen M, Fouchier R, de Swart R, Koopmans M, Haagmans BL |title=Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model |journal=Science |volume=368 |issue=6494 |pages=1012–1015 |date=May 2020 |pmid=32303590 |pmc=7164679 |doi=10.1126/science.abb7314 |url=}}</ref><ref name="pmid32563019" />
*[[Pathogenicity]], [[virology]], and predi<nowiki/>lection for [[infection]] site are different for every [[virus]]. The main pathogenic site for [[COVID-19]] is [[throat]] and [[nose]].<ref name="pmid32303590">{{cite journal |vauthors=Rockx B, Kuiken T, Herfst S, Bestebroer T, Lamers MM, Oude Munnink BB, de Meulder D, van Amerongen G, van den Brand J, Okba NMA, Schipper D, van Run P, Leijten L, Sikkema R, Verschoor E, Verstrepen B, Bogers W, Langermans J, Drosten C, Fentener van Vlissingen M, Fouchier R, de Swart R, Koopmans M, Haagmans BL |title=Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model |journal=Science |volume=368 |issue=6494 |pages=1012–1015 |date=May 2020 |pmid=32303590 |pmc=7164679 |doi=10.1126/science.abb7314 |url=}}</ref><ref name="pmid32563019" />
*[[Viral load|Viral loads]] of COVID-19 are higher<nowiki/> in the [[nasal cavity]] than any other site of [[infection]] ([[throat]], [[lungs]]), both, in [[symptomatic]] and [[asymptomatic]] individuals.<ref name="pmid32074444">{{cite journal |vauthors=Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J |title=SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients |journal=N. Engl. J. Med. |volume=382 |issue=12 |pages=1177–1179 |date=March 2020 |pmid=32074444 |pmc=7121626 |doi=10.1056/NEJMc2001737 |url=}}</ref><ref name="pmid32563019" />
*[[Viral load|Viral loads]] of COVID-19 are higher<nowiki/> in the [[nasal cavity]] than any other site of [[infection]] ([[throat]], [[lungs]]), both, in [[symptomatic]] and [[asymptomatic]] individuals.<ref name="pmid32074444">{{cite journal |vauthors=Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J |title=SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients |journal=N. Engl. J. Med. |volume=382 |issue=12 |pages=1177–1179 |date=March 2020 |pmid=32074444 |pmc=7121626 |doi=10.1056/NEJMc2001737 |url=}}</ref><ref name="pmid32563019" /><br />
 
<br />


*
*
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==Differentiating COVID-19-associated anosmia from other Diseases==
==Differentiating COVID-19-associated anosmia from other Diseases==
<br />
[[Anosmia]] due to [[COVID-19]] [[infection]] may present indenticaly as other [[Anosmia|anosmias]] from [[Upper respiratory infections|upper respiratory viral infections]].<br />


==Epidemiology and Demographics==
==Epidemiology and Demographics==
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* Severe [[Olfaction|olfactory]] loss (complete [[anosmia]]) is estimated to have an estimated [[prevalence]] of around 5% in general population studies (independently of infection).<ref name="pmid32277751" /><ref name="pmid15064632">{{cite journal |vauthors=Brämerson A, Johansson L, Ek L, Nordin S, Bende M |title=Prevalence of olfactory dysfunction: the skövde population-based study |journal=Laryngoscope |volume=114 |issue=4 |pages=733–7 |date=April 2004 |pmid=15064632 |doi=10.1097/00005537-200404000-00026 |url=}}</ref>
* Severe [[Olfaction|olfactory]] loss (complete [[anosmia]]) is estimated to have an estimated [[prevalence]] of around 5% in general population studies (independently of infection).<ref name="pmid32277751" /><ref name="pmid15064632">{{cite journal |vauthors=Brämerson A, Johansson L, Ek L, Nordin S, Bende M |title=Prevalence of olfactory dysfunction: the skövde population-based study |journal=Laryngoscope |volume=114 |issue=4 |pages=733–7 |date=April 2004 |pmid=15064632 |doi=10.1097/00005537-200404000-00026 |url=}}</ref>
*Further studies are requiered to establish the incidence of [[anosmia]] in [[COVID-19]]+ patients.<ref name="pmid32277751" />
*Further studies are requiered to establish the incidence of [[anosmia]] in [[COVID-19]]+ patients.<ref name="pmid32277751" />
*The [[incidence]] of [[anosmia]] related to [[COVID-19]] vary widely from one study to the other:
*The [[prevalence]] of [[anosmia]] related to [[COVID-19]] vary widely from one study to the other among several countries:<ref name="MenniValdes2020">{{cite journal|last1=Menni|first1=Cristina|last2=Valdes|first2=Ana|last3=Freydin|first3=Maxim B|last4=Ganesh|first4=Sajaysurya|last5=El-Sayed Moustafa|first5=Julia|last6=Visconti|first6=Alessia|last7=Hysi|first7=Pirro|last8=Bowyer|first8=Ruth C E|last9=Mangino|first9=Massimo|last10=Falchi|first10=Mario|last11=Wolf|first11=Jonathan|last12=Steves|first12=Claire|last13=Spector|first13=Tim|year=2020|doi=10.1101/2020.04.05.20048421}}</ref>
 
