In a not negligible number of patients affected by COVID‐19 (coronavirus disease 2019), especially if paucisymptomatic, anosmia and ageusia can represent the first or only symptomatology present. ...Laryngoscope, 130:1787–1787, 2020
Background
The first European case series are detecting a very high frequency of chemosensitive disorders in COVID‐19 patients, ranging between 19.4% and 88%.
Methods
Olfactory and gustatory function ...was objectively tested in 72 COVID‐19 patients treated at University Hospital of Sassari.
Results
Overall, 73.6% of the patients reported having or having had chemosensitive disorders. Olfactory assessment showed variable degree hyposmia in 60 cases and anosmia in two patients. Gustatory assessment revealed hypogeusia in 33 cases and complete ageusia in one patient. Statistically significant differences in chemosensitive recovery were detected based on age and distance from the onset of clinical manifestations.
Conclusion
Olfactory and gustatory dysfunctions represent common clinical findings in COVID‐19 patients. Otolaryngologists and head‐neck surgeons must by now keep this diagnostic option in mind when evaluating cases of ageusia and nonspecific anosmia that arose suddenly and are not associated with rhinitis symptoms.
Background
Objective data on chemosensitive disorders during COVID‐19 are lacking in the Literature.
Methods
Multicenter cohort study that involved four Italian hospitals. Three hundred and ...forty‐five COVID‐19 patients underwent objective chemosensitive evaluation.
Results
Chemosensitive disorders self‐reported by 256 patients (74.2%) but the 30.1% of the 89 patients who did not report dysfunctions proved objectively hyposmic. Twenty‐five percentage of patients were seen serious long‐lasting complaints. All asymptomatic patients had a slight lowering of the olfactory threshold. No significant correlations were found between the presence and severity of chemosensitive disorders and the severity of the clinical course. On the contrary, there is a significant correlation between the duration of the olfactory and gustatory symptoms and the development of severe COVID‐19.
Conclusions
Patients under‐report the frequency of chemosensitive disorders. Contrary to recent reports, such objective testing refutes the proposal that the presence of olfactory and gustatory dysfunction may predict a milder course, but instead suggests that those with more severe disease neglect such symptoms in the setting of severe respiratory disease.
Background
Chemosensitive disorders are very frequent in the early stages of COVID‐19 and in paucisymptomatic cases. These patients are typically placed in home quarantine. This study has the aim of ...validating a new olfactory and gustatory objective evaluation test in these patients.
Methods
Thirty‐three home‐quarantined COVID‐19 patients have undergone a self‐administered chemosensitive test the day before the control swab. On this occasion, the patients underwent operator‐administered already validated tests. The results were finally compared.
Results
The differences between the results of the two tests were not significant for both the olfaction (P =.201) and the taste (P =.180).
Conclusion
The olfactory and gustatory evaluation by self‐administered test can be considered a valid tool, fundamental for obtaining objective qualitative and quantitative data on the extent of chemosensitive disorders in home‐quarantined COVID‐19 patients.
Chemosensitive dysfunctions are now considered as frequent and early symptoms of coronavirus disease 2019 (COVID-19). In the last few weeks, researchers' greatest efforts have been focusing mainly on ...the analysis of olfactory disorders, neglecting taste dysfunctions. According to our psychophysical evaluations, it can be inferred that the pathogenesis of taste disorders in COVID-19 patients is largely smell-independent. Moreover, isolated gustatory disorders are highly specific of SARS-CoV-2 infection. For these reasons, it is essential that gustatory dysfunctions, like olfactory disorders, are included in the COVID-19 guidelines.
To investigate the effectiveness of platelet-rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID-19) patients with persistent olfactory dysfunction (OD).
...Controlled study.
Multicenter study.
From March 2022 to November 2022, COVID-19 patients with persistent OD were recruited from three European hospitals to undergo PRP injections into the olfactory clefts. Olfactory function was evaluated at baseline and 10 weeks postinjection with the Olfactory Disorder Questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Data were compared with a control group of untreated patients.
Eighty-one patients who underwent PRP injection and 78 controls were included. Sixty-five PRP patients (80.3%) experienced subjective smell improvement after a mean duration of 3.4 ± 1.9 weeks. The parosmia, life quality statement, and ODQ sub- and total scores significantly decreased from pre- to 10-week postinjection in the PRP group. The TDI sub- and total scores significantly increased 10 weeks postinjection. In controls, the ODQ score did not change over time, while the discrimination, identification, and total TDI scores significantly increase after 10 weeks of follow-up. The 10-week TDI and ODQ scores were significantly better in the PRP group compared with the controls.
Patients who underwent PRP injection reported better 10-week subjective and objective smell outcomes than controls. Future randomized-controlled studies using saline injection into the olfactory cleft of controls are needed to determine the superiority of PRP over placebo.
The aim of this study was to evaluate retrospectively the accuracy of a protocol for completely in-house, computer-assisted, orthognathic surgery, generating resin printed intermediate surgical ...guides. A retrospective, observational study was made on a cohort of 15 patients treated consecutively from September 2017 to May 2019, who underwent bimaxillary orthognathic surgery planned with the same 3-dimensional program and whose surgical intermediate splints were obtained with the same all-in-house protocol. Virtual planned surgical movements were compared with the real surgical outcome. The differences were not significant for eight of the 12 variables considered. The p values, calculated with the Wilcoxon signed rank test, were evenly distributed and ranged from p=0.001 to p=0.820. Significant differences were reported in four measurements: angle between sella-nasion plane and a line connecting the incisal edge and the apex of the root of the most prominent incisor (U1-SN) (p=0.001), angle between Frankfort plane and a line connecting the incisal edge and the root apex of the most prominent upper incisor (p=0.008), dental midline discrepancies (p=0.006), and occlusal plane tilt (U1-FH) (p=0.001), basically due to intraoperative settings. The 3-dimensional resin printed surgical guides were shown to be a reliable alternative to the commercial ones and showed high rate of accuracy for most of the variables assessed. Four out of 12 of these showed significant errors, but two of them were only minimal discrepancies with no clinical implications.
Based on the results obtained, the authors found a significantly higher viral load in nasopharyngeal swab in patients with chemosensory dysfunction. The cycle threshold (CT) value on the PCR assay on ...the nasopharyngeal swab was determined for all patients (median 29.95, IQR 26.27–32.39). Most of the authors reported a higher frequency of olfactory and gustatory disturbances in patients with mild COVID-19 while such dysfunctions are uncommon in severe forms of the disease 8–10.
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