DOCSLIB.ORG

Taste and Smell Impairment in COVID-19: an AAO-HNS Anosmia Reporting Tool

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Taste and Smell Impairment in COVID-19: an AAO-HNS Anosmia Reporting Tool Complete Manuscript Click here to access/download;Complete Manuscript;Manuscript-Revised.doc This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 1 Taste and smell impairment in COVID-19: An AAO-HNS anosmia reporting tool- 2 based comparative study 3 4 İbrahim Sayin1 MD, Kadriye Kart Yaşar2 MD, Zahide Mine Yazici1 MD. 5 1: Department of Otolaryngology Head and Neck Surgery, Bakırköy Dr.Sadi Konuk 6 Teaching and Research Hospital, Istanbul, Turkey. 7 2: Department of Infectious Diseases, Bakırköy Dr.Sadi Konuk Teaching and 8 Research Hospital, Istanbul, Turkey. 9 10 Corresponding author: Ibrahim Sayin, MD 11 Department of Otolaryngology Head and Neck Surgery Bakırköy Dr. Sadi Konuk 12 Teaching and Research Hospital, Tevfik sağlam Caddesi, No:11. 34147, 13 Bakırköy/İstanbul 14 Telephone/Telefax: +90 414 7253/+90 212 542 44 91 15 E-mail: [email protected] 16 Funding: None Conflicts of interest: None 17 Ibrahim Sayin: conception and design of the work, collecting data, analysis, writing 18 manuscript, final approval of manuscript 19 Kadriye Kart Yaşar: conception of the work, data collection, drafting work, final 20 approval of manuscript 21 Zahide Mine Yazıcı: design of the work, collecting data, analysis, drafting the work, 22 final approval of manuscript 1 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 23 Abstract 24 Objective: To identify the taste and smell impairment in COVID-19 positive subjects 25 and compare the findings with COVID-19 negative subjects using the American 26 Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) Anosmia Reporting 27 Tool. 28 Setting: Tertiary referral center/COVID-19 pandemic hospital 29 Study design: Comparative study 30 Subjects and Methods: After power analysis 128 subjects were divided into two 31 groups according to Real-time Polymerase Chain Reaction (RT-PCR) COVID-19 32 testing results. Subjects were called via telephone and the AAO-HNS Anosmia 33 Reporting Tool was used to collect responses. 34 Results: The mean age of the study group was 38.63 ± 10.08 years old. At the time 35 of sampling rhinorrhea were significantly high in the COVID-19 negative group, 36 whereas those complaints described as ‘’other’’ were significantly high in the COVID- 37 19 positive group. There was a significant difference in the smell/taste impairment 38 rates of the groups (n = 46-71.9% for the COVID-19 positive group vs n = 17-26.6% 39 for the COVID-19 negative group, p = 0.001). For subjects with a smell impairment, 40 anosmia rates did not differ between the groups. The rates of hyposmia and 41 parosmia were significantly high in the COVID-19 positive group. For the subjects 42 with taste impairment, ageusia rates did not differ between groups. The rate of 43 hypogeusia and dysgeusia was significantly high in the COVID-19 positive group. 44 Logistic regression analysis indicates that smell/taste impairment in COVID-19 45 positive subjects increases the ODDS ratio by 6.956 (95% CI: 3.16-15.29) times. 2 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 46 Conclusion: COVID-19 positive subjects are strongly associated with smell/taste 47 impairment. 48 Keywords: COVID-19, coronavirus, chemosensory, anosmia, dysgeusia 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 66 Introduction 67 The world was faced with a novel form of coronavirus, named COronaVIrus Disease 68 2019 (COVID-19) by the World Health Organization (WHO) in December 2019. 69 According to the Coronavirus Study Group (CSG) of the International Committee the 70 virus became known as SARS-CoV-2 .1 71 Since there is no specific treatment or effective vaccine, the outbreak can only be 72 controlled by strict isolation and hygiene rules. COVID-19 is a form of Upper 73 Respiratory Tract Infection (URTI) and the clinical course of every URTI is different, 74 so presenting and alarm symptoms are needed to restrict transmission.2 75 In the early phases of the outbreak, fever, dyspnea, coughing, and travel to endemic 76 counties were used as the main screening parameters. However, during the course 77 of the outbreak, different symptomatology including headache, sore throat, nasal 78 congestion, rhinorrhea, fatigue, tonsil swelling, and conjunctivitis began to be 79 published.3 Among these, frequent chemosensory involvement, as evaluated by 80 smell and taste dysfunctions, were reported.4,5,6 81 During the outbreak many authors reported an increase in the presence of anosmia 82 in COVID-19 subjects. After initial reports, a few studies indicated that anosmia 83 presenting in COVID-19 subjects is more frequent than expected for a routine