Frequency of olfactory dysfunction in pregnant women with SARS-CoV-2 infection.

INTRODUCTION: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. OBJECTIVE: To know the frequency at which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. METHODS: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. RESULTS: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). CONCLUSION: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.

INTRODUCCIÓN: En pacientes con COVID-19 se ha reportado disfunción olfatoria y anosmia; en la mujer embarazada se presenta hasta en 24.2 %. OBJETIVO: Conocer la frecuencia con la que las mujeres embarazadas e infección por SARS-CoV-2 tienen disfunción olfatoria. MÉTODOS: Se preguntó edad, edad gestacional, temperatura, presencia de constipación nasal o rinorrea, mialgias, cefalea, tos o dolor torácico, además de evaluar si las mujeres percibían e identificaban el aroma de jugo de uva, café en polvo y mentol. Se utilizaron medidas de tendencia central y dispersión, frecuencias y porcentajes. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. La U de Mann-Whitney y el contraste de proporciones sirvieron para las comparaciones entre los grupos. RESULTADOS: Hubo mayor proporción de mujeres con tos, cefalea, disnea, mialgias, odinofagia, rinorrea, dolor torácico y anosmia en mujeres positivas a SARS-CoV-2. De las pacientes sin COVID-19, 88.9 % detectó cada uno de los aromas; solo 31.8 % del grupo positivo detectó el aroma a uva, 47.7 % el de café y 59.1 % el de mentol, el cual tuvo los porcentajes más altos en sensibilidad (40 %), especificidad (21 %), valores predictivos positivo (59 %) y negativo (11 %). CONCLUSIÓN: la disfunción olfatoria se presenta en un porcentaje importante de las mujeres embarazadas con COVID-19.

Diagnostic value of combined assessment of olfaction and sustantia nigra hyperechogenicity for Parkinson's disease.

INTRODUCTION: Hyposmia and substantia nigra hyperechogenicity (SN+) are characteristic markers of Parkinson's disease (PD), although their diagnostic value in isolation may be limited. We evaluated the combined prevalence of both disorders in patients diagnosed with PD and assessed their diagnostic yield compared to a sample with essential tremor (ET) and another group of healthy subjects. METHODS: Patients diagnosed with PD and ET and treated in our outpatient clinic were enrolled. Olfaction was assessed using the "Sniffin' Sticks" odour identification test (SS-12) and hyperechogenicity of the substantia nigra (SN+) was assessed by transcranial duplex ultrasound. RESULTS: A total of 98 subjects were analysed, comprising 30 with PD, 21 with ET, and 47 controls. The respective prevalence rates of hyposmia (SS-12 < 8) and SN+ (area > .24cm(2)) were 70% and 83.3% in PD, 33.3% and 9.5% in ET, and 17% and 10.6% in controls. Both markers were present in 63% of patients with PD, none of the patients with ET, and only 2 of the controls. CONCLUSIONS: Combined use of substantia nigra sonography and olfactory testing with SS-12, two rapid, safe, and accessible tests, was more specific than each isolated marker for distinguishing patients with PD from patients with ET and control subjects. Since both markers have been described in very early phases of PD, combined use may be helpful in providing early diagnosis of PD.

Comparative imaging study of patients with persistent olfactory dysfunction due to mild COVID-19 using structural and functional MRI.

INTRODUCTION: Persistent post-COVID olfactory dysfunction continues to be studied due to the controversy in its pathophysiology and neuroimaging. MATERIALS AND METHODS: The patients had confirmed mild COVID-19 infection with olfactory dysfunction of more than one month of evolution and they were compared to controls with normal olfaction, assessed using the Sniffin' Sticks Olfactory Test and underwent brain, magnetic resonance imaging (MRI) of the olfactory bulb and olfactory function. RESULTS: A total of 8 patients and 2 controls participated. The average age of the patients was 34.5 years (SD 8.5), and that of the controls was 28.5 (SD 2.1). The average score in the patients' olfactory test was 7.9 points (SD 2.2). In brain and olfactory bulb MRI tests, no morphological differences were found. When evaluated by functional MRI, none of the patients activated the entorhinal area in comparison to the controls, who did show activation at this level. Activation of secondary olfactory areas in cases and controls were as follows: orbitofrontal (25% vs 100%), basal ganglia (25% vs 50%) and insula (38% vs 0%) respectively. CONCLUSIONS: There were no observed morphological changes in the brain MRI. Unlike the controls, none of the patients activated the entorhinal cortex in the olfactory functional MRI.

[Frequency and predictive validity of olfactory and taste dysfunction in patients with SARS-CoV-2 infection]. / Frecuencia de aparición y validez predictiva de la disfunción olfatoria y del gusto en pacientes con infección por SARS-CoV-2.