** A  study from Germany described that approximately two thirds of confirmed [[COVID-19]] infections presented [[anosmia]] and [[dysgeusia]] at some point of the [[disease]].<ref name="urlNeue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus">{{cite web |url=https://www.faz.net/aktuell/gesellschaft/gesundheit/coronavirus/neue-corona-symptome-entdeckt-virologe-hendrik-streeck-zum-virus-16681450.html |title=Neue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus |format= |work= |accessdate=}}</ref>
** A study from South Korea, with 3191 mild-[[disease]] patients reported only 15.3% of [[anosmia]] or [[dysgeusia]].<ref name="url[단독]대구 확진자 3191명 중 15%, 후각이나 미각 잃었다 - 중앙일보">{{cite web |url=https://news.joins.com/article/23738003?cloc=joongang-mhomegroup6&fbclid=IwAR33__i-aKtLN2MzCs5A |title=[단독]대구 확진자 3191명 중 15%, 후각이나 미각 잃었다 - 중앙일보 |format= |work= |accessdate=}}</ref>
** In a [[Retrospective study|retrospective]] study made by Klopfenstein et al., 54 (47%) out of 114 confirmed [[COVID-19]] patients presented with [[anosmia]].<ref name="pmid32305563">{{cite journal |vauthors=Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V, Zayet S |title=Features of anosmia in COVID-19 |journal=Med Mal Infect |volume= |issue= |pages= |date=April 2020 |pmid=32305563 |pmc=7162775 |doi=10.1016/j.medmal.2020.04.006 |url=}}</ref>
**Smell  loss (hyposmia or anosmia) were reported in 68% (40/59) of patients with positive COVID-19 infection.<ref name="pmid32279441">{{cite journal |vauthors=Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS |title=Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms |journal=Int Forum Allergy Rhinol |volume= |issue= |pages= |date=April 2020 |pmid=32279441 |pmc=7262089 |doi=10.1002/alr.22579 |url=}}</ref>
**Of 202 individuals with positive COVID-19, altered sense of smell or taste was reported by 130 patients (64.4%).<ref name="pmid32320008">{{cite journal |vauthors=Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C, Boscolo-Rizzo P |title=Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection |journal=JAMA |volume= |issue= |pages= |date=April 2020 |pmid=32320008 |pmc=7177631 |doi=10.1001/jama.2020.6771 |url=}}</ref>
* The [[prevalence]] of  [[anosmia]] in patients with [[COVID-19]] has also varied from one country to another: <ref name="MenniValdes2020">{{cite journal|last1=Menni|first1=Cristina|last2=Valdes|first2=Ana|last3=Freydin|first3=Maxim B|last4=Ganesh|first4=Sajaysurya|last5=El-Sayed Moustafa|first5=Julia|last6=Visconti|first6=Alessia|last7=Hysi|first7=Pirro|last8=Bowyer|first8=Ruth C E|last9=Mangino|first9=Massimo|last10=Falchi|first10=Mario|last11=Wolf|first11=Jonathan|last12=Steves|first12=Claire|last13=Spector|first13=Tim|year=2020|doi=10.1101/2020.04.05.20048421}}</ref>


