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This paper is aimed at comprehensively reviewing olfactory and gustatory disorders caused by SARS-CoV-2 in children and adults. An electronic and manual search was done on three data bases: MEDLINE, Embase, and Web of Science. Inclusion criteria included publications written in English, involving humans in the age range of 0 to 99 years that were captured by a controlled vocabulary of thesaurus terms. Olfactory and gustatory disorders rates in COVID-19 ranged from 22% to 71.9% in adults and 16.6% to 25.8% in children. Olfactory and gustatory disorders might appear as the first symptom, and in adults might even be the only symptom (4.8% to 10%). Anosmia is the most common olfactory disorder and hypogeusia is the most common gustatory disorder. In 33% to 89% of cases, olfactory and gustatory disorders resolve spontaneously within a few weeks, coinciding with the resolution of other COVID-19 symptoms, both in adults and children. However, in some patients, olfactory and gustatory disorders persist beyond the resolution of other symptoms. Notably, children generally experience a swifter and more favorable recovery compared to adults. The precise pathogenesis underlying olfactory and gustatory disorders in the context of COVID-19 remains unclear and is likely multifactorial. Presently, no established treatment protocol exists for olfactory and gustatory disorders and current treatments reviewed lack robust evidence and are not readily available for clinical use. Olfactory training represents the only therapy currently recommended by international authorities. Pediatric practitioners and general dental practitioners should be aware of olfactory and gustatory disorders in both pediatric and adult populations, including their biologic mechanisms, treatment options, and recovery rates. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Method Results Conclusion Implications Impact Reporting Method Patient or Public Contribution To explore trajectories of understanding and managing persistent chemosensory dysfunction after COVID‐19 in patients undergoing clinical treatment.A descriptive qualitative interview study with a realist approach.Data were collected in Sweden, from August 2022 to March 2023 through semi‐structured interviews with 30 patients undergoing treatment for long‐lasting smell and taste dysfunction resulting from COVID‐19. Thematic analysis was applied in a process that involved continuous discussions and refinement of codes into themes and subthemes.Three main themes were identified: (1) Understanding the sensory alterations, which includes subthemes of Searching for validation and Seeking remedies; (2) Practical coping strategies, encompassing Adapted eating and Managing olfactory training and (3) Navigating the emotional landscape, featuring Self‐persuasion and suppression and The ambivalence of acceptance. These themes highlight the cyclic and fluid nature of coping with the dysfunction, reflecting a dynamic process of adaptation. Despite treatment options like olfactory training, participants frequently experienced frustration due to limited perceived improvement and the psychological toll of managing their condition.The study highlights the complex and personal nature of coping with long‐term smell and taste dysfunction post‐COVID‐19. Coping strategies varied widely and evolved over time, reflecting a dynamic process of adaptation. The emotional and psychological impact was profound, underscoring the need for comprehensive treatment approaches that include both physiological and psychological support. There is a need for more effective interventions and support mechanisms to improve the quality of life for those affected by these persistent symptoms.This study contributes to the understanding of COVID‐19's long‐term effects on smell and taste, highlighting the need for ongoing support from health care, further research into effective interventions, and a comprehensive approach to care for individuals affected by these conditions.This study addresses trajectories and challenges of coping with persistent chemosensory dysfunction. Findings emphasise the complexity of managing persistent chemosensory dysfunction and the critical role of personalised care. The study contributes to knowledge for nurses in understanding patients with chemosensory dysfunction.This research adheres to the EQUATOR guidelines: Standards for reporting qualitative research (SRQR).No patient or public contribution. [ABSTRACT FROM AUTHOR]

During its pre-motor stage, Parkinson's disease (PD) presents itself with a multitude of non-motor symptoms with different degrees of specificity and sensitivity. The most important among them are REM sleep behavior disorder (RBD) and olfactory dysfunction. RBD is a parasomnia characterized by the loss of REM sleep muscle atonia and dream-enacting behaviors. Olfactory dysfunction in individuals with prodromal PD is usually described as hyposmia (reduced sense of smell) or anosmia (complete loss of olfactory function). These symptoms can precede the full expression of motor symptoms by decades. A close comprehension of these symptoms and the underlying mechanisms may enable early screening as well as interventions to improve patients' quality of life. Therefore, these symptoms have unmatched potential for identifying PD patients in prodromal stages, not only allowing early diagnosis but potentially opening a window for early, possibly disease-modifying intervention. However, they come with certain challenges. This review addresses some of the key opportunities and pitfalls of both RBD and olfactory dysfunction as early markers of PD. [ABSTRACT FROM AUTHOR]

Purpose: To estimate long-term prognosis of chemosensory dysfunctions among patients recovering from COVID-19 disease. Methods: Between April 2020 and July 2022, we conducted a prospective, observational study enrolling 48 patients who experienced smell and/or taste dysfunction during the acute-phase of COVID-19. Patients were evaluated for chemosensory function up to 24 months after disease onset. Results: During the acute-phase of COVID-19, 80% of patients reported anosmia, 15% hyposmia, 63% ageusia, and 33% hypogeusia. At two years' follow-up, 53% still experienced smell impairment, and 42% suffered from taste impairment. Moreover, 63% of patients who reported parosmia remained with olfactory disturbance. Interestingly, we found a negative correlation between visual analogue scale scores for smell and taste impairments during the acute-phase of COVID-19 and the likelihood of long-term recovery. Conclusion: Our study sheds light on the natural history and long-term follow-up of chemosensory dysfunction in patients recovering from COVID-19 disease. Most patients who initially suffered from smell and/or taste disturbance did not reach full recovery after 2 years follow-up. The severity of impairment may serve as a prognostic indicator for full recovery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the platelet-rich plasma (PRP) effectiveness in patients with a long-lasting postviral olfactory dysfunction (LPOD). Methods: Forty-three consecutive patients with a long-lasting postviral OD were prospectively recruited. The injection of 1 mL of PRP was carried out in both olfactory clefts. The pre- to 6-month post-PRP injection change in olfaction was assessed with the olfactory disorder questionnaire (ODQ) and the threshold, discrimination, and identification (TDI) tests. Results: Forty-three patients received bilateral PRP injections (24 females). The mean age of patients was 58.9 ± 16.8 years. The mean duration of LPOD was 8.7 years. The pre to 6-month post-injection mean TDI significantly improved from 10.3 ± 10.2 to 20.12 ± 12.07 (p = 0.001). The mean ODQ significantly decreased from 29.8 ± 13.0 to 23.4 ± 11.3 (p = 0.013). The average change of the TDI and the ODQ were 9.8 and 6.4, respectively. Age was inversely associated with the 6-month threshold score. Conclusion: PRP appears to be a promising therapeutic strategy for long-lasting postviral OD. Our findings support the conduction of controlled randomized trial in this population of patients. [ABSTRACT FROM AUTHOR]

