الفهرس 
Corona virus disease 2019(Covid- 19)Only 14 pages are availabe for public view
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Abstract
Summary
The olfactory epithelium is placed superiorly and posteriorly in the nasal cavity, and the nose is shaped in part to funnel inspired air in its direction. Physically detecting odorants begins with a sniff, creating turbulent airflow that transports odorants to the superior olfactory epithelium in the nose. Both the olfactory nerve (cranial nerve I) and the trigeminal nerve (cranial nerve V) are responsible for chemosensory processing in the nose.
Multiple nerve fibers/rootlets from the receptor cells compose the olfactory nerve. There must be no compromise in the Everything from the olfactory receptor cells and nerves to the olfactory bulb and tract to the olfactory striae and the olfactory brain.
Those with an olfactory impairment either have a diminished sense of smell or an altered capacity to interpret odors. Hyposmia is a diminished ability to smell odors. The inability to smell altogether is known as anosmia. Phantosmia is the experience of smelling something that isn’t actually present, while parosmia is an abnormality in the normal sense of odors.
Infection with the coronavirus 2 subtype causing severe acute respiratory syndrome causes the multiorgan manifestation known as ” COVID-19”. Interest in olfactory dysfunction in otherwise symptom-free individuals as a possible early predictor of SARS-CoV-2 infection has been sparked by reports of such dysfunction. Current research suggests that SARS-CoV-2-related anosmia may be a new viral disease specific to COVID-19and can be caused by intranasal injection of SARS-CoV-2 into the olfactory neuronal pathway.
In cases where COVID-19-related OD improves on its own, medical intervention may not be necessary. However, treatment should be sought when damage lasts longer than two weeks. Some potential avenues of treatment are, Olfactory training involves recurrent and deliberate smelling of a group of odorants. Patients with postinfectious OD have been treated with oral and intranasal corticosteroids to rule out an inflammatory component. In addition to systemic omega-3, intranasal vitamin A, which may promote olfactory neurogenesis, and systemic omega-3, which may act through neuroregenerative or anti-inflammatory means, have all shown promise in the treatment of postinfectious OD.
Failure of retinoic acid synthesis in the olfactory epithelium was shown to impede the regeneration of olfactory neurons using an explant method. Because of their vitamin A deficiency, the patients had trouble detecting odors. After olfactory injury, Tucker et al. found that giving retinoic acid prompted an immunological response and accelerated the recovery of olfactory-guided behavior. It was revealed that Isotretinoin enhanced the considerable performance of patients in the olfactory test.
In COVID-19, vitamin A was described as a useful treatment for olfactory impairment under control. The initial dose was 25,000 IU orally once every day for two weeks. Vitamin A has not been linked to any increased risk of diabetes. Systolic and diastolic blood pressure were both favorably and substantially linked with serum vitamin A.
The purpose of this research is to examine the efficacy of oral vitamin A in conjunction with nasal steroid spray in helping individuals with Covid 19 regain normal olfactory function.
Sixty individuals with a confirmed diagnosis of Covid infection and symptoms of olfactory impairment (anosmia or hyposmia) that persisted during treatment participated in this prospective interventional research.
The main results of the study revealed that:
● Age of the studied patients ranged from 23 – 60 years with mean BMI was 27.45 kg/m2 and (56.7%) of them were females.
● The 51.7% of the patients were diabetics, 31.7% of the patients were smokers and 18.3% of the patients had cardiac disease.
● Mean heart rate 87.42 ± 12.96 and mean RR 16.5 ± 2.96. While mean SBP was 121.7 ±10.23 mmHg and mean DBP was 73.3 ± 6.89 mmHg.
● Mean Hb was 11.84 ± 1.38 g/dl, mean TLC was 11.42 ± 4.61 x103/µL and mean platelets was 286.9 ± 36.74 x103/µL. Mean RBS was 139.76 mg/dl, mean serum albumin was 3.69 g/dL, mean total bilirubin was 1.03 mg/dL, and mean serum creatinine was 0.862 mg/dL while mean ESR was 44.52 mm/hr, and mean CRP was 6.72 mg/L.
● Mean COVID-19 duration was 18.33 ± 4.56 days and mean Anosmia/hyposmia duration before recovery was 8.27 ± 2.83 days.
● there is a significant increase in smell VAS from discharge (2.54 ± 0.747) till 2 months after (9.78 ± 0.261)
● 65% of the patients achieved complete smell recovery with mean anosmia/hyposmia duration till recovery was 32.49 ± 8.75 days.
●Younger age, non-diabetic, small COVID-19duration, and low severity were found to be significantly associated factors with smell recovery.