COVID-19-associated anosmia: Difference between revisions

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==Historical Perspective==
==Historical Perspective==


* [[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 and was discovered 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>
*On March 12, 2020, the World Health Organization declared the [[COVID-19]] outbreak a [[pandemic]].
*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, 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 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" />
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==Pathophysiology==
==Pathophysiology==


*The pathogenesis of [[anosmia]] associated to [[COVID-19]] is characterized by total loss o<nowiki/>f olfaction due to afection to the [[olfactory bulb]].<ref name="pmid32563019" />
*The extent of potential [[olfactory]] [[dysfunction]] due to [[COVID-19]] is still unclear.<ref name="pmid32563019" /><ref name="pmid29528615">{{cite journal |vauthors=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 |title=Position paper on olfactory dysfunction |journal=Rhinol. Suppl. |volume=54 |issue=26 |pages=1–30 |date=March 2017 |pmid=29528615 |doi=10.4193/Rhino16.248 |url=}}</ref><nowiki/>
*The extent of potential [[olfactory]] [[dysfunction]] due to [[COVID-19]] is still unclear.<ref name="pmid32563019" /><ref name="pmid29528615">{{cite journal |vauthors=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 |title=Position paper on olfactory dysfunction |journal=Rhinol. Suppl. |volume=54 |issue=26 |pages=1–30 |date=March 2017 |pmid=29528615 |doi=10.4193/Rhino16.248 |url=}}</ref><nowiki/>
*Now in day, more than 200 types of [[viruses]] are identified to cause [[anosmia]]; [[coronavirus|coronav]]<nowiki/>[[coronavirus|irus]] [[Strain (biology)|strains]] (7 of them) are responsable of 10-15% of the cases.<ref name="pmid32277751">{{cite journal |vauthors=Hopkins C, Surda P, Kumar N |title=Presentation of new onset anosmia during the COVID-19 pandemic |journal=Rhinology |volume=58 |issue=3 |pages=295–298 |date=June 2020 |pmid=32277751 |doi=10.4193/Rhin20.116 |url=}}</ref><ref name="pmid16253889">{{cite journal |vauthors=Eccles R |title=Understanding the symptoms of the common cold and influenza |journal=Lancet Infect Dis |volume=5 |issue=11 |pages=718–25 |date=November 2005 |pmid=16253889 |pmc=7185637 |doi=10.1016/S1473-3099(05)70270-X |url=}}</ref><ref name="pmid32563019" /> <nowiki/>
*[[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" />
*It is thought that the [[Genotype|genotypes]] o<nowiki/>f A and C [[Strain (biology)|strains]] of [[COVID-19|SARS-Cov]][[COVID-19|-2]] have a greater [[pathogenicity]] for the nasal cavity in humans, this explains the higher [[incidence]] of [[anosmia]] in European countries, where these [[Strain (biology)|strains]] prevail.<ref name="pmid32563019" /><ref name="ForsterForster2020">{{cite journal|last1=Forster|first1=Peter|last2=Forster|first2=Lucy|last3=Renfrew|first3=Colin|last4=Forster|first4=Michael|title=Phylogenetic network analysis of SARS-CoV-2 genomes|journal=Proceedings of the National Academy of Sciences|volume=117|issue=17|year=2020|pages=9241–9243|issn=0027-8424|doi=10.1073/pnas.2004999117}}</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>
*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" />
*[[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 />
*[[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 />


