Anosmia in COVID-19: Underlying Mechanisms and Assessment of an Olfactory Route to Brain Infection
Anosmia in COVID-19: Underlying Mechanisms and Assessment of an Olfactory Route to Brain Infection
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DOI：
10.1177/1073858420956905
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发表时间：
2020-09-11
期刊：
影响因子：
5.6
通讯作者：
von Bartheld, Christopher S.
中科院分区：
文献类型：
--
作者：
Butowt, Rafal;von Bartheld, Christopher S.
近几个月来，新冠病毒--导致COVID-19大流行的原因--导致大部分患者的嗅觉和味觉下降。化学感受缺陷通常是SARS-CoV-2病毒无症状携带者最早出现的，有时也是唯一的症状。COVID-19中令人惊讶的早期和特异性化学感觉功能障碍的原因现在开始得到阐明。在这篇假设综述中，我们讨论了最近发现的含义，即COVID-19患者的嗅觉和味觉功能障碍的患病率在人群之间存在差异，可能是因为不同病毒株的刺突蛋白存在差异，或者是因为使病毒进入的宿主蛋白存在差异，从而改变了感染性。我们回顾了最近的进展，在定义潜在的病毒诱导的嗅觉丧失的细胞和分子机制，重点是新出现的关键作用的嗅上皮支持细胞。我们批判性地研究了目前的证据，SARS-CoV-2病毒是否以及如何从鼻子中的嗅觉上皮细胞进入大脑以实现大脑感染，我们讨论了使用COVID-19中观察到的嗅觉和味觉功能障碍作为早期和快速诊断筛查工具的前景。
In recent months it has emerged that the novel coronavirus-responsible for the COVID-19 pandemic-causes reduction of smell and taste in a large fraction of patients. The chemosensory deficits are often the earliest, and sometimes the only signs in otherwise asymptomatic carriers of the SARS-CoV-2 virus. The reasons for the surprisingly early and specific chemosensory dysfunction in COVID-19 are now beginning to be elucidated. In this hypothesis review, we discuss implications of the recent finding that the prevalence of smell and taste dysfunction in COVID-19 patients differs between populations, possibly because of differences in the spike protein of different virus strains or because of differences in the host proteins that enable virus entry, thus modifying infectivity. We review recent progress in defining underlying cellular and molecular mechanisms of the virus-induced anosmia, with a focus on the emerging crucial role of sustentacular cells in the olfactory epithelium. We critically examine the current evidence whether and how the SARS-CoV-2 virus can follow a route from the olfactory epithelium in the nose to the brain to achieve brain infection, and we discuss the prospects for using the smell and taste dysfunctions seen in COVID-19 as an early and rapid diagnostic screening tool.