Asghari Kimia Motlagh, Kakavand Nasim, Khosroshahi Mahdieh Taiyeb, Alamdari Sina Janbaz, Karami Shaghayegh, Jaberinezhad Mehran
Physical Medicine and Rehabilitation Research Center Tabriz University of Medical Sciences Tabriz Iran.
Faculty of Medicine Isfahan University of Medical Sciences Isfahan Iran.
Health Sci Rep. 2025 Jun 18;8(6):e70917. doi: 10.1002/hsr2.70917. eCollection 2025 Jun.
Olfactory dysfunction associated with viral infections, including the recent SARS-CoV-2 pandemic, has raised significant clinical interest. Understanding the viral etiologies and histopathological characteristics of permanent olfactory dysfunction is essential for optimizing diagnostic and therapeutic strategies. This systematic review aims to synthesize the available evidence on the histopathological features of viral-induced permanent olfactory dysfunction. By focusing on direct viral damage, inflammatory responses, and vascular changes, this study seeks to elucidate the underlying mechanisms of post-viral olfactory impairment.
This systematic review adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024520500). Searches were conducted in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar up to February 14, 2024. Inclusion criteria encompassed observational studies investigating human subjects diagnosed with permanent olfactory dysfunction attributable to viral etiologies. Two reviewers independently screened studies, extracted data using predefined forms, and assessed study quality using NOS, STROBE, and JBI tools.
Eight studies met the inclusion criteria. Predominant viral etiologies included SARS-CoV-2 and common cold viruses (e.g., adenovirus). Diagnostic tools varied but commonly included clinical evaluations and validated olfactory tests. Histopathological findings revealed diverse nasal tissue alterations, such as mucosal atrophy, inflammatory infiltrates, and neuroepithelial degeneration. SARS-CoV-2 infections demonstrated distinctive neuroepithelial and endothelial pathology contributing to olfactory dysfunction.
Viral-induced permanent olfactory dysfunction involves multifaceted histopathological changes, including direct viral neuroinvasion and inflammatory responses. Understanding these pathophysiological mechanisms is crucial for developing targeted interventions and managing long-term sequelae of viral infections affecting olfaction. This systematic review, the first conducted on this topic, underscores the need for further research on viral etiologies beyond COVID-19, as they are currently understudied.
与病毒感染相关的嗅觉功能障碍，包括近期的SARS-CoV-2大流行，已引起了极大的临床关注。了解永久性嗅觉功能障碍的病毒病因和组织病理学特征对于优化诊断和治疗策略至关重要。本系统评价旨在综合有关病毒诱导的永久性嗅觉功能障碍组织病理学特征的现有证据。通过关注病毒直接损伤、炎症反应和血管变化，本研究旨在阐明病毒感染后嗅觉障碍的潜在机制。
本系统评价遵循PRISMA指南，并在PROSPERO（CRD42024520500）中注册。截至2024年2月14日，在PubMed、EMBASE、Scopus、Web of Science和谷歌学术上进行了检索。纳入标准包括调查被诊断为归因于病毒病因的永久性嗅觉功能障碍的人类受试者的观察性研究。两名评审员独立筛选研究，使用预定义表格提取数据，并使用NOS、STROBE和JBI工具评估研究质量。
八项研究符合纳入标准。主要病毒病因包括SARS-CoV-2和普通感冒病毒（如腺病毒）。诊断工具各不相同，但通常包括临床评估和经过验证的嗅觉测试。组织病理学发现显示鼻腔组织有多种改变，如粘膜萎缩、炎症浸润和神经上皮变性。SARS-CoV-2感染表现出导致嗅觉功能障碍的独特神经上皮和内皮病理。
病毒诱导的永久性嗅觉功能障碍涉及多方面的组织病理学变化，包括病毒直接神经侵袭和炎症反应。了解这些病理生理机制对于制定针对性干预措施和管理影响嗅觉的病毒感染的长期后遗症至关重要。本系统评价是首次针对该主题进行的，强调了对COVID-19以外的病毒病因进行进一步研究的必要性，因为目前对它们的研究不足。