{| class="wikitable"
{| class="wikitable"
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|April 17, 2020
|April 17, 2020
|Iran
|Iran
|Moein et al.<ref name="MoeinHashemian2020">{{cite journal|last1=Moein|first1=Shima T.|last2=Hashemian|first2=Seyed MohammadReza|last3=Mansourafshar|first3=Babak|last4=Khorram‐Tousi|first4=Ali|last5=Tabarsi|first5=Payam|last6=Doty|first6=Richard L.|title=Smell dysfunction: a biomarker for COVID‐19|journal=International Forum of Allergy & Rhinology|year=2020|issn=2042-6976|doi=10.1002/alr.22587}}</ref>
|Moein et al.<ref name="MoeinHashemian20202" />
|60
|60
|98.33%
|98.33%
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|April 22, 2020
|April 22, 2020
|Iran
|Iran
|Heidari et al.<ref name="HeidariKarimi2020">{{cite journal|last1=Heidari|first1=F.|last2=Karimi|first2=E.|last3=Firouzifar|first3=M.|last4=Khamushian|first4=P.|last5=Ansari|first5=R.|last6=Mohammadi Ardehali|first6=M.|last7=Heidari|first7=F.|title=Anosmia as a Prominent Symptom of COVID-19 Infection|journal=Rhinology journal|volume=58|issue=3|year=2020|pages=302–303|issn=03000729|doi=10.4193/Rhin20.140}}</ref>  
|Heidari et al.<ref name="HeidariKarimi2020">{{cite journal|last1=Heidari|first1=F.|last2=Karimi|first2=E.|last3=Firouzifar|first3=M.|last4=Khamushian|first4=P.|last5=Ansari|first5=R.|last6=Mohammadi Ardehali|first6=M.|last7=Heidari|first7=F.|title=Anosmia as a Prominent Symptom of COVID-19 Infection|journal=Rhinology journal|volume=58|issue=3|year=2020|pages=302–303|issn=03000729|doi=10.4193/Rhin20.140}}</ref>
|23
|23
|69.57%
|69.57%
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|April 22, 2020
|April 22, 2020
|Spain
|Spain
|Beltran-Corbellini et al.<ref name="Beltrán‐CorbelliniChico‐García2020">{{cite journal|last1=Beltrán‐Corbellini|first1=Á.|last2=Chico‐García|first2=J. L.|last3=Martínez‐Poles|first3=J.|last4=Rodríguez‐Jorge|first4=F.|last5=Natera‐Villalba|first5=E.|last6=Gómez‐Corral|first6=J.|last7=Gómez‐López|first7=A.|last8=Monreal|first8=E.|last9=Parra‐Díaz|first9=P.|last10=Cortés‐Cuevas|first10=J. L.|last11=Galán|first11=J. C.|last12=Fragola‐Arnau|first12=C.|last13=Porta‐Etessam|first13=J.|last14=Masjuan|first14=J.|last15=Alonso‐Cánovas|first15=A.|title=Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study|journal=European Journal of Neurology|year=2020|issn=1351-5101|doi=10.1111/ene.14273}}</ref>  
|Beltran-Corbellini et al.<ref name="Beltrán‐CorbelliniChico‐García2020">{{cite journal|last1=Beltrán‐Corbellini|first1=Á.|last2=Chico‐García|first2=J. L.|last3=Martínez‐Poles|first3=J.|last4=Rodríguez‐Jorge|first4=F.|last5=Natera‐Villalba|first5=E.|last6=Gómez‐Corral|first6=J.|last7=Gómez‐López|first7=A.|last8=Monreal|first8=E.|last9=Parra‐Díaz|first9=P.|last10=Cortés‐Cuevas|first10=J. L.|last11=Galán|first11=J. C.|last12=Fragola‐Arnau|first12=C.|last13=Porta‐Etessam|first13=J.|last14=Masjuan|first14=J.|last15=Alonso‐Cánovas|first15=A.|title=Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study|journal=European Journal of Neurology|year=2020|issn=1351-5101|doi=10.1111/ene.14273}}</ref>
|79
|79
|31.65%
|31.65%
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** Advanced [[age]]<ref name="pmid31693018" />
** Advanced [[age]]<ref name="pmid31693018" />
**[[Male]] gender<ref name="pmid31152646" />
**[[Male]] gender<ref name="pmid31152646" />
**Genetic susceptibility
*Susceptibility to [[COVID-19]] [[infection]] is influenced to some degree by the host genotype, making a 47-fold heritability for anosmia.<ref name="pmid32563019" /><ref name="WilliamsFreydin2020">{{cite journal|last1=Williams|first1=Frances MK|last2=Freydin|first2=Maxim|last3=Mangino|first3=Massimo|last4=Couvreur|first4=Simon|last5=Visconti|first5=Alessia|last6=Bowyer|first6=Ruth CE|last7=Le Roy|first7=Caroline I|last8=Falchi|first8=Mario|last9=Sudre|first9=Carole|last10=Davies|first10=Richard|last11=Hammond|first11=Christopher|last12=Menni|first12=Cristina|last13=Steves|first13=Claire|last14=Spector|first14=Tim|year=2020|doi=10.1101/2020.04.22.20072124}}</ref>