Background and Objectives There is a paucity of data on the prevalence, risk factors, and impact of olfactory impairment (OI) on key health indicators and economic outcomes in Asian populations. We aimed to address these gaps in a population of community-dwelling older adults. Research Design and Methods We included 2 101 participants (mean age ± standard deviation [ SD ]: 72.9 ± 8.1 years; 55.1% women) from the baseline assessment of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study (2017–2022). Any OI was based on a score of <11 on the 16-item identification segment of the Sniffin' Sticks test battery; subcategorized into hyposmia (score 9–10) and anosmia (score ≤8). Sociodemographic, clinical, and lifestyle risk determinants, health indicators (health-related quality of life, depressive symptoms, daily caloric intake, frailty, and cognitive impairment), and economic outcomes (healthcare expenditure, productivity loss) were assessed via standardized clinical testing and validated questionnaires. Multivariable logistic and linear regression models were utilized to explore the risk factor profile of OI across its severity spectrum and its impact on health indicators and economic outcomes. Results The census-adjusted prevalence of any OI, hyposmia, and anosmia were 34.0%, 20.5%, and 13.5%, respectively. Older age and male gender were associated with increased likelihood of hyposmia and anosmia, while the presence of diabetes and >4 days/week alcohol consumption were associated with increased odds of having anosmia only (all p  < .05). Both hyposmia and anosmia were also associated with more than twofold increased odds of having CI. Discussion and Implications Over a third of our community-dwelling older Singaporean population had OI, with 1-in-10 experiencing total olfaction loss. Those with OI had more than double the odds of having CI, regardless of its severity. Our results suggest the importance of community-based programs aimed at detecting and delaying the progression of OI in high-risk individuals. [ABSTRACT FROM AUTHOR]

Objective: To compare, using state‐of‐the‐art psychophysical tests, the olfactory function of patients complaining and not complaining of olfactory hypersensitivity. Study Design: Retrospective cross‐sectional. Setting: The Smell and Taste Center at the University of Pennsylvania. Methods: University of Pennsylvania Smell Identification Test (UPSIT) scores were obtained from 148 patients complaining of hyperosmia and 494 patients with no such complaints; detection threshold test scores were obtained from 77 and 483 patients of these respective groups. The effects of subject group, age, and sex on the test scores were assessed using analyses of variance. Categorical variables were evaluated by χ2. Responses to items within a detailed intake questionnaire, for example, the Beck Depression Inventory (BDI‐II), were also evaluated. Results: Unexpectedly, those complaining of hyperosmia had lower olfactory test scores than those with no such complaints (respective UPSIT means [95% confidence interval [CIs]] = 27.86 (26.85, 28.87) and 32.19 (31.67, 32.71); P <.001; respective threshold means (log vol/vol) = −4.49 (−4.89, −4.09) and −5.22 (−5.36, −5.06); P <.001). Remarkably, 70.95% of the self‐identified hyperosmics exhibited mild to severe microsmia. The hyposmia complainers also exhibited elevated BDI scores (11.02 [9.53, 12.51] vs 7.58 [6.80, 8.34]). Conclusion: When objectively tested, many patients who complain of hypersensitivity to odors are actually less sensitive to them. The basis of this phenomenon is unclear. It could reflect the presence of emotionally disturbing altered smell sensations, or one or more comorbidities, such as hypochondria or osmophobia. These findings point to the importance of objective testing of persons with complaints of chemosensory dysfunction and reiterate the inaccuracy of self‐reports. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Olfactory dysfunction (OD) is a key symptom of chronic rhinosinusitis (CRS). Although extensively studied in CRS with nasal polyps (CRSwNP), OD in CRS without nasal polyps (CRSsNP) remains under‐researched. This study aims to assess the prevalence of OD and its evolution in surgically naïve patients with CRSsNP undergoing endoscopic sinus surgery (ESS).This prospective study included 97 participants with CRSsNP (mean age, 46.5 years; 70.1% men) and 97 healthy controls (mean age, 46.5 years; 70.1% men). Participants underwent psychophysical evaluations of orthonasal (using the Sniffin’ Sticks test) and retronasal olfaction (using powdered aromas) at enrolment and 6 months post‐ESS.Out of 97 patients, 81 (83.5%) completed all assessments. At enrolment, 23 (28.4%) CRSsNP patients had OD based on composite threshold, discrimination, identification scores, compared with 7 (8.6%) controls (absolute % difference, 19.8% [95% CI, 8.2–31.4]). Retronasal olfactory function was also significantly worse in CRSsNP patients. Six months post‐ESS, 30 patients (37.0%) experienced a clinically significant improvement in olfactory, whereas nonsignificant changes were observed in retronasal olfactory score, and 3.7% of patients experienced a deterioration of the olfactory function.In conclusion, although 37% of patients experienced a clinically significant improvement in their sense of smell following ESS, the overall prevalence of OD in this surgically naive population appears relatively low, especially when compared to that observed in patients with CRSwNP. Therefore, ESS may offer some benefits for enhancing orthonasal olfactory function, but the extent of these improvements appears to be limited. [ABSTRACT FROM AUTHOR]