upper 84 respiratory tract infection. Although most of these reports were not comparative, 85 these findings are also in the Centers for Disease Control and Prevention (CDC) list 86 of symptoms and, according to the CDC, “new loss of taste or smell” can occur within 87 2-14 days of exposure.7 Chemosensory involvement can also occur as a first sign of 88 the disease. This is important because, given that there is no specific treatment or 89 effective vaccine, the outbreak can only be controlled by strict isolation and hygiene 4 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 90 measures.1,2 In addition, these subjects are potential ENT clinic patients in the future 91 for sustained taste and smell loss. The clinical course, along with other symptoms 92 and their timing, requires specialist monitoring to identify its properties. Clarifying the 93 chemosensory involvement not only provides valuable data for clinical evaluation but 94 also gives important clinical information of the virus characteristics, which may be 95 used by researchers from different disciplines. 96 The American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) are 97 continuously screening the outbreak and providing Otolaryngology Head and Neck 98 Surgery specialists with information about various aspects of the outbreak. As a 99 result of cumulative anecdotal evidence of anosmia/dysgeusia around the world 100 during the outbreak, the COVID-19 Anosmia Reporting Tool was developed in March 101 2020 by the AAO-HNS.8 This tool was developed by two committees of the AAO- 102 HNS; the Infectious Disease, and Patient Safety Quality Improvement committees. 103 The tool is completed online either by the medical provider or the patient, and 104 consists of 17 questions relating to demographic factors, COVID status, risk factors, 105 symptoms, and onset of anosmia/dysgeusia etc., and may be found at 106 https://www.entnet.org/content/reporting-tool-patients-anosmia-related-covid-19. This 107 anosmia reporting tool collects data to establish the importance of smell and taste 108 impairment in the clinical course of COVID-19. For this purpose we used the tool and 109 conducted a comparative study with COVID-19 negative subjects. 110 111 112 113 5 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 114 Methods 115 This study was conducted at Bakırköy Dr.Sadi Konuk Teaching and Research 116 Hospital, with ethical approval obtained from Bakırköy Dr.Sadi Konuk Teaching and 117 Research Hospital local ethics committee. Subjects with upper respiratory tract 118 infection symptoms who had been assessed as COVID-19 positive were enrolled. All 119 subjects underwent Real-time Polymerase Chain Reaction (RT-PCR) testing. 120 The exclusion criteria included subjects under the age of 18 and those without upper 121 respiratory tract infection symptoms. These subjects had undergone routine COVID- 122 19 testing as relatives of COVID-19 subjects and healthcare workers etc. In addition, 123 the exclusion criteria included subjects with pending results, those who had tested 124 negative for COVID-19 but were regarded as COVID-19 positive based on their 125 clinical presentations (presumed positive), and subjects required to remain in an 126 intensive care unit. 127 Subjects were divided into two groups; COVID-19 Positive (Group A) and COVID-19 128 Negative (Group B) according to RT-PCR results. Two questionnaires were 129 prepared, based on the AAO-HNS Anosmia Reporting Tool, for groups A and B 130 respectively. 131 According to power analysis, 64 subjects were required for each group. All 132 questionnaires were uploaded to Google Forms, and subjects admitted to clinics and 133 hospital began screening. All subjects were contacted by telephone and asked to 134 confirm they fulfill the inclusion criteria. Where the subject fulfilled the inclusion 135 criteria and informed consent was then obtained, the questionnaire was completed 136 with the assistance of physicians(1, 2, 3) and recorded to Google Forms. 137 6 This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. This manuscript has been accepted for publication in Otolaryngology-Head and Neck Surgery. 138 Questionnaires 139 Questionnaire of COVID-19 positive subjects ( Supplemental questionnaire 1) 140 The AAO-HNS Anosmia Reporting Tool was used to evaluate subjects.8 The 141 questionnaire included 17 questions, with one question asking about both anosmia 142 and dysgeusia. To obtain more detailed data, we expanded this question and 143 separated anosmia and dysgeusia questions from each other. Subjects were asked 144 to identify the type of smell and taste impairments separately, with a smell 145 impairment sub-grouped as anosmia, hyposmia and parosmia, and a taste 146 impairment sub-grouped as ageusia, hypogeusia and dysgeusia.