==Screening==
==Screening==
Line 171: Line 167:
==Diagnosis==
==Diagnosis==
===Diagnostic Study of Choice===
===Diagnostic Study of Choice===
<br />
Olfactory function test (OFT) has been the study of choice for diagnosis of [[anosmia]] and [[olfactory]] [[dysfunction]].<ref name="OttavianoCarecchio2020">{{cite journal|last1=Ottaviano|first1=G.|last2=Carecchio|first2=M.|last3=Scarpa|first3=B.|last4=Marchese-Ragona|first4=R.|title=Olfactory and rhinological evaluations in SARS-CoV-2 patients complaining of olfactory loss|journal=Rhinology journal|volume=0|issue=0|year=2020|pages=0–0|issn=03000729|doi=10.4193/Rhin20.136}}</ref><ref name="pmid32563019" /><ref name="MoeinHashemian20202" /><ref name="VairaSalzano20202">{{cite journal|last1=Vaira|first1=Luigi Angelo|last2=Salzano|first2=Giovanni|last3=Petrocelli|first3=Marzia|last4=Deiana|first4=Giovanna|last5=Salzano|first5=Francesco Antonio|last6=De Riu|first6=Giacomo|title=Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine|journal=Head & Neck|year=2020|issn=10433074|doi=10.1002/hed.26228}}</ref>
 
In many studies, full olfactory function tests have been disregarded.<ref name="pmid32563019" /><br />


===History and Symptoms===
===History and Symptoms===


* [[Anosmia]] may occur suddenly as the only symptom of [[COVID-19]] in approximately 16% of individuals.<ref name="pmid32277751" /><ref name="pmid32319971">{{cite journal |vauthors=Heidari F, Karimi E, Firouzifar M, Khamushian P, Ansari R, Mohammadi Ardehali M, Heidari F |title=Anosmia as a prominent symptom of COVID-19 infection |journal=Rhinology |volume=58 |issue=3 |pages=302–303 |date=June 2020 |pmid=32319971 |doi=10.4193/Rhin20.140 |url=}}</ref>
* Approximately two thirds of confirmed [[COVID-19]] infections presented [[anosmia]] and [[dysgeusia]] at some point of the [[disease]].<ref name="urlNeue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus">{{cite web |url=https://www.faz.net/aktuell/gesellschaft/gesundheit/coronavirus/neue-corona-symptome-entdeckt-virologe-hendrik-streeck-zum-virus-16681450.html |title=Neue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus |format= |work= |accessdate=}}</ref>
 
*[[Anosmia]] may occur suddenly as the only symptom of [[COVID-19]] in approximately 16% of individuals.<ref name="pmid32277751" /><ref name="pmid32319971">{{cite journal |vauthors=Heidari F, Karimi E, Firouzifar M, Khamushian P, Ansari R, Mohammadi Ardehali M, Heidari F |title=Anosmia as a prominent symptom of COVID-19 infection |journal=Rhinology |volume=58 |issue=3 |pages=302–303 |date=June 2020 |pmid=32319971 |doi=10.4193/Rhin20.140 |url=}}</ref>
* In a study, 74.4% reported complete loss of [[smell]].<ref name="pmid32277751" />
* In a study, 74.4% reported complete loss of [[smell]].<ref name="pmid32277751" />
* [[Anosmia]] occurs more commonly after the onset of other [[symptoms]]. In a study involving 1325 participants with anosmia (with no confirmatory [[COVID-19 diagnostic study of choice|COVID-19 test]]), 13% reported [[anosmia]] before their onset, 38.4% at the same time, and in 48.6% after the onset of [[symptoms]].<ref name="pmid32277751" />
*[[Anosmia]] occurs more commonly after the onset of other [[symptoms]]. In a study involving 1325 participants with anosmia (with no confirmatory [[COVID-19 diagnostic study of choice|COVID-19 test]]), 13% reported [[anosmia]] before their onset, 38.4% at the same time, and in 48.6% after the onset of [[symptoms]].<ref name="pmid32277751" />
* A study reports that [[anosmia]] typically developes after 4.4 days of [[COVID-19]] [[infection]].<ref name="pmid323055632">{{cite journal |vauthors=Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V, Zayet S |title=Features of anosmia in COVID-19 |journal=Med Mal Infect |volume= |issue= |pages= |date=April 2020 |pmid=32305563 |pmc=7162775 |doi=10.1016/j.medmal.2020.04.006 |url=}}</ref><ref name="pmid32563019" />
* A study reports that [[anosmia]] typically developes after 4.4 days of [[COVID-19]] [[infection]].<ref name="pmid323055632">{{cite journal |vauthors=Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V, Zayet S |title=Features of anosmia in COVID-19 |journal=Med Mal Infect |volume= |issue= |pages= |date=April 2020 |pmid=32305563 |pmc=7162775 |doi=10.1016/j.medmal.2020.04.006 |url=}}</ref><ref name="pmid32563019" />


