Značaj mirisa i ukusa u svakodnevnom životu: promene kod pacijenata sa COVID-19
Ključne reči:
SARS-CoV-2, anosmija, ageuzija, ACE2
Sažetak
Prenos koronavirusa (SARS-CoV-2), COVID-19 (bolest koronavirusa 2019), sa čoveka na čoveka karakteriše pandemijska eksponencijalna stopa, a pacijenti sa blagom do umerenom infekcijom imaju problema sa mirisom i ukusom koji predstavlja novu atipičnu bolest. Novi virusni sindrom akutne anosmije ili „novi gubitak ukusa ili mirisa“ bez rinitisa i nazalne opstrukcije ili rinoreje stavljen je na listu simptoma koji se mogu javiti 2 do 14 dana nakon izlaganja virusu COVID-19. Dva meseca nakon što je maja 2020. proglasila pandemiju COVID-19, Svetska zdravstvena organizacija (WHO) je prepoznala promene u percepciji mirisa i ukusa kao simptome ove bolesti. Opisani kardinalni simptomi češće se primećuju u populaciji mladih pacijentkinja i radno sposobnih ljudi, što utiče na lakše širenje bolesti. Značajno veća prevalencija pacijenata sa COVID-19 koji su izgubili ukus i miris se leči kod kuće (retka hospitalizacija), retko je oštećenje pluća kao i terapija kiseonikom uz blagu limfopeniju. Mogu se pretpostaviti različiti scenariji virusne infekcije SARS-CoV-2: verovatno je da virus ne ulazi direktno u olfaktorne senzorne neurone (ne poseduju receptore ACE2 i TMPRSS2) , već se lokalizuje na vaskularnim pericitima i uzrokuje zapaljenske procese i vaskulopatije. Sa druge strane moguća je direktna infekcija ne-neuronskih ćelija koje sadrže pomenute receptore, koje čine specifični tipovi ćelija u olfaktornom epitelu kao što su sustentakularne, horizontalne bazalne ćelije kao i Boumanove žlezde koje mogu dovesti do masivne degeneracije i gubitka olfaktornih neurona. Osećaj ukusa je složena senzacija koja je rezultat interakcije mirisa, ukusa, temperature i teksture hrane. Virus oštećuje kranijalne nerve, epitel receptora i krvne sudove što dovodi do oštećenja ukusa (ageuzija ili disgeuzija).
Multidisciplinarni pristup sa epidemiološkim, kliničkim i osnovnim istraživanjima potreban je kako bi se razjasnio mehanizam senzorineuralnog gubitka mirisa i ukusa izazvanog koronavirusom
Reference
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