DOI QR코드

DOI QR Code

Olfactory Dysfunction in COVID-19 from a Korean Medical Perspective

COVID-19 후각 이상에 대한 한의학적 고찰

  • Kim, Sanghyun (KM Data Division, Korea Institute of Oriental Medicine) ;
  • Kim, Jong-hyun (Dept. of Korean Medical Classics & History, College of Korean Medicine, Gachon University)
  • 김상현 (韓國韓醫學硏究院 한의약데이터부) ;
  • 김종현 (嘉泉大學校 韓醫科大學 原典醫史學敎室)
  • Received : 2022.05.09
  • Accepted : 2022.05.12
  • Published : 2022.05.25

Abstract

Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

Keywords

Acknowledgement

본 연구는 한국한의학연구원 주요사업 "임상수요 기반 치료기술 개발(KSN2022220)"의 지원을 받아 수행되었음

References

  1. 김동희 외. 상한론정해(개정판). 서울. 한의문화사. 2013.
  2. 譚春雨 整理. 中藏經. 北京. 人民衛生出版社. 2007.
  3. 동양의학대사전편찬위원회. 東洋醫學大事典(4). 서울. 경희대학교 출판국. 1999.
  4. 吳有性 著. 溫疫論. 北京. 人民衛生出版社. 1990.
  5. 吳鞠通 著, 丁彰炫 譯. 國譯 溫病條辨. 경기도 파주. 집문당. 2005.
  6. 섭천사 저, 조원준 역. 임증지남의안. 경기도 광주. 수퍼노바. 2020.
  7. 巢元方. 諸病源候論. 北京. 北京科學技術出版社, 2016.
  8. 嚴用和. 唐宋金元明名醫全書大成(嚴用和). 濟生方. 北京. 中國中醫藥出版社. 2002.
  9. 吳謙. 標點.索引 御纂醫宗金鑑. 서울. 법인문화사. 2006.
  10. 윤창열, 김용진. 難經硏究集成. 대전. 주민출판사. 2007.
  11. 李梴 編著, 陳柱杓 譯解. 新對譯 醫學入門. 서울. 법인문화사. 2009.
  12. 張介賓 원저, 전국한의과대학 원전학교실 유경 편찬위원회 편저. 懸吐.注釋 類經. 서울. 법인문화사. 2017.
  13. 전국한의과대학 원전학교실 편. 難經. 서울. 법인문화사. 2010.
  14. 陳言. 三因極一病證方論. 北京. 人民衛生出版社. 1983.
  15. 陳柱杓. 金元四大家 醫學全書(上). 서울. 법인문화사. 2007.
  16. 洪元植. 精校黃帝內經素問. 서울. 동양의학연구원출판사. 1985.
  17. 洪元植. 精校黃帝內經靈樞. 서울. 동양의학연구원출판사. 1985.
  18. Boscutti A et al. Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review. Brain Behav Immun Health. 2021. 15. https://doi.org/10.1016/j.bbih.2021.100268
  19. Saniasiaya J et al. Prevalence of Olfactory Dysfunction in Coronavirus Disease 2019 (COVID-19): A Meta-analysis of 27,492 Patients. Laryngoscope. 2021. 131(4). https://doi.org/10.1002/lary.29286
  20. Agyeman AA et al. Smell and Taste Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis. Mayo Clin Proc. 2020. 95(8). https://doi.org/10.1016/j.mayocp.2020.05.030
  21. von Bartheld CS et al. The D614G Virus Mutation Enhances Anosmia in COVID-19 Patients: Evidence from a Systematic Review and Meta-analysis of Studies from South Asia. ACS Chem Neurosci. 2021. 12(19). https://doi.org/10.1021/acschemneuro.1c00542
  22. Boscolo-Rizzo P et al. Coronavirus disease 2019 (COVID-19)-related smell and taste impairment with widespread diffusion of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) Omicron variant. Int Forum Allergy Rhinol. 2022. https://doi.org/10.1002/alr.22995
  23. Sudre CH et al. Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study. Lancet Digit Health. 2021. 3(9). https://doi.org/10.1016/S2589-7500(21)00115-1
  24. Dicpinigaitis PV et al. Post-viral Anosmia (Loss of Sensation of Smell) Did Not Begin with COVID-19!. Lung. 2021. 199(3). https://doi.org/10.1007/s00408-021-00448-4
  25. Mutiawati E. Anosmia and dysgeusia in SARS-CoV-2 infection: incidence and effects on COVID-19 severity and mortality, and the possible pathobiology mechanisms - a systematic review and meta-analysis. F1000Res. 2021. https://doi.org/10.12688/f1000research.28393.1
  26. Hwang CS. Olfactory neuropathy in severe acute respiratory syndrome: report of a case. Acta Neurol Taiwanica. 2006. 15(1).
  27. Munirah Saad Alshebri et al. Neurological Complications of SARS-CoV, MERS-CoV, and COVID-19. SN Comprehensive Clinical Medicine. 2020. 2(11). https://doi.org/10.1007/s42399-020-00589-2