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*It is thought that [[Goblet cell|Goblet cells]] and [[ciliated cells]] of the [[nasal mucosa]] may be the initial site of [[COVID-19]] infection when [[transmission]] is through airway.<ref name="pmid32563019" /><ref name="pmid32327758">{{cite journal |vauthors=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 |title=SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes |journal=Nat. Med. |volume=26 |issue=5 |pages=681–687 |date=May 2020 |pmid=32327758 |doi=10.1038/s41591-020-0868-6 |url=}}</ref>
*It is thought that [[Goblet cell|Goblet cells]] and [[ciliated cells]] of the [[nasal mucosa]] may be the initial site of [[COVID-19]] infection when [[transmission]] is through airway.<ref name="pmid32563019" /><ref name="pmid32327758">{{cite journal |vauthors=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 |title=SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes |journal=Nat. Med. |volume=26 |issue=5 |pages=681–687 |date=May 2020 |pmid=32327758 |doi=10.1038/s41591-020-0868-6 |url=}}</ref>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>Studies suggest that [[viruses]] may propagate from the [[Nasal cavity|nasal cavit]]<nowiki/>y to the [[olfactory bulb]] through neuron-to-neuron [[axonal]] transport, passive diffusion of released viral particles, or hematogenously.<ref name="pmid29925652" /><ref name="CapelliGatti2020">{{cite journal|last1=Capelli|first1=Marco|last2=Gatti|first2=Patrizia|title=Anosmia and COVID-19 in south Lombardy: description of the first cases series in Europe|journal=B-ENT|volume=16|issue=1|year=2020|pages=86–90|issn=26844907|doi=10.5152/B-ENT.2020.20129}}</ref>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>Studies suggest that [[viruses]] may propagate from the [[Nasal cavity|nasal cavit]]<nowiki/>y to the [[olfactory bulb]] through neuron-to-neuron [[axonal]] transport, passive diffusion of released viral particles, or hematogenously.<ref name="pmid29925652" /><ref name="CapelliGatti2020">{{cite journal|last1=Capelli|first1=Marco|last2=Gatti|first2=Patrizia|title=Anosmia and COVID-19 in south Lombardy: description of the first cases series in Europe|journal=B-ENT|volume=16|issue=1|year=2020|pages=86–90|issn=26844907|doi=10.5152/B-ENT.2020.20129}}</ref>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>Several theories have been given to explain the variation of [[Incidence|in]]<nowiki/>[[Incidence|cidence]] of [[Olfaction|olfactory]] [[dysfunction]] among different countries, among these reasons are the [[pathogenicity]] and [[mutation]] capability of [[COVID-19]].<ref name="YaoLu2020">{{cite journal|last1=Yao|first1=Hangping|last2=Lu|first2=Xiangyun|last3=Chen|first3=Qiong|last4=Xu|first4=Kaijin|last5=Chen|first5=Yu|last6=Cheng|first6=Linfang|last7=Liu|first7=Fumin|last8=Wu|first8=Zhigang|last9=Wu|first9=Haibo|last10=Jin|first10=Changzhong|last11=Zheng|first11=Min|last12=Wu|first12=Nanping|last13=Jiang|first13=Chao|last14=Li|first14=Lanjuan|year=2020|doi=10.1101/2020.04.14.20060160}}</ref><ref name="pmid32563019" /><ref name="urlwww.thelancet.com">{{cite web |url=https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30079-5/Abstract |title=www.thelancet.com |format= |work= |accessdate=}}</ref>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>Several theories have been given to explain the variation of [[Incidence|in]]<nowiki/>[[Incidence|cidence]] of [[Olfaction|olfactory]] [[dysfunction]] among different countries, among these reasons are the [[pathogenicity]] and [[mutation]] capability of [[COVID-19]].<ref name="YaoLu2020">{{cite journal|last1=Yao|first1=Hangping|last2=Lu|first2=Xiangyun|last3=Chen|first3=Qiong|last4=Xu|first4=Kaijin|last5=Chen|first5=Yu|last6=Cheng|first6=Linfang|last7=Liu|first7=Fumin|last8=Wu|first8=Zhigang|last9=Wu|first9=Haibo|last10=Jin|first10=Changzhong|last11=Zheng|first11=Min|last12=Wu|first12=Nanping|last13=Jiang|first13=Chao|last14=Li|first14=Lanjuan|year=2020|doi=10.1101/2020.04.14.20060160}}</ref><ref name="pmid32563019" /><ref name="urlwww.thelancet.com">{{cite web |url=https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30079-5/Abstract |title=www.thelancet.com |format= |work= |accessdate=}}</ref><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>It is thought that the [[Genotype|genotypes]] of A and C [[Strain (biology)|strains]] of [[COVID-19|SARS-Cov]]<nowiki/>[[COVID-19|-2]] have a greater [[pathogenicity]] for the nasal cavity in humans, this explains the higher [[incidence]] of [[anosmia]] in European countries, where these [[Strain (biology)|strains]] prevail.<ref name="pmid32563019" /><ref name="ForsterForster2020">{{cite journal|last1=Forster|first1=Peter|last2=Forster|first2=Lucy|last3=Renfrew|first3=Colin|last4=Forster|first4=Michael|title=Phylogenetic network analysis of SARS-CoV-2 genomes|journal=Proceedings of the National Academy of Sciences|volume=117|issue=17|year=2020|pages=9241–9243|issn=0027-8424|doi=10.1073/pnas.2004999117}}</ref>
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>To view the pathophysiology of COVID-19, [[COVID-19 pathophysiology|click here]].
*<nowiki/><nowiki/><nowiki/><nowiki/><nowiki/>To view the pathophysiology of COVID-19, [[COVID-19 pathophysiology|click here]].


