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Abstract
The coronavirus disease 2019 (COVID-19) pandemic is wreaking havoc on public-health and economic systems worldwide. Among the several neurological symptoms of patients with COVID-19 reported in clinical practice, olfactory dysfunction (OD) is the most common. OD occurs as the earliest or the only clinical manifestation in some patients. Increasing research attention has focused on OD, which is listed as one of the main diagnostic symptoms of severe acute respiratory syndrome-coronavirus-2 infection. Multiple clinical and basic-science studies on COVID-19-induced OD are underway to clarify the underlying mechanism of action. In this review, we summarize the clinical characteristics, mechanisms, evaluation methods, prognosis, and treatment options of COVID-19-induced OD. In this way, we hope to improve the understanding of COVID-19-induced OD to aid early identification and precise intervention.
Highlights
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2) infection
We review the clinical characteristics, mechanisms, evaluation methods, prognosis, and treatment options of COVID-19-induced olfactory dysfunction (OD)
The methods employed for subjective evaluation are visual analog scales and questionnaires
Summary
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndromecoronavirus-2 (SARS-CoV-2) infection. SARS-CoV-2 affects SUS cells directly through interactions with the ACE2 receptor and TMPRSS2, resulting in impaired or temporary loss of SUS-cell function and, abnormal transmission of odor molecules and direct/indirect damage to OSNs [82, 101]. Expression of ACE2 and TMPRSS2 is detected only in HBCs, which suggests that SARS-CoV-2 can infect HBCs directly, resulting in abnormal regeneration of OSNs [82]. SARS-CoV-2 infection can lead to vascular endothelial damage and abnormal production of cytokines and proinflammatory mediators These actions affect CNS function and cause secondary damage to nasal epithelial cells, thereby resulting in indirect effects upon olfactory function [13, 84, 87, 88, 105]
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