Objective: To identify predictors associated with loss and recovery of smell and taste after COVID‐19 infection. Methods: The Integrated Public Use Microdata Series (IPUMS) 2021 National Health Interview Series (NHIS) database was used to analyze factors associated with loss and recovery of smell and taste in respondents who had a previous COVID‐19 infection. Significant variables from univariate analysis were included in a stepwise backward regression model to identify independent predictors. Results: Of the 3844 individuals who answered yes to having contracted COVID‐19, 51.1% and 48.9% reported losing smell and taste, respectively. 95.7% recovered smell and 97% recovered taste. Predictors associated with higher odds of reporting a loss of smell included younger age (odds ratio [OR] 0.98; 95% confidence interval [CI] 0.98–0.99), female sex (OR 1.38; CI 1.17–1.63), use of e‐cigarettes (OR 1.59; CI 1.25–2.02), and Mexican ethnicity (OR 1.61; CI 1.22–2.11). Predictors of taste loss were younger age (OR 0.98; CI 0.98–0.99), female sex (OR 1.31; CI 1.08–1.58), and higher BMI (OR 1.02; CI 1.00–1.04). Female sex was associated with decreased odds of reporting a recovery of smell (OR 0.74; CI 0.59–0.92) and taste (OR 0.54; CI 0.42–0.69). Black/African American race (OR 1.44; CI 1.03–2.03) and non‐Mexican Hispanic ethnicities (OR 1.55; CI 1.02–2.34) were associated with an increased likelihood of reporting the recovery of smell. Conclusion: Various factors may be associated with the loss and recovery of smell and taste after COVID‐19 infections. Clinicians may use this information to better counsel patients with these symptoms. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Introduction The coronavirus disease 2019 (COVID-19), also referred to as the 2019 novel coronavirus, is caused by a single-stranded positive-sense RNA virus. This infectious agent spreads through respiratory routes, primarily utilizing aerosols. In our study, we shed light on ear, nose, and throat (ENT) manifestations, which can be considered as prognostic clinical biomarkers to reduce forthcoming complications among such critically ill patients. This makes it feasible for researchers to investigate or fetch early diagnosis in such cases with ease without the use of large, extensive hospital-base setups. Objective To study the otorhinolaryngological (ENT) manifestations in symptomatic COVID-19 patients. Methods From January to December 2021, a cross-sectional observational study was conducted at the Department of ENT of a tertiary care hospital in central India. All eligible symptomatic COVID-19 patients admitted to this institution during the study period were consecutively enrolled. The Institutional Ethics Committee gave its permission for the project. Results Out of the total of 1,375 patients, 78% of the patients diagnosed with COVID exhibited symptoms related to the ENT, while the remaining 22% did not display any ENT manifestations. Anosmia (71.2%), sore throat (55.62%), headache (44.3%), and loss of taste (66.3%) were among the most common ENT symptoms. Conclusion The present study highlights ENT manifestations, which play a crucial role in the early diagnosis of COVID-19 patients, ensuring faster treatment and isolation for better containment of the disease. Symptomatic treatment has shown efficacy, but objective tests are needed to prevent overestimation, understand pathogenesis, and enhance treatment. [ABSTRACT FROM AUTHOR]

Introduction Olfactory dysfunction (OD) has emerged as a notable symptom among coronavirus disease 2019 (COVID-19) patients, with its prevalence varying among different populations. Recognizing the need to provide therapeutic solutions for these individuals, the present study seeks to comprehensively review the current evidence on potential underlying mechanisms and treatment modalities to manage OD in COVID-19 patients. Objective To review the recent evidence on treatments for OD in COVID-19. From the beginning of the study until August 2nd, 2023, we conducted a systematic search on four electronic databases, PubMed, Scopus, Embase, and Web of Science, to find relevant publications. Data Synthesis In the present study, 37 articles were selected for data extraction and included in the final review. The total number of patients was of 3,560 (2,098 female and 1,462 male subjects). The predominant disorders reported were hyposmia, anosmia, and parosmia. In most of the studies, the pre and postintervention assessments were the same, except for one study, in which the pre-intervention assessment of the disorder was through the SST, Sniffin' Sticks Test (SST), and the post-intervention assessment was through the Visual Analog Scale (VAS) and the 22-item Sinonasal Outcome Test (SNOT-22). The findings suggest olfactory training (OT), ivermectin, palmitoylethanolamide, luteolin, and systemic corticosteroids, in combination with topical corticosteroids, are potential therapies for COVID-19 patients with olfactory impairment. Conclusion Although the review suggested several medications for OD treatment, further research must delve into the specific impact of OT, a non-pharmacological modality, regarding the mitigation of OD. By continuing to investigate and refine these therapeutic approaches, we can better support COVID-19 patients and improve their quality of life while navigating the challenges posed by OD. [ABSTRACT FROM AUTHOR]

Objective: Although olfactory dysfunction is one of the most common presenting signs of COVID‐19 infection, little is known about which populations are most susceptible. The aim of this study is to evaluate the risk of COVID‐19‐induced chemosensory dysfunction in malnourished individuals. Methods: The N3C database was queried for adults having positive COVID‐19 test result, diagnosis of chemosensory dysfunction within 2 weeks of positive test date, and overnutrition or undernutrition (i.e., deficiency or excess of micro‐ and macronutrients) related diagnoses prior to COVID‐19 infection. Individuals previously diagnosed with chemosensory dysfunction were excluded. COVID‐19‐positive adults without olfactory dysfunction were similarly analyzed. Statistical analysis was performed using odds ratio calculations (95% confidence interval [CI]). Results: Of 3,971,536 patients with COVID‐19, 73,211 adults were identified with a diagnosis of undernutrition and 428,747 adults were identified with a diagnosis of overnutrition prior to infection. Of those with undernutrition, 264 (0.36%) individuals were identified with a diagnosis of olfactory dysfunction within 2 weeks of infection. Of those with overnutrition, 2851 (0.66%) individuals were identified with a diagnosis of olfactory dysfunction within 2 weeks of infection. The calculated odds ratio for undernutrition and olfactory dysfunction was 0.731 (p < 0.0001, 95% CI [0.0647, 0.0825]). The calculated odds ratio for overnutrition and olfactory dysfunction was 1.419 (p < 0.0001, 95% CI [1.3359, 1.5081]). Conclusion: Overnutrition may increase the risk of COVID‐19‐related olfactory dysfunction, while undernutrition may slightly protect. While reasons are unclear, baseline differences in metabolic, inflammatory, and structural biochemistry deserve closer inspection. Level of Evidence: 3 Laryngoscope, 134:4338–4343, 2024 [ABSTRACT FROM AUTHOR]

