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Sekine R, Hernandez AK, Overbeck C, Hofer MK, Mori E, Hähner A, Hummel T. Comparison of Patient Characteristics and Olfactory Sensitivity for Trigger Odorants in Parosmia and Phantosmia. Laryngoscope 2024; 134:3277-3285. [PMID: 38578016 DOI: 10.1002/lary.31379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/30/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aimed to determine the characteristics of patients with qualitative olfactory dysfunction (qualOD) and whether individuals with parosmia exhibit increased olfactory sensitivity to previously reported odorous triggers of parosmia. METHODS This study included individuals aged ≥18 years, divided into quantitative OD only, parosmia, and phantosmia groups. Data collected included: clinical-demographic data, "Sniffin' Sticks" scores, questionnaires (depression scale, importance of olfaction), and information about parosmia and phantosmia. A proportion of patients underwent trigger odor threshold testing for 2-Furfurylthiol [FFT] found in coffee and 2,6-nonadienal [Nonadienal] found in cucumber. RESULTS Those with parosmia were typically younger women, with shorter OD duration due to post-viral OD (PVOD), hyposmic/normosmic, and experienced parosmia more severely. Parosmia was 3.5 times more likely in PVOD. Those with phantosmia were older, with longer OD duration due to idiopathic OD, hyposmic/anosmic, and experienced phantosmia less severely. There were no significant differences between FFT and Nonadienal threshold scores in patients with parosmia, phantosmia, or only quantitative OD, but all groups had significantly increased olfactory sensitivity for trigger odors compared to phenyl ethyl alcohol (PEA). CONCLUSION Parosmia and phantosmia patients have distinct characteristics. This may provide clinicians with a better understanding of possible olfactory outcomes in these patients. The higher olfactory sensitivity of all groups to trigger odors compared to PEA raises interesting points about parosmia triggers and odors in the context of warning for danger, in relation to the pathophysiology of parosmia that may be worth exploring in future studies. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3277-3285, 2024.
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Affiliation(s)
- Rumi Sekine
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Anna Kristina Hernandez
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - Clara Overbeck
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marlise K Hofer
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Grote H, Hoffmann A, Kerzel S, Lukasik H, Maier C, Mallon C, Schlegtendal A, Schwarzbach M, van Ackeren K, Volkenstein S, Brinkmann F. Subjective Smell Disturbances in Children with Sars-Cov-2 or Other Viral Infections do not Correspond with Olfactory Test Results. KLINISCHE PADIATRIE 2024; 236:129-138. [PMID: 38262421 DOI: 10.1055/a-2208-6245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Olfactory dysfunction associated with SARS-CoV-2 infection in children has not been verified by a validated olfactory test. We aimed to determine whether these complaints are objectifiable (test-based hyposmia), how often they occur during acute SARS-CoV-2 infection compared to other upper respiratory tract infections (URTI), as well as in children recovered from COVID-19 compared to children with long COVID. METHODS Olfactory testing (U-sniff test; hyposmia<8 points) and survey-based symptom assessments were performed in 434 children (5-17 years; 04/2021-06/2022). 186 symptom-free children served as controls. Of the children with symptoms of acute respiratory tract infection, SARS-CoV-2 PCR test results were positive in 45 and negative in 107 children (URTI group). Additionally, 96 children were recruited at least 4 weeks (17.6±15.2 weeks) after COVID-19, of whom 66 had recovered and 30 had developed long COVID. RESULTS Compared to controls (2.7%), hyposmia frequency was increased in all other groups (11-17%, p<0.05), but no between-group differences were observed. Only 3/41 children with hyposmia reported complaints, whereas 13/16 children with complaints were normosmic, with the largest proportion being in the long-COVID group (23%, p<0.05). CONCLUSION Questionnaires are unsuitable for assessing hyposmia frequency in children. Olfactory complaints and hyposmia are not specific for SARS-CoV-2 infection. The number of complaints in the long-COVID group could result from aversive olfactory perception, which is undetectable with the U-sniff test.
