ReviewJournal of clinical medicine2021
Dysautonomia and Implications for Anosmia in Long COVID-19 Disease.
Review in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05638620 (Evaluating the Effectiveness of Dual Sympathetic Blocks for Patients Experiencing Sympathetically-Mediated Symptoms From Post-Acute Sequelae of SARS-CoV-2), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluating the Effectiveness of Dual Sympathetic Blocks for Patients Experiencing Sympathetically-Mediated Symptoms From Post-Acute Sequelae of SARS-CoV-2 (PASC)
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Long COVID and endometriosis: a systematic review and meta-analysis.BMC women's health · 2025Pooled it
- Endophytic extract from Zanthoxylum piperitum as a promising source of anti-SARS-CoV-2 agents.The Journal of antibiotics · 2026Article
- Blood-Brain Barrier Changes and Related Microvascular Outcomes in Long-COVID: A Comprehensive Review.Life (Basel, Switzerland) · 2026Review
- Olfactory impairment associated with reduced physical capacity 24 months after COVID-19.Brain, behavior, & immunity - health · 2025Article
- Article
- Persistent Post-COVID-19 Olfactory Dysfunction and Its Association with Autonomic Nervous System Function: A Case-Control Study.Diseases (Basel, Switzerland) · 2024Article
- Patients recovering from COVID-19 who presented with anosmia during their acute episode have behavioral, functional, and structural brain alterations.Scientific reports · 2024Article
- Association between SARS-CoV-2 variants and post COVID-19 condition: findings from a longitudinal cohort study in the Belgian adult population.BMC infectious diseases · 2023Article
- Tachykinins and the potential causal factors for post-COVID-19 condition.The Lancet. Microbe · 2023Review
- Pathogenesis and progression of anosmia and dysgeusia during the COVID-19 pandemic.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Review
- Autonomic dysfunction entwined with post-COVID but absent in non-post-COVID patients: a neurophysiological and neurosonology study.Therapeutic advances in neurological disorders · 2023Article
- COVID-19, Anosmia, and Allergies: Is There a Relationship? A Pediatric Perspective.Journal of clinical medicine · 2022Article
- Article
- Investigation on the Factors Associated with the Persistence of Anosmia and Ageusia in Saudi COVID-19 Patients.International journal of environmental research and public health · 2022Article
- Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies.Frontiers in neurology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Long COVID-19 patients often reported anosmia as one of the predominant persisting symptoms. Recent findings have shown that anosmia is associated with neurological dysregulations. However, the involvement of the autonomic nervous system (ANS), which can aggregate all the long COVID-19 neurological symptoms, including anosmia, has not received much attention in the literature. Dysautonomia is characterized by the failure of the activities of components in the ANS. Long COVID-19 anosmia fatigue could result from damage to olfactory sensory neurons, leading to an augmentation in the resistance to cerebrospinal fluid outflow by the cribriform plate, and further causing congestion of the glymphatic system with subsequent toxic build-up in the brain. Studies have shown that anosmia was an important neurologic symptom described in long COVID-19 in association with potential COVID-19 neurotropism. SARS-CoV-2 can either travel via peripheral blood vessels causing endothelial dysfunction, triggering coagulation cascade and multiple organ dysfunction, or reach the systemic circulation and take a different route to the blood-brain barrier, damaging the blood-brain barrier and leading to neuroinflammation and neuronal excitotoxicity. SARS-CoV-2 entry via the olfactory epithelium and the increase in the expression of TMPRSS2 with ACE2 facilitates SARS-CoV-2 neurotropism and then dysautonomia in long COVID-19 patients. Due to this effect, patients with anosmia persisting 3 months after COVID-19 diagnosis showed extensive destruction of the olfactory epithelium. Persistent anosmia observed among long COVID-19 patients may be involved by a cascade of effects generated by dysautonomia leading to ACE2 antibodies enhancing a persistent immune activation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.