Load more

Recommended publications
  • Taste Alteration in COVID-19: a Rapid Review with Data Synthesis Reveals Significant Geographical Differences
    medRxiv preprint doi: https://doi.org/10.1101/2020.09.11.20192831; this version posted September 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Taste alteration in COVID-19: a rapid review with data synthesis reveals significant geographical differences By Nicola Cirillo Melbourne Dental School, The University of Melbourne, 3053 Carlton, Victoria, Australia *Address for Correspondence: Prof. Dr. Nicola Cirillo Melbourne Dental School The University of Melbourne 720 Swanston Street, Carlton 3053 Victoria, AUS Tel/fax. +61 03 9341 1473 e-mail: [email protected] NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.09.11.20192831; this version posted September 13, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Abstract To facilitate a timely understanding of the differences in the prevalence of gustatory disturbances (GD) in individuals infected with SARS-CoV-2, we undertook a rapid systematic review of articles published in the repository of the National Library of Medicine (MEDLINE/PubMed) and medRxiv from their inception until September 3, 2020. The minimum requirements for completing a restricted systematic review were met.
    [Show full text]
  • SPRAVATO® Esketamine Hydrochloride DATA SHEET
    SPRAVATO® esketamine hydrochloride DATA SHEET 1. PRODUCT NAME SPRAVATO® esketamine hydrochloride 32.3mg (equivalent to 28mg esketamine) nasal spray 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each single use nasal spray device delivers two sprays, one spray into each nostril. Total volume of drug product per device to be delivered is 0.2 mL containing a total of 32.3 mg of esketamine hydrochloride (equivalent to 28 mg of esketamine). For the full list of excipients, see Section 6.1 List of Excipients. 3. PHARMACEUTICAL FORM Nasal spray, solution. Clear, colourless, aqueous solution. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications SPRAVATO in conjunction with an oral antidepressant, is indicated for: - treatment resistant depression (Major Depressive Disorder in adults who have not responded adequately to at least two different antidepressants of adequate dose and duration to treat the current depressive episode). - rapid reduction of depressive symptoms in patients with Major Depressive Disorder who have acute suicidal ideation or behaviour. SPRAVATO is not indicated to prevent suicide or in reducing suicidal ideation or behaviour (see section 4.4. Special Warnings And Precautions For Use) 4.2 Dose and method of administration In patients with TRD, SPRAVATO should be administered in conjunction with a newly initiated oral antidepressant (AD) therapy. In patients with MDSI, SPRAVATO should be administered in conjunction with standard of care therapy. During the Phase III MDSI clinical program, standard of care oral AD treatment (either AD monotherapy or AD plus augmentation therapy) was initiated or optimised. Important Considerations Prior to Initiating and During Therapy SPRAVATO must be administered under the direct supervision of a healthcare provider.
    [Show full text]
  • Second Edition
    COVID-19 Evidence Update COVID-19 Update from SAHMRI, Health Translation SA and the Commission on Excellence and Innovation in Health Updated 4 May 2020 – 2nd Edition “What is the prevalence, positive predictive value, negative predictive value, sensitivity and specificity of anosmia in the diagnosis of COVID-19?” Executive Summary There is widespread reporting of a potential link between anosmia (loss of smell) and ageusia (loss of taste) and SARS-COV-2 infection, as an early sign and with sudden onset predominantly without nasal obstruction. There are calls for anosmia and ageusia to be recognised as symptoms for COVID-19. Since the 1st edition of this briefing (25 March 2020), there has been a significant expansion of literature on this topic, including 3 systematic reviews. Predictive value: The reported prevalence of anosmia/hyposmia and ageusia/hypogeusia in SARS-COV-2 positive patients are in the order of 36-68% and 33-71% respectively. There are reports of anosmia as the first symptom in some patients. Estimates from one study for hyposmia and hypogeusia: • Positive likelihood ratios: 4.5 and 5.8 • Sensitivity: 46% and 62% • Specificity: 90% and 89% The US Centres for Disease Control and Prevention (CDC) has added new loss or taste or smell to its list of recognised symptoms for SARS-COV-2 infection. To date, the World Health Organization has not. Conclusion: There is sufficient evidence to warrant adding loss of taste and smell to the list of symptoms for COVID-19 and promoting this information to the public. Context • Early detection of COVID-19 is key to the ongoing management of the pandemic.