==Causes==
==Causes==


* Human [[Strain (biology)|strains]] of [[Coronavirus, SARS associated|coronavirus]] ([[Novel human coronavirus infection|HCoV]]<nowiki/>s) can infect and spread through the [[olfactory bulb]].<ref name="pmid29925652" /><ref name="pmid32277751" /><ref name="pmid172776212">{{cite journal |vauthors=Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S |title=Identification of viruses in patients with postviral olfactory dysfunction |journal=Laryngoscope |volume=117 |issue=2 |pages=272–7 |date=February 2007 |pmid=17277621 |pmc=7165544 |doi=10.1097/01.mlg.0000249922.37381.1e |url=}}</ref>
*[[Anosmia]] associated to [[COVID-19]] is<nowiki/> caused by human [[Strain (biology)|strains]] of [[Coronavirus, SARS associated|coronavirus]] ([[Novel human coronavirus infection|HCoV]]<nowiki/>s) that infect and spread through the [[olfactory bulb]].<ref name="pmid29925652" /><ref name="pmid32277751" /><ref name="pmid172776212">{{cite journal |vauthors=Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S |title=Identification of viruses in patients with postviral olfactory dysfunction |journal=Laryngoscope |volume=117 |issue=2 |pages=272–7 |date=February 2007 |pmid=17277621 |pmc=7165544 |doi=10.1097/01.mlg.0000249922.37381.1e |url=}}</ref>
 


* Now in day, more than 200 types of [[viruses]] are identified to cause [[anosmia]]; [[coronavirus]] [[Strain (biology)|strains]] (7 of them) are responsable of 10-15% of the cases.<ref name="pmid32277751" /><ref name="pmid16253889">{{cite journal |vauthors=Eccles R |title=Understanding the symptoms of the common cold and influenza |journal=Lancet Infect Dis |volume=5 |issue=11 |pages=718–25 |date=November 2005 |pmid=16253889 |pmc=7185637 |doi=10.1016/S1473-3099(05)70270-X |url=}}</ref><ref name="pmid32563019" />
*To view causes of COVID-19, [[COVID-19 causes|click here]].
*To view causes of COVID-19, [[COVID-19 causes|click here]].


==Differentiating COVID-19-associated anosmia from other Diseases==
==Differentiating COVID-19-associated anosmia from other Diseases==


* When differentiating [[anosmia]] due to [[COVID-19]] [[infection]] from other causes, it is important to pay attention into the presentation:
*[[Anosmia]] associated to [[COVID-19]] must be differentiated from other diseases that cause acute [[smell]] loss.
*When differentiating [[anosmia]] due to [[COVID-19]] [[infection]] from other causes, it is important to pay attention into the presentation:
**Acute [[smell]] loss (other [[Upper respiratory infections|upper respiratory viral infections]], head injuries).<ref name="urlAnosmia - StatPearls - NCBI Bookshelf" />
**Acute [[smell]] loss (other [[Upper respiratory infections|upper respiratory viral infections]], head injuries).<ref name="urlAnosmia - StatPearls - NCBI Bookshelf" />
**Chronic [[smell]] loss (normal aging, [[rhinitis]], [[Nasal polyp|nasal polyps]], [[neoplasms]], [[Neurodegenerative disease|neurodegenerative disorders]]).<ref name="urlAnosmia - StatPearls - NCBI Bookshelf" />
**Chronic [[smell]] loss (normal aging, [[rhinitis]], [[Nasal polyp|nasal polyps]], [[neoplasms]], [[Neurodegenerative disease|neurodegenerative disorders]]).<ref name="urlAnosmia - StatPearls - NCBI Bookshelf" />
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==Epidemiology and Demographics==
==Epidemiology and Demographics==