Line 218: Line 218:


===Secondary Prevention===
===Secondary Prevention===
<br />
Self-administered olfactory function tests can help the early detection of COVID-19 and isolation.<ref name="pmid32563019" /><ref name="VairaSalzano20203">{{cite journal|last1=Vaira|first1=Luigi Angelo|last2=Salzano|first2=Giovanni|last3=Petrocelli|first3=Marzia|last4=Deiana|first4=Giovanna|last5=Salzano|first5=Francesco Antonio|last6=De Riu|first6=Giacomo|title=Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine|journal=Head & Neck|year=2020|issn=10433074|doi=10.1002/hed.26228}}</ref><br />


==References==
==References==

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo M.D.

Synonyms and keywords:

Overview

Anosmia has been formally recognized as a characteristic symptom of COVID-19 infection, and may be the most common sign of infection due to this virus.[1]

The extent of potential olfactory dysfunction due to COVID-19 is still unclear.[2]

Historical Perspective

Classification

  • There is no established system for the classification of COVID-19 associated anosmia.

Pathophysiology

Causes

Human strains of coronavirus (HCoVs) can infect and spread through the olfactory bulb.[10][1]

Now in day, more than 200 types of viruses are identified to cause anosmia; coronavirus strains (7 of them) are responsable of 10-15% of the cases.[1][13][2]

Differentiating COVID-19-associated anosmia from other Diseases

Anosmia due to COVID-19 infection may present indenticaly as other anosmias from upper respiratory viral infections.

Epidemiology and Demographics

Prevalence of anosmia in patients with COVID-19[2]
Date of publication Country Author Number of patients Prevalence
March 26, 2020 Italy Giacomelli et al.[17] 59 33.9%
March 27, 2020 Iran Bagheri et al.[18] 10,069 48.23%
April 1, 2020 Italy Vaira et al.[19] 320 19.4%
April 6, 2020 European countries Lechien et al.[20] 417 85.6%
April 7, 2020 United Kingdom Menni et al.[21] 579 59.41%
April 12, 2020 United States Yan et al.[22] 59 68%
April 16, 2020 France Klopfenstein et al.[23] 47 47%
April 17, 2020 Iran Moein et al.[3] 60 98.33%
April 22, 2020 United Kingdom Spinato et al.[24] 202 64.4%
April 22, 2020 Iran Heidari et al.[25] 23 69.57%
April 22, 2020 Spain Beltran-Corbellini et al.[26] 79 31.65%
April 24, 2020 United States Yan et al.[27] 169 75.7%
May 1, 2020 Germany Luers et al.[28] 72 74%
May 1, 2020 Italy Vaira et al.[29] 33 75.8%


Risk Factors

Screening


Natural History, Complications, and Prognosis

Anosmia related to COVID-19, typically has a duration of 8.96 days.[2][36]

Approximately 98% of patients with anosmia related to COVID-19 recover within 28 days.[2][36]

Diagnosis

Diagnostic Study of Choice

Olfactory function test (OFT) has been the study of choice for diagnosis of anosmia and olfactory dysfunction.[37][2][3][38]

In many studies, full olfactory function tests have been disregarded.[2]