Since the introduction of vaccines for severe acute respiratory syndrome coronavirus 2 in the United States, there has been significant vaccine hesitancy, in part due to fear of adverse effects. We sought to investigate the rates of smell and taste changes after COVID‐19 vaccination compared to other common vaccines. Our study cohort included individuals identified by Current Procedural Terminology code in the TriNetX database receiving the COVID‐19 first series, COVID‐19 booster, influenza, tetanus, diphtheria, pertussis (TDAP), or pneumococcal vaccines between December 15, 2020, and August 15, 2023. After 1:1 propensity score matching, postvaccination incidence of disturbance of smell and taste was significantly less likely after COVID‐19 first series vaccine compared to influenza (odds ratios, OR: 0.27 [95% confidence interval, CI: 0.20‐0.36]), TDAP (OR: 0.35 [95% CI: 0.26‐0.47]), and pneumococcal vaccines (OR: 0.17 [95% CI: 0.09‐0.32]). Similarly, incidence of disturbance of smell and taste was significantly less likely after COVID‐19 booster vaccine compared to the influenza (OR: 0.60 [95% CI: 0.48‐0.76]), TDAP (OR: 0.63 [95% CI: 0.47‐0.85]), and pneumococcal vaccines (OR: 0.44 [95% CI: 0.28‐0.68]). This study builds upon the literature demonstrating the safety of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

The association of anosmia/ageusia with a positive severe respiratory syndrome coronavirus 2 (SARS-CoV-2) test is well-established, suggesting these symptoms are reliable indicators of coronavirus disease 2019 (COVID-19) infection. This study investigates the clinical characteristics and systemic inflammatory markers in hospitalized COVID-19 patients in Taiwan, focusing on those with anosmia/ageusia. We conducted a retrospective observational study on 231 hospitalized COVID-19 patients (alpha variant) from April to July 2021. Clinical symptoms, dyspnea grading, and laboratory investigations, including neutrophil-lymphocyte ratios (NLRs), platelet-lymphocyte ratios (PLRs), and ANDC scores (an early warning score), were analyzed. Cough (64.1%), fever (58.9%), and dyspnea (56.3%) were the most common symptoms, while anosmia/ageusia affected 9% of patients. Those with anosmia/ageusia were younger, had lower BMI, lower systemic inflammatory markers, and better ANDC scores than those without these symptoms. Female patients exhibited lower NLR values and ANDC scores compared to male patients (all p < 0.05). Multivariable regression analysis demonstrated significant associations between NLR and CRP and ferritin levels (all p < 0.01), and between PLR and ESR and ferritin levels (p < 0.01). Categorized ANDC scores significantly correlated with the total hospital length of stay (all p < 0.05). Despite ethnic differences in the prevalence of anosmia/ageusia, our study highlights similar clinical presentations and inflammatory profiles to those observed in Western countries. The ANDC score effectively predicted hospital stay duration. These findings suggest that anosmia/ageusia may be associated with less severe disease and a lower inflammatory response, particularly in younger and female patients. The ANDC score can serve as a valuable prognostic tool in assessing the severity and expected hospital stay of COVID-19 patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exposed the precarious porosity of the human body. Biological vulnerability and the fear of contagion in recent times has prompted the exercise of caution by enforcing distinct demarcating boundaries between the environment, the self, and the other. Thus, the faculty of touch is restricted despite its importance in functional, developmental, haptic, intimate, non-verbal, therapeutic, cultural, and social dimensions. Avenues of direct contact have been barred, with digital and mediated touch dominating various spheres. The lived experience of a population negotiating with the loss of tactile contact finds expression within the subjective narratives of the viral subject detailed insightfully through the medium of comics. Taking instances from graphic medicine, this paper aims to analyse the parameters of touch and tactility during the COVID-19 pandemic by close reading comic panels from various sources. [ABSTRACT FROM AUTHOR]

Introduction: To comprehensively evaluate the reported clinical effectiveness of platelet‐rich plasma (PRP) in patients with chronic sinusitis undergoing endoscopic sinus surgery (ESS). Methods: We performed a systematic review and meta‐analysis of randomised controlled trials (RCTs). Five digital online databases (PubMed, Scopus, Web of Science, Google Scholar and Cochrane CENTRAL) were searched from inception up to 1st May 2023. Our specific outcomes involved postoperative nasal endoscopy scores measured via Lund‐Kennedy score or Meltzer score, olfactory sensation scores and pre‐operative anosmia duration. All data were pooled as standardised mean difference (SMD) with a 95% confidence interval (CI), using the RevMan software. Results: Six RCTs were included in this systematic review and meta‐analysis, with a total of 169 patients. The risk of bias in the included RCTs was low in three RCTs, some concerns in one RCT and high risk in two RCTs. The overall analysis of the postoperative nasal endoscopy scores showed that the PRP group had lower scores compared to the control group (n = 3 RCTs, SMD = −1.19; 95% CI [−1.94, −0.44], p =.002). There was no significant difference between the PRP and control groups regarding anosmia duration (n = 2 RCTs, SMD = 0.21; 95% CI [−0.17, 0.59], p = 0.28) or olfactory sensation scores, despite the PRP group having higher scores (n = 2 RCTs, SMD = 0.53; 95% CI [−0.32, 1.39], p = 0.22). Conclusion: This study highlights the potential advantages of using PRP as an additional treatment for individuals with chronic sinusitis undergoing ESS. The improvements associated with PRP include facilitating wound healing, reducing inflammation and enhancing surgical outcomes. To optimise the use of PRP in clinical settings, future research should focus on conducting larger trials with standardised protocols. [ABSTRACT FROM AUTHOR]