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Affiliation(s)
- Hanna Grote
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Anna Hoffmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Sebastian Kerzel
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Regensburg at Campus St. Hedwig, University Regensburg, University Hospital Regensburg, Germany
| | - Hannah Lukasik
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Christoph Maier
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Claire Mallon
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Anne Schlegtendal
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Michaela Schwarzbach
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Konstantin van Ackeren
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Stefan Volkenstein
- Department of Ear, Nose and Throat, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany
- Department of Paediatric Pneumology, University Hospital Schleswig Holstein Campus Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), German Center for Lung Research, Lübeck, Germany
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de Souza CDF, Magalhães AJDA, Silva Nobre YV, Souza CA, do Nascimento ALO, de Faria LR, Bezerra-Santos M, Armstrong ADC, Nicácio JM, Gomes OV, do Carmo RF. Prevalence and Factors Associated with Olfactory Dysfunction in Individuals with COVID-19 in Brazil: A Study of 20,669 Cases from 2020 to 2021. Med Princ Pract 2024; 33:164-172. [PMID: 38198785 PMCID: PMC11096791 DOI: 10.1159/000536191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE The aim of the study is to determine the prevalence and factors associated with olfactory dysfunction in individuals with COVID-19 in the first 2 years of the pandemic in Brazil. MATERIALS AND METHODS This is a prevalent study involving the confirmed cases of COVID-19 recorded in the municipality between the years 2020 and 2021. Individuals symptomatic for COVID-19, with a positive laboratory result and aged 12 or older were included in this study. Measures of central tendency and dispersion were used in the description of continuous variables and frequency was used for categorical variables. The Shapiro-Wilk test was used to evaluate data distribution. RESULTS Data from 20,669 individuals were analyzed. The prevalence of olfactory disorders was 17.9% and increased from 11.5% to 21.9% between 2020 and 2021. A female gender predominance was observed among individuals who reported anosmia, with 61.1% (n = 564) in 2020 and 61.7% (n = 1,713) in 2021. On the other hand, the median age of individuals with olfactory disorders was lower than that of the group without disorders (35 [IQR 27-46] vs. 39 [IQR 29-50]; p < 0.001). Smell disturbances were present in 18.2% (n = 3,634) of patients who recovered and in 7.1% (n = 38) of those who died. Furthermore, in 2021, a prevalence rate of 30.6% for olfactory disorders was linked to obesity as a comorbidity. CONCLUSION The prevalence of olfactory disorders was lower compared to other studies, with cough and fever being negatively related to olfactory dysfunction and headache, coryza, and taste disorders being positively related. Obesity was the only associated comorbidity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Rodrigo Feliciano do Carmo
- Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
- Postgraduate Program in Health and Biological Sciences, Federal University of Vale do São Francisco (UNIVASF), Petrolina, Brazil
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Daniel D, Paula LN, Eduardo BM, Daniel GA, Andrea DE, Fernando LN, Armando MC. Intranasal insulin for COVID-19-related smell loss. Eur Arch Otorhinolaryngol 2024; 281:201-205. [PMID: 37608216 DOI: 10.1007/s00405-023-08176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Quantitative (hyposmia and anosmia) and qualitative (phantosmia and parosmia) olfactory disorders are common consequences of COVID-19 infection found in more than 38% of patients even months after resolution of acute disease. SARS-CoV-2 has tropism for angiotensin-converting enzyme 2 (ACE2) in the respiratory system, suggesting that it is the mechanism of damage to the olfactory neuroepithelium and of involvement at the central nervous system. The olfactory bulb is the organ with the highest insulin uptake in the central nervous system. Insulin increases the production of Growth Factors (GF); therefore, in this study, the administration of intranasal insulin is proposed as a viable treatment for olfactory disturbances. The aim of this study was to obtain improvement in olfaction after 4 weeks of intranasal insulin administration in a group of patients presenting chronic olfactory disturbances secondary to COVID-19 infection, quantified using the Threshold, Discrimination, and Identification (TDI) score based on the Sniffin Sticks®. METHODS Experimental, longitudinal, prolective and prospective study of patients with a previous diagnosis of COVID-19 in the last 3-18 months and who persisted with anosmia or hyposmia. The sample size was calculated with "satulator". The intervention was performed from January to May 2022. Throughout four appointments, a baseline olfactory measurement was obtained using the TDI score based on the Sniffin Sticks® test. In the first three appointments, Gelfoam® cottonoids soaked in 40 IU of NPH insulin were placed on the nasal roof of each nostril for 15 min. Descriptive statistics, student's paired t test and a multiple linear regression were utilized to ascertain statistical significance of the outcome on the TDI score obtained on the fourth and final appointment. RESULTS 27 patients were included in the study. Table 1 summarizes the sample characteristics. The results exhibit that 93% of the sample had an improvement. The initial mean TDI score was 67% (63-71) compared to the final mean of 83% (80-86, p < 0.01). TDI subsection analysis is shown in Table 2. There was no significant difference in pre-intervention and post-intervention glucose measurements after the intranasal insulin administration. CONCLUSIONS The administration of intranasal insulin has promising results, pointing towards an alternative of treatment for chronic olfactory disturbances secondary to neuroepithelial damage caused by upper respiratory tract infections. Furthermore, this is the first study to use a three-point assessment of olfaction in post-COVID-19 patients, while using the Sniffin Sticks® TDI score adapted to Latin Spanish.