    [Show full text]
  • Taste and Smell Disorders in Clinical Neurology
    TASTE AND SMELL DISORDERS IN CLINICAL NEUROLOGY OUTLINE A. Anatomy and Physiology of the Taste and Smell System B. Quantifying Chemosensory Disturbances C. Common Neurological and Medical Disorders causing Primary Smell Impairment with Secondary Loss of Food Flavors a. Post Traumatic Anosmia b. Medications (prescribed & over the counter) c. Alcohol Abuse d. Neurodegenerative Disorders e. Multiple Sclerosis f. Migraine g. Chronic Medical Disorders (liver and kidney disease, thyroid deficiency, Diabetes). D. Common Neurological and Medical Disorders Causing a Primary Taste disorder with usually Normal Olfactory Function. a. Medications (prescribed and over the counter), b. Toxins (smoking and Radiation Treatments) c. Chronic medical Disorders ( Liver and Kidney Disease, Hypothyroidism, GERD, Diabetes,) d. Neurological Disorders( Bell’s Palsy, Stroke, MS,) e. Intubation during an emergency or for general anesthesia. E. Abnormal Smells and Tastes (Dysosmia and Dysgeusia): Diagnosis and Treatment F. Morbidity of Smell and Taste Impairment. G. Treatment of Smell and Taste Impairment (Education, Counseling ,Changes in Food Preparation) H. Role of Smell Testing in the Diagnosis of Neurodegenerative Disorders 1 BACKGROUND Disorders of taste and smell play a very important role in many neurological conditions such as; head trauma, facial and trigeminal nerve impairment, and many neurodegenerative disorders such as Alzheimer’s, Parkinson Disorders, Lewy Body Disease and Frontal Temporal Dementia. Impaired smell and taste impairs quality of life such as loss of food enjoyment, weight loss or weight gain, decreased appetite and safety concerns such as inability to smell smoke, gas, spoiled food and one’s body odor. Dysosmia and Dysgeusia are very unpleasant disorders that often accompany smell and taste impairments.
    [Show full text]
  • Unifying the Motor & Non-Motor Features of Parkinson's Disease
    Unifying the Motor & Non-motor Features of Parkinson’s Disease Ali Shalash Professor of Neurology Chair of Ain Shams Movement Disorders Group Department of Neurology, Ain Shams Univeristy Cairo, Egypt AGENDA 1. Motor and non-motor Symptoms 2. Pathophysiology of Motor & NMS 3. Relation To Disease Course 4. NMS in motor subtypes 5. Motor & NMS fluctuation 6. Treatment of Motor & NMS: links Parkinson’s Disease • PD prevalence 1 % of populations older than 65 years (Abbas et al., 2018) • From 1990 to 2015, the number of with PD patients doubled to over 6 million, and double again to over 12 million by 2040 (Dorsey et al, 2018) • Aging populations, increasing longevity, decreasing smoking rates, and the by- products of industrialization MDS Clinical Diagnostic Criteria for PD Postuma et al 2015 MDS Clinical Diagnostic Criteria for PD Postuma et al 2015 Non-motor Symptoms of PD • Neuropsychiatric symptoms • Autonomic dysfunction • Depression up to 50-70 % • Drooling • Anxiety up to 60 % • Orthostatic hypotension 30–58% • Apathy 60 % • Urinary dysfunction • Psychosis up to 40% • Erectile dysfunction • Impulse control and related disorders • Gastrointestinal dysfunction 25–67% • Dementia, 24% to 40%. • Excessive sweating • Cognitive impairment 20-25% (other • Others than dementia mainly mild cognitive impairment) • Pain 30–85% • Fatigue 50% • Disorders of sleep and wakefulness • Olfactory dysfunction 90% • • Sleep fragmentation and insomnia Ophthalmologic dysfunction • Rapid eye movement sleep behavior disorder 65 % • Excessive daytime sleepiness Pathophysiology of Motor & NMS Neuropathology of PD: Motor Symptoms Two major pathologic processes: (a) premature selective loss of dopamine neurons: 30–70% cell loss ⇢ motor symptoms. (b) the accumulation of Lewy bodies, composed of α-synuclein Poewe, W.
