scholarly journals Sustained Chemosensory Dysfunction during the COVID-19 Pandemic

ORL ◽  
2021 ◽  
pp. 1-10
Author(s):  
Janne Schwab ◽  
Caroline Damsgaard Jensen ◽  
Alexander Wieck Fjaeldstad
Keyword(s):  
Prognostic Factors ◽  
Female Gender ◽  
Olfactory Dysfunction ◽  
Young Age ◽  
Olfactory Function ◽  
Specific Symptom ◽  
Baseline Questionnaire ◽  
Gustatory Function ◽  
Chemosensory Function

<b><i>Introduction:</i></b> Chemosensory dysfunction (CD) has proven valuable in prediction of COVID-19, as it is a frequent and specific symptom of the disease. The aim of this study was to investigate the duration of CD in patients with sudden subjective olfactory and/or gustatory loss during the SARS-CoV-2 pandemic. The secondary aim was to identify possible prognostic factors for the duration of CD. <b><i>Methods:</i></b> An online baseline questionnaire was designed to assess subjective CD. Three rounds of follow-up questionnaires were sent out to any participants with persistent CD in 6-week intervals, prospectively assessing subjective chemosensory function and extending the follow-up time of this cohort significantly. <b><i>Results:</i></b> In total, 467 participants completed the baseline questionnaire. The most significant improvement and recovery of chemosensory function was observed within the first month after the initial loss. Rates became stagnant after about 2 months, and only little improvement and recovery was seen after 2–4 months. After a mean follow-up of 95.9 days (olfactory dysfunction) and 94.0 days (gustatory dysfunction), 86.7% of participants reported gustatory improvement and 82.6% reported olfactory improvement, while 55.0% reported full gustatory recovery and 43.8% reported full olfactory recovery. Female gender was associated with better improvement of gustatory function. High subjective severity of chemosensory loss was associated with lower rates of olfactory and gustatory recovery as well as improvement of olfactory function. Young age was not associated with a better prognosis. <b><i>Discussion/Conclusion:</i></b> Rates of improvement and recovery of chemosensory function decreased after 2–4 months after initial chemosensory loss, possibly indicating that prolonged and perhaps permanent chemosensory loss may be a complication of SARS-CoV-2 infections. High subjective severity of CD may worsen the prognosis for improvement and recovery of chemosensory function.

Recovery Over Time and Prognostic Factors in Treated Patients with Post-Infectious Olfactory Dysfunction: A Retrospective Study

2020 ◽  
Vol 129 (10) ◽  
pp. 977-982
Author(s):  
Takao Ogawa ◽  
Keigo Nakamura ◽  
Sayuri Yamamoto ◽  
Ichiro Tojima ◽  
Takeshi Shimizu
Keyword(s):  
Prognostic Factors ◽  
Time Course ◽  
Early Period ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Clinical Predictors ◽  
Younger Age ◽  
Number Of Patients ◽  
Over Time

Objectives: The aims of the present study were to clarify the time-course of olfactory recovery and the prognostic factors in PIOD patients treated with Toki-shakuyaku-san (TSS). Methods: A retrospective cohort study of patients with PIOD was conducted by reviewing patients’ medical records. This study included patients who received TSS or a combination of TSS and zinc sulfate. Olfactory function was examined by T&T olfactometer at each 3-monthly follow-up visit. Patients with normal and mild olfactory dysfunction were excluded. Gender, age, treatment, duration of disease until the first visit and olfactory function scores of the T&T olfactometer at the first visit were analyzed as candidate clinical predictors of recovery. Results: A total of 82 PIOD patients with ages ranging from 16 to 79 years were included. The mean duration of follow-up was 14.5 months (range 3-45 months). The number of patients with olfactory recovery increased for 24 months and the cumulative recovery rate was 77.3%. In about 60% of patients, olfactory recovery occurred within 6 months. Multivariate analysis showed that younger age (<65 years) and residual olfactory function were significantly associated with good olfactory recovery. Conclusions: We revealed recovery rates over time in patients with PIOD. The recovery of olfactory function often occurred during the early period (≤6 months). However, the number of patients with olfactory recovery increased for a long-term of 24 months after the first visit. Residual olfactory function and younger age were prognostic factors exactly. TSS may be a useful therapeutic agent for patients with PIOD. We believe that these results provide important information that is useful for counseling patients with PIOD.

