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Infeção por coronavírus e outras doenças associadas à anosmia e ageusia
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O nariz e a boca são sentinelas do mundo químico que nos rodeia. São estes sistemas sensoriais que nos alertam para perigos como comida deteriorada, fugas de gás, ar poluído, fumo do tabaco, etc. Distúrbios destes dois sistemas podem perturbar significativamente a qualidade de vida. O tipo de disfunção destes dois sistemas é muito variável. Podemos falar em disfunções totais ou parciais. Podem ainda existir distorções ou sensações espontâneas. A disfunção olfativa e/ou gustativa pode ser um indicador precoce de doenças tão variadas como doença de Alzheimer, doença de Parkinson e ainda da mais recente Covid-19. A anosmia e a ageusia podem também surgir por uma enorme variedade de causas, sendo as mais comuns as doenças sinonasais, as doenças pós-infeciosas e as situações pós-traumáticas. A presença de recetores gustativos na cavidade sinonasal poderá ter uma relação íntima com a imunidade inata local. Da mesma forma, a microbiota local, intraindividual e interindividual, e todas as relações que estabelece entre si e com agentes patogénicos exógenos poderão influenciar a imunidade e o aparecimento de algumas das disfunções destes dois sistemas. Com esta revisão narrativa, pretende-se rever, de forma seletiva e rigorosa, a literatura existente sobre a anosmia e ageusia no que toca a aspetos-chave da sua fisiologia normal, da sua presença na clínica rotineira e enquanto sintomas relevantes de várias situações patológicas, com especial enfoco enquanto sintomas da recente, e tão presente, pandemia da COVID-19.
The nose and the mouth are sentinels of the chemical world that surround us. It is these sensorial systems that warn us about dangers such as spoiled food, gas leaks, polluted air, cigarette smoke, etc. Disfunctions of these two systems can significantly disturb a person’s quality of life. The type of disfunction of these two systems is very variable. The disfunction may be total or partial. It is also possible to exist distortions or spontaneous sensations. Smell and taste disfunction can be an early indicator of diseases such as Alzheimer’s disease, Parkinson’s disease and the newly Covid-19. Anosmia and ageusia may also appear from a huge variety of causes, being the more common the sinonasal diseases, the post-infectious diseases and the post-traumatic diseases. The presence of taste receptors in the sinonasal cavity may have an intimate relation with the local innate immunity. Also, the local microbiome, intraindividual and interindividual, and all the relations between them and exogenous pathogenic agents may influence immunity and the onset of some disfunctions of these two systems. With this narrative review, I pretend, selectively and rigorously, to review the existent literature about anosmia and ageusia concerning key aspects of the smell’s and taste’s normal physiology, their presence in the routine medical clinic and as relevant symptoms of various pathological situations, with special focus as symptoms of the so present Covid-19 pandemic.
The nose and the mouth are sentinels of the chemical world that surround us. It is these sensorial systems that warn us about dangers such as spoiled food, gas leaks, polluted air, cigarette smoke, etc. Disfunctions of these two systems can significantly disturb a person’s quality of life. The type of disfunction of these two systems is very variable. The disfunction may be total or partial. It is also possible to exist distortions or spontaneous sensations. Smell and taste disfunction can be an early indicator of diseases such as Alzheimer’s disease, Parkinson’s disease and the newly Covid-19. Anosmia and ageusia may also appear from a huge variety of causes, being the more common the sinonasal diseases, the post-infectious diseases and the post-traumatic diseases. The presence of taste receptors in the sinonasal cavity may have an intimate relation with the local innate immunity. Also, the local microbiome, intraindividual and interindividual, and all the relations between them and exogenous pathogenic agents may influence immunity and the onset of some disfunctions of these two systems. With this narrative review, I pretend, selectively and rigorously, to review the existent literature about anosmia and ageusia concerning key aspects of the smell’s and taste’s normal physiology, their presence in the routine medical clinic and as relevant symptoms of various pathological situations, with special focus as symptoms of the so present Covid-19 pandemic.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Anosmia Ageusia Perda de olfato Microbioma nasal COVID-19