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Olfactory impairment (reduced acuity, impaired identification of odors) reduces patients' quality of life and can be a symptom of a wide range of physical pathologies, especially neurodegenerative processes in the brain. Quantitative measurement of olfactory acuity is required for the diagnosis of olfactory dysfunctions and monitoring changes in olfactory function after treatment or surgery. The problem of finding optimal methods for analyzing olfactory thresholds in animal models of human diseases accompanied by anosmia and comparing them is particularly relevant at the moment. This is required for selecting valid animal models for the purpose of developing new drugs and methods of therapy for a wide range of pathologies. This review analyzes publications addressing diseases accompanied by anosmia or hyposmia, their animal models, and methods for assessing olfactory function. The analysis includes models for COVID-19 coronavirus infection, Alzheimer's disease, Parkinson's disease, diabetes type 1 and 2, Kallmann syndrome, and Bardet–Biedl syndrome, all of which involve olfactory function disorders and/or defects in the olfactory system. The lack of data on measurement of olfactory thresholds in model animals is noted. [ABSTRACT FROM AUTHOR]

Objective: To identify predictors of chronic rhinosinusitis (CRS) in patients presenting with the chief complaint of nasal allergies. Study Design: Cross‐sectional study. Setting: Tertiary care, academic center. Methods: Clinical and demographic characteristics were collected from participants who were patients presenting with the chief complaint of nasal allergies. From all participants, a 22‐item Sinonasal Outcome Test (SNOT‐22) was collected, and a modified Lund‐Kennedy endoscopy score was calculated from nasal endoscopy. Association was sought between having CRS and variables of clinical and demographic characteristics, SNOT‐22, and endoscopy score. Results: A total of 219 patients were recruited and 91.3% were diagnosed with allergic rhinitis; 45.2% were also diagnosed with CRS. Approximately half of the patients with CRS reported no intranasal corticosteroid usage. Having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30‐4.04, P =.004), endoscopy score (OR = 1.96, 95% CI: 1.59‐2.42, P <.001), and the SNOT‐22 nasal subdomain score (OR = 1.07, 95% CI: 1.03‐1.11, P =.001) related to SNOT‐22 items: "need to blow nose," "thick nasal discharge," "sense of taste/smell," and "blockage/congestion of nose." At least moderate (item score ≥3) "blockage/congestion of nose" or "thick nasal discharge," mild "need to blow nose" (item score ≥2) or very mild decreased "sense of taste/smell" (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS. Conclusion: Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment. [ABSTRACT FROM AUTHOR]

Abstract The association of anosmia/ageusia with a positive severe respiratory syndrome coronavirus 2 (SARS-CoV-2) test is well-established, suggesting these symptoms are reliable indicators of coronavirus disease 2019 (COVID-19) infection. This study investigates the clinical characteristics and systemic inflammatory markers in hospitalized COVID-19 patients in Taiwan, focusing on those with anosmia/ageusia. We conducted a retrospective observational study on 231 hospitalized COVID-19 patients (alpha variant) from April to July 2021. Clinical symptoms, dyspnea grading, and laboratory investigations, including neutrophil-lymphocyte ratios (NLRs), platelet-lymphocyte ratios (PLRs), and ANDC scores (an early warning score), were analyzed. Cough (64.1%), fever (58.9%), and dyspnea (56.3%) were the most common symptoms, while anosmia/ageusia affected 9% of patients. Those with anosmia/ageusia were younger, had lower BMI, lower systemic inflammatory markers, and better ANDC scores than those without these symptoms. Female patients exhibited lower NLR values and ANDC scores compared to male patients (all p

Background Olfactory dysfunction (OD) represents a frequent manifestation of the coronavirus disease 2019 (COVID-19). Apolipoprotein E (APOE) is a protein that interacts with the angiotensin-converting enzyme receptor, essential for viral entry into the cell. Previous publications have suggested a possible role of APOE in COVID-19 severity. As far as we know, no publications found significant associations between this disease's severity, OD, and APOE polymorphisms (E2, E3, and E4).

Platinum-based chemotherapy is known to cause taste and smell changes (TSCs) via a host of mechanisms, including altered receptor activity, saliva/mucus production, and induction of receptor destruction via mitotic inhibition. In the literature to date, these changes have primarily resulted in worsening of taste and smell. In this case report, we document the first instance of an individual regaining their sense of olfactory detection following treatment with oxaliplatin for colorectal adenocarcinoma. We theorize that the improvement in his sense of smell may have resulted from oxaliplatin-induced destruction of his nasal polyps through the caspase-9/procaspase-9 apoptotic pathway, a pathway shared with other mechanisms of nasal polyp destruction. These findings were supported by nasal endoscopy and sphenoid sinusoscopy, which demonstrated no clinical persistence of nasal polyps, in contrast to nasal endoscopy prior to chemotherapy which demonstrated persistent nasal polyposis. Objective smell testing post-treatment revealed a diminished ability to discriminate odors. Chemotherapy-induced TSCs play a key role in poor weight gain, food aversion, emotional distress, and an overall decrease in quality of life, and patients should be informed of these potential consequences prior to starting treatment. However, in patients with anosmia secondary to nasal polyposis, treatment with platinum-based chemotherapy may provide an additional therapeutic benefit. Further studies may help elucidate the potential therapeutic benefits of these agents in managing steroid-resistant polyposis for patients suffering from olfactory dysfunction.