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Sowerby LJ, Almubarak Z, Biadsee A, Rocha T, Hopkins C. Coronavirus disease 2019 related parosmia: an exploratory survey of demographics and treatment strategies. J Laryngol Otol 2023; 137:1256-1260. [PMID: 37194063 PMCID: PMC10627779 DOI: 10.1017/s0022215123000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To investigate the clinical features, therapeutic efficacy and symptom time course of post-coronavirus disease 2019 parosmia. METHODS A 22-item online questionnaire was distributed to AbScent research group and Facebook coronavirus disease 2019 anosmia group adult members to assess clinical features, interventions and their subjective efficacy for parosmia. RESULTS A total of 209 participants (86 per cent females) reported: smell loss on average 3 days after coronavirus symptoms, recovery 4 weeks later, and first parosmia symptoms 12 weeks post infection. Respondents reported 10 per cent body weight loss, and listed onion and garlic as significant parosmia triggers. Regarding quality of life, depression was the most cited item (54 per cent). Smell training was trialled by 74 per cent of participants, followed by nasal corticosteroid spray (49 per cent). Stellate ganglion block, trialled by 16 per cent of respondents, had the highest reported improvement (45 per cent), with 21 per cent reporting a sustained benefit - the highest rate amongst registered treatment options. CONCLUSION Post-coronavirus parosmia has a significant impact and remains challenging to treat. Stellate ganglion block appears to be successful relative to other reported treatments. Further research into the pathophysiology, efficacy and mechanism of stellate ganglion block effect is warranted.
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Affiliation(s)
- L J Sowerby
- Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Z Almubarak
- Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - A Biadsee
- Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Otorhinolaryngology – Head and Neck Surgery, Meir Medical Center, Kfar-Saba, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T Rocha
- Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - C Hopkins
- Department of ENT, Guy's Hospital, London, UK
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Li S, Boscolo-Rizzo P, Uderzo F, Tirelli G, Whitcroft KL, Hummel T. Orthonasal and retronasal odor identification in patients with parosmia. Eur Arch Otorhinolaryngol 2023; 280:4933-4938. [PMID: 37338584 PMCID: PMC10562280 DOI: 10.1007/s00405-023-08072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To compare retronasal and orthonasal perception in parosmic COVID-19 patients, in order to determine whether COVID-19 has a differential effect on these functions. METHODS Using the Sniffin Sticks test battery orthonasal function was examined for odor threshold, discrimination and identification. Retronasal function was assessed using 20 tasteless aromatized powders. Gustatory function was measured using the Taste Strips test. RESULTS This study included 177 patients (127 women, 50 men; mean age 45 years), of whom 127 (72%) were hyposmic and 50 (28%) normosmic. Compared to patients without parosmia, parosmic patients performed worse in odor identification for both orthonasal (F = 4.94, p = 0.03) and retronasal tests (F = 11.95, p < 0.01). However, an interaction effect between route of odor identification (orthonasal or retronasal) and parosmia status was found (F = 4.67, p = 0.03): patients with parosmia had relatively lower retronasal scores than patients without parosmia. CONCLUSION Our results suggest that COVID-19 may affect the olfactory mucosa differently along the anterior-posterior axis, thereby possibly contributing to the pathophysiology of parosmia. Patients with parosmia also exhibit a higher degree of impairment when odors are presented through the retronasal route during eating and drinking.
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Affiliation(s)
- Shubin Li
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Francesco Uderzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Katherine L. Whitcroft
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technical University of Dresden, Fetscherstrasse. 74, 01307 Dresden, Germany
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Trache MC, Schipp JMH, Haack M, Adderson-Kisser C, Högerle C, Becker S, Betz CS. Characteristics of smell and taste disorders depending on etiology: a retrospective study. Eur Arch Otorhinolaryngol 2023; 280:4111-4119. [PMID: 37160463 PMCID: PMC10382332 DOI: 10.1007/s00405-023-07967-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study investigates the impact of etiology on the epidemiologic profile, disease severity, type of treatment and therapy outcome in smell and taste disorders. METHODS This is a retrospective analysis of 270 patients that presented with a smell or taste disorder in a specialized, tertiary care center. An established questionnaire was used to collect data from patients and physicians. Olfactometry was performed with the Sniffin' Sticks test kit, while gustometry was performed by taste strips. RESULTS Post-traumatic etiology was associated with young age (median 46 years) and male sex, and showed the most severe degrees of smell loss compared to other etiologies (64.3% anosmia). Postinfectious causes occurred more frequently in females (77.3%) and correlated with a history of pharyngeal surgery, suggesting a vulnerability for virally mediated sensory dysfunction following adenoid/tonsil removal. Parosmia also correlated with both postinfectious etiology (62.5%) and female sex. In sinunasal etiology, the presence of nasal polyps worsened the overall olfactory test score by approximately 50%. In particular, smell threshold and discrimination were reduced, while smell identification was not significantly impacted by nasal polyp obstruction. Sinunasal dysfunction was the only etiology to show significant improvement after therapy (73.9% improved). Finally, we could establish good correlations between the subjective impairment and objective dysfunction for each sensory modality. CONCLUSION Each etiology of chemosensory dysfunction shows particular distributions of variables like sex, age, comorbidities and operations, disease severity, sensory threshold, discrimination and identification. This paper offers a detailed account of the correlations between the cause and the characteristics of smell and taste loss.