    [Show full text]
  • COVID-19 Psychosis: a Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response?
    Journal Articles 2020 COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response? S. J. Ferrando L. Klepacz Northwell Health, [email protected] S. Lynch M. Tavakkoli R. Dornbush See next page for additional authors Follow this and additional works at: https://academicworks.medicine.hofstra.edu/articles Part of the Psychiatry Commons Recommended Citation Ferrando SJ, Klepacz L, Lynch S, Tavakkoli M, Dornbush R, Baharani R, Smolin Y, Bartell A. COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response?. 2020 Jan 01; 61(5):Article 6623 [ p.]. Available from: https://academicworks.medicine.hofstra.edu/articles/6623. Free full text article. This Article is brought to you for free and open access by Donald and Barbara Zucker School of Medicine Academic Works. It has been accepted for inclusion in Journal Articles by an authorized administrator of Donald and Barbara Zucker School of Medicine Academic Works. For more information, please contact [email protected]. Authors S. J. Ferrando, L. Klepacz, S. Lynch, M. Tavakkoli, R. Dornbush, R. Baharani, Y. Smolin, and A. Bartell This article is available at Donald and Barbara Zucker School of Medicine Academic Works: https://academicworks.medicine.hofstra.edu/articles/6623 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
    [Show full text]
  • The Effect of Radiotherapy on Taste Sensation in Head and Neck Cancer
    Asif et al. Radiation Oncology (2020) 15:144 https://doi.org/10.1186/s13014-020-01578-4 RESEARCH Open Access The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study Michal Asif1†, Assaf Moore1,2*† , Noam Yarom3,4 and Aron Popovtzer1,2 Abstract Background: One of the main side effects of head and neck (H&N) radiation therapy (RT) is alteration in taste sensation. It causes significant morbidity and has a major effect on quality of life (QoL). The aim of this study was to prospectively define the effect of RT on taste sensation (general, and four basic tastes) and correlate these findings with changes in saliva secretion and QoL questionnaires. Methods: Patients with H&N cancer treated with RT, in which the oral cavity was expected to receive a mean dose of 30 Gray (Gy). Patients were evaluated by Whole-Saliva Sialometry, validated Taste Strips and European Organization for Research and Treatment of Cancer H&N QoL questionnaires prior to RT (T0), mid-point of radiotherapy dose (T1), at the end of radiotherapy (T2) and 1 (T3), 3 (T4) and 12 months (T5) after completion of treatment course. Results: Twenty-eight patients were recruited, and 21 patients completed study procedures and were analyzed. Median age was 66 years (range 18–90). The most common tumor site was the oral cavity. The median prescribed radiation dose to the high dose volume was 66 (range 60–70). The median mean and max dose to the oral cavity were 25.1 (range 14–69) and 64.9 (range 30–70), respectively.
    [Show full text]
  • Abadie's Sign Abadie's Sign Is the Absence Or Diminution of Pain Sensation When Exerting Deep Pressure on the Achilles Tendo
    A.qxd 9/29/05 04:02 PM Page 1 A Abadie’s Sign Abadie’s sign is the absence or diminution of pain sensation when exerting deep pressure on the Achilles tendon by squeezing. This is a frequent finding in the tabes dorsalis variant of neurosyphilis (i.e., with dorsal column disease). Cross References Argyll Robertson pupil Abdominal Paradox - see PARADOXICAL BREATHING Abdominal Reflexes Both superficial and deep abdominal reflexes are described, of which the superficial (cutaneous) reflexes are the more commonly tested in clinical practice. A wooden stick or pin is used to scratch the abdomi- nal wall, from the flank to the midline, parallel to the line of the der- matomal strips, in upper (supraumbilical), middle (umbilical), and lower (infraumbilical) areas. The maneuver is best performed at the end of expiration when the abdominal muscles are relaxed, since the reflexes may be lost with muscle tensing; to avoid this, patients should lie supine with their arms by their sides. Superficial abdominal reflexes are lost in a number of circum- stances: normal old age obesity after abdominal surgery after multiple pregnancies in acute abdominal disorders (Rosenbach’s sign). However, absence of all superficial abdominal reflexes may be of localizing value for corticospinal pathway damage (upper motor neu- rone lesions) above T6. Lesions at or below T10 lead to selective loss of the lower reflexes with the upper and middle reflexes intact, in which case Beevor’s sign may also be present. All abdominal reflexes are preserved with lesions below T12. Abdominal reflexes are said to be lost early in multiple sclerosis, but late in motor neurone disease, an observation of possible clinical use, particularly when differentiating the primary lateral sclerosis vari- ant of motor neurone disease from multiple sclerosis.