* Postviral [[anosmia]] constitutes 40% of all [[anosmia]] causes in adults.<ref name="pmid32277751">{{cite journal |vauthors=Hopkins C, Surda P, Kumar N |title=Presentation of new onset anosmia during the COVID-19 pandemic |journal=Rhinology |volume=58 |issue=3 |pages=295–298 |date=June 2020 |pmid=32277751 |doi=10.4193/Rhin20.116 |url=}}</ref><ref>{{Cite journal|last=Zhu N, Zhang D, Wang W et al. A Novel Welge -Lussen A, Wolfensberger M.|first=|date=2006|title=Olfactory disorders following upper respiratory tract infections|url=|journal=Adv Otorhinolaryngol|volume=|pages=|via=}}</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" />
*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>
*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>


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|33
|75.8%
|75.8%
|}
|}<br />


* To view screening for COVID-19, [[COVID-19 epidemiology and demographics|click here]].<br />
*Further studies are requiered to establish the [[incidence]] of [[anosmia]] in [[COVID-19]]+ patients.<ref name="pmid32277751" />
*Postviral [[anosmia]] constitutes 40% of all [[anosmia]] causes in adults.<ref name="pmid32277751" /><ref>{{Cite journal|last=Zhu N, Zhang D, Wang W et al. A Novel Welge -Lussen A, Wolfensberger M.|first=|date=2006|title=Olfactory disorders following upper respiratory tract infections|url=|journal=Adv Otorhinolaryngol|volume=|pages=|via=}}</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>
*To view screening for COVID-19, [[COVID-19 epidemiology and demographics|click here]].<br />


==Risk Factors==
==Risk Factors==
Line 181: Line 183:
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


* [[Anosmia]] related to [[COVID-19]], typically has a duration of 8.96 days.<ref name="pmid32563019" /><ref name="pmid323055632" />
* Early clinical features before developing [[anosmia]] related to [[COVID-19]] include [[cough]], [[fever]], and [[Arthralgia|arthralgias]].
*[[Anosmia]] related to [[COVID-19]], typically has a duration of 8.96 days.<ref name="pmid32563019" /><ref name="pmid323055632" />
* Approximately 82% of patients with [[anosmia]] related to [[COVID-19]] recover within 2 weeks and 98% of them within 28 days.<ref name="pmid32563019" /><ref name="pmid323055632" /><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>
* Approximately 82% of patients with [[anosmia]] related to [[COVID-19]] recover within 2 weeks and 98% of them within 28 days.<ref name="pmid32563019" /><ref name="pmid323055632" /><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>
*The intensity and duration of the [[Olfaction|olfactory]] [[disfunction]] associated to [[COVID-19]], is highly variable depending on the capacity and rate of regeneration of the neuroepitielium.<ref name="pmid32466862" />
*The intensity and duration of the [[Olfaction|olfactory]] [[disfunction]] associated to [[COVID-19]], is highly variable depending on the capacity and rate of regeneration of the neuroepitielium.<ref name="pmid32466862" />

Revision as of 05:45, 8 July 2020

WikiDoc Resources for COVID-19-associated anosmia

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List of terms related to COVID-19-associated anosmia

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

Synonyms and keywords:anosmia, olfactory dysfunction, SARS-CoV-2, dysgeusia

Overview

Total or parcial loss of olfactory function (anosmia/hyposmia) 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. Anosmia may appear without any other symptoms or signs in patients with COVID-19 infection. The extent of potential olfactory dysfunction due to COVID-19 is still unclear. Female gender and advanced age are risk factors for developing anosmia related to COVID-19. Anosmia related to COVID-19, typically has a duration of 8.96 days. To view the complete page of COVID-19, click here.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating COVID-19-associated anosmia from other Diseases

