Category: Corona Virus

ROCHESTER, N.Y. (WROC) The five-day isolation period for COVID-19 could be done as a federal guideline later this year.

The CDC has not confirmed this widely reported change, but should they make the change, it would be the first major change to the isolation protocol since 2021.

Instead of the five-day isolation period, people would be able to leave their homes if theyve been fever-free, without medication, for 24 hours, but these new isolation recommendations would not apply to hospitals and other healthcare settings with more vulnerable populations.

Dr. Lara Jirmanus from the watchdog group, The Peoples CDC said to CBS News that this proposed change does not follow the science.

Most people continue to be shedding virus for about 9 days with a range of 6-11 days, she said. The more doses of vaccine you have, younger patients will tend to be infectious for maybe one day less than that. Older patients and patients with severe disease can shed the virus for a longer time.

Local pediatrician Dr. Edward Lewis says should this guidance be changed:

Practically speaking, I think a lot of people have been operating under this premise anyways. but in general, were sort of at a point before things went upside down and COVID is a virus, he said. Coronavirus has been around for years and it causes really bad colds.

NYSDOH said in a statement they continue to follow CDCs COVID-19 guidance, and if CDCs isolation guidance changes, so too will ours.

See the original post:

Local, national expert on reported possible change of CDC COVID-19 isolation guidance - RochesterFirst

On average, a mild to moderate COVID-19 infection lasts for 10 days. However, how quickly you bounce back from a COVID-19 infection depends on various factors, including your health before the infection, any underlying conditions you may have, and which variant of the virus you have contracted.

This article will cover how long you can expect to have symptoms, pass your infection to others, and fully recover from the newest variants that cause COVID-19 infection.

AnastasiaNurullina / Getty Images

The average recovery time of COVID-19 infections can vary based on what you consider "recovered." Some people never develop any symptoms with a COVID-19 infection, some have mild infections, and others go on to fight severe illness.

People with a mild to moderate COVID-19 infection have symptoms like:

Symptoms like shortness of breath don't usually occur with mild to moderate COVID-19, and blood oxygen levels don't typically fall below normal limits.

Mild to moderate illness from COVID-19 usually lasts an average of 10 days. For some people, symptoms fade in a matter of days; for others, it takes weeks.

Even mild COVID-19 cases can progress to long COVID or post-COVID syndrome, in which ongoing symptoms remain long after the initial infection. A healthcare provider may diagnose you with long COVID if you've had unresolved symptoms for more than one month.

According to one report, 10% to 30% of people infected with asymptomatic, mild, or moderate infections develop long COVID.

Generally, the incubation period between your initial exposure to the virus and when you begin to notice symptoms is between two and five days. You can be infectious to others during this time, especially in the two days before your symptoms start. You can also pass a COVID-19 infection to others if you have a COVID-19 infection but never develop symptoms.

Beyond the incubation period, the duration of your symptoms and overall illness varies, but how long your incubation period lasts could be linked to how long you are sick and can pass the illness to others.

People vaccinated against COVID-19 or those who have natural immunity (having acquired the disease through infection) can still be infected with COVID-19 again.

The severity and duration of the repeated illness depends on what strain you were vaccinated against, what strain is causing your current infection, and how much time has passed since your most recent COVID-19 infection and/or immunization.

One study suggests that infections in people vaccinated against COVID-19 can last as little as two days, and these infections are usually less severe compared to those in people who are not immunized against COVID-19.

The Centers for Disease Control and Prevention (CDC) recommends that all Americans over age 12 have at least one dose of the updated COVID-19 vaccine, released in September 2023, regardless of prior infection or vaccination status.

Newer COVID-19 strains have shorter incubation periods. Older variants could incubate for up to 14 days, but two to five days for incubation is more common for more recent versions of the virus.

Some studies suggest that the length of the incubation period predicts the length of illness, with a shorter incubation period leading to a faster recovery.

The recommendation from the CDC is to isolate yourself for the first five days of symptoms. Most people recover around day 10 but may still be contagious to others. The CDC recommends masking between days five and 10 to minimize transmission.

Symptoms can continue for days to weeks if you have mild to moderate illness with a COVID-19 infection. Long COVID is a diagnosis that healthcare providers may consider when you have ongoing problems related to your COVID-19 infection for four weeks or more.