    [Show full text]
  • Clinical Diagnosis and Treatment of Olfactory Dysfunction
    Clinical Diagnosis and Treatment of Olfactory Dysfunction Seok Hyun Cho Hanyang Med Rev 2014;34:107-115 http://dx.doi.org/10.7599/hmr.2014.34.3.107 Department of Otorhinolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea pISSN 1738-429X eISSN 2234-4446 Olfactory dysfunction is a relatively common disorder that is often under-recognized by Correspondence to: Seok Hyun Cho Department of Otorhinolaryngology-Head both patients and clinicians. It occurs more frequently in older ages and men, and decreases and Neck Surgery, Hanyang University patients’ quality of life, as olfactory dysfunction may affect the emotion and memory func- Hospital, 222 Wangsimni-ro, Seongdong-gu, tions. Three main causes of olfactory dysfunction are sinonasal diseases, upper respiratory Seoul 133-792, Korea Tel: +82-2-2290-8583 viral infection, and head trauma. Olfactory dysfunction is classified quantitatively (hypos- Fax: +82-2-2293-3335 mia and anosmia) and qualitatively (parosmia and phantosmia). From a pathophysiologi- E-mail: [email protected] cal perspective, olfactory dysfunction is also classified by conductive or sensorineural types. All patients with olfactory dysfunction will need a complete history and physical examina- Received 17 April 2014 Revised 23 June 2014 tion to identify any possible or underlying causes and psychophysical olfactory tests are Accepted 3 July 2014 essential to estimate the residual olfactory function, which is the most important prognos- This is an Open Access article distributed under tic factor. CT or MRI may be adjunctively used in some indicated cases such as head trauma the terms of the Creative Commons Attribution and neurodegenerative disorders.
    [Show full text]
  • Varenicline Tartrate Tablets CHAMPIX®
    For the use of a Registered Medical Practitioner or a Hospital or a Laboratory Varenicline Tartrate Tablets CHAMPIX® 1. NAME OF THE MEDICINAL PRODUCT CHAMPIX® 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains Varenicline tartrate equivalent to Varenicline 0.5 mg. Each film-coated tablet contains Varenicline tartrate equivalent to Varenicline 1 mg. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Film-coated tablets. 0.5 mg film-coated tablets: White, capsular-shaped, biconvex tablets debossed with “Pfizer” on one side and “CHX 0.5” on the other side. 1 mg film-coated tablets: Light blue, capsular-shaped, biconvex tablets debossed with “Pfizer” on one side and “CHX 1.0” on the other side. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications Varenicline is indicated for smoking cessation in adults. 4.2 Posology and Method of Administration Smoking cessation therapies are more likely to succeed for patients who are motivated to stop smoking and who are provided with additional advice and support. ® Trademark Proprietor: C.P. Pharmaceuticals International C.V. Licensed User – Pfizer Limited, India® CHAMPIX Film-coated Tablets Page 1 of 26 LPDCHX092019 The recommended dose of varenicline is 1 mg twice daily following a 1-week titration as follows: Days 1 – 3: 0.5 mg once daily Days 4 – 7: 0.5 mg twice daily Day 8 – End of treatment: 1 mg twice daily The patient should set a date to stop smoking. Varenicline dosing should start 1 week before this date (see section 5.1 Pharmacodynamic Properties). Varenicline tablets should be swallowed whole with water.