scholarly journals High prevalence of long-term olfactory dysfunction confirmed by olfactory testing after a community COVID-19 outbreak

HNO ◽  
2021 ◽  
Author(s):  
Hilmar Gudziol ◽  
Timo Kirschstein ◽  
Mathias W. Pletz ◽  
Sebastian Weis ◽  
Orlando Guntinas-Lichius ◽  
...  
Keyword(s):  
Population Based ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Taste Disturbance ◽  
Gustatory Function ◽  
Psychophysical Testing ◽  
Olfactory Testing ◽  
High Prevalence ◽  
Normal Taste

Abstract Purpose The prevalence of long-term olfactory and gustatory dysfunction in participants suffering from sudden chemosensory loss due to coronavirus disease 2019 (COVID-19) is unknown. Furthermore, evaluations of the reliability of participants’ self-reporting of olfactory function (SOF) and gustatory function (SGF) using extended objective psychophysical testing are missing. Methods In this population-based cohort study in a PCR-tested community in Thuringia, Germany, olfactory function was extensively examined 4 months after a COVID-19 outbreak using the “Sniffin Sticks” test battery to determine the TDIa score, i.e., the sum of results obtained for threshold, discrimination, and identification scores averaged for both nasal sides. Gustatory function was assessed using the three-drop test resulting in the gustatory composite score (CSg). The data were compared with SOF and SGF. Results Of 43 adult convalescents (median age: 68 years; 58% female) after SARS-CoV‑2 infection, 18 participants (42%) had olfactory complaints due to SOF, one participant (2%) complained of taste disturbance due to SGF. The TDIa was 22.0 ± 5.9. Normosmia, hyposmia, and anosmia were seen in 17, 18, and eight participants, respectively. TDIa correlated with SOF (rs = −0.434, p = 0.004); CSg was 23.5 ± 2.7. Normogeusia and hypogeusia were objectified in 39 and four participants, respectively. The prevalence of long-term olfactory dysfunction and gustatory dysfunction in the study group was 60.5 and 9.3%, respectively. Conclusion The SOF was reliable, especially for participants who felt a sudden chemosensory dysfunction during the outbreak. At 4 months after SARS-CoV‑2 infection, a high proportion of participants were dysosmic, whereas nearly all of them had normal taste function.

Prognostic Factors Affecting Clinical Outcomes of Arthroscopic Assisted Reduction and Volar Plating through Preservation of Pronator Quadratus for Intra-Articular Distal Radius Fracture

2020 ◽  
Vol 25 (03) ◽  
pp. 345-352
Author(s):  
Jae-Uk Jung ◽  
Seok-Won Yang ◽  
Jung-Sang Kim ◽  
Jae-Wook Park ◽  
Jong-Pil Kim
Keyword(s):  
Prognostic Factors ◽  
Clinical Outcomes ◽  
Distal Radius ◽  
Univariate Analysis ◽  
Female Gender ◽  
Volar Plating ◽  
Pronator Quadratus ◽  
Radiographic Parameters ◽  
Significant Difference

Background: This study aimed to evaluate the clinical and radiological outcomes following an arthroscopic-assisted reduction and volar plating (AR-VP) surgery through pronator quadratus (PQ) preservation for treating intra-articular distal radius fractures (IA-DRFs) and to assess prognostic factors that affect functional outcomes. Methods: Between March 2014 and February 2017, 54 patients who had intra-articular DRF and underwent AR-VP through the PQ preservation technique and completed 1-year follow-up were enrolled. Patients were divided into the satisfactory group (excellent and good results) and an unsatisfactory group (fair and poor results) based on the modified Mayo Wrist Scoring System (MMWS) scored at 1-year follow-up to determinate prognostic factors that affected clinical outcomes. Patients’ demographics, clinical outcome measures (VAS, DASH, PRWE, etc.), and pre-and post-operative radiographic parameters were analyzed. Results: The outcomes according to MMWS were 10 excellent, 22 good, 14 fair, and 8 poor. A univariate analysis showed a significant difference between the groups (p < .05) for all radiographic parameters, sex, and the presence of an intra-articular comminution. In the multivariate analysis, female gender, presence of an intra-articular comminution, and difference of palmar articular tilt compared to uninjured wrist (> 20.1°) at trauma were considered as significant poor prognostic factors of functional outcome. Conclusions: AR-VP surgery through PQ preservation for intra-articular DRFs has reliable clinical and radiological outcomes. However, female gender, presence of an intra-articular comminution, and difference of palmar articular tilt compared to the uninjured wrist (> 20.1°) at initial injury were considered poor prognostic factors for AR-VP through PQ preservation for intra-articular DRF.

