45
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      More than smell – COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

      research-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 29 , 35 , 37 , 29 , 38 , 39 , 40 , 41 , 42 , 42 , 43 , 44 , 45 , 46 , 29 , 47 , 48 , 49 , 50 , 51 , 52 , 36 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 65 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 78 , 79 , 81 , 4 , 84 , 86 , 108 , 29 , 109 , 106 , 110 , 6 , GCCR Group Author
      Chemical Senses
      Oxford University Press
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation and initial results of a multi-lingual, international questionnaire to assess self-reported quantity and quality of perception in three distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, 8 other, ages 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± SD), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell, but also affects taste and chemesthesis. The multimodal impact of COVID-19 and lack of perceived nasal obstruction suggest that SARS-CoV-2 infection may disrupt sensory-neural mechanisms.

          Related collections

          Most cited references80

          • Record: found
          • Abstract: found
          • Article: not found

          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Endothelial cell infection and endotheliitis in COVID-19

            Cardiovascular complications are rapidly emerging as a key threat in coronavirus disease 2019 (COVID-19) in addition to respiratory disease. The mechanisms underlying the disproportionate effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with cardiovascular comorbidities, however, remain incompletely understood.1, 2 SARS-CoV-2 infects the host using the angiotensin converting enzyme 2 (ACE2) receptor, which is expressed in several organs, including the lung, heart, kidney, and intestine. ACE2 receptors are also expressed by endothelial cells. 3 Whether vascular derangements in COVID-19 are due to endothelial cell involvement by the virus is currently unknown. Intriguingly, SARS-CoV-2 can directly infect engineered human blood vessel organoids in vitro. 4 Here we demonstrate endothelial cell involvement across vascular beds of different organs in a series of patients with COVID-19 (further case details are provided in the appendix). Patient 1 was a male renal transplant recipient, aged 71 years, with coronary artery disease and arterial hypertension. The patient's condition deteriorated following COVID-19 diagnosis, and he required mechanical ventilation. Multisystem organ failure occurred, and the patient died on day 8. Post-mortem analysis of the transplanted kidney by electron microscopy revealed viral inclusion structures in endothelial cells (figure A, B ). In histological analyses, we found an accumulation of inflammatory cells associated with endothelium, as well as apoptotic bodies, in the heart, the small bowel (figure C) and lung (figure D). An accumulation of mononuclear cells was found in the lung, and most small lung vessels appeared congested. Figure Pathology of endothelial cell dysfunction in COVID-19 (A, B) Electron microscopy of kidney tissue shows viral inclusion bodies in a peritubular space and viral particles in endothelial cells of the glomerular capillary loops. Aggregates of viral particles (arrow) appear with dense circular surface and lucid centre. The asterisk in panel B marks peritubular space consistent with capillary containing viral particles. The inset in panel B shows the glomerular basement membrane with endothelial cell and a viral particle (arrow; about 150 nm in diameter). (C) Small bowel resection specimen of patient 3, stained with haematoxylin and eosin. Arrows point to dominant mononuclear cell infiltrates within the intima along the lumen of many vessels. The inset of panel C shows an immunohistochemical staining of caspase 3 in small bowel specimens from serial section of tissue described in panel D. Staining patterns were consistent with apoptosis of endothelial cells and mononuclear cells observed in the