Possible physiopathology mechanisms of dysgeusia associated with SARS-CoV-2 infection - Literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v12i3.40424

Keywords:

Coronavirus; Dysgeusia; Ageusia.

Abstract

Since the beginning of the COVID-19 pandemic in December 2019, many infected patients have reported changes in taste and smell as early symptoms. The dentist must be able to diagnose this symptom and refer the patient to specialized health services.  This study aimed to carry out a narrative review on the possible physiopathology of dysgeusia and ageusia in patients infected with SARS-CoV-2.  Data were collected from studies identified in the VHL, Google Scholar, LILACS, PubMed, SciELO and Web of Science databases, using as descriptors: dysgeusia, ageusia, pathophysiology and coronavirus.  Among the possible mechanisms for dysgeusia, stand out the viral invasion into nervous tissue, secondary to olfactory alterations, relation with comorbidities and drugs, association with the great presence of the virus in saliva and its high affinity for several angiotensin-2 enzyme receptors present in the oral cavity.  Therefore, taste changes are typical symptoms in patients infected with SARS-CoV-2 and who tend to regress over time.  However, its pathophysiology, action mechanism and prognosis are still not well established, requiring further experimental studies.

References

Amorim Dos Santos, J., Normando, A. G. C., Carvalho da Silva, R. L., Acevedo, A. C., De Luca Canto, G., Sugaya, N., Santos-Silva, A. R., & Guerra, E. N. S. (2021). Oral Manifestations in Patients with COVID-19: A 6-Month Update. Journal of dental research, 100(12), 1321–1329. https://doi.org/10.1177/00220345211029637

Aziz, M., Perisetti, A., Lee-Smith, W. M., Gajendran, M., Bansal, P., & Goyal, H. (2020). Taste Changes (Dysgeusia) in COVID-19: A Systematic Review and Meta-analysis. Gastroenterology, 159(3), 1132–1133. https://doi.org/10.1053/j.gastro.2020.05.003

Baig A. M. (2020). Neurological manifestations in COVID-19 caused by SARS-CoV-2. CNS neuroscience & therapeutics, 26(5), 499–501. https://doi.org/10.1111/cns.13372

Beltrán-Corbellini, Á., Chico-García, J. L., Martínez-Poles, J., Rodríguez-Jorge, F., Natera-Villalba, E., Gómez-Corral, J., Gómez-López, A., Monreal, E., Parra-Díaz, P., Cortés-Cuevas, J. L., Galán, J. C., Fragola-Arnau, C., Porta-Etessam, J., Masjuan, J., & Alonso-Cánovas, A. (2020). Acute-onset smell and taste disorders in the context of COVID-19: a pilot multicentre polymerase chain reaction based case-control study. European journal of neurology, 27(9), 1738–1741. https://doi.org/10.1111/ene.14273

Brandão, T. B., Gueiros, L. A., Melo, T. S., Prado-Ribeiro, A. C., Nesrallah, A. C. F. A., Prado, G. V. B., Santos-Silva, A. R., & Migliorati, C. A. (2021). Oral lesions in patients with SARS-CoV-2 infection: could the oral cavity be a target organ? Oral surgery, oral medicine, oral pathology and oral radiology, 131(2), e45–e51. https://doi.org/10.1016/j.oooo.2020.07.014

Calcagno, N., Colombo, E., Maranzano, A., Pasquini, J., Keller Sarmiento, I. J., Trogu, F., & Silani, V. (2020). Rising evidence for neurological involvement in COVID-19 pandemic. Neurological sciences: official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 41(6), 1339–1341. https://doi.org/10.1007/s10072-020-04447-w

Carignan, A., Valiquette, L., Grenier, C., Musonera, J. B., Nkengurutse, D., Marcil-Héguy, A., Vettese, K., Marcoux, D., Valiquette, C., Xiong, W. T., Fortier, P. H., Généreux, M., & Pépin, J. (2020). Anosmia and dysgeusia associated with SARS-CoV-2 infection: an age-matched case-control study. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 192(26), E702–E707. https://doi.org/10.1503/cmaj.200869

