r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2020-25-6-4-11r-n-j-126Research ArticleОБЗОРLITERATURE REVIEWНарушение обоняния у больных COVID-19Smell dysfunction in patients with COVID-19https://orcid.org/0000-0002-6219-3384АртеменкоА. Р.АrtemenkоA. R.aartemenko@gmail.comhttps://orcid.org/0000-0003-2958-4479ДаниловАл. Б.DanilovAl. B.

119991, Москва

danilov@intermeda.ruhttps://orcid.org/0000-0002-3030-1918ПлиеваА. М.PlievaA. M.

119991, Москва

plieva_amilta@mail.ruФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202006012021256411Copyright © Артеменко А.Р., Данилов А.Б., Плиева А.М., 20212021Артеменко А.Р., Данилов А.Б., Плиева А.М.Аrtemenkо A.R., Danilov A.B., Plieva A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/126

Коронавирусная болезнь 2019 года (COVID-19) вызвала глобальную пандемию и стала объектом активного изучения. COVID-19 имеет множество клинических проявлений, но нарушение обоняния стало его своеобразной «визитной карточкой». Целью данного обзора является анализ научных данных об аносмии при COVID-19 по результатам первичных исследований с использованием баз данных PubMed, Google Scholar, eLIBRARY. Нарушение обоняния — очень распространенный симптом при COVID-19: до 85% пациентов сообщают об этих субъективных ощущениях, но объективное обонятельное тестирование демонстрирует еще более высокую распространенность — до 98% пациентов. До 27% пациентов могут испытывать внезапное начало аносмии в качестве первого симптома. Поэтому аносмия может иметь решающее значение для своевременной идентификации инфицированных SARS-CoV-2 лиц, которые могут передавать вирус. Особенностью нарушений обоняния при COVID-19 является сохранность условий для нормального трансназального потока воздуха, когда характерные для других респираторных вирусных инфекций отек, гиперемия слизистой носа и ринорея выражены незначительно или вообще отсутствуют. Результаты исследований показывают, что обонятельный эпителий полости носа — область усиленного связывания, репликации и накопления SARS-CoV-2, что обусловлено активной экспрессией двух рецепторов «хозяина» (протеаз АПФ2 и TMПС2) многочисленными ненейрональными клетками обонятельного эпителия. Предполагается, что первично поражаются преимущественно опорные клетки обонятельного эпителия, а поражение обонятельных рецепторных нейронов и нейронов обонятельной луковицы происходит вторично. Однако окончательную клиническую и патофизиологическую значимость обонятельных симптомов еще предстоит выяснить.

Coronavirus disease 2019 (COVID-19) is the cause of a global pandemic and the object of numerous studies worldwide. COVID-19 has many clinical manifestations, but smell dysfunction has become its unique “visiting card”. The purpose of this review is to analyze scientific data on anosmia in COVID-19 based on the results of primary research using PubMed, Google Scholar, and eLIBRARY databases. Olfactory dysfunction is a very common symptom in COVID-19: up to 85% of patients report these subjective sensations, but objective olfactory testing shows a higher prevalence — up to 98%. Up to 27% of patients may experience a sudden onset of anosmia as the first symptom. Therefore, anosmia can be crucial in timely identification of individuals infected with SARS-CoV 2. A feature of olfactory disorders in COVID-19 is the preservation of normal transnasal air flow conditions, when edema, hyperemia of the nasal mucosa and rhinorrhea characteristic of other respiratory viral infections are expressed slightly or aren`t expressed at all. Many studies show that the olfactory epithelium of the nasal cavity is an area of enhanced binding, replication, and accumulation of SARS-CoV2, which is due to the active expression of two host receptors (APF2 and TMPS2 proteases) by numerous non-neuronal olfactory epithelium cells. It is supposed that supporting cells of the olfactory epithelium are primarily affected, and olfactory receptor neurons and olfactory bulb neurons are affected secondarily. However, the final clinical and pathophysiological significance of olfactory symptoms remains to be determined

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The authors declare that there are no conflicts of interest present.