Background: COVID-19 developed a sudden onset of smelling disorders. Researchers used self-reported or special tests to study this issue. We aimed to investigate whether quantitative-test smell disorders have a considerable difference from self-reported or not. Methods: We searched 554 studies published between December 2019 to September 2020 by the PICO model. Our search strategies were based on MeSH terms in the electronic databases Web of Science (136 articles), Scopus (84 articles), and PubMed (334 articles). The duplicated articles were excluded, then the preferred reporting items for systematic reviews and meta-analysis guidance were utilized. Finally, we divided the studies into two (self-report (33 articles) and specific-test (9 articles)) groups. Results: 33 (80%) articles expressed olfactory dysfunction by self-report of patients and 9(20%) studies were conducted by a specific test. Only three studies, one in self-report; ((internal reliability, Cronbach α = 0.84) and validity (r = -0.60, p < 0.001)) and two in specific-test groups; ((test-retest r=0.94) and another study (test-retest r >0.7)) conducted validity and reliability. Self-reported studies published a various range of prevalence (20% _97%) in patients with COVID-19. COVID-19 patients with a specific-test group were found to have a primary incidence of anosmia of over 65%, even reaching 98% depending on the types of tests. Conclusion: Self-reporting of COVID-19 detection can be affected by sociodemographic factors. Although self-reported questionnaires are economical and easy to use, standardized tests provide more reliable comparisons and professional assessments. Therefore, standardized tests are recommended for more accurate screening over self-reporting. [ABSTRACT FROM AUTHOR]

Objective The assessment of baseline olfactory function before endoscopic skull base surgery (ESBS) has been relatively limited compared with analysis before functional endoscopic sinus surgery (FESS). Our study addresses this knowledge gap, assessing preoperative olfactory function in ESBS and FESS and elucidating any differences. Study Design We conducted a retrospective review of patients undergoing anterior ESBS or FESS at a single institution between 2021 and 2022. We included 171 patients and compared their reported and measured preoperative olfactory function using the Sino-Nasal Outcome Test questionnaire and the 40-item University of Pennsylvania Smell Identification Test. Results Of the 171 patients included in this study, 30% of patients underwent ESBS and 70% underwent FESS. Of all patients, only 57% correctly reported their objective preoperative olfactory function. Of the 36 ESBS patients with measured preoperative hyposmia, only 31% correctly reported hyposmia, while 69% incorrectly reported normosmia. This distribution significantly differs (p < 0.0001) from the FESS subset (89 patients), with 64% correctly reporting hyposmia and 36% incorrectly reporting normosmia. Conclusion Our analysis demonstrates higher than anticipated underreporting of preoperative hyposmia in patients undergoing ESBS as well as discrepancies between subjective and objective olfactory functions in the FESS population. The results highlight several gaps in knowledge regarding perioperative olfactory function that would be best examined with more thorough pre- and postoperative objective olfactory testing. This analysis demonstrates significant prognostic uncertainty for patients and providers and creates significant medicolegal uncertainty regarding the appropriate attribution of postoperative olfactory loss in cases without objective preoperative testing. [ABSTRACT FROM AUTHOR]

Reduced sense of smell is a common symptom in patients with chronic rhinosinusitis (CRS). Although it is often under-diagnosed by healthcare providers, reduced sense of smell can have a substantial negative impact on patient's quality of life as measured by health-related quality of life (HRQoL) assessments and patient-reported outcomes. This narrative review describes current smell loss diagnosis and management guidelines in CRS, and the relationship between smell loss and CRS. Reduced sense of smell can be an indication of CRS disease severity in patients with (CRSwNP) and without nasal polyps (CRSsNP), and recovery of smell can be an indicator of successful CRS treatment. The current first-line therapeutic options for smell loss are intranasal corticosteroids and nasal irrigation, and second-line therapeutic options include systemic steroids and surgery. Shared decision-making between patient, caregiver, and healthcare provider is important when choosing the most appropriate CRS treatment option. Emerging biologic therapies that target type 2 inflammation signaling pathways, such as dupilumab, omalizumab, and mepolizumab, have been shown to improve smell and taste in randomized controlled trials of patients with CRSwNP. A graphical abstract and video abstract are available with this article. Plain Language Summary: Chronic rhinosinusitis (CRS) is an inflammatory condition often associated with a loss of smell and taste. Patients with CRS and a loss of smell often rate their quality of life as poor and are more likely to also suffer from depression and anxiety than patients without smell loss. Patients with severe smell loss are also more likely to have increased severity of CRS disease by other measures. Standard treatments for smell loss include topical steroids, corticosteroids absorbed into the whole body system (systemic), and/or sinonasal surgery, but the effects may not last, and patients may experience side effects when they use repeated short bursts or long-term treatment with systemic corticosteroids. A newer treatment option for CRS is biologic therapy, which targets the immunologic pathways associated with inflammation. Biologic therapies have been shown to be effective in the treatment of CRS with nasal polyps including improvement in sense of smell. Here, we review the most common diagnostic tests and treatment options for CRS-associated smell loss and show how severity of smell loss is linked to severity of CRS. -o4AhrHG7BfpfqMBka8hwD Supplementary file1 (MP4 60193 kb) [ABSTRACT FROM AUTHOR]

Objectives. Among people over the age of 65, the prevalence of olfactory disorders can reach nearly 14%. The buildup of beta-amyloid plaques and tau neurofibrillary tangles in neurons in the hippocampus and entorhinal cortex causes olfactory dysfunction, a decline in memory and learning processes, and, eventually, Alzheimer's disease. According to current research, people aged 57 to 85 who have hyposmia are twice as likely to develop dementia within five years as people of the same age who do not have hyposmia. Anosmia is one of the most common COVID-19 symptoms. Methodology. An 81-year-old female patient is referred to the psychiatry clinic by her family physician after presenting with a two-year history of panic attacks, anxiety, and anosmia following the SARS-CoV-2 infection. At the first visit, the patient was examined neurologically, psychiatrically, and neurocognitively with the Mini-Mental State Examination-2 and Cognitive Reserve Questionnaire. The patient was recommended for laboratory tests, magnetic resonance imaging scan, and a complex neuropsychological evaluation. Results. The score on the Mini-Mental State Examination-2 (standard version) was 28/30, with fluent language, high cognitive reserve (score of 168), normal muscle tone and strength, and no evidence of cerebellar dysfunction or balance impairment with a normal gait. The extensive neuropsychological evaluation scores were: Mini-Mental State Examination-2 (extended version) 42/90; three words from 25 retained from short story recall; Montreal Cognitive Assessment 20/30; poor verbal fluency (patient was able to produce only six animal names and one word that starts with the letter F in one minute); and impaired visuospatial and executive abilities. Brain imaging results reveal moderate cortical atrophy, cerebral microangiopathy modifications with leukoaraiosis, and cerebral lacunarism. Conclusions. Olfactory impairment is a possible sign of prodromal dementia. Infection with the SARS-Cov-2 virus has worsened cognitive decline in patients with Alzheimer's disease.