One of the distinguishing features of long-term COVID-19 is an evolving set of symptoms. Active COVID-19 infections can feature 20 symptoms or more during the infection, and symptoms may change or come and go throughout the recovery period. One study found that post-acute COVID symptoms ranged anywhere from two weeks to 100 days.

It is unclear exactly how long post-COVID syndrome can last. Some of the earliest people infected have reported long COVID symptoms for months to years after the initial illness.

Severe or critical illness from a COVID-19 infection is most common in people over 50 and those with weakened immune systems or multiple health problems. Severe infections or those requiring hospitalization can take weeks to recover from, and long-term symptoms will depend on what complications or co-infections that develop during your treatment.

The specific variant that causes your COVID-19 infection has a lot to do with how long your illness lasts. However, additional factors can contribute to infection duration, such as:

Some people never develop any symptoms of their COVID-19 infection, but most people infected with recent variants develop symptoms between two and five days after exposure. Symptoms can last for around two weeks.

The CDC recommends isolating for the first five days after a positive COVID-19 test or the start of symptoms and masking around others to prevent transmission until the 10th day after a positive test or the onset of symptoms.

Maintaining good health practices can help you build a robust immune system that can fight viruses like SARS-CoV-2 (the virus that causes COVID-19). You can also protect yourself by practicing good hand hygiene and avoiding people you know are sick.

Vaccination is another strategy that can help shorten the duration of a COVID-19 infection. Vaccines may not protect you against COVID-19 100% of the time, but they have been shown to lessen the duration and severity of the illness if you become infected.

COVID-19 is a viral illness that can appear with various symptoms lasting days to weeks. People who get COVID-19 can develop long COVIDongoing problems from the infection that lasts yearsregardless of illness severity.

Individuals with weakened immune systems or multiple health problems also usually have a longer road to recovery after COVID-19. Maintaining your overall health and staying up-to-date on your COVID-19 vaccinations can help reduce the severity and duration of the illness.

Go here to read the rest:

How Long Does COVID-19 Last? Average Recovery Timeline - Verywell Health

An analysis of mortality statistics suggests the death count in the United States from COVID-19 is higher than the 1.1 million officially linked to the disease, according to new University of Minnesota research.

A U sociologist teamed up with public health researchers in Boston and Philadelphia to analyze excess deaths mortality from natural causes that surpasses historical norms. They found a pattern that only makes sense if COVID played a key role. Excess deaths not ascribed to COVID almost always occurred at the beginning of pandemic waves, and then disappeared when those waves reached peak levels of illness, the researchers found.

"If these excess natural cause deaths had nothing to do with COVID, you would probably see them happening throughout this period, irrespective of when the COVID waves are," said Elizabeth Wrigley-Field, the U sociologist and demographer who coauthored the study.

The results were published in a prestigious science journal, the Proceedings of the National Academy of Sciences, and argue that many of the 162,000 excess deaths assigned to other causes during the first 30 months of the pandemic should actually be tied to COVID. Exactly how many isn't specified.

The accuracy of COVID death reporting remains divisive, even after the federal COVID public health emergency ended last spring. Donald Trump as president in 2020 had questioned whether doctors were inflating COVID death counts to obtain more federal relief money. Some lawmakers in Minnesota early in the pandemic questioned whether the state's death toll was inflated by as much as 40%.

The latest findings come amid a decline in COVID activity, following an increase in illnesses driven by holiday gatherings and the fast-spreading JN.1 coronavirus variant that made up 78% of infections at the end of 2023. Testing in wastewater treatment plants is showing the lowest viral levels in Minnesota since Thanksgiving.

The most likely explanation for non-COVID deaths surging right before pandemic waves is that people weren't worrying about COVID as much or testing for it at those times. So deaths related to the infectious disease were missed, the study concluded. Testing then rapidly increased as the pandemic waves became apparent, which reduced the share of excess deaths attributed to other causes.

Minnesota's official count was updated Thursday to 15,776 COVID-19 deaths, including 220 deaths in 2024 that were mostly among people 75 and older.

The latest research suggests that Minnesota's total is close to the mark; throughout COVID waves, far fewer of the state's excess deaths were attributed to causes other than the infectious disease. Federal estimates show that COVID caused almost 4,000 more deaths than expected in the winter 2020 pandemic wave in Minnesota, for example, compared to 150 more deaths than expected from other causes.