Cetinkaya E. A. (2020). Coincidence of COVID-19 Infection and Smell-Taste Perception Disorders. The Journal of craniofacial surgery, 31(6), e625–e626. https://doi.org/10.1097/SCS.0000000000006601

Das, G., Mukherjee, N., & Ghosh, S. (2020). Neurological Insights of COVID-19 Pandemic. ACS chemical neuroscience, 11(9), 1206–1209. https://doi.org/10.1021/acschemneuro.0c00201

Deems, D. A., Doty, R. L., Settle, R. G., Moore-Gillon, V., Shaman, P., Mester, A. F., Kimmelman, C. P., Brightman, V. J., & Snow, J. B., Jr (1991). Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Archives of otolaryngology--head & neck surgery, 117(5), 519–528. https://doi.org/10.1001/archotol.1991.01870170065015

Di Gennaro, F., Pizzol, D., Marotta, C., Antunes, M., Racalbuto, V., Veronese, N., & Smith, L. (2020). Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review. International journal of environmental research and public health, 17(8), 2690. https://doi.org/10.3390/ijerph17082690

Ferraro, S., Tuccori, M., Convertino, I., Valdiserra, G., Cappello, E., Maggi, F., Blandizzi, C., & Focosi, D. (2021). Olfactory and gustatory impairments in COVID-19 patients: Role in early diagnosis and interferences by concomitant drugs. British journal of clinical pharmacology, 87(5), 2186–2188. https://doi.org/10.1111/bcp.14634

Franco, J. B., Camargo, A. R. de, & Peres, M. P. S. de M. (2020). Cuidados Odontológicos na era do COVID-19: recomendações para procedimentos odontológicos e profissionais. Rev Assoc Paul Cir Dent, 74(1), 18–21. Retrieved from: https://www.researchgate.net/publication/342361015_Cuidados_Odontologicos_na_era_do_COVID-19_recomendacoes_para_procedimentos_odontologicos_e_profissionais

Gasparyan, A. Y., Ayvazyan, L., Blackmore, H., & Kitas, G. D. (2011). Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatology international, 31(11), 1409–1417. https://doi.org/10.1007/s00296-011-1999-3

Guyton, A. C. (2011). Tratado de Fisiologia Médica. Elsevier.

Hu, Y., Sun, J., Dai, Z., Deng, H., Li, X., Huang, Q., Wu, Y., Sun, L., & Xu, Y. (2020). Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology, 127, 104371. https://doi.org/10.1016/j.jcv.2020.104371

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5

Lee, D. J., Lockwood, J., Das, P., Wang, R., Grinspun, E., & Lee, J. M. (2020). Self-reported anosmia and dysgeusia as key symptoms of coronavirus disease 2019. CJEM, 22(5), 595–602. https://doi.org/10.1017/cem.2020.420

Liguori, C., Pierantozzi, M., Spanetta, M., Sarmati, L., Cesta, N., Iannetta, M., Ora, J., Mina, G. G., Puxeddu, E., Balbi, O., Pezzuto, G., Magrini, A., Rogliani, P., Andreoni, M., & Mercuri, N. B. (2020). Subjective neurological symptoms frequently occur in patients with SARS-CoV2 infection. Brain, behavior, and immunity, 88, 11–16. https://doi.org/10.1016/j.bbi.2020.05.037

Lorenzo Villalba, N., Maouche, Y., Alonso Ortiz, M. B., Cordoba Sosa, Z., Chahbazian, J. B., Syrovatkova, A., Pertoldi, P., Andres, E., & Zulfiqar, A. A. (2020). Anosmia and Dysgeusia in the Absence of Other Respiratory Diseases: Should COVID-19 Infection Be Considered? European journal of case reports in internal medicine, 7(4), 001641. https://doi.org/10.12890/2020_001641

Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA neurology, 77(6), 683–690. https://doi.org/10.1001/jamaneurol.2020.1127

Mariz, B. A. L. A., Brandão, T. B., Ribeiro, A. C. P., Lopes, M. A., & Santos-Silva, A. R. (2020). New Insights for the Pathogenesis of COVID-19-Related Dysgeusia. Journal of dental research, 99(10), 1206. https://doi.org/10.1177/0022034520936638