BACKGROUND AND OBJECTIVE: Olfactory and taste dysfunction (OD, TD) have been considered symptoms of SARS-CoV-2 infection. However, its presence in certain populations, especially those with mild clinical symptoms, has not been clarified. The objective was to estimate the frequency of OD and TD, and its predictive validity in patients detected in Primary Care. PATIENTS AND METHODS: A cross-sectional study was carried out in the Spanish National Health System. An epidemiological survey was administered to patients who were requested the PCR test for SARS-CoV-2. Odds ratio (OR) were estimated to measure the magnitude of the association between OD and TD and the existence of SARS-CoV-2 infection. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of these symptoms in SARS-CoV-2 infection were calculated. RESULTS: Of 1,038 patients screened, 20.1% had SARS-CoV-2 infection. OD and DG were present in 64.4% (95% CI 56.0-72.1) and 56.2% (95% CI 47.9-64.2) of the subjects with infection, respectively. The OR for OD was 12.2 (95% CI 8.26-18.06) and for TD was 7.95 (95% CI 5.48-11.53). TD presented a sensitivity of 41.1% (95% CI 34.4-46.1), a specificity of 91.9% (95% CI 89.8-93.7), a PPV of 56.2% (95% CI48.0-64.2) and a NPV of 86.1% (95% CI 83.6-88.3), while the OD showed a sensitivity of 45.0% (95% CI 37.6-51.5), a specificity of 93.7% (95% CI 91.8-95.0), a PPV of 64.4% (95% CI 56.0-72.1) and a NPV of 87.1% (95% CI 84.7-89.2). CONCLUSIONS: More than half of the subjects with SARS-CoV-2 infection have OD or TD. The presence of OD or TD could be of diagnostic utility due to its ability to predict infection in more than half of the cases.

Frecuencia de aparición y validez predictiva de la disfunción olfatoria y del gusto en pacientes con infección por SARS-CoV-2 / Frequency and predictive validity of olfactory and taste dysfunction in patients with SARS-CoV-2 infection

Antecedentes y objetivo: La disfunción olfatoria (DO) y gustativa (DG) han demostrado ser síntomas de la infección por SARS-CoV-2. Sin embargo, su presencia en determinadas poblaciones, sobre todo en aquellas con cuadros clínicos leves, aún debe aclararse. El objetivo fue estimar la frecuencia de DO y DG, y su validez predictiva en pacientes detectados en Atención Primaria.Pacientes y métodosSe realizó un estudio transversal en el Sistema Nacional de Salud español. Se administró una encuesta epidemiológica dirigida a pacientes a los que se les solicitó la prueba PCR para SARS-CoV-2. Se estimaron las odds ratio (OR) para medir la magnitud de la asociación entre la DO y DG y la existencia de infección por SARS-CoV-2. Se calculó la sensibilidad, la especificidad y los valores predictivos positivos (VPP) y negativos (VPN) de estos síntomas en la infección por SARS-CoV-2.ResultadosSe captaron 1.038 pacientes, de los cuales el 20,1% presentaban infección por SARS-CoV-2. Las DO y DG estuvieron presentes en el 64,4% (IC 95% 56,0-72,1) y el 56,2% (IC 95% 47,9-64,2) de los sujetos con infección, respectivamente. La OR para la DO fue de 12,2 (IC 95% 8,26-18,06) y para la DG de 7,95 (IC 95% 5,48-11.53). La DG presentó una sensibilidad del 41,1% (IC 95% 34,4-46,1), una especificidad del 91,9% (IC 95% 89,8-93,7), un VPP del 56,2% (IC 95% 48,0-64,2) y un VPN de 86,1% (IC 95% 83,6-88,3), mientras que la DO mostró una sensibilidad del 45,0% (IC 95% 37,6-51,5), una especificidad del 93,7% (IC 95% 91,8-95,0), un VPP del 64,4% (IC 95% 56,0-72,1) y un VPN del 87,1% (IC 95% 84,7-89,2).ConclusionesMás de la mitad de los sujetos con infección por SARS-CoV-2 presentan DO o DG. La presencia de DO o de DG podría ser de utilidad diagnostica por su capacidad para predecir la infección en más de la mitad de las ocasiones. (AU)