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Affiliation(s)
- Mihnea Cristian Trache
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | | | - Mareike Haack
- Department of Otorhinolaryngology, Ludwig-Maximillian University Hospital (LMU), Munich, Germany
| | | | - Catalina Högerle
- Department of Otorhinolaryngology, Ludwig-Maximillian University Hospital (LMU), Munich, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, University Hospital Tübingen, Tübingen, Germany
| | - Christian Stephan Betz
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Reiss AB, Greene C, Dayaramani C, Rauchman SH, Stecker MM, De Leon J, Pinkhasov A. Long COVID, the Brain, Nerves, and Cognitive Function. Neurol Int 2023; 15:821-841. [PMID: 37489358 PMCID: PMC10366776 DOI: 10.3390/neurolint15030052] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
SARS-CoV-2, a single-stranded RNA coronavirus, causes an illness known as coronavirus disease 2019 (COVID-19). Long-term complications are an increasing issue in patients who have been infected with COVID-19 and may be a result of viral-associated systemic and central nervous system inflammation or may arise from a virus-induced hypercoagulable state. COVID-19 may incite changes in brain function with a wide range of lingering symptoms. Patients often experience fatigue and may note brain fog, sensorimotor symptoms, and sleep disturbances. Prolonged neurological and neuropsychiatric symptoms are prevalent and can interfere substantially in everyday life, leading to a massive public health concern. The mechanistic pathways by which SARS-CoV-2 infection causes neurological sequelae are an important subject of ongoing research. Inflammation- induced blood-brain barrier permeability or viral neuro-invasion and direct nerve damage may be involved. Though the mechanisms are uncertain, the resulting symptoms have been documented from numerous patient reports and studies. This review examines the constellation and spectrum of nervous system symptoms seen in long COVID and incorporates information on the prevalence of these symptoms, contributing factors, and typical course. Although treatment options are generally lacking, potential therapeutic approaches for alleviating symptoms and improving quality of life are explored.
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Affiliation(s)
- Allison B Reiss
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Caitriona Greene
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Christopher Dayaramani
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | | | | | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
| | - Aaron Pinkhasov
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Long Island, NY 11501, USA
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Ali FA, Jassim G, Khalaf Z, Yusuf M, Ali S, Husain N, Ebrahim F. Transient Anosmia and Dysgeusia in COVID-19 Disease: A Cross Sectional Study. Int J Gen Med 2023; 16:2393-2403. [PMID: 37333880 PMCID: PMC10275370 DOI: 10.2147/ijgm.s408706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Objective This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients. Methods This is a cross-sectional study. Patients diagnosed with COVID-19 between 1st October 2020 and 30th June 2021 were randomly selected from a national COVID-19 registry. COVID-19 cases were diagnosed using molecular testing method which measured the viral E gene. The Anosmia Reporting Tool, and a brief version of the questionnaire on olfactory disorders were used to measure the outcomes via telephone interviews. Data were analysed using SPSS 27 statistics software. Results A total of 405 COVID-19 adults were included in this study, 220 (54.3%) were males and 185 (45.8%) were females. The mean±SD age of participants was 38.2 ± 11.3 years. Alterations in the sense of smell and taste were reported by 206 (50.9%), and 195 (48.1%) of the patients, respectively. Sex and nationality of participants were significantly associated with anosmia and dysgeusia (p < 0.001) and (p-value=0.001) respectively. Among patients who experienced anosmia and dysgeusia, alterations in eating habits (64.2%), impact on mental wellbeing (38.9%), concerns that the alterations were permanent (35.4%), and physical implications and difficulty performing activities of daily living (34%) were reported. Conclusion Anosmia and dysgeusia are prevalent symptoms of COVID-19 disease, especially among females. Although transient, anosmia and dysgeusia had considerable impact on patient's life. Neuropsychological implications of COVID-19 in acute infection phase and prognosis of anosmia and dysgeusia in COVID-19 are areas for further exploration.