    [Show full text]
  • Hypogeusia As the Initial Presenting Symptom of COVID-19 Lauren E Melley ‍ ‍ ,1 Eli Bress,2 Erik Polan3
    Unusual association of diseases/symptoms BMJ Case Rep: first published as 10.1136/bcr-2020-236080 on 13 May 2020. Downloaded from Case report Hypogeusia as the initial presenting symptom of COVID-19 Lauren E Melley ,1 Eli Bress,2 Erik Polan3 1Doctor of Osteopathic Medicine SUMMARY severe respiratory distress, acute cardiopulmonary Program, Philadelphia College COVID-19 is the disease caused by the novel coronavirus, arrest and death.5 Coronaviruses have previously of Osteopathic Medicine, severe acute respiratory syndrome coronavirus 2 (SARS- been identified as a family of viruses associated with Philadelphia, Pennsylvania, USA CoV-2), which first arose in Wuhan, China, in December anosmia.6 Anecdotal evidence from otolaryngolo- 2Department of Otolaryngology– gists worldwide has suggested that otherwise mild Head and Neck Surgery, 2019 and has since been declared a pandemic. The Philadelphia College of clinical sequelae vary from mild, self-limiting upper cases of COVID-19 caused by the novel betacoro- Osteopathic Medicine, respiratory infection symptoms to severe respiratory navirus, SARS- CoV-2, may be significantly associ- Philadelphia, Pennsylvania, USA distress, acute cardiopulmonary arrest and death. ated with olfactory dysfunction. 3Department of Internal Otolaryngologists around the globe have reported a We present a case of COVID-19 resulting in ICU Medicine, Philadelphia College significant number of mild or otherwise asymptomatic admission, presenting with the initial symptom of Osteopathic Medicine, patients with COVID-19 presenting with olfactory of disrupted taste and flavour perception prior to Philadelphia, Pennsylvania, USA dysfunction. We present a case of COVID-19 resulting in respiratory involvement. The purpose of this paper intensive care unit (ICU) admission, presenting with the was to review the clinical course of SARS- CoV-2 in Correspondence to relation to the reported symptom of hyposmia and Lauren E Melley; initial symptom of disrupted taste and flavour perception lm244130@ pcom.
    [Show full text]
  • Timeline and Outcome of Anosmia and Ageusia Associated with Covid-19 Infection: a Case Report
    Crimson Publishers Case Report Wings to the Research Timeline and Outcome of Anosmia and Ageusia Associated with Covid-19 Infection: A Case Report Viviane Flumignan Z1*, Cristina Scavasine V1, Ghizoni Teive HA1, Branco Germiniani FM1, Azevedo VF2, Paulo Roberto Z3 and Camargo Rogenski CAM4 1Neurology division, Brazil ISSN: 2639-0531 2Rheumatology division, Brazil 3Occupational medicine division, Brazil 4Othorrinolaringology division, Brazil Abstract Background: Viral respiratory diseases can present with ageusia (hypogeusia) and anosmia (hyposmia) due to viral neurotropism, usually manifest together with other symptoms in the acute phase neurologicand have in manifestations most instances do both not aprovide good and information short recovery. about Duringneither the the epidemic timeline, periodnor the of outcome COVID-19, of thesedoctors symptoms should consider in this scenario. SARS-CoV-2 infection as a differential diagnosis. Recent series reporting these Patient’s concerns: *Corresponding author: onset of fever, followed by A dry54-year-old cough on female the second physician day, andwith on well-controlled the 4th day the diabetes, patient hypertensionnoticed a sudden and gnan Z, Department of vascular neurolo arrhythmia who presented with an acute respiratory syndrome with influenza symptoms, with sudden gy, Brazil Viviane Flumi- - and total loss of smell and taste sensations. After 20 days, she noticed a mild return of flavor perception, Submission: mainly for spicy foods, but still complained of hyposmia and dysgeusia until the end of this report (30 Diagnoses: Published: days after the onset of neuropathic symptoms). April 28, 2020 COVID 19 associated with anosmia and ageusia induced by viral respiratory disease May 12, 2020 inflammation.Intervention: Outcomes: HowVolume to 2 - Issuecite 4this article: cyanocobalamin supplementation to 9,000 micrograms per day.
    [Show full text]