Abstract Objectives Olfactory dysfunction is one of the most recognized symptoms of COVID‐19, significantly impacting quality of life, particularly in cases where recovery is prolonged. This review aims to explore patterns of olfactory recovery post‐COVID‐19 infection, with particular focus on delayed recovery. Data Sources Published literature in the English language, including senior author's own work, online and social media platforms, and patients' anecdotal reports. Method A comprehensive review of the literature was undertaken by the authors with guidance from the senior author with expertise in the field of olfaction. Results Based on self‐report, an estimated 95% of patients recover their olfactory function within 6 months post‐COVID‐19 infection. However, psychophysical testing detects higher rates of persistent olfactory dysfunction. Recovery has been found to continue for at least 2 years postinfection; negative prognostic indicators include severe olfactory loss in the acute phase, female sex, and older age. Variability in quantitative and qualitative disturbance in prolonged cases likely reflects both peripheral and central pathophysiological mechanisms. Limitations of many of the reviewed studies reflect lack of psychophysical testing and baseline olfactory assessment. Conclusions Post‐COVID‐19 olfactory dysfunction remains a significant health and psychosocial burden. Emerging evidence is improving awareness and knowledge among clinicians to better support patients through their olfactory rehabilitation, with hope of recovery after several months or years. Further research is needed to better understand the underlying pathogenesis of delayed recovery, identify at risk individuals earlier in the disease course, and develop therapeutic targets.

Abstract Objectives 2019 novel coronavirus disease (COVID‐19) infection is commonly associated with olfactory dysfunctions, but the basic pathogenesis of these complications remains controversial. This study seeks to evaluate the value of magnetic resonance spectroscopy (MRS) in determining the molecular neurometabolite alterations within the main brain olfactory areas in patients with COVID‐19‐related anosmia. Methods In a cross‐sectional study, seven patients with persistent COVID‐19‐related anosmia (mean age: 29.57 years) and seven healthy volunteers (mean age: 27.28 years) underwent MRS in which N‐acetyl‐aspartate (NAA), choline (Cho), creatine (Cr), and their ratios were measured in the anterior cingulate cortex, dorsolateral prefrontal cortex, orbitofrontal cortex (OFC), insular cortex, and ventromedial prefrontal cortex. Data were analyzed using TARQUIN software (version 4.3.10), and the results were compared with an independent sample t‐test and nonparametric Mann–Whitney test based on the normality of the MRS data distribution. Results The mean duration of anosmia before imaging was 8.5 months in COVID‐19‐related anosmia group. MRS analysis elucidated a significant association between MRS findings within OFC and COVID‐19‐related anosmia (Pdisease

Abstract Objective The aim of this study was to review findings from a large prospective national database of chemosensory disturbances associated with coronavirus disease 2019 (COVID‐19) infection. Data Sources The Virginia Commonwealth University Smell and Taste Center national database of COVID‐19 chemosensory disturbances. Methods A series of online surveys, first opened on April 10, 2020, was made accessible nationwide to any adult with sudden chemosensory dysfunction since January 2020. Participants received subsequent follow‐up surveys 14 days, 1 month, 3 months, and 6 months after enrollment. An additional survey was sent to all participants on May 28, 2022 to assess long‐term outcomes. Information pertaining to demographics, symptoms, comorbidities, treatments, and life impact was collected. Results Of 363 participants who reported complete smell recovery, 51.2% recovered within 1 month, 70% within 3 months, and 79% within 6 months, while 8.8% took over 1 year to completely recover. Among all participants, 7.5% had no smell recovery. Positive predictors of recovery included age

Olfactory perception is an important physiological function for human well-being and health. Loss of olfaction, or anosmia, caused by viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has received considerable attention, especially in persistent cases that take a long time to recover. This review discusses the integration of different components of the olfactory epithelium to serve as a structural and functional unit and explores how they are affected during viral infections, leading to the development of olfactory dysfunction. The review mainly focused on the role of receptors mediating the disruption of olfactory signal transduction pathways such as angiotensin converting enzyme 2 (ACE2), transmembrane protease serine type 2 (TMPRSS2), neuropilin 1 (NRP1), basigin (CD147), olfactory, transient receptor potential vanilloid 1 (TRPV1), purinergic, and interferon gamma receptors. Furthermore, the compromised function of the epithelial sodium channel (ENaC) induced by SARS-CoV-2 infection and its contribution to olfactory dysfunction are also discussed. Collectively, this review provides fundamental information about the many types of receptors that may modulate olfaction and participate in olfactory dysfunction. It will help to understand the underlying pathophysiology of virus-induced anosmia, which may help in finding and designing effective therapies targeting molecules involved in viral invasion and olfaction. To the best of our knowledge, this is the only review that covered all the receptors potentially involved in, or mediating, the disruption of olfactory signal transduction pathways during COVID-19 infection. This wide and complex spectrum of receptors that mediates the pathophysiology of olfactory dysfunction reflects the many ways in which anosmia can be therapeutically managed. [ABSTRACT FROM AUTHOR]

