Clinical diagnosis and treatment of olfactory dysfunction related to COVID-19: A literature review

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Paulina Elizabeth Bombón-Albán
Luís Geovanny Escobar-Ronquillo
Christian Adrián Cisneros-Hinostroza

Abstract

Introduction: Coronavirus disease 2019 is a pandemic disease that has caused more than six million deaths worldwide. The clinical picture of the infection can vary depending on the severity of the disease and usually includes general, ENT and neurological symptoms. Objective: To provide a narrative review of the scientific literature on the clinical diagnosis and treatment of olfactory dysfunction related to coronavirus disease 2019. Results: Olfactory dysfunction defined as the reduced or distorted ability to smell when inhaling (orthonasal smell) or when eating (postnasal smell), is often reported in mild or even asymptomatic cases. The prevalence
of olfactory dysfunction can vary with respect to the clinical setting, with rates of total loss of smell as high as 70% in patients with mild coronavirus disease 2019. In addition, to date there is a paucity of articles prospectively evaluating recovery rates of olfactory dysfunction in patients with coronavirus disease 2019. Conclusion: Coronavirus disease 2019 is associated with olfactory dysfunction in various
patients. Active and collaborative research is required to delineate the natural history and appropriate management of olfactory dysfunction in this virulent disease. In the meantime, diagnosis and targeted treatments such as olfactory training may be helpful
in olfactory dysfunction related to coronavirus disease 2019.


 

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Bombón-Albán PE, Escobar-Ronquillo LG, Cisneros-Hinostroza CA. Clinical diagnosis and treatment of olfactory dysfunction related to COVID-19: A literature review. Acta otorrinolaringol cir cabeza cuello [Internet]. 2022Sep.30 [cited 2024Jul.3];50(3):212 - 219. Available from: https://revista.acorl.org.co/index.php/acorl/article/view/636
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References

Le Bon SD, Konopnicki D, Pisarski N, Prunier L, Lechien JR, Horoi M. Efficacy and safety of oral corticosteroids and

olfactory training in the management of COVID-19-related loss of smell. Eur Arch Otorhinolaryngol. 2021;278(8):3113-

doi: 10.1007/s00405-020-06520-8

Boscolo-Rizzo P, Borsetto D, Fabbris C, Spinato G, Frezza D, Menegaldo A, et al. Evolution of Altered Sense of Smell

or Taste in Patients With Mildly Symptomatic COVID-19. JAMA Otolaryngol Head Neck Surg. 2020;146(8):729-732. doi: 10.1001/jamaoto.2020.1379

Tan BKJ, Han R, Zhao JJ, Tan NKW, Quah ESH, Tan CJ, et al. Prognosis and persistence of smell and taste dysfunction

in patients with covid-19: meta-analysis with parametric cure modelling of recovery curves. BMJ. 2022;378:e069503. doi:

1136/bmj-2021-069503

Le Bon SD, Pisarski N, Verbeke J, Prunier L, Cavelier G, Thill MP, et al. Psychophysical evaluation of chemosensory functions 5 weeks after olfactory loss due to COVID-19: a prospective cohort study on 72 patients. Eur Arch Otorhinolaryngol. 2021;278(1):101-08. doi: 10.1007/s00405-020-06267-2

Vaira LA, Hopkins C, Petrocelli M, Lechien JR, Chiesa-Estomba CM, Salzano G, et al. Smell and taste recovery in

coronavirus disease 2019 patients: a 60-day objective and prospective study. J Laryngol Otol. 2020;134(8):703-9. doi:

1017/S0022215120001826

Huart C, Philpott C, Konstantinidis I, Altundag A, Whitcroft KL, Trecca EMC, et al. Comparison of COVID-19 and common

cold chemosensory dysfunction. Rhinology. 2020;58(6):623-25. doi: 10.4193/Rhin20.251

Suzuki M, Saito K, Min W-P, Vladau C, Toida K, Itoh H, et al. Identification of viruses in patients with postviral olfactory

dysfunction. Laryngoscope, 2017;117(2):272-77. doi:10.1097/01.mlg.0000249922.37381.1e