Epidemiology and Demographics

Prevalence of anosmia in patients with COVID-19[1]
Date of publication Country Author Number of patients Prevalence
March 26, 2020 Italy Giacomelli et al.[22] 59 33.9%
March 27, 2020 Iran Bagheri et al.[23] 10,069 48.23%
April 1, 2020 Italy Vaira et al.[24] 320 19.4%
April 6, 2020 European countries Lechien et al.[25] 417 85.6%
April 7, 2020 United Kingdom Menni et al.[26] 579 59.41%
April 12, 2020 United States Yan et al.[27] 59 68%
April 16, 2020 France Klopfenstein et al.[28] 47 47%
April 17, 2020 Iran Moein et al.[2] 60 98.33%
April 22, 2020 United Kingdom Spinato et al.[29] 202 64.4%
April 22, 2020 Iran Heidari et al.[30] 23 69.57%
April 22, 2020 Spain Beltran-Corbellini et al.[31] 79 31.65%
April 24, 2020 United States Yan et al.[32] 169 75.7%
May 1, 2020 Germany Luers et al.[33] 72 74%
May 1, 2020 Italy Vaira et al.[34] 33 75.8%


Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

    • Closely inspect the nasal cavity and paranasal sinuses to look for polyps or neoplasms.[20]
    • Complete a neurological examination for neurodegenerative disorders.[20]
    • Do a fundoscopy for evidence of raised intracranial pressure due to head trauma.[20]
    • Do skin prick testing for allergic rhinitis.[20]
  • To view the complete physical examination in COVID-19, click here.

Laboratory Findings

Electrocardiogram

X-ray

  • X-ray imaging to the nasal cavity and sinus (Cadwell and Waters projections) does not demonstrate any typical finidings in patients with anosmia due to COVID-19, but may be used to exclude other causes
  • To view the x-ray finidings on COVID-19, click here.

Echocardiography or Ultrasound

CT scan

MRI

  • MRI imaging to the nasal cavity and sinus does not demonstrate any typical finidings in patients with anosmia due to COVID-19, but may be used to exclude other causes.
  • To view the MRI findings on COVID-19, click here.

Other Imaging Findings

  • Ultrasound imaging to the nasal cavity and sinus does not demonstrate any typical finidings in patients with anosmia due to COVID-19, but may be used to exclude other causes.
  • To view other imaging findings on COVID-19, click here.

Other Diagnostic Studies

  • To view other diagnostic studies for COVID-19, click here.