The Minnesota Department of Health for the first three years of the pandemic had workers verify that deaths linked to COVID on death certificates were actually caused by the infectious disease. The state halted that costly process at the start of 2023 and started counting all deaths as related to COVID when people had tested positive for the infectious disease and their death certificates listed it as a cause, said Lydia Fess, an epidemiologist in the Health Department's emerging infectious diseases section.

Internal research showed little change with this switch, and that COVID death reporting remained consistent across age, race and other demographic categories, she said.

Other factors beyond underreporting of COVID could have resulted in more excess deaths from non-COVID causes during pandemic waves. Minnesota hospital leaders warned during the pandemic that overcrowding threatened to delay or worsen care and increased risks of harm for all patients. However, the authors of the latest study noted that excess deaths from non-COVID causes tended to decline at the peak of pandemics, when the consequences of hospital overcrowding should have been at their worst.

The authors called for more consistency in the U.S. system of reporting deaths, because excess deaths from non-COVID causes appeared inflated in some rural counties and regions of the country where political appointees and others lacking medical training were responsible for declaring official causes. Those officials may have allowed political views about COVID and the nation's pandemic response to influence their determinations, or have been persuaded by family members who didn't want COVID listed on death certificates, they wrote.

Northeastern states such as Massachusetts and Rhode Island attributed so many of their excess deaths during the pandemic to COVID that it raises the potential of an overcount. However, Wrigley-Field said those states probably had fewer deaths from non-COVID causes, because their aggressive responses to the pandemic reduced the threat of other infections such as influenza.

Original post:

University of Minnesota study: Most 'excess deaths' during pandemic were COVID - Star Tribune

Acknowledging that we are now at a different point in time with reduced impacts from COVID-19 compared to previous years, the California Department of Public Health (CDPH) has updated its COVID-19 isolation guidelines in an effort to minimize workplace disruption when a person tests positive for the virus.

Under the new guidelines, those who test positive for COVID-19 but have mild and improving symptoms need only isolate until 24 hours have passed with no fever, without the use of fever-reducing medications. Moreover, people who test positive for COVID-19 but have no symptoms need not isolate at all. However, the CDPH still advises any person who tests positive for COVID-19 to wear a mask and avoid contact with those at higher risk of severe disease for 10 days.

Please consult the guidelines for updated definitions of close contact as well.

In response to these updates, Cal/OSHA has provided new testing guidance for the COVID-19 Prevention Non-Emergency Regulations. Now, in isolated cases of COVID-19, employers must only test people with new COVID-19 symptoms and close contacts who are at higher risk of severe disease or who have contact with people who are at higher risk of severe disease rather than all close contacts.

However, employers are still required to make free COVID-19 testing available to all close contacts (except for asymptomatic employees who recently recovered from COVID-19) during paid time.

The definition of outbreak has also been relaxed in non-healthcare settingsan outbreak is now at least three COVID-19 cases in a seven-day period rather than three or more COVID-19 cases in a fourteen-day period. If an outbreak occurs under the new definition, employers must still follow the testing, investigation and other rules outlined in California Code of Regulations 3205.1.

You can find more information in Cal/OSHAs recently updated COVID-19 Prevention Non-Emergency Standards Frequently Asked Questions.

The Los Angeles Department of Public Health website has updated its instructions for COVID-19 cases to conform to the CDPHs new guidelines.

The Centers for Disease Control and Prevention also reportedly plans to follow Californias lead and drop its five-day COVID-19 isolation recommendation under new guidance expected to be released in April for public feedback.

Continue reading here:

California Relaxes COVID-19 Isolation and Testing Guidelines | Greenberg Glusker LLP - JDSupra - JD Supra

In Michigan, the state health department still follows the CDC guidelines,offering direct links to the CDCs recommendation for people who have been exposed to COVID or who have tested positive.

Related:

As of Friday, those recommendations remain to isolate for five days.

The confusion began this week when the Washington Post and New York Times reported that the CDC plans to change its recommendations for the first time since 2021. The new guidelines, the news outlets reported, would mirror guidance on how to avoid transmitting flu and RSV.

But another news report suggested that wasnt going to happen any time soon.

Meanwhile, COVID continues to circulate in Michigan, with an average of 521 new cases every day, according to state data released Tuesday. And COVID remains deadly, especially for those over 80 years old.

