Effect of drug therapies on self-reported chemosensory outcomes after COVID-19

Objective:The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection on self-reported alterations in taste and/or smell function.Methods:Seven hundred and fourteen persons with self-reported postcoronavirus disease 2019(post-COVID-19)chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the disease.The dependent measure—self-reported total recovery of chemosensory symptoms—was subjected to stepwise logistic regression.Independent predictors included demographic and clinical variables,in addition to specific medications used to mitigate disease symptoms(i.e.,systemic corticosteroids,oseltamivir,vitamin C,ibuprofen,hydroxychloroquine,azithromycin,ivermectin,nitazoxanide,anticoagulants,and zinc).Results:The median time between COVID-19 symptom onset and the interviews was 81 days(interquartile range:60-104).Of the 714 subjects,249(34.9%)reported total recovery of their chemosensory function;437(61.2%)had at least one treatment since the beginning of the disease.Women and those with more comorbidities had undergone more treatments.The recovery rates of the treated and nontreated groups did not differ significantly.Nonetheless,respondents who had used nitazoxanide tended to have a higher rate of self-reported taste or smell recovery.Those who took oral zinc were less likely to improve.Conclusions:No medication employed during the first months after SARS-CoV-2 infection had a clear positive effect on returning self-reported smell or taste function to normal,although nitrazoxide trended in a positive direction.Oral zinc had a negative effect on the reported recovery of these senses.

Post-tonsillectomy taste dysfunction: Myth or reality?

Lingual branches of the glossopharyngeal nerve (CN Ⅸ) are at risk of injury during ton-sillectomy due to their proximity to the muscle layer of the palatine tonsillar bed. However, it is unclear how often this common surgery leads to taste disturbances. We conducted a literature search using PubMed, Embase, Cochrane Library, Google Scholar, PsychInfo, and Ovid Medline to evaluate the available literature on post-tonsillectomy taste disorders. Studies denoting self-reported dysfunction, as well as those employing quantitative testing, i.e., chemogustometry and electrogustometry, were identified. Case reports were excluded. Of the 8 original articles that met our inclusion criteria, only 5 employed quantitative taste tests. The highest prevalence of self-reported taste disturbances occurred two weeks after surgery (32%). Two studies reported post-operative chemical gustometry scores consistent with hypogeusia. However, in the two studies that compared pre- and post-tonsillectomy test scores, one found no difference and the other found a significant difference only for the left rear of the tongue 14 days post-op. In the two studies that employed electrogustometry, elevated post-operative thresholds were noted, although only one compared pre- and post-operative thresholds. This study found no significant differences. No study employed a normal control group to assess the influences of repeated testing on the sensory mea-sures. Overall, this review indicates that studies on post-tonsillectomy taste disorders are limited andambiguous.Future researchemploying appropriate control groups andtaste testingprocedures are needed to define the prevalence, duration, and nature of post-tonsillectomy taste disorders.

Impact of antibiotics on smell dysfunction

Objective: Viral or bacterial respiratory infections can cause long-lasting olfactory dysfunction. Antibiotic therapy is indicated in severe cases; however, it is unclear whether antibiotic use produces a positive, negative, or null effect on olfactory function. This retro-spective study sought to determine whether antibiotic use has an influence on odor identifica-tion and detection threshold test scores of patients with smell dysfunction secondary to upper respiratory infections (URIs), lower respiratory infections (LRIs), or rhinosinusitis. Methods: Data from a total of 288 patients presenting to the University of Pennsylvania Smell and Taste Center were evaluated. Results: Patients with a URI etiology who had taken bactericidal antibiotics had lower detec-tion thresholds than did patients who had not taken antibiotics (P < 0.023; analysis of covari-ance with age and time since infection onset as covariates). Moreover, thresholds were lower for bactericidal antibiotic users than for bacteriostatic antibiotic users with either URI (P = 0.023) or rhinosinusitis (P = 0.028) etiologies. No meaningful influences of antibiotics on the odor identification test scores were evident. Conclusions: These findings, which need to be confirmed in prospective double-blind studies, suggest that bactericidal antibiotic therapy may be beneficial in mitigating, at least to some degree, chronic decrements in smell sensitivity due to URIs and rhinosinusitis.

Neurophysics Assessment of the Muscle Bioenergy Generated by Transcranial Magnetic Stimulation

Te content of the rectifed motor evoked potential(MEP)induced by transcranial magnetic stimulation(TMS)has ambiguously been assessed without the precision that energy calculation deserves.Tis fact has misled data interpretation and misguided biomedical interventions.To defnitively fll the gap that exits in the neurophysics processing of these signals,we computed,in Walls(̂�),the bioenergy within the rectifed MEP recorded from the human frst digitorum index(FDI)muscle at rest and under isometric contraction.We also gauged the biowork exerted by this muscle.Here we show that bioenergy and biowork can accurately and successfully be assessed,validated,and determined in̂�from MEP signals induced by TMS,regardless of knowing the mathematical expression of the function of the signal.Our novel neurophysics approach represents a dramatic paradigm shif in analysis and interpretation of the content of the MEP and will give a true meaning to the content of rectifed signals.Importantly,this innovative approach allowed unveiling that women exerted more bioenergy than men at the magnetic stimulations used in this study.Revisitation of conclusions drawn from studies published elsewhere assessing rectifed EMG signals that have used ambiguous units is strongly recommended.

Preface

Although often taken for granted, odors and tastes signifi-cantly impact our everyday lives, influencing our eating habits, nutrition, and safety. How many of us look forward to the aroma of brewing coffee and sizzling bacon in the morning and a delicious dinner accompanied by a fine wine in the evening?