History and Symptoms

Physical Examination


Laboratory Findings


Electrocardiogram


X-ray


Echocardiography or Ultrasound


CT scan


MRI


Other Imaging Findings


Other Diagnostic Studies


Treatment

Medical Therapy


Surgery


Primary Prevention


Secondary Prevention

Self-administered olfactory function tests can help the early detection of COVID-19 and isolation.[2][41]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Hopkins C, Surda P, Kumar N (June 2020). "Presentation of new onset anosmia during the COVID-19 pandemic". Rhinology. 58 (3): 295–298. doi:10.4193/Rhin20.116. PMID 32277751 Check |pmid= value (help).
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 Meng X, Deng Y, Dai Z, Meng Z (June 2020). "COVID-19 and anosmia: A review based on up-to-date knowledge". Am J Otolaryngol. 41 (5): 102581. doi:10.1016/j.amjoto.2020.102581. PMC 7265845 Check |pmc= value (help). PMID 32563019 Check |pmid= value (help).
  3. ↑ 3.0 3.1 3.2 Moein, Shima T.; Hashemian, Seyed MohammadReza; Mansourafshar, Babak; Khorram‐Tousi, Ali; Tabarsi, Payam; Doty, Richard L. (2020). "Smell dysfunction: a biomarker for COVID‐19". International Forum of Allergy & Rhinology. doi:10.1002/alr.22587. ISSN 2042-6976.
  4. ↑ "[2004.09338] Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis".
  5. ↑ Beltrán‐Corbellini, Á.; Chico‐García, J. L.; Martínez‐Poles, J.; Rodríguez‐Jorge, F.; Natera‐Villalba, E.; Gómez‐Corral, J.; Gómez‐López, A.; Monreal, E.; Parra‐Díaz, P.; Cortés‐Cuevas, J. L.; Galán, J. C.; Fragola‐Arnau, C.; Porta‐Etessam, J.; Masjuan, J.; Alonso‐Cánovas, A. (2020). "Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study". European Journal of Neurology. doi:10.1111/ene.14273. ISSN 1351-5101.
  6. ↑ Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehne A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A (March 2017). "Position paper on olfactory dysfunction". Rhinol. Suppl. 54 (26): 1–30. doi:10.4193/Rhino16.248. PMID 29528615.
  7. ↑ Baig AM, Khaleeq A, Ali U, Syeda H (April 2020). "Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms". ACS Chem Neurosci. 11 (7): 995–998. doi:10.1021/acschemneuro.0c00122. PMC 7094171 Check |pmc= value (help). PMID 32167747 Check |pmid= value (help).
  8. ↑ Rockx B, Kuiken T, Herfst S, Bestebroer T, Lamers MM, Oude Munnink BB, de Meulder D, van Amerongen G, van den Brand J, Okba N, Schipper D, van Run P, Leijten L, Sikkema R, Verschoor E, Verstrepen B, Bogers W, Langermans J, Drosten C, Fentener van Vlissingen M, Fouchier R, de Swart R, Koopmans M, Haagmans BL (May 2020). "Comparative pathogenesis of COVID-19, MERS, and SARS in a nonhuman primate model". Science. 368 (6494): 1012–1015. doi:10.1126/science.abb7314. PMC 7164679 Check |pmc= value (help). PMID 32303590 Check |pmid= value (help). Vancouver style error: initials (help)
  9. ↑ Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J (March 2020). "SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients". N. Engl. J. Med. 382 (12): 1177–1179. doi:10.1056/NEJMc2001737. PMC 7121626 Check |pmc= value (help). PMID 32074444 Check |pmid= value (help).
  10. ↑ 10.0 10.1 10.2 Dubé M, Le Coupanec A, Wong A, Rini JM, Desforges M, Talbot PJ (September 2018). "Axonal Transport Enables Neuron-to-Neuron Propagation of Human Coronavirus OC43". J. Virol. 92 (17). doi:10.1128/JVI.00404-18. PMC 6096804. PMID 29925652. Vancouver style error: initials (help)
  11. ↑ Koyuncu OO, Hogue IB, Enquist LW (April 2013). "Virus infections in the nervous system". Cell Host Microbe. 13 (4): 379–93. doi:10.1016/j.chom.2013.03.010. PMC 3647473. PMID 23601101.
  12. ↑ Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M, Talavera-López C, Maatz H, Reichart D, Sampaziotis F, Worlock KB, Yoshida M, Barnes JL (May 2020). "SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes". Nat. Med. 26 (5): 681–687. doi:10.1038/s41591-020-0868-6. PMID 32327758 Check |pmid= value (help).