Mehraeen, E., Behnezhad, F., Salehi, M. A., Noori, T., Harandi, H., & SeyedAlinaghi, S. (2021). Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 278(2), 307–312. https://doi.org/10.1007/s00405-020-06120-6

Niazkar, H. R., Zibaee, B., Nasimi, A., & Bahri, N. (2020). The neurological manifestations of COVID-19: a review article. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 41(7), 1667–1671. https://doi.org/10.1007/s10072-020-04486-3

Passarelli, P. C., Lopez, M. A., Mastandrea Bonaviri, G. N., Garcia-Godoy, F., & D'Addona, A. (2020). Taste and smell as chemosensory dysfunctions in COVID-19 infection. American journal of dentistry, 33(3), 135–137.

Patel, A., Charani, E., Ariyanayagam, D., Abdulaal, A., Denny, S. J., Mughal, N., & Moore, L. S. P. (2020). New-onset anosmia and ageusia in adult patients diagnosed with SARS-CoV-2 infection. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 26(9), 1236–1241. https://doi.org/10.1016/j.cmi.2020.05.026

Rathee, M., & Jain, P. (2022). Ageusia. In StatPearls. StatPearls Publishing.

Ren, Y. F., Rasubala, L., Malmstrom, H., & Eliav, E. (2020). Dental Care and Oral Health under the Clouds of COVID-19. JDR clinical and translational research, 5(3), 202–210. https://doi.org/10.1177/2380084420924385

Román, G. C., Spencer, P. S., Reis, J., Buguet, A., Faris, M. E. A., Katrak, S. M., Láinez, M., Medina, M. T., Meshram, C., Mizusawa, H., Öztürk, S., Wasay, M., & WFN Environmental Neurology Specialty Group (2020). The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. Journal of the neurological sciences, 414, 116884. https://doi.org/10.1016/j.jns.2020.116884

Romero-Sánchez, C. M., Díaz-Maroto, I., Fernández-Díaz, E., Sánchez-Larsen, Á., Layos-Romero, A., García-García, J., González, E., Redondo-Peñas, I., Perona-Moratalla, A. B., Del Valle-Pérez, J. A., Gracia-Gil, J., Rojas-Bartolomé, L., Feria-Vilar, I., Monteagudo, M., Palao, M., Palazón-García, E., Alcahut-Rodríguez, C., Sopelana-Garay, D., Moreno, Y., Ahmad, J., … Segura, T. (2020). Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology, 95(8), e1060–e1070. https://doi.org/10.1212/WNL.0000000000009937

Rothan, H. A., & Byrareddy, S. N. (2020). The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity, 109, 102433. https://doi.org/10.1016/j.jaut.2020.102433

Russell, B., Moss, C., Rigg, A., Hopkins, C., Papa, S., & Van Hemelrijck, M. (2020). Anosmia and ageusia are emerging as symptoms in patients with COVID-19: What does the current evidence say? Ecancermedicalscience, 14, ed98. https://doi.org/10.3332/ecancer.2020.ed98

Sayin, İ., Yaşar, K. K., & Yazici, Z. M. (2020). Taste and Smell Impairment in COVID-19: An AAO-HNS Anosmia Reporting Tool-Based Comparative Study. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 163(3), 473–479. https://doi.org/10.1177/0194599820931820

Shereen, M. A., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020). COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. Journal of advanced research, 24, 91–98. https://doi.org/10.1016/j.jare.2020.03.005

Sohrabi, C., Alsafi, Z., O'Neill, N., Khan, M., Kerwan, A., Al-Jabir, A., Iosifidis, C., & Agha, R. (2020). World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International journal of surgery (London, England), 76, 71–76. https://doi.org/10.1016/j.ijsu.2020.02.034

Tong, J. Y., Wong, A., Zhu, D., Fastenberg, J. H., & Tham, T. (2020). The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 163(1), 3–11. https://doi.org/10.1177/0194599820926473