scholarly journals Olfactory Dysfunction in β-Thalassemia Major Patients Treated with Iron-Chelating Agents

2017 ◽  
Vol 96 (10-11) ◽  
pp. E8-E12 ◽  
Author(s):  
Serhan Derin ◽  
Selvet Erdogan ◽  
Murat Sahan ◽  
Mehmet Fatih Azik ◽  
Hatice Derin ◽  
...  
Keyword(s):  
Chelating Agents ◽  
Thalassemia Major ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Facial Trauma ◽  
Control Group ◽  
History Of ◽  
And Control ◽  
Iron Chelating Agents

Ocular and ophthalmologic adverse effects may occur in patients with β-thalassemia major (BTM) treated regularly with blood transfusions and iron-chelating agents. We hypothesized that olfactory dysfunction may be present in this patient population. We aimed to investigate olfactory dysfunction in patients with BTM and to determine etiologic factors. A total of 43 patients with BTM were included in the study. Forty-three subjects without nasal complaints, history of facial trauma, or nasal surgery were included as the controls. All participants had nasal endoscopy. The use of iron-chelating agents by patients with BTM and their duration of use were recorded, as well as hemoglobin and ferritin levels. The Sniffin Sticks test (SST) was used to assess olfactory function, comparing results between the BTM and control groups. The correlations of SST scores with the other study parameters were analyzed. Eight (18.6%) of 43 patients in the BTM group and none of the subjects in the control group had hyposmia (p < 0.001). Older age, low hemoglobin level, and longer use of deferoxamine were found to be correlated with olfactory dysfunction. Olfactory dysfunction can occur in patients with BTM treated with iron-chelating agents. The results suggest that screening for olfactory function should be part of the routine follow-up of patients with BTM.

Predictors of death, heart transplantation and relapse in clinically suspected and biopsy-proven myocarditis in the pre-immunosuppression era

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Baritussio ◽  
C Cheng ◽  
F Fachin ◽  
F Vacirca ◽  
D Marcolongo ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Heart Transplantation ◽  
Univariate Analysis ◽  
Female Gender ◽  
High Titre ◽  
Left Ventricular ◽  
Young Age ◽  
Left Ventricular Ejection ◽  
Organ Specific

