COVID-19-associated anosmia: Difference between revisions

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{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo M.D.]]
{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo M.D.]]


{{SK}}  
{{SK}}[[anosmia]], olfactory dysfunction, [[SARS-CoV-2]], [[dysgeusia]]


==Overview==
==Overview==
[[Anosmia]] has been formally recognized as a characteristic [[symptom]] of [[COVID-19]] [[infection]], and may be the most common [[Sign (medicine)|sign]] of [[infection]] due to this [[Virus (biology)|virus]].<ref name="pmid32277751" />
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 (medicine)|sign]] of [[infection]] due to this [[Virus (biology)|virus]].<ref name="pmid32277751" />
 
[[Anosmia]] may appear without any other [[Symptom|symptoms]] or [[Medical sign|signs]] in patients with [[COVID-19]] [[infection]].<ref name="pmid322777512" />


The extent of potential [[olfactory]] [[dysfunction]] due to [[COVID-19]] is still unclear.<ref name="pmid32563019" />
The extent of potential [[olfactory]] [[dysfunction]] due to [[COVID-19]] is still unclear.<ref name="pmid32563019" />
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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 or passive diffusion of released viral particles.<ref name="pmid29925652" />
*<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 or passive diffusion of released viral particles.<ref name="pmid29925652" />
*<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/>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>


==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" />


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" />
* 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>
 
 
* 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" />


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


Approximately 98% of patients with [[anosmia]] related to [[COVID-19]] recover within 28 days.<ref name="pmid32563019" /><ref name="pmid323055632" />
* [[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>


==Diagnosis==
==Diagnosis==
===Diagnostic Study of Choice===
===Diagnostic Study of Choice===
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 />
* [[Olfaction|Olfactory]] [[Function (biology)|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 [[Olfaction|olfactory]] [[Function (biology)|function]] tests have been disregarded.<ref name="pmid32563019" /><br />


===History and Symptoms===
===History and Symptoms===
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*[[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>
*[[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 184: Line 191:


===Laboratory Findings===
===Laboratory Findings===
<br />
 
* [[Laboratory diagnosis of virus|Laboratory testing]] and self-isolation should be made in patients who present [[anosmia]], even as a sole [[symptom]].<ref name="pmid32563019" /><br />


===Electrocardiogram===
===Electrocardiogram===
Line 196: Line 204:


===CT scan===
===CT scan===
<br />
 
* [[Computed tomography|CT scan]] imaging to the [[nasal cavity]] and [[sinus]] may be used to exclude other causes, for example, a case report that revealed [[Inflammation|inflammatory]] blockage of the olfactory cleft in one patient.<ref name="pmid32563019" />


===MRI===
===MRI===
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==Treatment==
==Treatment==
===Medical Therapy===
===Medical Therapy===
<br />
 
* [[Oral steroids]] may be used in patients with [[anosmia]] related to [[COVID-19]], when duration exceeds 2 weeks.<ref name="pmid322777512" />
* Olfactory training suggest small to moderate benefit for patients with post-viral [[Olfaction|olfactory]] [[dysfunction]].<ref name="pmid322777512">{{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>
* [[Alpha lipoic acid]],<ref name="pmid12439184">{{cite journal |vauthors=Hummel T, Heilmann S, Hüttenbriuk KB |title=Lipoic acid in the treatment of smell dysfunction following viral infection of the upper respiratory tract |journal=Laryngoscope |volume=112 |issue=11 |pages=2076–80 |date=November 2002 |pmid=12439184 |doi=10.1097/00005537-200211000-00031 |url=}}</ref> [[omega-3]] supplementation,<ref name="pmid319501562">{{cite journal |vauthors=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 |title=Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial |journal=Neurosurgery |volume= |issue= |pages= |date=January 2020 |pmid=31950156 |doi=10.1093/neuros/nyz559 |url=}}</ref> and intranasal [[Vitamin A derivatives|vitamin A]]<ref name="pmid28040824">{{cite journal |vauthors=Sorokowska A, Drechsler E, Karwowski M, Hummel T |title=Effects of olfactory training: a meta-analysis |journal=Rhinology |volume=55 |issue=1 |pages=17–26 |date=March 2017 |pmid=28040824 |doi=10.4193/Rhin16.195 |url=}}</ref> have been shown to improve objective tests of [[Olfaction|olfactory]] recovery in a small uncontrolled studies of patients with [[COVID-19]] related [[anosmia]], although, further investigation is needed before these therapies can be widely recomended.<ref name="pmid322777512" /><br />


===Surgery===
===Surgery===
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===Primary Prevention===
===Primary Prevention===
<br />
 
* Telemedicine in [[otorhinolaryngology]] may be a good strategy for reducing [[cross-infection]] [[COVID-19]] in physicians.<ref name="pmid32563019" /><ref name="MengDai2020">{{cite journal|last1=Meng|first1=Xiangming|last2=Dai|first2=Zhiyong|last3=Hang|first3=Chao|last4=Wang|first4=Yangyang|title=Smartphone-enabled wireless otoscope-assisted online telemedicine during the COVID-19 outbreak|journal=American Journal of Otolaryngology|volume=41|issue=3|year=2020|pages=102476|issn=01960709|doi=10.1016/j.amjoto.2020.102476}}</ref> <br />


===Secondary Prevention===
===Secondary Prevention===
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 />
 
* Self-administered [[Olfaction|olfactory]] [[Function (biology)|function]] tests can help the early detection of [[COVID-19]] and [[Isolation (health care)|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==

Revision as of 22:09, 3 July 2020

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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: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.[1]

Anosmia may appear without any other symptoms or signs in patients with COVID-19 infection.[2]

The extent of potential olfactory dysfunction due to COVID-19 is still unclear.[3]

Historical Perspective

Classification

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

Pathophysiology

Causes


Differentiating COVID-19-associated anosmia from other Diseases

Epidemiology and Demographics

Prevalence of anosmia in patients with COVID-19[3]
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.[4] 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


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


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. ↑ 2.0 2.1 2.2 2.3 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).
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 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).
  4. ↑ 4.0 4.1 4.2 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.
  5. ↑ "[2004.09338] Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis".
  6. ↑ 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.
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  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. ↑ 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).
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  16. ↑ 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.
  17. ↑ 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.
  18. ↑ 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.
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  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. ↑ 35.0 35.1 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.
  36. ↑ 36.0 36.1 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.
  37. ↑ 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)
  38. ↑ 38.0 38.1 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)
  39. ↑ "www.entuk.org" (PDF).
  40. ↑ 40.0 40.1 "AAO-HNSF 2020 Annual Meeting & OTO Experience | American Academy of Otolaryngology-Head and Neck Surgery".
  41. ↑ 41.0 41.1 41.2 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).
  42. ↑ 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).
  43. ↑ 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.
  44. ↑ 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.
  45. ↑ "Neue Corona-Symptome entdeckt: Virologe Hendrik Streeck zum Virus".
  46. ↑ 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).
  47. ↑ 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.
  48. ↑ 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.
  49. ↑ 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.
  50. ↑ 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.
  51. ↑ 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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