The CDC now recommends several steps if you test positive for COVID:

The Michigan Department of Health and Human Services considers CDC recommendations first when making recommendations to Michigan families, spokesperson Chelsea Wuth said in an email to Bridge.

We encourage Michiganders to use tools available to them including staying up-to-date on vaccinations, staying home if unwell, keeping a supply of tests handy, and other hygiene to prevent illness including hand-washing, she said.

The recommendations pit science COVID is still contagious and even deadly for a few, against the practical against economic and practical concerns, as not everyone can afford or wants to miss school or work for the sniffles or less.

And an unknown number of people unknowingly work and go to school or socialize without knowing they are COVID-positive because they have no symptoms. Moreover, nearly every American had some sort of antibodies from previous infection or vaccination, according to the CDCs own report.

All of this makes it difficult to persuade people to stay home, said Dr. Teena Chopra, an infectious disease expert at Wayne State University.

If theres 100% protection in the public policy, but zero compliance to that policy, the outcome is still zero, she said.

To be clear, shes not suggesting ignoring the current guidelines. Rather, she said, its the reality of everyday life deep into a fourth year alongside the virus.

President of the Michigan Academy of Family Physicians, Dr. Beena Nagappala said CDC recommendations should stay in place, at least for now, smack-dab in the middle of respiratory season.

Most of her patients with COVID are not severely ill, but serious cases still happen, she said. One of her patients less than two weeks ago was hospitalized with COVID.

Immunity from past infections or the vaccine are reassuring, she said, but they are no guarantee.

Others say changes are long overdue.

If the CDC were to drop the recommendations, theyd be catching up to where the rest of the world has been for about a year and a half, said Brian Calley, president and CEO of the Small Business Association of Michigan.

People have been treating (COVID) for at least the last year according to their own risk tolerances, he said.

The rest is here:

COVID-positive? Five-day isolation still recommended in Michigan - Bridge Michigan

L.L. Bean has just added a third shift at its factory in Brunswick, Maine, in an attempt to keep up with demand for its iconic boot.

Orders have quadrupled in the past few years as the boots have become more popular among a younger, more urban crowd.

The company says it saw the trend coming and tried to prepare, but orders outpaced projections. They expect to sell 450,000 pairs of boots in 2014.

People hoping to have the boots in time for Christmas are likely going to be disappointed. The bootsare back ordered through February and even March.

"I've been told it's a good problem to have but I"m disappointed that customers not getting what they want as quickly as they want," said Senior Manufacturing Manager Royce Haines.

Customers like, Mary Clifford, tried to order boots on line, but they were back ordered until January.

"I was very surprised this is what they are known for and at Christmas time you can't get them when you need them," said Clifford.

People who do have boots are trying to capitalize on the shortage and are selling them on Ebay at a much higher cost.

L.L. Bean says it has hired dozens of new boot makers, but it takes up to six months to train someone to make a boot.

The company has also spent a million dollars on new equipment to try and keep pace with demand.

Some customers are having luck at the retail stores. They have a separate inventory, and while sizes are limited, those stores have boots on the shelves.

Read the original post:

Should COVID isolation guidelines change? Experts weigh in amid reports of potential shift - NBC Chicago

Insights from Dr. Ralph Barics Transcribed Interview

In a transcribed interview conducted by the Select Subcommittee on the Coronavirus Pandemic, Dr. Ralph Baric shared his valuable perspective on the origins of the virus, the global response to the pandemic, as well as the development of vaccines and therapeutics. The full transcript of the interview and related documents will be made publicly accessible at a later date. Dr. Baric emphasized the critical need for ongoing research and preparedness measures to effectively tackle future pandemics.

One of the key aspects discussed by Dr. Baric was the origins of SARS-CoV-2, the virus causing COVID-19. Amidst the ongoing debate on the viruss origin, the possibility of the virus originating from zoonotic transfer a process where viruses jump from animals to humans is strongly backed up by scientific evidence. Bats are considered the most probable natural reservoir of SARS-CoV-2, yet differences between bat coronaviruses and SARS-CoV-2 suggest that humans may have been infected via an intermediate host. Based on genomic sequences and contact tracing, estimates place the origin point of SARS-CoV-2 in humans between mid-October and mid-November 2019.