haematoxylin-eosin-stained sections, indicating that apoptosis is induced in a substantial proportion of these cells. (D) Post-mortem lung specimen stained with haematoxylin and eosin showed thickened lung septa, including a large arterial vessel with mononuclear and neutrophilic infiltration (arrow in upper inset). The lower inset shows an immunohistochemical staining of caspase 3 on the same lung specimen; these staining patterns were consistent with apoptosis of endothelial cells and mononuclear cells observed in the haematoxylin-eosin-stained sections. COVID-19=coronavirus disease 2019. Patient 2 was a woman, aged 58 years, with diabetes, arterial hypertension, and obesity. She developed progressive respiratory failure due to COVID-19 and subsequently developed multi-organ failure and needed renal replacement therapy. On day 16, mesenteric ischaemia prompted removal of necrotic small intestine. Circulatory failure occurred in the setting of right heart failure consequent to an ST-segment elevation myocardial infarction, and cardiac arrest resulted in death. Post-mortem histology revealed lymphocytic endotheliitis in lung, heart, kidney, and liver as well as liver cell necrosis. We found histological evidence of myocardial infarction but no sign of lymphocytic myocarditis. Histology of the small intestine showed endotheliitis (endothelialitis) of the submucosal vessels. Patient 3 was a man, aged 69 years, with hypertension who developed respiratory failure as a result of COVID-19 and required mechanical ventilation. Echocardiography showed reduced left ventricular ejection fraction. Circulatory collapse ensued with mesenteric ischaemia, and small intestine resection was performed, but the patient survived. Histology of the small intestine resection revealed prominent endotheliitis of the submucosal vessels and apoptotic bodies (figure C). We found evidence of direct viral infection of the endothelial cell and diffuse endothelial inflammation. Although the virus uses ACE2 receptor expressed by pneumocytes in the epithelial alveolar lining to infect the host, thereby causing lung injury, the ACE2 receptor is also widely expressed on endothelial cells, which traverse multiple organs. 3 Recruitment of immune cells, either by direct viral infection of the endothelium or immune-mediated, can result in widespread endothelial dysfunction associated with apoptosis (figure D). The vascular endothelium is an active paracrine, endocrine, and autocrine organ that is indispensable for the regulation of vascular tone and the maintenance of vascular homoeostasis. 5 Endothelial dysfunction is a principal determinant of microvascular dysfunction by shifting the vascular equilibrium towards more vasoconstriction with subsequent organ ischaemia, inflammation with associated tissue oedema, and a pro-coagulant state. 6 Our findings show the presence of viral elements within endothelial cells and an accumulation of inflammatory cells, with evidence of endothelial and inflammatory cell death. These findings suggest that SARS-CoV-2 infection facilitates the induction of endotheliitis in several organs as a direct consequence of viral involvement (as noted with presence of viral bodies) and of the host inflammatory response. In addition, induction of apoptosis and pyroptosis might have an important role in endothelial cell injury in patients with COVID-19. COVID-19-endotheliitis could explain the systemic impaired microcirculatory function in different vascular beds and their clinical sequelae in patients with COVID-19. This hypothesis provides a rationale for therapies to stabilise the endothelium while tackling viral replication, particularly with anti-inflammatory anti-cytokine drugs, ACE inhibitors, and statins.7, 8, 9, 10, 11 This strategy could be particularly relevant for vulnerable patients with pre-existing endothelial dysfunction, which is associated with male sex, smoking, hypertension, diabetes, obesity, and established cardiovascular disease, all of which are associated with adverse outcomes in COVID-19.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China

