Title Hiposmija uzrokovana infekcijom COVID-19 Title (english) COVID-19 induced hyposmia Author Mia Grgić Mentor Tamara Braut (mentor)Committee member Dubravko Manestar (predsjednik povjerenstva)Committee member Margita Belušić-Gobić (član povjerenstva)Committee member Natalia Kučić (član povjerenstva) Granter University of Rijeka Defense date and country 2022, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Hiposmija je simptom prepoznat kao jedan od najvažnijih simptoma SARS-CoV-2. Najčešće je prolazna, s povratom osjeta njuha nakon nekoliko dana ili tjedana te se razlikuje od istih povezanih s drugim virusima po svom iznenadnom nastanku i brzom oporavku.
Oboljeli od COVID-19 infekcije obično prijavljuju hiposmiju bez prisutnosti nazalne kongestije ili rinoreje. Ove značajke upućuju na to da bi hiposmija mogla biti posljedica otežanog protoka zraka ili senzoneuralnog oštećenja povezanog s ACE-2 receptorom i TMPRSS2 staničnom proteazom, lokalne infekcije vaskularnih i sustentakularnih stanica, infekcije vaskularnih pericita, oštećenja i gubitka cilija te prema najnovijem down-regulacije OR-a i njihovih signalnih komponenti.
Prema podatcima iz različitih epidemioloških istraživanja, na razini svijeta, hiposmija je prijavljivana kao simptom COVID-19 infekcije u postotku od 84%, dok je u RH zabilježeno oko 40% slučajeva.
Pacijenti zaraženi s COVID-19 infekcijom mogu doživjeti iznenadni početak hiposmije bez ikakvih drugih simptoma ili prije pojave hiposmije mogu imati i druge blaže simptome. Olfaktorna disfunkcija, odnosno hiposmija često je praćena disgeuzijom, odnosno poremećajem okusa.
Dijagnostički postupci u procjeni hiposmije uzrokovane SARS-CoV-2 uključuju subjektivne i objektivne testove za procjenu olfaktorne funkcije. Primjeri objektivnih testova za procjenu mirisa su CCCRC i UPSIT test. Najdostupnija metoda u diferencijalnoj dijagnozi ostalih uzroka olfaktorne disfunkcije je endoskopija nosa te osnovna neurološka obrada. Ostale metode koje se koriste u dijagnostici hiposmije uključuju slikovne metode poput fMR-a, MRI-a, SPECT/CT-a i PET-a.
Prosječno trajanje hiposmije procjenjuje se na 2-3 tjedna, nakon čega slijedi spontani oporavak. No, postoje i bolesnici s perzistentnom hiposmijom koja može trajati i dulje od 3 mjeseca. Liječenje hiposmije uzrokovane COVID-19 infekcijom uključuje olfaktorni trening, ali i lijekove od kojih se najčešće koriste intranazalni kortikosteroidi. Potencijalno liječenje u budućnosti predstavljaju stimulacija i transplantacija matičnih stanica olfaktornog epitela te direktna stimulacija olfaktornog bulbusa.
PCOD označava perzistentnu olfaktornu disfunkciju u trajanju duljem od nekoliko mjeseci koja dovodi do težeg oštećenja olfaktornog epitela te pogađa velik dio populacije. Rizične skupine predstavljaju starije osobe, osobe koje boluju od dijabetesa te pacijenti s duljom perzistencijom virusa u tijelu. U liječenju PCOD-a preporuča se olfaktorni trening te primjena lokalnih, a u izuzetnim slučajevima, ponekad i sistemskih kortikosteroida.
Abstract (english) Hyposmia is a symptom recognized as one of the most important symptoms of SARS-CoV-2. It is usually transient, with a return of smell after a few days or weeks. It differs from those associated with other viruses in its sudden onset and rapid recovery.
Patients with COVID-19 infection usually report hyposmia without the presence of nasal congestion or rhinorrhea. These features suggest that hyposmia may be due to obstructed airflow or sensorineural damage associated with ACE-2 receptor and TMPRSS2 cell protease, local vascular and sustentacular cell infections, vascular pericyte infections, ciliate damage and loss, and recent down-regulation of ORs and their signaling components.
According to data from various epidemiological studies, worldwide, hyposmia has been reported as a symptom of COVID-19 infection in a percentage of 84%, while in the Republic of Croatia about 40% of cases have been reported.
Patients infected with COVID-19 infection may experience a sudden onset of hyposmia without any other symptoms or may have other milder symptoms before hyposmia occurs. Olfactory dysfunction (hyposmia), is often accompanied by dysgeusia, (taste disturbance).
Diagnostic procedures in the assessment of hyposmia caused by SARS-CoV-2 include subjective and objective tests to assess olfactory function. Examples of objective odor assessment tests are the CCCRC and the UPSIT test. The most available method in the differential diagnosis of other causes of olfactory dysfunction is nasal endoscopy and basic neurological treatment. Other methods used in the diagnosis of hyposmia include imaging methods such as fMR, MRI, SPECT / CT, and PET.
The average duration of hyposmia is estimated at 2-3 weeks, followed by spontaneous recovery. However, there are patients with persistent hyposmia that can last longer than 3 months. Treatment of hyposmia caused by COVID-19 infection includes olfactory training, but also drugs, the most commonly used being intranasal corticosteroids. Potential treatments in the future are stimulation and transplantation of olfactory epithelial stem cells and direct stimulation of the olfactory bulb.
PCOD refers to persistent olfactory dysfunction lasting more than a few months that leads to severe damage of the olfactory epithelium and affects a large part of the population. Risk groups include the elderly, people with diabetes and patients with prolonged persistence of the virus in the body. In the treatment of PCOD, olfactory training and the use of local and, in exceptional cases, systemic corticosteroids is recommended.
Keywords
Hiposmija
COVID-19
SARS-CoV-2
olfaktorna disfunkcija
Keywords (english)
Hyposmia
COVID-19
SARS-CoV-2
Olfactory Dysfunction
Language croatian URN:NBN urn:nbn:hr:184:700088 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-06-30 20:45:58