Hura N, Xie DX, Choby GW, Schlosser RJ, Orlov CP, Seal SM, et al. Treatment of post-viral olfactory dysfunction: an

evidence-based review with recommendations. Int Forum Allergy Rhinol. 2020;10(9):1065-86. doi: 10.1002/alr.22624

Pinto JM, Wroblewski KE, Kern DW, Schumm LP, McClintock MK. Olfactory dysfunction predicts 5-year mortality in older

adults. PLoS One. 2014;9(10):e107541. doi: 10.1371/journal.pone.0107541

Miwa T, Ikeda K, Ishibashi T, Motoo Y, Fujieda S, Kurono Y, et al. Clinical practice guidelines for the management of olfactory dysfunction: secondary publication. Auris Nasus Larynx. 2019;46(5):653-62. doi: 10.1016/j.anl.2019.04.002

Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al.SARS-CoV-2 viral load in upper respiratory specimens of

infected patients. N Engl J 2020;382(12):1177-79. doi: 10.1056/NEJMc2001737

Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M, et al. SARS-CoV-2 entry factors are highly

expressed in nasal epithelial cells together with innate immune genes. Nat Med. 2020;26(5):681-7. doi: 10.1038/s41591-020-0868-6

Hou Y, Okuda K, Edwards C, Martínez D, Asakura T, Dinnon K, et al. SARS-CoV-2 reverse genetics reveals a variable infection gradient in the respiratory tract. Cell. 2020;182(2):429-46. doi:10.1016/j.cell.2020.05.042

Ziegler CG, Allon SJ, Nyquist SK, Mbano IM, Miao VN,Tzouanas CN, et al. SARS-CoV-2 receptor ACE2 is an

interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell.

;181(5):1016-1035. doi: 10.1016/j.cell.2020.04.035

Gallo O, Locatello LG, Mazzoni A, Novelli L, Annunziato F. The central role of the nasal microenvironment in the

transmission, modulation, and clinical progression of SARSCoV-2 infection. Mucosal Immunol. 2020;14(2):305-16. doi:

1038/s41385-020-00359-2

Sommerstein R, Fux CA, Vuichard-Gysin D, Abbas M, Marschall J, Balmelli C, et al. Risk of SARS-CoV-2 transmission

by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrob Resist Infect

Control. 2020;9:100. doi: 10.1186/s13756-020-00763-0

WHO Scientific Brief: Transmission of SARS-CoV-2: implications for infection prevention precautions. Geneva:

World Health Organization; 2020. [acceso 10 de abril de 2021]. Disponible en: https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infectionprevention-precautions

Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of Smell and Taste in 2013 European

Patients With Mild to Moderate COVID-19. Ann. Intern. Med. 2020;173(8):672-75. doi: 10.7326/M20-2428

Boesveldt S, Postma EM, Boak D, Welge-Luessen A, Schopf V, Mainland, J, et al. Anosmia - A Clinical Review. Chemical

Senses. 2017;42(7):513-23. doi: 10.1093/chemse/bjx025

Izquierdo-Domínguez A, Rojas-Lechuga MJ, Mullol J, Alobid I. Olfactory dysfunction during COVID-19 pandemic. Med

Clin (Barc). 2020;155(9):403-408. English, Spanish. doi:10.1016/j.medcli.2020.06.006

Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, et al. Real-time tracking of self-reported symptoms

to predict potential COVID-19. Nat Med. 2020;26(7):1037-40.doi: 10.1038/s41591-020-0916-2

Solomon IH, Normandin E, Bhattacharyya S, Mukerji SS, Keller K, Ali AS, et al. Neuropathological Features of Covid-19.

The N Engl J Med. 2020;383(10):989-92. doi: 10.1056/NEJMc2019373

Brann DH, Tsukahara T, Weinreb C, Lipovsek M, Van den Berge K, Gong B, et al. Non-neuronal expression of

SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci

Adv. 2020;6(31):eabc5801. doi: 10.1126/sciadv.abc5801

Desai M, Oppenheimer J. The Importance of Considering Olfactory Dysfunction During the COVID-19 Pandemic and

in Clinical Practice. JACI. 2021;9(1):7-12. doi: 10.1016/j.jaip.2020.10.036

Whitcroft KL, Hummel T. Clinical Diagnosis and Current Management Strategies for Olfactory Dysfunction: A Review.