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Affiliation(s)
- Fatema Ahmed Ali
- Department of Internal Medicine, South West Acute Hospital, Western Health and Social Care Trust, Enniskillen, Northern Ireland, UK
| | - Ghufran Jassim
- Family Medicine Department, Royal College of Surgeons in Ireland — Medical University of Bahrain (RCSI Bahrain), Busaiteen, Kingdom of Bahrain
| | - Zahra Khalaf
- Department of Postgraduate Studies, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Manaf Yusuf
- Children’s & Adolescent Services, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sara Ali
- Ministry of Health Bahrain, COVID-19 National Team, Sanabis, Kingdom of Bahrain
| | - Nada Husain
- Department of Internal Medicine, Private Health Sector, Manama, Kingdom of Bahrain
| | - Fatema Ebrahim
- Department of Internal Medicine, Private Health Sector, Manama, Kingdom of Bahrain
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Kelly CE. Parosmia and altered taste in patients recovering from Covid 19. CLINICAL NUTRITION OPEN SCIENCE 2023; 48:1-10. [PMID: 36514442 PMCID: PMC9731923 DOI: 10.1016/j.nutos.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Parosmia is a well-documented consequence of smell loss associated with Covid 19. Those who experience this qualitative olfactory disorder during recovery find that the odour of common foods and household items is distorted, and the experience can range from merely altered to profoundly disgusting. This can lead to a greatly altered relationship with food, including the physical symptoms of loss of appetite, nausea, vomiting, as well as wider reaching issues such as withdrawal from social situations, emotional distancing from others in their close social circles, and anhedonia. There is at present no known cure or intervention to mitigate the condition. The AbScent Parosmia and Phantosmia support group on Facebook became an important resource for patients with this condition during the early part of the pandemic, and the crowd-sourcing of experiences, tips and peer-to-peer advice became a valuable source of information for the community as well as researchers trying to understand the condition. Using protocols described in earlier literature on the use of social media for qualitative research, this paper provides information on the management of parosmia based on the experiences of over 30k patients in the AbScent Parosmia and Phantosmia group on Facebook and 6k member of the AbScent Network.
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Sequeria Rodriguez P, Santana Ortiz R, Ortiz-Hernández E. Late onset and persistent parosmia and dysgeusia as neurosensorial complication by the SARS virus COV 2. OTOLARYNGOLOGY CASE REPORTS 2023; 26:100510. [PMID: 36691459 PMCID: PMC9850639 DOI: 10.1016/j.xocr.2023.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
About the neurological manifestations of COVID-19, smell impairment with some distortion or parosmia is currently one of the longest-lasting post-covid sequelae affecting many young adults around the world, we present a case of a 25yo patient that after the COVID-19 infection initiates with anosmia and dysgeusia of difficult control and some weeks later begins with parosmia associated to general discomfort and vomiting preceded by nausea, accompanied by poor oral intake, generating weight loss in 3 weeks, and depression probably related to the clinical profile and the confinement due to the pandemic. She was treated with prednisone, gabapentin, nasal irrigations and olfactory rehabilitation, with mild improvement, which was greater after the second dose of covid-19 vaccine.
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Affiliation(s)
- Patricia Sequeria Rodriguez
- Servicio de Otorrinolaringología, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, Mexico
| | | | - Enrique Ortiz-Hernández
- Servicio de Otorrinolaringología, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco, Mexico,Corresponding author. Servicio de Otorrinolaringología, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Coronel Calderon 777, Guadalajara, 44280, Jalisco, Mexico
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Gary JB, Gallagher L, Joseph PV, Reed D, Gudis DA, Overdevest JB. Qualitative Olfactory Dysfunction and COVID-19: An Evidence-Based Review with Recommendations for the Clinician. Am J Rhinol Allergy 2023; 37:95-101. [PMID: 35957578 PMCID: PMC9379596 DOI: 10.1177/19458924221120117] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nearly 40% of patients who experience smell loss during SARS-CoV-2 infection may develop qualitative olfactory dysfunction, most commonly parosmia. Our evidence-based review summarizes the evolving literature and offers recommendations for the clinician on the management of patients experiencing parosmia associated with COVID-19. METHODS We performed a systematic search using independent queries in PubMed, Embase, Ovid, and Cochrane databases, then categorized articles according to themes that emerged regarding epidemiology, effect on quality of life, disease progression, prognosis, pathophysiology, diagnosis, and treatment of parosmia. RESULTS We identified 123 unique references meeting eligibility and performed title and abstract review with 2 independent reviewers, with 74 articles undergoing full-text review. An inductive approach to thematic development provided 7 central themes regarding qualitative olfactory dysfunction following COVID-19. CONCLUSIONS While other respiratory viruses are known to cause qualitative olfactory disturbances, the incidence of parosmia following COVID-19 is notable, and correlates negatively with age. The presence of parosmia predicts persistent quantitative olfactory dysfunction. Onset can occur months after infection, and symptoms may persist for well over 7 months. Affected patients report increased anxiety and decreased quality of life. Structured olfactory training with essential oils is the preferred treatment, where parosmia predicts recovery of aspects of quantitative smell loss when undergoing training. There is limited evidence that nasal corticosteroids may accelerate recovery of olfactory function. Patients should be prepared for the possibility that symptoms may persist for years, and providers should guide them to resources for coping with their psychosocial burden.