Background and objective: Olfactory and taste dysfunction (OD, TD) have been considered symptoms of SARS-CoV-2 infection. However, its presence in certain populations, especially those with mild clinical symptoms, has not been clarified. The objective was to estimate the frequency of OD and TD, and its predictive validity in patients detected in Primary Care.Patients and methodsA cross-sectional study was carried out in the Spanish National Health System. An epidemiological survey was administered to patients who were requested the PCR test for SARS-CoV-2. Odds ratio (OR) were estimated to measure the magnitude of the association between OD and TD and the existence of SARS-CoV-2 infection. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of these symptoms in SARS-CoV-2 infection were calculated.ResultsOf 1,038 patients screened, 20.1% had SARS-CoV-2 infection. OD and DG were present in 64.4% (95% CI 56.0-72.1) and 56.2% (95% CI 47.9-64.2) of the subjects with infection, respectively. The OR for OD was 12.2 (95% CI 8.26-18.06) and for TD was 7.95 (95% CI 5.48-11.53). TD presented a sensitivity of 41.1% (95% CI 34.4-46.1), a specificity of 91.9% (95% CI 89.8-93.7), a PPV of 56.2% (95% CI48.0-64.2) and a NPV of 86.1% (95% CI 83.6-88.3), while the OD showed a sensitivity of 45.0% (95% CI 37.6-51.5), a specificity of 93.7% (95% CI 91.8-95.0), a PPV of 64.4% (95% CI 56.0-72.1) and a NPV of 87.1% (95% CI 84.7-89.2).ConclusionsMore than half of the subjects with SARS-CoV-2 infection have OD or TD. The presence of OD or TD could be of diagnostic utility due to its ability to predict infection in more than half of the cases. (AU)

Frecuencia de disfunción olfatoria en mujeres embarazadas con infección por SARS-CoV-2 / Frequency of olfactory dysfunction in pregnant women with SARS-CoV-2 infection

Resumen Introducción: En pacientes con COVID-19 se ha reportado disfunción olfatoria y anosmia; en la mujer embarazada se presenta hasta en 24.2 %. Objetivo: Conocer la frecuencia con la que las mujeres embarazadas e infección por SARS-CoV-2 tienen disfunción olfatoria. Métodos: Se preguntó edad, edad gestacional, temperatura, presencia de constipación nasal o rinorrea, mialgias, cefalea, tos o dolor torácico, además de evaluar si las mujeres percibían e identificaban el aroma de jugo de uva, café en polvo y mentol. Se utilizaron medidas de tendencia central y dispersión, frecuencias y porcentajes. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. La U de Mann-Whitney y el contraste de proporciones sirvieron para las comparaciones entre los grupos. Resultados: Hubo mayor proporción de mujeres con tos, cefalea, disnea, mialgias, odinofagia, rinorrea, dolor torácico y anosmia en mujeres positivas a SARS-CoV-2. De las pacientes sin COVID-19, 88.9 % detectó cada uno de los aromas; solo 31.8 % del grupo positivo detectó el aroma a uva, 47.7 % el de café y 59.1 % el de mentol, el cual tuvo los porcentajes más altos en sensibilidad (40 %), especificidad (21 %), valores predictivos positivo (59 %) y negativo (11 %). Conclusión: la disfunción olfatoria se presenta en un porcentaje importante de las mujeres embarazadas con COVID-19.

Abstract Introduction: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. Objective: To know the frequency in which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. Methods: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. Results: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). Conclusion: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.

Lesiones olfatorias postraumáticas: Revisión de la literatura / Post-traumatic olfactory injuries: Literature review

Las alteraciones del olfato son frecuentemente halladas en pacientes con lesión traumática cerebral. Las lesiones del nervio olfatorio pueden asociadas a equimosis periorbitaria, fistula de líquido cefalorraquídeo, epitaxis, fractura nasal y epitaxis. La disfunción olfatoria postraumática es de manera usual infraevaluada. Presentamos una revisión narrativa sobre los aspectos más relevantes de las lesiones postraumáticas del nervio olfatorio.

Alterations in smell are frequently found in patients with traumatic brain injury. Olfactory nerve lesions can be associated with periorbital ecchymosis, cerebrospinal fluid fistula, epistaxis, and nasal fracture. Posttraumatic olfactory dysfunction is usually under-appreciated. We present a narrative review of the most relevant characteristics of post-traumatic injuries affecting the olfactory nerve.

Entrenamiento olfatorio: revisión de literatura / Olfactory training: review of literature

RESUMEN La disfunción olfatoria es una patología frecuente que trae consigo una disminución importante en la calidad de vida de los pacientes y que incluso conlleva una mortalidad aumentada respecto a la población general. Sin embargo, es una condición subdiagnosticada, ya sea por desconocimiento de los profesionales o por falta de un método diagnóstico adecuado. A la fecha no existe un tratamiento efectivo para estos pacientes y generalmente se les deja sin tratar. Una alternativa para este gran problema es el entrenamiento olfatorio, tratamiento propuesto recientemente con resultados promisorios.

ABSTRACT Olfactory dysfunction is a frequent pathology associated with an important decrease in the quality of life of patients and an increased mortality respect to the general population. However, it is an underdiagnosed condition, either due to lack of knowledge of the professionals or due to the lack of an adequate diagnostic method. To date there is no effective treatment for these patients and they are usually left untreated. An alternative to this problem is olfactory training, a treatment recently proposed with promising results.