JAMA Otolaryngol Head Neck Surg. 2019;145(9):846-53. doi:10.1001/jamaoto.2019.1728

Moein ST, Hahemian SMR, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for

COVID-19. Int Forum Allergy Rhinol. 2020;10(8):944-50. doi:10.1002/alr.22587

Sorokowska A, Drechsler E, Karwowski M, Hummel T.Effects of olfactory training: a meta-analysis. Rhinology

;55(1):17-26. doi: 10.4193/Rhin16.195

Kandemirli SG, Altundag A, Yildirim D, Tekcan Sanli DE, Saatci O. Olfactory Bulb MRI and Paranasal Sinus CT Findings

in Persistent COVID-19 Anosmia. Acad Radiol. 2021;28(1):28-35. doi: 10.1016/j.acra.2020.10.006

Aragao M, Leal MC, Cartaxo Filho OQ. Anosmia in COVID-19 associated with injury to the olfactory bulbs evident on MRI.AJNR Am J Neuroradiol. 2020;41(9):1703-06. doi: 10.3174/ajnr.A6675

Galougahi MK, Ghorbani J, Bakhshayeshkaram M. Olfactory bulb magnetic resonance imaging in SARS-CoV-2-induced

anosmia: the first report. Acad Radiol. 2020;27(6):892-93. doi:10.1016/j.acra.2020.04.002

Laurendon T, Radulesco T, Mugnier J. Bilateral transient olfactory bulbs edema during COVID-19-related

anosmia. Neurology. 2020;95(5):224-25. doi: 10.1212/WNL.0000000000009850

Politi LS, Salsano E, Grimaldi M. Magnetic resonance imaging alteration of the brain in a patient with coronavirus disease 2019(COVID-19) and anosmia. JAMA Neurol. 2020;77(8):1028-29. doi: 10.1001/jamaneurol.2020.2125

Doty RL. Treatments for smell and taste disorders: A critical review. Handb Clin Neurol. 2019;164:455-479. doi: 10.1016/

B978-0-444-63855-7.00025-3

Scangas GA, Bleier BS. Anosmia: Differential Diagnosis, Evaluation, and Management. Am J Rhinol Allergy.

;31(1):3-7. doi: 10.2500/ajra.2017.31.4403

Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A, et al. Objective evaluation of anosmia and ageusia in

COVID-19 patients: single-center experience on 72 cases.Head Neck. 2020;42(6):1252-8. doi: 10.1002/hed.26204

Cooper KW, Brann DH, Farruggia MC, Bhutani S, Pellegrino R, Tsukahara T, et al. COVID-19 and the chemical senses:

supporting players take center stage. Neuron. 2020;107(2):219-

doi: 10.1016/j.neuron.2020.06.032

Konstantinidis I, Tsakiropoulou E, Bekiaridou P, KazantzidouC, Constantinidis J. Use of Olfactory Training in Post-Traumatic and Postinfectious Olfactory Dysfunction. The Laryngoscope.2013;123(12):E85-90. doi: 10.1002/lary.24390

Pellegrino R, Han P, Reither N, Hummel T. Effectiveness of Olfactory Training on Different Severities of Posttraumatic

Loss of Smell. The Laryngoscope. 2019;129(8):1737-43. doi:10.1002/lary.27832

Patel ZM. Olfactory Loss and Olfactory Training. JAMA Otolaryngol Head Neck Surg. 2021;147(9):840. doi: 10.1001/

jamaoto.2021.1507

Pekala K, Chandra RK, Turner JH. Efficacy of olfactory training in patients with olfactory loss: a systematic review and

meta-analysis. Int Forum Allergy Rhinol. 2016;6(3):299-307.doi: 10.1002/alr.21669

Lavinsky J, Kosugi EM, Baptistella E, Roithmann R, Dolci E, Ribeiro TK, et al. An update on COVID-19 for

the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF)

Position Statement. Braz J Otorhinolaryngol. 2020;86(3):273-80. doi: 10.1016/j.bjorl.2020.04.002

Walker A, Pottinger G, Scott A, Hopkin C. Anosmia and loss of smell in the era of covid-19. BMJ. 2020;370:m2808. doi:

1136/bmj.m2808