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Affiliation(s)
- Joseph B. Gary
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Liam Gallagher
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Paule V. Joseph
- National Institute on Alcohol Abuse and
Alcoholism, Bethesda, MD, USA
- National Institute of Nursing Research,
Bethesda, MD, USA
| | - Danielle Reed
- Monell Chemical Senses
Center, Philadelphia, PA, USA
| | - David A. Gudis
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
| | - Jonathan B. Overdevest
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
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13
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Altundag A. Parosmia and Phantosmia: Managing Quality Disorders. CURRENT OTORHINOLARYNGOLOGY REPORTS 2023; 11:19-26. [PMID: 36721659 PMCID: PMC9880375 DOI: 10.1007/s40136-023-00441-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 01/28/2023]
Abstract
Purpose of Review The purpose of this review was to summarize the current knowledge on parosmia and phantosmia and introduce support and treatment algorithms for the two qualitative olfactory disorders. Recent Findings Recent literature regarding parosmia has revealed that patients with the disorder are mainly triggered by certain substances, including thiols and pyrazines. In 2015, the existing "olfactory training" regimen was improved to more effectively treat post-infectious olfactory loss and was named "modified olfactory training" (MOT). It was also found in 2022 that MOT is also effective against COVID-19-induced parosmia. Summary Parosmia, the distortion of smells, is a symptom in qualitative olfactory disorders that severely affects patients' mental well-being and enjoyment of their everyday lives. The condition was first documented in 1895 and can affect up to 5% of the general population. Etiologies of parosmia include sinonasal diseases, viruses, surgeries, traumatic brain injury, neurological and psychiatric conditions, toxic chemicals, and medications. Parosmia has seen a surge in cases since the onset of the COVID-19 pandemic and is linked to changes in brain structure following an infection. The evaluation of the symptom is done using surveys, smell identification tests, fMRI, MRI, PET/CT, and gas chromatography. Treatment for parosmia can vary in duration, which makes it essential to focus not only on helping the patients regain normosmia, but also on supporting the patient through the recovery journey. Parosmia should not be confused with phantosmia, in which the distortion of smells occurs in the absence of olfactory stimuli. The etiology of phantosmia can vary from infections and traumatic brain injury to psychiatric disorders like schizophrenia. Unlike parosmia, the treatment of phantosmia is less straightforward, with an emphasis on determining the etiology and providing symptomatic relief.
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Affiliation(s)
- Aytug Altundag
- Otorhinolaryngology Department, Biruni University School of Medicine, Istanbul, Turkey
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14
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Al-Ani RM, Al Tameemi KM. COVID-19-related Rhino-orbital-cerebral Mucormycosis. Qatar Med J 2022; 2022:47. [PMID: 36258686 PMCID: PMC9574569 DOI: 10.5339/qmj.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background: There is an increasing number of COVID-19-related Rhino-orbital-cerebral mucormycosis (ROCM), especially from India. Objectives: To evaluate the demographic, clinical, radiological, and outcome of the COVID-19-related ROCM cases in a single center. Materials and Methods: The medical records of the patients with COVID-19-related ROCM were retrospectively reviewed. The study covered 22 months duration from March 2020 to December 2021 in Imam Hussain Medical City, Karbala city, Iraq. Results: Of the 14 patients with COVID-19-related ROCM, there were 71.4% males with a male-to-female ratio of 2.5:1. The median age was 61 years (age range: 27-80 years). There were 42.9% of patients with a history of being a current smoker. All patients had a history of DM, and 57.1% of patients had a history of hypertension. All patients were without a history of the previous episode of COVID-19 or taking the vaccine. The median duration from the COVID-19 diagnosis to the diagnosis of ROCM was 19 days (duration range of 10-40 days). Most of the cases were of severe type (57.1%). All of the patients were taking corticosteroid and oxygen therapy. Nasal obstruction, nasal discharge, cheek swelling, and necrotic tissue were clinical features in all patients. The majority of the cases were on the left side (71.4%). Stage 3 was found in 42.9%. Amphotericin B was used for all patients and surgical debridement in 13 cases. Five patients have died (35.7%). Conclusion: COVID-19-related ROCM is an aggressive disease associated with a high mortality rate of 35.7%. Early diagnosis and on-time initiation of treatment are recommended to get the best outcome.