Abstract Background Myocarditis is an infectious or autoimmune inflammatory disease of the myocardium; diagnosis relies on the exclusion of an acute coronary syndrome, and is confirmed by endomyocardial biopsy (EMB). Prognosis is highly variable, outcome predictors are not well defined. Purpose To identify clinical, imaging and immunological predictors of death, heart transplantation (HTx) and relapse in patients with myocarditis in the pre-immunosuppression era. Methods From 1993 to 2012 we consecutively enrolled 466 patients (68% male, mean age 37±17 years), 216 with clinically suspected and 250 with EMB-proven myocarditis. All patients underwent coronary angiogram and transthoracic echocardiogram, 44% of patients underwent cardiac magnetic resonance (CMR). Circulating auto-antibodies were measured in patients' sera by indirect immunofluorescence. All patients were prospectively followed-up at the local Cardio-immunology outpatient clinic. Results After a median follow-up of 50 months (IQR 25–75), 366 patients (79%) were alive, while 42 (9%) were dead or underwent HTx; 58 were lost to follow-up. Ten-year survival free from death or HTx was overall 83%, but was lower in patients with EMB-proven myocarditis (76% vs 94% in patients with clinically suspected myocarditis, p&lt;0.001). On univariate analysis, predictors of death and HTx were female gender (p=0.003), previous myocarditis (p=0.03), heart failure on presentation and advanced NYHA class (p&lt;0.001, respectively), histological diagnosis of giant-cell myocarditis (p=0.002), positivity for anti-heart antibodies (AHA, p=0.04), anti-cardiac endothelial cell (AECA, p=0.002) and anti-nucleus antibodies (ANA, p=0.003). On multivariate analysis, female gender (HR 2.69, p=0.02), lower left ventricular ejection fraction on echocardiogram (p&lt;0.001), positivity for high-titre organ-specific AHA (HR 4.1, p=0.02) and for ANA (HR 5.1, p&lt;0.001) were independent predictors of death and HTx. Seventy-seven patients had relapsing myocarditis; on univariate analysis, young age (p&lt;0.001), previous myocarditis (p&lt;0.001), symptoms preceding diagnosis (p=0.004), positivity for anti-intercalated disk autoantibody (AIDA, p=0.02), and presence of diffuse late gadolinium enhancement (LGE) on CMR (p&lt;0.001) were predictors of relapse. On multivariate analysis young age (p=0.02) and previous myocarditis (HR 8.4, p&lt;0.001) were independent predictors of relapse. Predictors of death, HTx and relapse, respectively, did not differ when considering separately patients with EMB-proven myocarditis and those with clinically suspected myocarditis. Conclusions In the pre-immunosuppressive era, young age and a previous episode of myocarditis were independent predictors of relapse, female gender, left ventricular dysfunction at presentation and high-titre organ-specific AHA and ANA were independent predictors of death and HTx, suggesting that autoimmune features in myocarditis predict worse prognosis. Funding Acknowledgement Type of funding source: None

scholarly journals Olfactory Dysfunction Predicts Disease Progression in Parkinson’s Disease: A Longitudinal Study

2020 ◽  
Vol 14 ◽  
Author(s):  
Runcheng He ◽  
Yuwen Zhao ◽  
Yan He ◽  
Yangjie Zhou ◽  
Jinxia Yang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Mmse Score ◽  
Clinical Manifestations ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Motor Symptom

Background and Objective:Olfactory dysfunction (hyposmia) is an important non-motor symptom of Parkinson’s disease (PD). To investigate the potential prognostic value of hyposmia as a marker for disease progression, we prospectively assessed clinical manifestations and longitudinal changes of hyposmic PD patients and normosmic ones.MethodsOlfactory function was evaluated with the Sniffin’ Sticks in PD patients at baseline. One hundred five hyposmic PD patients and 59 normosmic PD patients were enrolled and followed up for 2 years. They were subsequently evaluated at baseline and during follow-up periods with neurological and neuropsychological assessments. Clinical manifestations and disease progressions were compared between hyposmic and normosmic patients. In addition, the relationship between disease progressions and olfactory function was analyzed.ResultsOur study suggested that hyposmic PD patients and normosmic ones were similar in gender, age, education levels, age of onset, disease duration, and clinical features at baseline. Hyposmic PD patients exhibited more severe Unified Parkinson’s Disease Rating Scale Part II–III (UPDRS II-III) scores, higher levodopa equivalent dose (LED) needs, and poorer Mini-Mental State Examination (MMSE) score at follow-up visits compared to those in normosmic PD patients. Hyposmia also showed greater rates in the increase of LED needs, improvement of UPDRS III score, and deterioration of MMSE score. Both improvement of UPDRS III score and decline of MMSE score were associated with poorer odor identification.ConclusionOur prospective study demonstrated that hyposmic PD patients showed a relatively worse clinical course compared with normosmic patients. Olfactory dysfunction is a useful predictor of disease progression.

scholarly journals Differences in Correlation between Subjective and Measured Olfactory and Gustatory Dysfunctions after Initial Ear, Nose and Throat Evaluation

2021 ◽  
Author(s):  
Hans Jacob Nørgaard ◽  
Alexander Wieck Fjaeldstad
Keyword(s):  
Case Series ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Clinical Tests ◽  
Positive Correlation ◽  
Taste Disorder ◽  
Strong Indicator ◽  
Olfactory Impairment ◽  
Chemosensory Function ◽  
Nose And Throat