  28. Chi H et al. One-Seventh of Patients with COVID-19 Had Olfactory and Gustatory Abnormalities as Their Initial Symptoms: A Systematic Review and Meta-Analysis. Life (Basel). 2020. 10(9). https://doi.org/10.3390/life10090158
  29. Pang KW et al. Frequency and Clinical Utility of Olfactory Dysfunction in COVID-19: a Systematic Review and Meta-analysis. Curr Allergy Asthma Rep. 2020. 20(12). https://doi.org/10.1007/s11882-020-00972-y
  30. Giorli A et al. A Literature Systematic Review with Meta-Analysis of Symptoms Prevalence in Covid-19: the Relevance of Olfactory Symptoms in Infection Not Requiring Hospitalization. Curr Treat Options Neurol. 2020. 22(10). https://doi.org/10.1007/s11940-020-00641-5
  31. Antolin Amerigo D et al. Loss of Smell and Taste are Newly Emerging Symptoms in COVID-19 Patients Necessitating More Insights into their Diagnostic Evaluation. J Investig Allergol Clin Immunol. 2021. 36(2). https://doi.org/10.5001/omj.2021.118
  32. Nguyen NN et al. Long-Term Persistence of Olfactory and Gustatory Disorders in COVID-19 Patients. Front Med (Lausanne). 2022. 27(6). https://doi.org/10.1016/j.cmi.2020.12.021
  33. Algahtani SN et al. Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients. Int J Environ Res Public Health. 2022. 19(3). https://doi.org/10.3390/ijerph19031047
  34. Hoang MP et al. Self-reported olfactory and gustatory dysfunction and psychophysical testing in screening for COVID-19: A systematic review and meta-analysis. Int Forum Allergy Rhinol. Int Forum Allergy Rhinol. 2021. 12(5). https://doi.org/10.1002/alr.22923
  35. Meng X et al. COVID-19 and anosmia: The story so far. Ear Nose Throat J. 2021. https://doi.org/10.1177/01455613211048998
  36. Koyama AK et al. Symptoms Reported With New Onset of Loss of Taste or Smell in Individuals With and Without SARS-CoV-2 Infection. JAMA Otolaryngol Head Neck Surg. 2021. 147(10). https://doi.org/10.1001/jamaoto.2021.2239
  37. Galluzzi F et al. Risk Factors for Olfactory and Gustatory Dysfunctions in Patients with SARS-CoV-2 Infection. Neuroepidemiology. 2021. 55(2). https://doi.org/10.1159/000514888
  38. Wu D et al. The prevalence of olfactory and gustatory dysfunction in covid-19 - A systematic review. Auris Nasus Larynx. 2022. 49(2). https://doi.org/10.1016/j.anl.2021.07.007
  39. Lucidi D et al. Patient-reported olfactory recovery after SARS-CoV-2 infection: A 6-month follow-up study. Int Forum Allergy Rhinol. 2021. 11(8). https://doi.org/10.1002/alr.22775
  40. Ahmad S et al. How common are taste and smell abnormalities in COVID-19? A systematic review and meta-analysis. J Taibah Univ Med Sci. 2022. 17(2). https://doi.org/10.1016/j.jtumed.2021.10.009
  41. Al-Washahi M et al. Loss of Smell and Taste are Newly Emerging Symptoms in COVID-19 Patients Necessitating More Insights into their Diagnostic Evaluation. Oman Med J. 2021. 36(2). https://doi.org/10.5001/omj.2021.118
  42. Di Stadio A et al. Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study. Brain Sci. 2022. 12(2). https://doi.org/10.3390/brainsci12020154
  43. Pirker-Kees A et al. Hyposmia Is Associated with Reduced Cognitive Function in COVID-19: First Preliminary Results. Dement Geriatr Cogn Disord. 2021. 50(1). https://doi.org/10.1159/000515575
  44. Cristillo V et al. Age and subtle cognitive impairment are associated with long-term olfactory dysfunction after COVID-19 infection. J Am Geriatr Soc. 2021. 69(10). https://doi.org/10.1111/jgs.17296