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention


References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 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).
  2. ↑ 2.0 2.1 2.2 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.
  3. ↑ "[2004.09338] Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis".
  4. ↑ 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.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 Lop Gros J, Iglesias Coma M, González Farré M, Serra Pujadas C (May 2020). "Olfactory dysfunction in COVID-19, a review of the evidence and implications for pandemic management". Acta Otorrinolaringol Esp. doi:10.1016/j.otorri.2020.04.003. PMID 32466862 Check |pmid= value (help).
  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. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 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).
  8. ↑ 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.
  9. ↑ 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)
  10. ↑ Forster, Peter; Forster, Lucy; Renfrew, Colin; Forster, Michael (2020). "Phylogenetic network analysis of SARS-CoV-2 genomes". Proceedings of the National Academy of Sciences. 117 (17): 9241–9243. doi:10.1073/pnas.2004999117. ISSN 0027-8424.
  11. ↑ 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).
  12. ↑ 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).
  13. ↑ 13.0 13.1 13.2 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)
  14. ↑ 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.
  15. ↑ 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).
  16. ↑ Capelli, Marco; Gatti, Patrizia (2020). "Anosmia and COVID-19 in south Lombardy: description of the first cases series in Europe". B-ENT. 16 (1): 86–90. doi:10.5152/B-ENT.2020.20129. ISSN 2684-4907.
  17. ↑ Yao, Hangping; Lu, Xiangyun; Chen, Qiong; Xu, Kaijin; Chen, Yu; Cheng, Linfang; Liu, Fumin; Wu, Zhigang; Wu, Haibo; Jin, Changzhong; Zheng, Min; Wu, Nanping; Jiang, Chao; Li, Lanjuan (2020). doi:10.1101/2020.04.14.20060160. Missing or empty |title= (help)
  18. ↑ "www.thelancet.com".
  19. ↑ Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S (February 2007). "Identification of viruses in patients with postviral olfactory dysfunction". Laryngoscope. 117 (2): 272–7. doi:10.1097/01.mlg.0000249922.37381.1e. PMC 7165544 Check |pmc= value (help). PMID 17277621.
  20. ↑ 20.0 20.1 20.2 20.3 20.4 20.5 20.6 20.7 "Anosmia - StatPearls - NCBI Bookshelf".
  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. ↑ 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).
  23. ↑ 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)
  24. ↑ 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).
  25. ↑ 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).
  26. ↑ 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)
  27. ↑ 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).
  28. ↑ 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.
  29. ↑ 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.
  30. ↑ 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.
  31. ↑ 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.
  32. ↑ 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.
  33. ↑ 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.
  34. ↑ 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.
  35. ↑ 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.
  36. ↑ 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.
  37. ↑ 37.0 37.1 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.
  38. ↑ 38.0 38.1 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.
  39. ↑ 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)
  40. ↑ Nguyen DT, Rumeau C, Gallet P, Jankowski R (April 2016). "Olfactory exploration: State of the art". Eur Ann Otorhinolaryngol Head Neck Dis. 133 (2): 113–8. doi:10.1016/j.anorl.2015.08.038. PMID 26384780.
  41. ↑ Simopoulos E, Katotomichelakis M, Gouveris H, Tripsianis G, Livaditis M, Danielides V (July 2012). "Olfaction-associated quality of life in chronic rhinosinusitis: adaptation and validation of an olfaction-specific questionnaire". Laryngoscope. 122 (7): 1450–4. doi:10.1002/lary.23349. PMID 22566102.
  42. ↑ 42.0 42.1 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)
  43. ↑ "www.entuk.org" (PDF).
  44. ↑ 44.0 44.1 "AAO-HNSF 2020 Annual Meeting & OTO Experience | American Academy of Otolaryngology-Head and Neck Surgery".
  45. ↑ 45.0 45.1 45.2 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).
  46. ↑ 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).
  47. ↑ 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.
  48. ↑ 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.
  49. ↑ Doty RL (2007). "Office procedures for quantitative assessment of olfactory function". Am J Rhinol. 21 (4): 460–73. doi:10.2500/ajr.2007.21.3043. PMID 17882917.
  50. ↑ Joseph T, Auger SD, Peress L, Rack D, Cuzick J, Giovannoni G, Lees A, Schrag AE, Noyce AJ (August 2019). "Screening performance of abbreviated versions of the UPSIT smell test". J. Neurol. 266 (8): 1897–1906. doi:10.1007/s00415-019-09340-x. PMC 6647236 Check |pmc= value (help). PMID 31053960.
  51. ↑ "Neue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus".
  52. ↑ 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).
  53. ↑ 53.0 53.1 53.2 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).
  54. ↑ Hummel T, Heilmann S, Hüttenbriuk KB (November 2002). "Lipoic acid in the treatment of smell dysfunction following viral infection of the upper respiratory tract". Laryngoscope. 112 (11): 2076–80. doi:10.1097/00005537-200211000-00031. PMID 12439184.
  55. ↑ Yan CH, Rathor A, Krook K, Ma Y, Rotella MR, Dodd RL, Hwang PH, Nayak JV, Oyesiku NM, DelGaudio JM, Levy JM, Wise J, Wise SK, Patel ZM (January 2020). "Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial". Neurosurgery. doi:10.1093/neuros/nyz559. PMID 31950156.
  56. ↑ Sorokowska A, Drechsler E, Karwowski M, Hummel T (March 2017). "Effects of olfactory training: a meta-analysis". Rhinology. 55 (1): 17–26. doi:10.4193/Rhin16.195. PMID 28040824.
  57. ↑ Seiden AM (December 2004). "Postviral olfactory loss". Otolaryngol. Clin. North Am. 37 (6): 1159–66. doi:10.1016/j.otc.2004.06.007. PMID 15563908.
  58. ↑ Meng, Xiangming; Dai, Zhiyong; Hang, Chao; Wang, Yangyang (2020). "Smartphone-enabled wireless otoscope-assisted online telemedicine during the COVID-19 outbreak". American Journal of Otolaryngology. 41 (3): 102476. doi:10.1016/j.amjoto.2020.102476. ISSN 0196-0709.
  59. ↑ 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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