The theory that the virus leaked from a laboratory, known as the lab leak theory, has gained popularity, particularly in the United States, where it has been promoted by conservative personalities. However, its crucial to note that there is no evidence supporting the existence of the virus in any laboratory before the pandemic. The World Health Organization (WHO) has deemed the possibility of a lab leak highly unlikely, and plans for laboratory audits were rejected by China. Despite the controversy, the majority of the scientific community remains skeptical about a laboratory origin, citing a lack of evidence and abundant support for zoonotic transfer.

Dr. Baric also discussed the global response to the pandemic and the development of vaccines and therapeutics. The rapid development and distribution of vaccines have showcased the incredible capacity of the scientific community to respond to global health crises. However, the pandemic has also highlighted areas for improvement, particularly in terms of global collaboration and equity in vaccine distribution.

Emphasizing the need for continued research and preparedness for future pandemics, Dr. Baric underscored the importance of learning from this pandemic to better equip the global community for future health crises. With the potential for new infectious diseases to emerge through spillover events from animals, either wildlife or farmed animals, ongoing research into zoonotic diseases is crucial. Its clear that understanding the origins and effective responses to pandemics is a complex, multidisciplinary endeavor that requires sustained investment and collaboration across nations.

View original post here:

Understanding the Origin and Response to the Coronavirus Pandemic: Insights from Dr. Ralph Baric - Medriva

Newly released mortality figures by the Illinois Department of Public Health show deaths in 2022 were still coming in at a much higher rate than what the state was seeing before the COVID-19 pandemic. Daily Herald File Photo

Newly released mortality data shows Illinois residents still dying at a rate well above pre-pandemic levels.

The most recent figures released last week by the Illinois Department of Public Health show 122,977 residents died in 2022. Thats 17,512 more deaths than what the state was averaging in the 10 years leading up to the COVID-19 pandemic, a 16.6% increase.

The states overall population declined 2% from 2010 to 2022, according to U.S. Census Bureau tracking.

Though COVID-19 deaths are on the decline, the effects from infections may be spurring the spike in other causes of deaths, medical experts and public health officials warn.

COVID-19 accounted directly for 7,149 Illinois residents dying in 2022, the states fourth leading cause of death, IDPH figures show. It was the third leading cause of death for the two years prior.

Health officials note heart disease and stroke deaths remain elevated as well, while deaths from cancer and chronic respiratory ailments have dipped.

We knew people were very much not getting the same access to care that they were used to during the pandemic, IDPH Director Dr. Sameer Vohra said. They missed a lot of appointments and preventive screenings, but we also know theres an increased risk of heart attack and stroke after a COVID infection.

Heart disease remains the states leading cause of death, but it killed 4.9% more Illinois residents between 2020 and 2022 than it did in the three years leading up to the pandemic, IDPH records show. Stroke deaths are up 11.8% during the same time period.

An October 2023 report by the National Institutes of Health indicates research has shown a likely link between COVID-19 infections and greater risk for heart attack or stroke.

The findings suggest that (COVID-19) may increase the risk of heart attacks and stroke by infecting artery wall tissue, the report stated. This provokes inflammation in atherosclerotic plaques, which could lead to heart attack or stroke.

People may survive a COVID-19 infection, but not survive the effects of the infection.

We have to consider that COVID is going to have an ongoing culling effect on the population, and not just the old, said Dr. Emily Landon, head of the University of Chicago's infectious disease prevention and control program. It definitely results in increased risk of other conditions that cause death.

As for cancer and chronic respiratory disease deaths declining, thats a population that is most at risk from the worst outcomes of a COVID-19 infection. Individuals with those ailments likely make up the majority of those who succumbed to COVID-19, medical experts said. That was especially true in 2022 when vaccines and antiviral medications were more accessible to the general population.

The bottom line is were just not as healthy as we were before COVID for whatever reason, Landon said. Our life span has decreased.

In 2022, life expectancy for the average American climbed to 77.5 years. But thats still more than a year below pre-pandemic levels, according to research by the U.S. Centers for Disease Control and Prevention.

Accidental deaths also remained above pre-pandemic levels in 2022 and were the third-leading cause of death in Illinois that year, records show.

Between 2020 and 2022, accidental deaths were 22.9% higher than in the three years prior. These include drug overdoses and motor vehicle crashes.