  13. ↑ Eccles R (November 2005). "Understanding the symptoms of the common cold and influenza". Lancet Infect Dis. 5 (11): 718–25. doi:10.1016/S1473-3099(05)70270-X. PMC 7185637 Check |pmc= value (help). PMID 16253889.
  14. ↑ Zhu N, Zhang D, Wang W et al. A Novel Welge -Lussen A, Wolfensberger M. (2006). "Olfactory disorders following upper respiratory tract infections". Adv Otorhinolaryngol.
  15. ↑ Brämerson A, Johansson L, Ek L, Nordin S, Bende M (April 2004). "Prevalence of olfactory dysfunction: the skövde population-based study". Laryngoscope. 114 (4): 733–7. doi:10.1097/00005537-200404000-00026. PMID 15064632.
  16. ↑ Menni, Cristina; Valdes, Ana; Freydin, Maxim B; Ganesh, Sajaysurya; El-Sayed Moustafa, Julia; Visconti, Alessia; Hysi, Pirro; Bowyer, Ruth C E; Mangino, Massimo; Falchi, Mario; Wolf, Jonathan; Steves, Claire; Spector, Tim (2020). doi:10.1101/2020.04.05.20048421. Missing or empty |title= (help)
  17. ↑ Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, Rusconi S, Gervasoni C, Ridolfo AL, Rizzardini G, Antinori S, Galli M (March 2020). "Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study". Clin. Infect. Dis. doi:10.1093/cid/ciaa330. PMC 7184514 Check |pmc= value (help). PMID 32215618 Check |pmid= value (help).
  18. ↑ Bagheri, Seyed Hamid Reza; Asghari, Ali Mohammad; Farhadi, Mohammad; Shamshiri, Ahmad Reza; Kabir, Ali; Kamrava, Seyed Kamran; Jalessi, Maryam; Mohebbi, Alireza; Alizadeh, Rafieh; Honarmand, Ali Asghar; Ghalehbaghi, Babak; Salimi, Alireza (2020). doi:10.1101/2020.03.23.20041889. Missing or empty |title= (help)
  19. ↑ Vaira LA, Salzano G, Deiana G, De Riu G (July 2020). "Anosmia and Ageusia: Common Findings in COVID-19 Patients". Laryngoscope. 130 (7): 1787. doi:10.1002/lary.28692. PMC 7228304 Check |pmc= value (help). PMID 32237238 Check |pmid= value (help).
  20. ↑ Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S (April 2020). "Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study". Eur Arch Otorhinolaryngol. doi:10.1007/s00405-020-05965-1. PMC 7134551 Check |pmc= value (help). PMID 32253535 Check |pmid= value (help).
  21. ↑ Menni, Cristina; Valdes, Ana; Freydin, Maxim B; Ganesh, Sajaysurya; El-Sayed Moustafa, Julia; Visconti, Alessia; Hysi, Pirro; Bowyer, Ruth C E; Mangino, Massimo; Falchi, Mario; Wolf, Jonathan; Steves, Claire; Spector, Tim (2020). doi:10.1101/2020.04.05.20048421. Missing or empty |title= (help)
  22. ↑ Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS (April 2020). "Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms". Int Forum Allergy Rhinol. doi:10.1002/alr.22579. PMC 7262089 Check |pmc= value (help). PMID 32279441 Check |pmid= value (help).
  23. ↑ Klopfenstein, T.; Kadiane-Oussou, N.J.; Toko, L.; Royer, P.-Y.; Lepiller, Q.; Gendrin, V.; Zayet, S. (2020). "Features of anosmia in COVID-19". Médecine et Maladies Infectieuses. doi:10.1016/j.medmal.2020.04.006. ISSN 0399-077X.
  24. ↑ Spinato, Giacomo; Fabbris, Cristoforo; Polesel, Jerry; Cazzador, Diego; Borsetto, Daniele; Hopkins, Claire; Boscolo-Rizzo, Paolo (2020). "Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection". JAMA. 323 (20): 2089. doi:10.1001/jama.2020.6771. ISSN 0098-7484.
  25. ↑ Heidari, F.; Karimi, E.; Firouzifar, M.; Khamushian, P.; Ansari, R.; Mohammadi Ardehali, M.; Heidari, F. (2020). "Anosmia as a Prominent Symptom of COVID-19 Infection". Rhinology journal. 58 (3): 302–303. doi:10.4193/Rhin20.140. ISSN 0300-0729.