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Affiliation(s)
- Raid M. Al-Ani
- College of Medicine, University of Anbar, Anbar, Iraq ,E-mail:
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15
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Said M, Luong T, Jang SS, Davis ME, DeConde AS, Yan CH. Clinical factors associated with lower health scores in COVID-19-related persistent olfactory dysfunction. Int Forum Allergy Rhinol 2022; 12:1242-1253. [PMID: 35032409 PMCID: PMC9011709 DOI: 10.1002/alr.22978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Patients with persistent COVID-19 olfactory dysfunction (OD) commonly report parosmia. Understanding the impact of COVID-19 OD and parosmia is critical to prioritizing research and interventions. In this study we investigate the impact of parosmia and other clinical and disease characteristics on health state utility values (HUVs) for those with persistent COVID-19 OD. METHODS Patients with a history of COVID-19 diagnosis and persistent OD were recruited from a tertiary medical center and a social media support forum for chemosensory dysfunction. Clinical characteristics and disease-specific symptoms were obtained along with self-reported history of smell function and presence of parosmia. HUVs were calculated using indirect (EuroQol 5-Dimension [EQ-5D]) and direct (VAS) measures. RESULTS Our study included 286 subjects (75.52% women) with persistent COVID-19-related OD. Results (mean ± standard deviation) of HUVs based on EQ-5D and VAS were 0.81 ± 0.14 and 0.73 ± 0.21, respectively. Mean self-reported smell function (on a 0-10 scale) was 9.67 ± 1.25 pre-COVID-19, 0.93 ± 2.34 at diagnosis, and 3.39 ± 2.32 at most current assessment. A total of 89.16% of the subjects reported parosmia and 24.13% sought medical care for anosmia. Seeing an MD for OD (p < 0.001), female gender (EQ-5D only, p = 0.002), a history of chronic pain (p < 0.05) and depression/anxiety (EQ-5D only, p < 0.001) predicted worse health. Parosmia and persistent symptoms, such as shortness of breath, were associated with lower EQ-5D and VAS scores, but did not independently predict poorer health scores on multivariable analysis. CONCLUSION Persistent COVID-19 OD results in health states comparable to other chronic diseases.
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Affiliation(s)
- Mena Said
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
| | - Thanh Luong
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
- School of MedicineUniversity of California San DiegoSan DiegoCA
| | - Sophie S Jang
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
| | - Morgan E. Davis
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
| | - Adam S. DeConde
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
| | - Carol H. Yan
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of California San DiegoSan DiegoCA
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16
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Analysis of Prevalence and Predictive Factors of Long-Lasting Olfactory and Gustatory Dysfunction in COVID-19 Patients. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081256. [PMID: 36013436 PMCID: PMC9410278 DOI: 10.3390/life12081256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
Background: Although smell and taste disorders are highly prevalent symptoms of COVID-19 infection, the predictive factors leading to long-lasting chemosensory dysfunction are still poorly understood. Methods: 102 out of 421 (24.2%) mildly symptomatic COVID-19 patients completed a second questionnaire about the evolution of their symptoms one year after the infection using visual analog scales (VAS). A subgroup of 69 patients also underwent psychophysical evaluation of olfactory function through UPSIT. Results: The prevalence of chemosensory dysfunction decreased from 82.4% to 45.1% after 12 months, with 46.1% of patients reporting a complete recovery. Patients older than 40 years (OR = 0.20; 95% CI: [0.07, 0.56]) and with a duration of loss of smell longer than four weeks saw a lower odds ratio for recovery (OR = 0.27; 95% CI: [0.10, 0.76]). In addition, 28 patients (35.9%) reported suffering from parosmia, which was associated with moderate to severe taste dysfunction at the baseline (OR = 7.80; 95% CI: [1.70, 35.8]). Among the 69 subjects who underwent the UPSIT, 57 (82.6%) presented some degree of smell dysfunction, showing a moderate correlation with self-reported VAS (r = −0.36, p = 0.0027). Conclusion: A clinically relevant number of subjects reported persistent chemosensory dysfunction and parosmia one year after COVID-19 infection, with a moderate correlation with psychophysical olfactory tests.
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Drug-Associated Parosmia: New Perspectives from the WHO Safety Database. J Clin Med 2022; 11:jcm11164641. [PMID: 36012880 PMCID: PMC9409668 DOI: 10.3390/jcm11164641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 12/21/2022] Open
Abstract
Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase® (the WHO pharmacovigilance database) was queried for all reports of “Parosmia” (MedDRA Preferred Term), registered up to 23 January 2022. Disproportionality analysis relied on the reporting odds ratio and the information component. A signal is detected when the lower end of the 95% confidence interval of the information component is positive. We found 14,032 reports of parosmia, with a median patient age of 53 years. Most reported drugs were antiinfectives, among which COVID-19 vaccines accounted for 27.1% of reports. Antibiotics and corticosteroids were involved in 6.8% and 4.6% of reports. Significant disproportionate reporting was detected for corticosteroids, antibiotics, drugs used in nicotine dependence, COVID-19 and HPV vaccines, serotonin–norepinephrine reuptake inhibitors (SNRI), and incretin mimetics. We suggest potential safety signals involving nicotine replacement therapies and vaccines. We also highlight the potential role of less suspected classes, such as SNRIs and incretin mimetics. An iatrogenic etiology should be evoked when parosmia occurs, especially in the elderly.
