{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T10:34:01Z","timestamp":1783161241746,"version":"3.54.6"},"reference-count":11,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:00:00Z","timestamp":1612483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Olfactory dysfunction (OD) affects a majority of COVID-19 patients, is atypical in duration and recovery, and is associated with focal opacification and inflammation of the olfactory epithelium. Given recent increased emphasis on airborne transmission of SARS-CoV-2, the purpose of the present study was to experimentally characterize aerosol dispersion within olfactory epithelium (OE) and respiratory epithelium (RE) in human subjects, to determine if small (sub 5\u03bcm) airborne aerosols selectively deposit in the OE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Healthy adult volunteers inhaled fluorescein-labeled nebulized 0.5\u20135\u03bcm airborne aerosol or atomized larger aerosolized droplets (30\u2013100\u03bcm). Particulate deposition in the OE and RE was assessed by blue-light filter modified rigid endoscopic evaluation with subsequent image randomization, processing and quantification by a blinded reviewer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>0.5\u20135\u03bcm airborne aerosol deposition, as assessed by fluorescence gray value, was significantly higher in the OE than the RE bilaterally, with minimal to no deposition observed in the RE (maximum fluorescence: OE 19.5(IQR 22.5), RE 1(IQR 3.2), p&lt;0.001; average fluorescence: OE 2.3(IQR 4.5), RE 0.1(IQR 0.2), p&lt;0.01). Conversely, larger 30\u2013100\u03bcm aerosolized droplet deposition was significantly greater in the RE than the OE (maximum fluorescence: OE 13(IQR 14.3), RE 38(IQR 45.5), p&lt;0.01; average fluorescence: OE 1.9(IQR 2.1), RE 5.9(IQR 5.9), p&lt;0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our data experimentally confirm that despite bypassing the majority of the upper airway, small-sized (0.5\u20135\u03bcm) airborne aerosols differentially deposit in significant concentrations within the olfactory epithelium. This provides a compelling aerodynamic mechanism to explain atypical OD in COVID-19.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0244127","type":"journal-article","created":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T17:42:23Z","timestamp":1612719743000},"page":"e0244127","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Airborne aerosol olfactory deposition contributes to anosmia in COVID-19"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9573-6472","authenticated-orcid":true,"given":"Alan D.","family":"Workman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5254-3221","authenticated-orcid":true,"given":"Aria","family":"Jafari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin S.","family":"Bleier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,5]]},"reference":[{"key":"pone.0244127.ref001","article-title":"Self\u2010reported olfactory loss associates with outpatient clinical course in Covid\u201019","author":"CH Yan","year":"2020","journal-title":"Int Forum Allergy Rhinol"},{"key":"pone.0244127.ref002","article-title":"The Prevalence of Olfactory and Gustatory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis","author":"JY Tong","year":"2020","journal-title":"Otolaryngol Neck Surg"},{"key":"pone.0244127.ref003","article-title":"COVID-19 Anosmia Reporting Tool: Initial Findings","author":"R Kaye","year":"2020","journal-title":"Otolaryngol Neck Surg"},{"key":"pone.0244127.ref004","article-title":"Sudden and Complete Olfactory Loss Function as a Possible Symptom of COVID-19","author":"M Eliezer","year":"2020","journal-title":"JAMA Otolaryngol Neck Surg"},{"key":"pone.0244127.ref005","article-title":"Non-neural expression of SARS-CoV-2 entry genes in the olfactory epithelium suggests mechanisms underlying anosmia in COVID-19 patients","author":"DH Brann","year":"2020","journal-title":"bioRxiv"},{"key":"pone.0244127.ref006","article-title":"It is Time to Address Airborne Transmission of COVID-19","author":"L Morawska","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pone.0244127.ref007","article-title":"Transmission of SARS-CoV-2: implications for infection prevention precautions","author":"World Health Organization(WHO)","year":"2020","journal-title":"Sci Br"},{"key":"pone.0244127.ref008","article-title":"Smell dysfunction: a biomarker for COVID-19","author":"ST Moein","year":"2020","journal-title":"Int Forum Allergy Rhinol"},{"key":"pone.0244127.ref009","article-title":"Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection","author":"C Menni","year":"2020","journal-title":"medRxiv"},{"key":"pone.0244127.ref010","article-title":"Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms","author":"CH Yan","year":"2020","journal-title":"Int Forum Allergy Rhinol"},{"key":"pone.0244127.ref011","article-title":"Aerosol transmission of infectious disease","author":"RM Jones","year":"2015","journal-title":"J Occup Environ Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0244127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T17:42:23Z","timestamp":1612719743000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0244127"}},"subtitle":[],"editor":[{"given":"Vladimir","family":"Mikheev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,5]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0244127","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,5]]}}}