Objective: Olfactory dysfunction (OD) is a condition primarily affecting older adults. Several factors have been implicated in OD, such as age, socioeconomic status, and neurodegenerative disease; however, the effect of military service still requires additional investigation. Here, we aim to determine if there is an association between prior military service and OD among older adults. Methods: This cross‐sectional study included 2268 adults from Round 1 of the National Social Life, Health, and Aging Project. OD was defined as 0–3 odors correctly identified on the 5‐item Sniffin' Sticks test. Bivariate analysis was conducted to calculate crude odds ratios (cOR) for the association of prior military service with OD and identify covariates for regression. Associations between prior military service and OD were assessed using logistic regression, and adjusted odds ratios (aOR) were calculated controlling for age, gender, race/ethnicity, education, stroke history, dementia, diabetes, and mental health. All analyses were weighted using survey weights to account for sampling design. Results: OD was present in 489 adults (21.6%). Among those with OD, the average age was 71.0 ± 7.9 years, whereas the average age in those without OD was 67.0 ± 7.2 years. Among adults with OD, 34.4% reported prior military service, compared to 27.7% of adults without OD (cOR = 1.37; 95% CI: 1.05–1.79). However, after adjusting for covariates, prior military service was not associated with OD (aOR: 1.09; 95% CI: 0.79–1.50). Older age (aOR: 1.07; 95% CI: 1.05–1.09) and worse mental health (aOR: 1.68; 95% CI: 1.14–2.49) were associated with OD. Conclusion: Prior military service was not associated with OD among older adults after controlling for covariates. More nuanced research is needed to examine correlations between OD and specific elements of military service such as duration, toxin exposure, and head trauma. Level of Evidence: Level 4. [ABSTRACT FROM AUTHOR]

Background: Isolated hypogonadotropic hypogonadism is a heterogeneous clinical entity. There is a growing list of molecular defects that are associated with hypogonadotropic hypogonadism (HH). TCF12, a recently identified molecular defect, causes craniosynostosis and is suggested to be used as a biomarker for prognosis in various cancer types. Recently, TCF12 variants were shown in a cohort with HH. Case presentation: A 15.3 years old female patient was referred to the endocrinology clinic for obesity. She had been gaining weight from midchildhood. She had her first epileptic seizure at the age of 15.1 years and mildly elevated thyroid autoantibodies were detected during evaluation for etiology of seizures. She had not experienced menarche yet. She was operated for left strabismus at the age of 7 years. School performance was poor and she was receiving special education. Tanner stage of breast was 1 and pubic hair was 3. The endocrine workup revealed hypogonadotropic hypogonadism. Also, the Sniffin' Sticks test detected anosmia. Thyroid ultrasonography was performed due to the mildly elevated thyroid autoantibodies, and thyroid nodules with punctate calcifications were detected. Total thyroidectomy and central lymph node dissection were performed regarding the cytological findings of the nodules and multicentric papillary thyroid carcinoma with no lymph node metastasis was detected on pathology specimens. Regarding the phenotypic features of the patients, whole exome sequencing was performed and heterozygous deletion of exon 1 and exon 6-8 in TCF12 was detected. Conclusion: Haploinsufficiency of TCF12 causes anosmic HH. Probably due to the incomplete penetrance and variable expressivity of the disease, patients could display variable phenotypic features such as intellectual disability, developmental delay, and craniosynostosis. Further description of new cases with TCF12 variations could enhance our understanding of craniosynostosis and its potential link to Kallmann syndrome associated with this gene. [ABSTRACT FROM AUTHOR]

ANKRD11 (ankyrin repeat domain 11) is a chromatin regulator and the only gene associated with KBG syndrome, a rare neurodevelopmental disorder. We have previously shown that Ankrd11 regulates murine embryonic cortical neurogenesis. Here, we show a novel olfactory bulb phenotype in a KBG syndrome mouse model and two diagnosed patients. Conditional knockout of Ankrd11 in murine embryonic neural stem cells leads to aberrant postnatal olfactory bulb development and reduced size due to reduction of the olfactory bulb granule cell layer. We further show that the rostral migratory stream has incomplete migration of neuroblasts, reduced cell proliferation as well as aberrant differentiation of neurons. This leads to reduced neuroblasts and neurons in the olfactory bulb granule cell layer. In vitro, Ankrd11-deficient neural stem cells from the postnatal subventricular zone display reduced migration, proliferation, and neurogenesis. Finally, we describe two clinically and molecularly confirmed KBG syndrome patients with anosmia and olfactory bulb and groove hypo-dysgenesis/agenesis. Our report provides evidence that Ankrd11 is a novel regulator of olfactory bulb development and neuroblast migration. Moreover, our study highlights a novel clinical sign of KBG syndrome linked to ANKRD11 perturbations in mice and humans. [ABSTRACT FROM AUTHOR]

Purpose: Although COVID-19 anosmia is often transient, patients with persistent olfactory dysfunction (pOD) can experience refractory parosmia and diminished smell. This study evaluated four putative therapies for parosmia in patients with chronic COVID-19 olfactory impairment. Methods: After screening nasal endoscopy, 85 patients (49 female, 58%) with pOD and treatment-refractory parosmia were randomized to: (1) ultramicronized palmitoylethanolamide and luteolin + olfactory training (OT) (umPEALUT group, n = 17), (2) alpha-lipoic acid + OT (ALA group, n = 21), (3) umPEALUT + ALA + OT (combination group, n = 28), or 4) olfactory training (OT) alone (control group, n = 23). Olfactory function was assessed at baseline (T0) and 6 months (T1) using a parosmia questionnaire and Sniffin' Sticks test of odor threshold, detection, and identification (TDI). Analyses included one-way ANOVA for numeric data and Chi-Square analyses for nominal data on parosmia. Results: The umPEALUT group had the largest improvement in TDI scores (21.8 ± 9.4 to 29.7 ± 7.5) followed by the combination group (19.6 ± 6.29 to 27.5 ± 2.7), both p < 0.01. The control and ALA groups had no significant change. Patients in the combination and umPEALUT groups had significantly improved TDI scores compared to ALA and control groups (p < 0.001). Rates of parosmia resolution after 6 months were reported at 96% for combination, 65% for control, 53% for umPEALUT and 29% for ALA (p < 0.001). All treatment regimens were well-tolerated. Conclusions: umPEALUT and OT, with or without ALA, was associated with improvement in TDI scores and parosmia, whereas OT alone or OT with ALA were associated with little benefit. [ABSTRACT FROM AUTHOR]