No3-4(5) 2022
Back to the issue
DOI 10.37219/2528-8253-2022-3-71 |
Bezeha B
Our observations regarding olfactory disorders in COVID-19 |
Bohdan Bezeha
Communal enterprise «M.V. Sklifosovsky Poltava Regional Clinical Hospital
Poltava Regional Council»
ENT department
Otolaryngologist
Email: bogdanbezegalor@gmail.com;
ORCID ID: https://orcid.org/0000-0003-0517-9989 |
Abstract
Topicality: Despite a large number of patients and, accordingly, the
large number of publications in the medical literature, numerous clinical
manifestations of the disease due to COVID-19 have not yet been sufficiently
studied. One of the leading symptoms of COVID-19 is impaired olfactory
function, primarily anosmia. According to the literature, anosmia is noted
in 30 to 60% of patients. It can be an early and sometimes the only
characteristic symptom of the disease. Treatment of olfactory disorders is a
difficult task. Therefore timely detection of disorders and early targeted
therapy is of great medical and social importance.
Aim: to determine the features of the clinical manifestations of
olfactory dysfunction in patients with COVID-19.
Materials and methods: An analysis of the clinical and instrumental
examination of 53 pat ients with COVID-19 was carried out. In addition, an
endoscopic examination of the nasal cavity was carried out using the
workplace of an otorhinolaryngologist with the Mega Medical NET-1100
endovideo complex.
Results and their discussion: According to the analysis of survey
data of 130 patients with the help of a particular questionnaire developed
by us to determine sensory organ function disorders in patients with
COVID-19, the majority of subjects (69.2% of cases – 90 patients) noted
olfactory function disorders, mainly in the form of anosmia 25.4% (33
patients) or weakening of olfactory sensitivity by 22.3% (29 patients).
However, in 21.5% (28 patients) of cases, the sense of smell or its
enhancement was distorted. Mainly, smell impairment occurred in the first
few days of the disease, and hearing was partially or wholly restored after
recovery. However, in 26.2% - 34 patients, certain disorders persisted for
1-3 months after the illness, and in 15.3% - 20 patients, the sense of smell
did not fully recover five months after recovery.
We examined 53 patients who became ill with COVID-19 and complained of
impaired olfactory function, which persisted after recovery from 2 weeks to
1.5 months, mainly in the form of complete anosmia 34% (18 patients),
weakening of olfactory function 26, 4% (14 patients) and distortion 39.6%
(21 patients). In general, according to our observations, independent
recovery (primarily partial) is observed in patients with COVID-19 within 2
to 6 months, and more often, it occurs with changes in sensitivity and
distortions of the perception of some smells.
According to the endoscopic data, 54% of the examined had no visible signs
of mucosal disorders. It was pink, hydrated, and without signs of
inflammation, thinning, hypertrophy or oedema. In 13 patients (24.5%), there
was an increase in the vascular pattern and moderate oedema. Seven patients
(13.2%) showed signs of dryness and thinning of the mucous membrane,
sometimes with crusts. Approximately 79.3% (42 patients) of the examined
subjects had anatomical features that partially or significantly limited air
access to the olfactory zone (upper nasal passage). In addition, 19 (35.8%)
of the studied patients were diagnosed with marked curvature of the nasal
septum, and 5 (9.4%) with allergic rhinitis.
Conclusions:
1. In the vast majority of cases, the disease with COVID-19 is accompanied,
in addition to other symptoms, by damage to the olfactory analyser system.
2. Violat ion of smell with COVID-19 is usually observed immediately during
the disease and, in some patients (in 25-30% of cases), persists for a long
time after recovery.
3. Violations of the olfactory function in COVID-19 are manifested not only
in the form of anosmia but also in the form of a decrease, exacerbation, or
distortion of the sense of smell.
4. Violat ions of the olfactory function in COVID-19, which persist after
clinical recovery, in most cases are not manifested by visible disorders of
the mucous membrane of the olfactory zone of the nasal cavity. |
Keywords
COVID-19, smell, olfactory funct ion. |
Reference
- de Haro-Licer J, Roura-Moreno J, Vizit iu A, González-Fernández A,
González-Ares JA. Long term serious olfactory loss in colds and/or flu.
Acta
Otorrinolaringol Esp 2013;64:331-8. [Article in English, Spanish]. doi:
10.1016/j.otorri.2013. 04.003.
- Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, et
al. Self-reported olfactory and taste disorders in patients with severe
acute respiratory coronavirus 2 infection: a crosssect ional study. Clin
Infect Dis. 2020;71(15):889-90. doi: 10.1093/cid/ciaa330.
- Hopkins C, Surda P, Whitehead E, Kumar BN. Early Recovery following
New Onset Anosmia during the COVID-19 Pandemic – An Observat ional
Cohort Study. J Otolaryngol Head Neck Surg. 2020;49(1):26. doi:
10.1186/s40463-020-00423-8.
- Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD,
Rodriguez A, et al. 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.
2020;277(8): 2251-2261. doi: 10.1007/s00405-020-05965-1.
- Menni C, Valdes A, Freydin MB, Ganesh S, ElSayed Moustafa J,
Visconti A, et al. Loss of smell and taste in combination with other
symptoms is a strong predictor of COVID-19 infection. medRxiv preprint
doi: https://doi.org/10.1101/2020.04.05. 20048421. Available from:
https://www.medrxiv. org/content/10.1101/2020.04.05.20048421v1.
- Vaira LA, Salzano G, Deiana G, De Riu G. Anosmia and ageusia: common
findings in COVID-19 patients. Laryngoscope. 2020;130(7):1787. doi:
10.1002/lary.28692.
- Vallamkondu J, John A, Wani WY, Ramadevi SP, Jella KK, Reddy PH,
Kandimalla R. SARS-CoV-2 pathophysiology and assessment of coronaviruses
in CNS diseases with a focus on therapeutic targets. Biochim Biophys
Acta Mol Basis Dis. 2020;1866(10):165889. doi:
10.1016/j.bbadis.2020.165889.
- Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of
patients with COVID-19: evidence from meta-analysis. Aging (Albany NY).
2020;12(7):6049-6057. doi: 10.18632/aging.103000.
- Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous
system involvement after infection with COVID-19 and other coronaviruses.
Brain Behav Immun. 2020;87:18-22. doi: 10.1016/j.bbi.2020.03.031.
- Guan WJ, Zhong NS. Clinical Characteristics of Covid-19 in
China. Reply. N Engl J Med. 2020; 382(19):1861-2. doi:
10.1056/NEJMc2005203.
|
|