A lot of these continued excess mortalities are for younger adults, and that can have just huge distorting effects in many ways on the country, said Mary Pat Campbell, an insurance industry actuary who has written extensively about the pandemic-related mortality trends. With people under the age of 50 that are getting hit, these death rates may be much lower, but the percentage impact is so much higher. It could have some effect on economic stability.

Homicides declined year over year as well, but remain above pre-pandemic levels. IDPH reported 1,312 Illinois residents were murdered in 2022. While thats down from the previous two years, its significantly higher than any year from 2010 to 2019.

Most alarmingly, the data shows more female residents were murdered in 2022 than in any year since at least 2010. From 2010 to 2019, the state averaged 139 female murder victims a year. The 241 female homicide victims in 2022 represents a 73.3% increase from that pre-pandemic 10-year average.

Evidence shows that domestic violence help calls have been increasing in many countries during the COVID-19 pandemic, a 2021 report published by Science Direct titled The effect of COVID-19 on female homicides stated. Gender-based violence is a global phenomenon threatening women irrespective of race, nationality, education or socioeconomic status.

IDPH figures also show a skyrocketing number of injury-related deaths among Illinois residents 65 and older. The number of injury-related deaths among that population has nearly doubled since 2010 from 1,574 to 2,958 in 2022.

Vohra is worried that has to do with a breakdown in the social safety net, particularly during the pandemic.

The community structures that often support our aging population are not what they used to be, he said. During the pandemic, there was almost no access to community and personal social networks.

Among the other top 10 leading causes of deaths for Illinois residents, Alzheimers disease deaths have remained relatively stable through the pandemic, with a slight bump in 2022, records show. Deaths attributed to diabetes were up 20.5% between 2020 and 2022 when compared to the three previous years. Flu and pneumonia deaths are down 14% during that time frame as well, which is largely attributed to fewer gatherings during the pandemic.

The 2023 mortality data isnt expected until January 2025.

More here:

COVID-19 deaths are down, but Illinois' death rate is still higher than it was pre-pandemic - Daily Herald

As we near the fourth anniversary of COVID-19's arrival in New Zealand one thing is clear - the virus isn't going anywhere.

Professor Michael Baker says if anything, the pandemic has become more intense in the last few months, with this latest wave larger than the previous one.

Today, face masks are few and far between. We may still be experiencing a fifth wave of COVID-19, but experts are worried Kiwis are becoming complacent.

"I think it's really old news to be honest," one person told Newshub.

"I'm not super worried about it, it's kind of everyday life," another said.

It's become part of everyday life, unlike previous pandemics that were gone within a year.

"We didn't expect this pandemic to last for four years and if anything it's become more intense in the last three or four months with this fifth wave being bigger than the fourth wave," said Otago Uni Professor of public health Michael Baker.

The virus is also evolving.

"JN.1 is more than 90 percent of cases being detected. We haven't seen that dominance by a subvariant since omicron," he warned.

Prof Baker said in the future we could experience two major waves of COVID-19 each year. And we need to beef up our strategy to deal with them.

"It's getting ahead of our immune system and we need a different way of working," he said.

In the last year, COVID-19 has caused more than 1000 deaths here in New Zealand, and more than 12,000 hospitalisations. With free rapid antigen tests now extended until the end of June, Te Whatu Ora is urging people to have a supply at home and at the ready.

"We need to get on top of this ongoing pandemic. It's not going away, if anything it's getting worse," Prof Baker warned.

Right now Canterbury has the most active cases of COVID-19, with a recorded total of 694.

Earlier this week, Rangiora High School had to close its doors after nearly 40 teachers contracted the virus.

"The big thing is we have a really vulnerable health population, we don't have the health professionals that we have had and that's a scary thing. People need to treat them with respect and not put our small health workforce at risk," said Unichem Cashel pharmacist Annabel Turley.

By isolating if you're unwell, wearing a mask when visiting the doctor and staying up to date with your COVID boosters.

Read the rest here:

Coronavirus: Professor Michael Baker warns COVID-19 pandemic is intensifying - Newshub

In a recent study published in the journalDiagnostics,researchers investigate the relationship between olfactory dysfunction associated with the coronavirus disease 2019 (COVID-19) and subsequent neurocognitive disorders.

