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将患者的声音纳入治疗化疗感觉障碍的研究议程中。

Integrating the patient's voice into the research agenda for treatment of chemosensory disorders.

机构信息

Department of Psychology, San Diego State University, San Diego, CA, United States.

Department of Psychiatry, University of California, San Diego, CA, United States.

出版信息

Chem Senses. 2024 Jan 1;49. doi: 10.1093/chemse/bjae020.

Abstract

World-wide some 658 million people were infected with coronavirus disease 2019 (COVID-19) and millions suffer from chemosensory impairment associated with long COVID. Current treatments for taste and smell disorders are limited. Involving patients has the potential to catalyze the dynamic exchange and development of new ideas and approaches to facilitate biomedical research and therapeutics. We assessed patients' perceptions of the efficacy of treatments for chemosensory impairment using an online questionnaire completed by 5,815 people in the US Logistic regression determined variables predictive of reported treatment efficacy for patients aged 18 to 24, 25 to 39, 40 to 60, and 60+ yrs. who were treated with nasal steroids, oral steroids, zinc, nasal rinse, smell training, theophylline, platelet-rich plasma, and Omega 3. The most consistent predictor was age, with the majority of those 40 to 60 and 60+ reporting that nasal steroids, oral steroids, zinc, nasal rinse, and smell training were only slightly effective or not effective at all. Many of these treatment strategies target regeneration and immune response, processes compromised by age. Only those under 40 reported more than slight efficacy of steroids or smell training. Findings emphasize the need to include patients of all ages in clinical trials. Older adults with olfactory impairment are at increased risk for Alzheimer's disease (AD). We speculate that olfactory impairment associated with long COVID introduces the potential for a significant rise in AD. Long COVID-associated chemosensory impairment increases the urgency for translational and clinical research on novel treatment strategies. Suggestions for high-priority areas for epidemiological, basic, and clinical research on chemosensory impairment follow.

摘要

全球约有 6.58 亿人感染了 2019 年冠状病毒病(COVID-19),数百万人患有与长新冠相关的化学感觉障碍。目前治疗味觉和嗅觉障碍的方法有限。让患者参与其中有可能促进新想法和方法的动态交流和发展,从而促进生物医学研究和治疗。我们使用在线问卷评估了患者对化学感觉障碍治疗效果的看法,该问卷由美国的 5815 人完成。逻辑回归确定了年龄在 18 至 24 岁、25 至 39 岁、40 至 60 岁和 60 岁以上的接受鼻腔类固醇、口服类固醇、锌、鼻腔冲洗、嗅觉训练、茶碱、富含血小板的血浆和 Omega 3 治疗的患者报告治疗效果的预测变量。最一致的预测因素是年龄,大多数 40 至 60 岁和 60 岁以上的患者报告说,鼻腔类固醇、口服类固醇、锌、鼻腔冲洗和嗅觉训练只有轻微效果或根本没有效果。这些治疗策略大多针对再生和免疫反应,这些过程因年龄而受损。只有不到 40 岁的人报告说,类固醇或嗅觉训练的效果不止轻微。研究结果强调需要在临床试验中纳入所有年龄段的患者。嗅觉障碍的老年患者患阿尔茨海默病(AD)的风险增加。我们推测,与长新冠相关的嗅觉障碍可能会导致 AD 显著增加。与长新冠相关的化学感觉障碍增加了对新型治疗策略的转化和临床研究的紧迫性。以下是关于化学感觉障碍的流行病学、基础和临床研究的高优先级领域的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26c7/11154145/c4f1f5b01cfc/bjae020_fig1.jpg

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