              The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, is serious and has the potential to become an epidemic worldwide. Several studies have described typical clinical manifestations including fever, cough, diarrhea, and fatigue. However, to our knowledge, it has not been reported that patients with COVID-19 had any neurologic manifestations.
                Bookmark

                Author and article information

                Journal
                Chem Senses
                Chem. Senses
                chemse
                Chemical Senses
                Oxford University Press (UK )
                0379-864X
                1464-3553
                20 June 2020
                : bjaa041
                Affiliations
                [1 ] Department of Psychology, Temple University
                [2 ] Institute of Neuroscience and Medicine (INM-3), Research Center Jülich
                [3 ] Department of Anatomy, School of Medicine , Mersin University
                [4 ] Institute of Biochemistry, Food Science and Nutrition , The Hebrew University of Jerusalem
                [5 ] AbScent
                [6 ] Department of Food Science, The Pennsylvania State University
                [7 ] Interdepartmental Neuroscience Program, University of California Irvine
                [8 ] Institut de Chimie de Nice, Université Côte d'Azur
                [9 ] Centre for Global Health Research, Usher Institute , The University of Edinburgh
                [10 ] Department of Basic Medical Sciences, Neuroscience and Sensory Organs , Università degli Studi di Bari A. Moro
                [11 ] V1-B, CSIR-Central Scientific Instruments Organisation
                [12 ] Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro
                [13 ] Food Science and Human Nutrition, University of Illinois at Urbana Champaign
                [14 ] Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
                [15 ] GSBMS - Medecine Evolutive UMR5288, Université de Toulouse
                [16 ] National Centre for Biological Sciences, National Centre for Biological Sciences , Tata Institute of Fundamental Research
                [17 ] School of Life Sciences, Arizona State University
                [18 ] Department of Psychology and Anthropology, University of Extremadura
                [19 ] Department of General Psychology, University of Padova
                [20 ] Psychiatry, Yale University School of Medicine
                [21 ] Exercise and Nutritional Sciences, San Diego State University
                [22 ] Department of Otolaryngology, Hospital Unit West, Aarhus University
                [23 ] Biocomputation Group, University of Hertfordshire
                [24 ] Neuroscience Area, SISSA, International School for Advanced Studies
                [25 ] Neuropop Team, Lyon Neuroscience Research Center, CNRS UMR5292 - INSERM U1028 - University Lyon 1
                [26 ] Department of Food and Nutrition, Functional Foods Forum, University of Helsinki, University of Turku
                [27 ] Academic ORL Department, Aristotle University
                [28 ] Section In-silico Biology and Machine Learning, Leibniz-Institute for Food Systems Biology at the Technical University of Munich
                [29 ] Monell Chemical Senses Center
                [30 ] Mersin University
                [31 ] CSGA-Centre for Taste and Feeding Behavior, INRAE
                [32 ] Anatomy, Université du Québec à Trois-Rivières
                [33 ] Division of Human Nutrition and Health, Wageningen University
                [34 ] Otorhinolaryngology, Medical Science University
                [35 ] Translational Medicine Division, Sidra Medicine
                [36 ] Institut de Chimie de Nice, UMR CNRS 7272, Université Côte d'Azur
                [37 ] The University of Queensland Diamantina Institute, The University of Queensland
                [38 ] Food Technology, IRTA
                [39 ] DreamAir Llc
                [40 ] Neurobiology and Behavior, University of California, Irvine
                [41 ] Department of Zoology, Charles University
                [42 ] Médecine Evolutive UMR5288, Université de Toulouse-CNRS
                [43 ] Centre for Nutrition and Food Sciences, The University of Queensland
                [44 ] Department of Food Science, University of Massachusetts
                [45 ] Food Science and Technology, Oregon State University
                [46 ] Ear Institute, UCL
                [47 ] Lyon Neuroscience Research Center, Lyon Neuroscience Research Center, CNRS UMR5292 - INSERM U1028 - University Lyon 1
                [48 ] EEE, Karunya University
                [49 ] Otorhinolaryngology Department, Biruni University
                [50 ] ENT Department, Italian Academy Of Rhinology - Assi Sette Llaghi Varese
                [51 ] Department of Biology, Universidad de Chile
                [52 ] Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine
                [53 ] The Norfolk Smell & Taste Clinic, University of East Anglia
                [54 ] Institute of Philosophy, University of London
                [55 ] Department of Clinical Neuroscience, Karolinska Institutet
                [56 ] Department of Molecular Medicine, University of Padova
                [57 ] Department of Food and Nutritional Sciences, University of Reading
                [58 ] Laboratory of Behavioural Gastronomy, Maastricht University