Study:A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings. Image Credit:Mariia Boiko/ Shutterstock.com

Acute olfactory dysfunction is one of the earliest and most common symptoms associated with COVID-19, with an incidence rate of up to 75%. The manifestation of both olfactory and gustative dysfunction in COVID-19 can range from reduced or distorted perception to a complete loss of smell and/or taste.

In the context of COVID-19, acute olfactory dysfunction is defined as the altered sense of smell that persists for 14 days or less. Typically, olfactory dysfunction arises around the third day following initial infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with complete resolution of smell perception occurring within four to six weeks. However, up to 27% of COVID-19 patients will continue to experience altered olfactory perception for up to four months, with 21.3% of patients reporting an altered sense of smell for up to one year.

In addition to COVID-19, various other viral infections can lead to olfactory dysfunction, in addition to traumas, neurodegenerative pathological processes, and the secondary effects of sinus diseases. Despite the high prevalence of COVID-19-related olfactory dysfunction, few studies have discussed neuroimaging abnormalities associated with this symptom, including those that may affect the olfactory bulb (OB), olfactory sulcus (OS), olfactory cleft, and olfactory tract (OT).

In the present study, researchers performed a literature review on OB changes observed in patients with clinically confirmed olfactory dysfunction following a diagnosis of COVID-19. They also discussed current treatments for olfactory dysfunction associated with COVID-19.

To this end, the researchers searched multiple databases including PubMed, Scopus, and Google Scholar until December 5, 2023, using keywords including COVID-19, olfactory deficit, anosmia, imaging, SARS-CoV-2, magnetic resonance imaging (MRI), olfactory bulbs, neurocognitive deficits, mood disorders, neuropsychiatric sequelae, and treatments. This search led to a total of 12 observational studies and one case report included in the analysis.

SARS-CoV-2 is considered neurotropic, neuroinvasive, and neurovirulent, with some viral variants associated with a greater affinity for the central nervous system (CNS) than others. In particular, the ancestral D614G strain, followed by the Gamma, Delta, and Omicron BA1 variants, have been associated with the greatest neurotropism in descending order.

Despite several studies evaluating the impact of SARS-CoV-2 infection on olfaction, the precise pathogenesis and molecular mechanisms responsible for this dysfunction remain unclear. Some proposed hypotheses include mechanical obstruction due to congestion and rhinitis, which can compromise airflow and the transportation of odorants for smell perception. However, this hypothesis has been disproven, as several studies have found that olfactory dysfunction often persists for longer durations than respiratory symptoms, with many COVID-19 patients experiencing olfactory dysfunction without the associated nasal congestion needed to support this theory.

Researchers have also hypothesized that SARS-CoV-2 causes direct damage to olfactory neurons, which subsequently leads to olfactory dysfunction. Despite the absence of both the angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) on olfactory neurons, both of which are crucial for viral entry into cells, SARS-CoV-2 may use other pathways such as Basigin (BSG), neuropilin-1 (NRP1), TMPRSS11A, and furin receptors to infect the olfactory system and cause dysfunction.

The reviewed studies included several descriptions of MRI findings in patients with COVID-19, such as volumetric abnormalities and altered signal intensity of OBs, altered depth of OS, abnormalities within the olfactory cortex, as well as irregularities of neuron filia.

Measuring OB volume (OBV) and OS depth is the most common approach to evaluating the olfactory system. To this end, reduced OBV and OS depth in both the right and left side of hospitalized COVID-19 patients has been observed in several studies, thus suggesting that SARS-CoV-2 causes direct damage to olfactory neuronal pathways.

Up to one-third of patients who have recovered from COVID-19 report neurological symptoms, some of which include brain fog, insomnia, headache, depression, anxiety, and mental fatigue. In COVID-19, prolonged olfactory dysfunction has been associated with severe cognitive consequences, which may be attributed to inflammation, altered neurogenesis of the olfactory system, and functional changes within the brain structures.

Although olfactory dysfunction often spontaneously resolves in COVID-19 patients, a significant proportion of these individuals experience chronic olfactory dysfunction. Thus, a wide range of treatment approaches have been proposed for the treatment of COVID-19-related olfactory dysfunction, some of which include corticosteroids and intranasal insulin, dietary intake of various supplements, and olfactory training.

Future studies are needed to determine the efficacy of combining these treatment strategies to restore olfactory function.

Journal reference:

Read more:

COVID-19's lasting impact on smell and brain health unveiled - News-Medical.Net