Vaira, L. A., Hopkins, C., Salzano, G., Petrocelli, M., Melis, A., Cucurullo, M., Ferrari, M., Gagliardini, L., Pipolo, C., Deiana, G., Fiore, V., De Vito, A., Turra, N., Canu, S., Maglio, A., Serra, A., Bussu, F., Madeddu, G., Babudieri, S., Giuseppe Fois, A., … De Riu, G. (2020). Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study. Head & neck, 42(7), 1560–1569. https://doi.org/10.1002/hed.26269

Vaira, L. A., Salzano, G., Fois, A. G., Piombino, P., & De Riu, G. (2020). Potential pathogenesis of ageusia and anosmia in COVID-19 patients. International forum of allergy & rhinology, 10(9), 1103–1104. https://doi.org/10.1002/alr.22593

WORLD HEALTH ORGANIZATION. (2021, October 14). Coronavirus Disease (COVID-19) Situation Reports. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Xia, J., Tong, J., Liu, M., Shen, Y., & Guo, D. (2020). Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. Journal of medical virology, 92(6), 589–594. https://doi.org/10.1002/jmv.25725

Xu, H., Zhong, L., Deng, J., Peng, J., Dan, H., Zeng, X., Li, T., & Chen, Q. (2020). High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International journal of oral science, 12(1), 8. https://doi.org/10.1038/s41368-020-0074-x

Xydakis, M. S., Dehgani-Mobaraki, P., Holbrook, E. H., Geisthoff, U. W., Bauer, C., Hautefort, C., Herman, P., Manley, G. T., Lyon, D. M., & Hopkins, C. (2020). Smell and taste dysfunction in patients with COVID-19. The Lancet. Infectious diseases, 20(9), 1015–1016. https://doi.org/10.1016/S1473-3099(20)30293-0

Yan, C. H., Faraji, F., Prajapati, D. P., Boone, C. E., & DeConde, A. S. (2020). Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. International forum of allergy & rhinology, 10(7), 806–813. https://doi.org/10.1002/alr.22579

Zayet, S., Klopfenstein, T., Mercier, J., Kadiane-Oussou, N. J., Lan Cheong Wah, L., Royer, P. Y., Toko, L., & Gendrin, V. (2021). Contribution of anosmia and dysgeusia for diagnostic of COVID-19 in outpatients. Infection, 49(2), 361–365. https://doi.org/10.1007/s15010-020-01442-3

Zhang, H., Kang, Z., Gong, H., Xu, D., Wang, J., Li, Z., Cui, X., Xiao, J., Meng, T., Zhou, W., Liu, J., & Xu, H. (2020). The digestive system is a potential route of 2019-nCov infection: A bioinformatics analysis based on single-cell transcriptomes. BioRxiv. https://doi.org/10.1101/2020.01.30.927806

Zhou, P., Yang, X. L., Wang, X. G., Hu, B., Zhang, L., Zhang, W., Si, H. R., Zhu, Y., Li, B., Huang, C. L., Chen, H. D., Chen, J., Luo, Y., Guo, H., Jiang, R. D., Liu, M. Q., Chen, Y., Shen, X. R., Wang, X., Zheng, X. S., … Shi, Z. L. (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579(7798), 270–273. https://doi.org/10.1038/s41586-020-2012-7

Zubair, A. S., McAlpine, L. S., Gardin, T., Farhadian, S., Kuruvilla, D. E., & Spudich, S. (2020). Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA neurology, 77(8), 1018–1027. https://doi.org/10.1001/jamaneurol.2020.2065

Published

24/02/2023

How to Cite

BUENO, M. V. . .; GALVÃO, G. S. .; NEVES, I. L. I.; SCHRÖTER, G. T.; MOREIRA, M. S. .; SANTOS-PAUL, M. A. dos .; CARVALHO, C. M. A. de .; NEVES, R. S.; MONTANO , T. C. P. Possible physiopathology mechanisms of dysgeusia associated with SARS-CoV-2 infection - Literature review. Research, Society and Development, [S. l.], v. 12, n. 3, p. e6712340424, 2023. DOI: 10.33448/rsd-v12i3.40424. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/40424. Acesso em: 22 nov. 2024.

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Section

Review Article