{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:35:38Z","timestamp":1790476538362,"version":"4.1.0"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Smelling is a critical sense utilized daily. Consequently, smelling impairment or anosmia may lead to a reduction in life quality. Systemic diseases and particular autoimmune conditions can impair olfactory function; among others are Systemic Lupus Erythematosus, Sj\u00f6gren Syndrome, and Rheumatoid Arthritis. Interactions between the olfactory process and the immune systems cause this phenomenon. Alongside autoimmune conditions, in the recent COVID-19 pandemic, anosmia was also described as a prevalent infection symptom. Nevertheless, the occurrence of anosmia is significantly less common in Omicron-infected patients. Several theories have been proposed to explain this phenomenon. One possibility is that the Omicron variant preferentially enters host cells via endocytosis, rather than plasma cell membrane fusion. This endosomal pathway is less dependent on the activation of Transmembrane serine protease 2 (TMPRSS2), expressed at the olfactory epithelium. As a result, the Omicron variant may have reduced efficiency in penetrating the olfactory epithelium, leading to a lower prevalence of anosmia. Furthermore, olfactory changes are known to be associated with inflammatory conditions. The Omicron variant elicits a less robust autoimmune and inflammatory response, believed to reduce the probability of anosmia. This review elaborates on the commonalities and differences in autoimmune and COVID-19 omicron-associated anosmia.<\/jats:p>","DOI":"10.3390\/diagnostics13040641","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T02:55:54Z","timestamp":1675911354000},"page":"641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Autoimmunity, COVID-19 Omicron Variant, and Olfactory Dysfunction: A Literature Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-1729","authenticated-orcid":false,"given":"Yonatan","family":"Patt","sequence":"first","affiliation":[{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 5265601, Israel"},{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262100, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6209813, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-6244","authenticated-orcid":false,"given":"Lior","family":"Fisher","sequence":"additional","affiliation":[{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 5265601, Israel"},{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262100, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6209813, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"David","sequence":"additional","affiliation":[{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 5265601, Israel"},{"name":"Department of Medicine \u2018B\u2019, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262100, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6209813, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moriah","family":"Bergwerk","sequence":"additional","affiliation":[{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 5265601, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6209813, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehuda","family":"Shoenfeld","sequence":"additional","affiliation":[{"name":"Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan 5265601, Israel"},{"name":"Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, 199034 Saint-Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.tig.2009.02.002","article-title":"Human olfaction: From genomic variation to phenotypic diversity","volume":"25","author":"Lancet","year":"2009","journal-title":"Trends Genet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1002\/(SICI)1096-9861(19961223)376:4<509::AID-CNE1>3.0.CO;2-5","article-title":"Supporting cells as phagocytes in the olfactory epithelium after bulbectomy","volume":"376","author":"Suzuki","year":"1996","journal-title":"J. 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