Abstract Introduction Subjective chemosensory function can differ from measured function. Previous studies on olfactory assessment have found a positive correlation between subjective and measured scores. However, information on gustatory correlation between measured and subjective functions is sparse in patients who have undergone an initial ear, nose and throat (ENT) evaluation. Objectives To evaluate the correlation between subjective and measured olfactory and gustatory dysfunctions in a population complaining of taste and/or smell dysfunction after an initial ENT evaluation without chemosensory testing. Furthermore, we aimed to assess the need for chemosensory testing depending on the type of subjective chemosensory dysfunction. Methods A case series in which subjective chemosensory function was assessed through a questionnaire and measured chemosensory function was assessed by validated clinical tests. Results In total, 602 patients with complaints of olfactory and/or gustatory dysfunction were included. We found that 50% of the patients with normal gustatory function and an olfactory impairment classified their olfactory impairment as a subjective taste disorder. Furthermore, 98% of the patients who rated their olfactory function as absent did have a measurable olfactory impairment, but only 64% were anosmic. Conclusion Subjective gustatory dysfunction was poorly correlated with measured gustatory dysfunction, and was often found to reflect olfactory dysfunction. Contrarily, subjective olfactory dysfunction was positively correlated with measurable olfactory dysfunction. Although subjective anosmia was a strong indicator of measured anosmia or hyposmia, the existence of remaining olfactory function was frequently found in these patients. Validated chemosensory testing should be performed in patients with perceived olfactory or gustatory deficits, as this could help ensure increased diagnostic precision and a relevant treatment.

scholarly journals Prognostic Value of Olfactory and Gustatory Dysfunction As Initial Symptoms of COVID-19 Infection

2020 ◽  
Author(s):  
Ameen Biadsee ◽  
Or Dagan ◽  
Zeev Ormianer ◽  
Firas Kassem ◽  
Shchada Masarwa ◽  
...  
Keyword(s):  
Olfactory Function ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Gustatory Function ◽  
Negative Prognostic Factor ◽  
Initial Symptoms ◽  
Patient Reported ◽  
Study Population ◽  
Polymerase Chain

Abstract Introduction: Olfactory and gustatory chemosensory dysfunctions are very prevalent in COVID-19 infection, our aim is to further explore chemosensory recovery among these patients.Methods: This is a cross-sectional follow-up study, which serves as a sequel to a study by Biadsee, et al. Among the previous study population of 128 non-hospitalized patients, who were tested positive for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR). Ninety-seven patients participated in a telephone survey designed for this study. Recovery of olfactory and gustatory functions were defined when a score is greater or equal to that reported before the disease. Persistent hyposmia and hypogeusia were defined as lower scores reported during follow-up, compared with scores before the disease. Results: A total of 43 men and 54 women were included. Mean age was 37 years (range 18-73). Mean follow-up was 59.2 days (range 21-83). At follow-up, 72 (74.2%) patients reported normalization of gustatory function and 63 (64.9%) reported normalization of olfactory function. No patient reported nasal obstruction at follow-up. Recovery of olfactory function was positively correlated with gustatory recovery (p=0.003). Twenty-three (23.7%) reported persistent xerostomia. Women who reported persistent xerostomia had higher rates of olfactory and gustatory dysfunction (p=0.006 and p=0.008, respectively) than those who did not. Olfactory and gustatory disorders as initial symptoms were negative prognostic factors for recovery. Conclusion: Olfactory and/or gustatory dysfunction as a presenting symptom of COVID-19 infection may be a negative prognostic factor for full recovery of olfactory and gustatory function.

Prognostic factors that mandate long term follow up following surgery for appendix neuroendocrine tumours (aNETs)

2016 ◽  
Author(s):  
Edward Alabraba ◽  
Heman Joshi ◽  
Andrea Tufo ◽  
Hassan Malik ◽  
Melissa Banks ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumours ◽  
Long Term Follow Up
Sign in / Sign up

Export Citation Format

Share Document