                [59 ] Department of Computer Science, University of Hertfordshire
                [60 ] Institute of Psychology, University of Graz
                [61 ] Department of Anatomy, Howard University College of Medicine
                [62 ] Biological Sciences Department, Fisher College of Science and Mathematics, Towson University
                [63 ] Otolaryngology-Head and Neck Surgery, University of California San Diego Health
                [64 ] Clinical Neuroproteomics Unit, Navarrabiomed-IDISNA
                [65 ] Department of Psychology, Stockholm University
                [66 ] University of Gastronomic Sciences
                [67 ] Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences
                [68 ] Internal Medicine Department, Hadassah Medical Center
                [69 ] Neurobiology, Goethe Universität Frankfurt
                [70 ] ENT and Head and Neck Research Center and Department, Hazrat Rasoul Hospital, the Five Senses Institute, Iran University of Medical Sciences
                [71 ] Food Science Department, University of Tennessee
                [72 ] Health Care and Life Sciences, IBM T.J. Watson Research Center
                [73 ] Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels University
                [74 ] Psychiatry, Guangzhou Medical University
                [75 ] Otorhinolaringology, Buenos Aires University and GEOG (Grupo de Estudio de Olfato y Gusto)
                [76 ] Surgery Department, ENT Division , Sultan Qaboos University
                [77 ] Department of Physiology, The Federal University of Technology, Akure, Nigeria
                [78 ] Department of Otorhinolaryngology , University Hospital Basel , Basel
                [79 ]Department of Psychiatry and Psychotherapy , FAU Erlangen
                [80 ] Department of Surgery , Division of Otolaryngology , University of California San Diego
                [81 ] Psychology , Utrecht University
                [82 ]Innovative Technologies, Severtsov Institute of Ecology and Evolution RAS
                [83 ]Department of Otolaryngology-Head and Neck Surgery , Second Affiliated Hospital of Xi'an Jiaotong University
                [84 ] Department of Applied Biological Chemistry , The University of Tokyo
                [85 ]Perelman School of Medicine, University of Pennsylvania
                [86 ] Department of Oral Surgery and Oral Medicine , Faculty of Dentistry , University of Oslo
                [87 ] Psychology , University of Dayton
                [88 ]Agriculture and Food, The Commonwealth Scientific and Industrial Research Organisation (CSIRO)
                [89 ] Department of Biology , Indiana University
                [90 ] Department of Psychology , Northumbria University Newcastle
                [91 ]Division of Psychology , University of Stirling
                [92 ]Electrical and Electronics Engineering, Mersin University
                [93 ]Cognitive Science, Middle East Technical University
                [94 ] Department of Anthropology , Charles University , Faculty of Humanities
                [95 ] Faculty of Social and Behavioral Sciences , Utrecht University
                [96 ]Servicio Otorrinolaringología, Hospital Italiano de Buenos Aires
                [97 ]School of Biological Sciences, Institute for Research   in Fundamental Sciences
                [98 ] Department of Otorhinolaryngology , Smell and Taste Center, Dresden
                [99 ] Founder and CEO, Centro de Otorrinolaringología Respira Libre
                [100 ] Department of Neurology , University Medical Centre Ljubljana
                [101 ]National Center for Biological Sciences, Tata Institute of Fundamental Research
                [102 ] Department of Biochemistry , University of São Paulo , Brazil
                [103 ] Institute of Health Sciences , Mersin University
                [104 ]Bilkent Brain Research Center, Bilkent University
                [105 ] Department of Otolaryngology
                [106 ]Center for Smell and Taste, University of Florida
                [107 ] Department of Cell and Developmental Biology , University of Colorado Anschutz Medical Campus
                [108 ] Rhinology- Olfactology Unit, ENT Department , Geneva University Hospitals
                [109 ] Department of Otorhinolaryngology , TU Dresden
                [110 ] Department of Pharmacology and Therapeutics , University of Florida
                Author notes
                Correspondence concerning this article should be addressed to: Dr. John E. Hayes, Department of Food Science, Pennsylvania State University, 220 Erickson Food Science Building, University Park, PA 16802 USA, Email: jeh40@ 123456psu.edu , Twitter: @TasteProf
                Author information
                http://orcid.org/0000-0001-7265-0449
                Article
                bjaa041
                10.1093/chemse/bjaa041
                7337664
                32564071
                10b86ad4-04ae-4909-a5f1-3e0d4c338e14
                © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

                This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 04 May 2020
                Categories
                Original Article
                AcademicSubjects/SCI01180
                Custom metadata
                PAP
                accepted-manuscript

                Molecular biology
                Molecular biology

                Comments

                Comment on this article