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Pathogenesis of Olfactory Disorders in COVID-19
Laura Ziuzia-Januszewska1, Marcin Januszewski2
1Department of Otolaryngology, Central Clinical Hospital, Ministry of Interior and Administration, 02-507 Warsaw, Poland.
COVID-19 frequently causes smell disorders, primarily due to sensorineural damage. This involves olfactory support cell infection and inflammation, potentially impacting olfactory neurons.
Area of Science:
- Neurology
- Infectious Diseases
- Otorhinolaryngology
Background:
- Olfactory dysfunction is a common symptom of COVID-19.
- The exact mechanisms behind this smell impairment remain under investigation.
Purpose of the Study:
- To review the current understanding of smell loss pathogenesis in COVID-19.
- To identify future research directions for COVID-19-related olfactory disorders.
Main Methods:
- Literature review of studies on COVID-19 and olfactory dysfunction.
- Synthesis of proposed pathogenic theories for smell impairment.
Main Results:
- Multiple theories exist: nasal obstruction, mucosal edema, olfactory epithelium damage (direct/immune-mediated), olfactory bulb, and central pathway impairment.
- Sensorineural damage appears primary, involving support cell infection (ACE1 receptor) and inflammation-induced olfactory epithelium disruption.
- Potential direct olfactory sensory neuron infection (NRP-1 receptor) and central pathway involvement are also considered.
Conclusions:
- COVID-19-related anosmia is complex, primarily sensorineural.
- Inflammation and viral infection of olfactory support cells are key.
- Further research should explore central pathways, conductive components, and genetic factors.
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