  45. Elvan-Tuz A et al. Prevalence of Anosmia in 10.157 Pediatric COVID-19 Cases: Multicenter Study from Turkey. Pediatr Infect Dis J. 2022. https://doi.org/10.1097/INF.0000000000003526
  46. Karamali K, Elliott M, Hopkins C. COVID-19 related olfactory dysfunction. Curr Opin Otolaryngol Head Neck Surg. 2022. 30(1). https://doi.org/10.1097/MOO.0000000000000783
  47. Costa KVTD et al. Olfactory and taste disorders in COVID-19: a systematic review. Braz J Otorhinolaryngol. 2020. 86(6). https://doi.org/10.1016/j.bjorl.2020.05.008
  48. Konstantinidis I et al. Olfactory dysfunction after coronavirus disease 2019 (COVID-19) vaccination. Int Forum Allergy Rhinol. 2021. 11(9). https://doi.org/10.1002/alr.22809
  49. Jafar A et al. Olfactory recovery following infection with COVID-19: A systematic review. PLoS One. 2021. 16(11). https://doi.org/10.1371/journal.pone.0259321
  50. Liu N et al. Systematic review and meta-analysis of olfactory and gustatory dysfunction in COVID-19. Int J Infect Dis. 2022. 117. https://doi.org/10.1016/j.ijid.2022.02.004
  51. Coelho DH et al. Predictors of smell recovery in a nationwide prospective cohort of patients with COVID-19. Am J Otolaryngol. 2022. 43(1). https://doi.org/10.1016/j.amjoto.2021.103239
  52. Amirhossein Babaei et al. Factors associated with anosmia recovery rate in COVID-19 patients. Laryngoscope Investigative Otolaryngology. 2021. 6(6). https://doi.org/10.1002/lio2.690
  53. Hintschich CA et al. Persisting olfactory dysfunction in post-COVID-19 is associated with gustatory impairment: Results from chemosensitive testing eight months after the acute infection. PLoS One. 2022. 17(3). https://doi.org/10.1371/journal.pone.0265686
  54. Akinci T et al. Post-discharge persistent headache and smell or taste dysfunction after hospitalisation for COVID-19: a single-centre study. Ir J Med Sci. 2022. https://doi.org/10.1007/s11845-022-02980-5
  55. Aziz M et al. The Association of "Loss of Smell" to COVID-19: A Systematic Review and Meta-Analysis. Am J Med Sci. 2021. 361(2). https://doi.org/10.1016/j.amjms.2020.09.017
  56. Yagmur AR et al. Correlation of olfactory dysfunction with lung involvement and severity of COVID-19. Ir J Med Sci. 2021. https://doi.org/10.1007/s11845-021-02732-x
  57. Goshtasbi K et al. Association Between Olfactory Dysfunction and Critical Illness and Mortality in COVID-19: A Meta-analysis. Otolaryngol Head Neck Surg. 2022. 166(2). https://doi.org/10.1177/01945998211017442
  58. Borsetto D et al. Self-reported alteration of sense of smell or taste in patients with COVID-19: a systematic review and meta-analysis on 3563 patients. Rhinology. 2020. 58(5). https://doi.org/10.4193/Rhin20.185
  59. 陈姼姼 外 12. 新型冠状病毒肺炎患者合并嗅 觉障碍的中医临床特征分析. 辽宁中医药大学学报. 2021. 23(9). https://doi.org/10.13194/j.issn.1673-842x.2021.09.011
  60. Ono Rie et al. Kampo Medicine Promotes Early Recovery From Coronavirus Disease 2019-Related Olfactory Dysfunction: A Retrospective Observational Study. Front Pharmacol. 2022. 13. https://doi.org/10.3389/fphar.2022.844072
  61. 신상원. 宗氣의 의미에 대한 考察 -기존 논의에 대한 재검토를 중심으로-. 대한한의학 원전학회지. 2019. 32(3). https://doi.org/10.14369/jkmc.2019.32.3.147
  62. Beigi-Khoozani A et al. Magnetic Resonance Imaging Findings of Olfactory Bulb in Anosmic Patients with COVID-19: A Systematic Review. Chin Med Sci J. 2022. 37(1). https://doi.org/10.24920/003982
  63. 은석민. "溫邪上受" 개념의 형성요인에 대한 고찰. 대한한의학원전학회지. 2017. 30(2). https://doi.org/10.14369/jkmc.2017.30.2.011
  64. 文淵閣四庫全書電子版[便攜硬碟模式]. Ver.2.0. 香港. 迪志文化出版有限公司. 2016.