  26. ↑ Beltrán‐Corbellini, Á.; Chico‐García, J. L.; Martínez‐Poles, J.; Rodríguez‐Jorge, F.; Natera‐Villalba, E.; Gómez‐Corral, J.; Gómez‐López, A.; Monreal, E.; Parra‐Díaz, P.; Cortés‐Cuevas, J. L.; Galán, J. C.; Fragola‐Arnau, C.; Porta‐Etessam, J.; Masjuan, J.; Alonso‐Cánovas, A. (2020). "Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study". European Journal of Neurology. doi:10.1111/ene.14273. ISSN 1351-5101.
  27. ↑ Yan, Carol H.; Faraji, Farhoud; Prajapati, Divya P.; Ostrander, Benjamin T.; DeConde, Adam S. (2020). "Self‐reported olfactory loss associates with outpatient clinical course in COVID‐19". International Forum of Allergy & Rhinology. doi:10.1002/alr.22592. ISSN 2042-6976.
  28. ↑ Heindl, Ludwig M; Lehmann, Clara; Klein, Florian; Dewald, Felix; Augustin, Max; Wawer Matos, Philomena A; Loreck, Niklas; Rokohl, Alexander C; Luers, Jan C (2020). "Olfactory and Gustatory Dysfunction in Coronavirus Disease 19 (COVID-19)". Clinical Infectious Diseases. doi:10.1093/cid/ciaa525. ISSN 1058-4838.
  29. ↑ Vaira, Luigi Angelo; Salzano, Giovanni; Petrocelli, Marzia; Deiana, Giovanna; Salzano, Francesco Antonio; De Riu, Giacomo (2020). "Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine". Head & Neck. doi:10.1002/hed.26228. ISSN 1043-3074.
  30. ↑ 30.0 30.1 Stogbauer J, Wirkner K, Engel C, Moebus S, Pundt N, Teismann H, Loffler M, Hummel T, Beule AG, Berger K (April 2020). "Prevalence and risk factors of smell dysfunction - a comparison between five German population-based studies". Rhinology. 58 (2): 184–191. doi:10.4193/Rhin19.181. PMID 31693018.
  31. ↑ 31.0 31.1 Wang X, Zhang C, Xia X, Yang Y, Zhou C (October 2019). "Effect of gender on odor identification at different life stages: a meta-analysis". Rhinology. 57 (5): 322–330. doi:10.4193/Rhin19.005. PMID 31152646.
  32. ↑ Williams, Frances MK; Freydin, Maxim; Mangino, Massimo; Couvreur, Simon; Visconti, Alessia; Bowyer, Ruth CE; Le Roy, Caroline I; Falchi, Mario; Sudre, Carole; Davies, Richard; Hammond, Christopher; Menni, Cristina; Steves, Claire; Spector, Tim (2020). doi:10.1101/2020.04.22.20072124. Missing or empty |title= (help)
  33. ↑ 33.0 33.1 Robert Pellegrin, Keiland W. Cooper, Antonella Di Pizio, Paule V. Joseph, Surabhi Bhutani, Valentina Parma (2020). "Corona Viruses and the Chemical Senses: Past, Present, and Future". Oxford University. line feed character in |title= at position 40 (help)
  34. ↑ "www.entuk.org" (PDF).
  35. ↑ 35.0 35.1 "AAO-HNSF 2020 Annual Meeting & OTO Experience | American Academy of Otolaryngology-Head and Neck Surgery".
  36. ↑ 36.0 36.1 36.2 Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V, Zayet S (April 2020). "Features of anosmia in COVID-19". Med Mal Infect. doi:10.1016/j.medmal.2020.04.006. PMC 7162775 Check |pmc= value (help). PMID 32305563 Check |pmid= value (help).
  37. ↑ Ottaviano, G.; Carecchio, M.; Scarpa, B.; Marchese-Ragona, R. (2020). "Olfactory and rhinological evaluations in SARS-CoV-2 patients complaining of olfactory loss". Rhinology journal. 0 (0): 0–0. doi:10.4193/Rhin20.136. ISSN 0300-0729.
  38. ↑ Vaira, Luigi Angelo; Salzano, Giovanni; Petrocelli, Marzia; Deiana, Giovanna; Salzano, Francesco Antonio; De Riu, Giacomo (2020). "Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine". Head & Neck. doi:10.1002/hed.26228. ISSN 1043-3074.
  39. ↑ "Neue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus".
  40. ↑ Heidari F, Karimi E, Firouzifar M, Khamushian P, Ansari R, Mohammadi Ardehali M, Heidari F (June 2020). "Anosmia as a prominent symptom of COVID-19 infection". Rhinology. 58 (3): 302–303. doi:10.4193/Rhin20.140. PMID 32319971 Check |pmid= value (help).
  41. ↑ Vaira, Luigi Angelo; Salzano, Giovanni; Petrocelli, Marzia; Deiana, Giovanna; Salzano, Francesco Antonio; De Riu, Giacomo (2020). "Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine". Head & Neck. doi:10.1002/hed.26228. ISSN 1043-3074.


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