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Fortschr Neurol Psychiatr 2021; 89(06): 281-288
DOI: 10.1055/a-1375-0761
Übersicht

Störungen der Chemosensorik bei Covid-19: Pathomechanismen und klinische Relevanz

Chemosensory disorders in Covid-19: Pathomechanisms and clinical relevance
Stefan Isenmann
1   Klinik für Neurologie und klinische Neurophysiologie, St. Josef Krankenhaus Moers
,
Antje Haehner 
2   Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus, TU Dresden
,
Thomas Hummel
2   Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik für HNO-Heilkunde, Universitätsklinikum Carl Gustav Carus, TU Dresden
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Zusammenfassung

In dieser Übersichtsarbeit wurden aktuelle Angaben zu Häufigkeit und Relevanz chemosensorischer Störungen bei Covid-19 erfasst, pathophysiologisch zugeordnet und Aussagen zur prognostischen Bedeutung abgeleitet. Die Ergebnisse basieren auf einer umfassenden Literaturrecherche sämtlicher Literatur zu diesem Thema und eigenen Erfahrungen in der Behandlung von Patienten mit Riech- und Schmeckstörungen seit dem Beginn der Pandemie.

Bisherige Studienergebnisse deuten darauf hin, dass klinisch gering betroffene Covid-19-Patienten ohne stationäre Behandlungs- und Beatmungspflicht häufig Störungen der Chemosensorik aufweisen. Insbesondere bei jungen Patienten und Frauen scheinen sie ein Indikator einer günstigen Prognose des Krankheitsverlaufs zu sein. Riechstörungen können früh, isoliert oder als eines von mehreren Symptomen einer Covid-19-Erkrankung auftreten. Ob eine Ageusie eigenständig auftreten kann oder aber im Rahmen der Anosmie mit empfunden wird, ist noch nicht geklärt. In der Pandemie ist das neue Auftreten einer Anosmie ohne Kongestion / Obstruktion/Schnupfen wahrscheinlich Ausdruck einer Infektion mit SARS-CoV-2 und sollte stets zu Quarantäne und Testung auf SARS-CoV-2 Anlass geben. Die Riechstörung bei Covid-19 scheint meist vorübergehend zu sein; ob es regelhaft zu einer vollständigen Restitution kommt, kann noch nicht abschließend beurteilt werden. Die bereits bei anderen postviralen Riechstörungen etablierten Therapieansätze (z. B. Riechtraining) kommen auch hier zum Einsatz.

Abstract

In this review article, current information on the frequency and relevance of chemosensory disorders in Covid-19 was recorded, assigned pathophysiologically and statements on prognostic significance were derived. The results are based on a comprehensive literature search of all literature on this topic and our own experience in the treatment of patients with smell and taste disorders since the beginning of the pandemic.

Current study results indicate that clinically less affected Covid-19 patients without inpatient treatment and who do not require ventilation often have disorders of the chemosensory system. In young patients and women in particular, they seem to be an indicator of a favorable prognosis for the course of the disease. Smell disorders can appear early, as the sole symptom or together with other symptoms of Covid-19 disease. It has not yet been clarified whether ageusia can occur independently or whether it is also felt in the context of anosmia. In the pandemic, the new occurrence of anosmia without congestion / obstruction/runny nose is probably an expression of an infection with SARS-CoV-2 and should always give rise to quarantine and testing for SARS-CoV-2. The smell disorder in Covid-19 mostly seems to be temporary; It is not yet possible to conclusively assess whether there is usually a full restitution. The therapeutic approaches already established for other postviral olfactory disorders (e. g. olfactory training) are also used here.

Schlüsselwörter

Hyposmie - Ageusie - Epidemiologie - SARS-CoV-2 - Anosmie

Key words

anosmia - hyposmia - ageusia - epidemiology - SARS-CoV-2

Zusatzmaterial

    Zusätzliches Material finden Sie unter https://doi.org/10.1055/a-1375-0761
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Publication History

Received: 13 November 2020

Accepted: 21 January 2021

Article published online:
23 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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