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Pires ÍDAT, Steffens ST, Mocelin AG, Shibukawa DE, Leahy L, Saito FL, Amadeu NT, Lopes NMD, Garcia ECD, Albanese ML, De Mari LF, Ferreira IM, Veiga CA, Jebahi Y, Coifman H, Fornazieri MA, Hamerschmidt R. Intensive Olfactory Training in Post-COVID-19 Patients: A Multicenter Randomized Clinical Trial. Am J Rhinol Allergy 2022; 36:780-787. [PMID: 35866202 DOI: 10.1177/19458924221113124] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Olfactory dysfunction (OD)-including anosmia and hyposmia-is a common symptom of COVID-19. Previous studies have identified olfactory training (OT) as an important treatment for postinfectious OD; however, little is known about its benefits and optimizations after SARS-CoV-2 infection. OBJECTIVE This study aimed to assess whether olfactory training performance can be optimized using more fragrances over a shorter period of time in patients with persistent OD after COVID-19. In addition, we determined the presence of other variables related to OD and treatment response in this population. METHODS This multicenter randomized clinical trial recruited 80 patients with persistent OD and prior COVID-19 infection for less than 3 months. The patients were divided into 2 groups receiving either 4 or 8 essences over 4 weeks. Subjective assessments and the University of Pennsylvania Smell Identification Test (UPSIT) were performed before and after the treatment. RESULTS Significant olfactory improvement was measured subjectively and using the UPSIT in both groups; however, no significant differences between the groups were observed. Additionally, the presence of olfactory fluctuations was associated with higher UPSIT scores. CONCLUSION These data suggest that training intensification by increasing the number of essences for 4 weeks does not show superiority over the classical method. Moreover, fluctuant olfaction seems to be related to a higher score on the UPSIT.
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Affiliation(s)
| | - Sara T Steffens
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | | | | | - Letícia Leahy
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Fernanda L Saito
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Nicole T Amadeu
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | | | | | | | | | | | - César A Veiga
- Olfactory Intelligence Nucleus of the Boticario Group, Curitiba, Brazil
| | - Yasser Jebahi
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Herton Coifman
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Marco A Fornazieri
- Division of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil
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19
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Babaei A, Iravani K, Malekpour B, Golkhar B, Soltaniesmaeili A, Hosseinialhashemi M. Factors associated with anosmia recovery rate in COVID-19 patients. Laryngoscope Investig Otolaryngol 2021; 6:1248-1255. [PMID: 34909467 PMCID: PMC8661943 DOI: 10.1002/lio2.690] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/19/2021] [Accepted: 10/23/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives The present study aimed to assess the 4- and 8-week recovery rate of anosmia and determine the factors associated with recovery in COVID-19 patients. Method This retrospective study was conducted from December 2020 to March 2021. RT-PCR-proven COVID-19 adult patients (over 18 years of age) with a positive history of anosmia were included in this study. Anosmia was assessed based on the COVID-19 Anosmia Reporting Tool. The recovery rate of anosmia after 4 and 8 weeks were evaluated, and the relationship between the patients' recovery and their clinical and demographic data was assessed. Results A total of 235 patients were included. Their mean age (±SD) was 43.95 ± 15.27 years. Anosmia recovery was reported in 207(88.51%) and 219 (93.19%) participants till 4 and 8 weeks. The mean recovery time was 19.42 ± 8.81 days. The result of logistic regression showed that smoking (P = .031; OR = 10.813), ageusia (P = .002; OR = 5.340), headache (P = .006; OR = 0.243), and nasal discharge (P < .001; OR = 0.080) were significantly associated with 4 weeks anosmia recovery. The only risk factor which was associated with a lower rate of 8 weeks anosmia recovery was presence of nasal discharge (OR = 0.106, P = .002). Conclusion The only risk factor which was associated with a lower rate of 8 weeks anosmia recovery was presence of nasal discharge. Our result demonstrated that although smoking was associated with higher recovery rate till 4 weeks, it could not be considered as a protective factor after 8 weeks. More studies are recommended to investigate the relationship between anosmia and the associated factors by consideration of both short- and long-term recovery rates and assess the possible mechanisms that could justify this association. Levels of Evidence 3b.
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Affiliation(s)
- Amirhossein Babaei
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Kamyar Iravani
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
| | - Behzad Malekpour
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
| | - Behnaz Golkhar
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
| | - Amir Soltaniesmaeili
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
| | - Milad Hosseinialhashemi
- Otolaryngology Research Center, Department of OtolaryngologyShiraz University of Medical SciencesShirazIran
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Abstract
Altered smell is one of the most prevalent symptoms in acute COVID-19 infection. Although most patients recover normal neurosensory function in a few weeks, approximately one-tenth of patients report long-term smell dysfunction, including anosmia, hyposmia, parosmia and phantosmia, with a particularly notable impact on quality of life. In this complex scenario, inflammation and cellular damage may play a key role in the pathogenesis of olfactory dysfunctions and may affect olfactory signaling from the peripheral to the central nervous system. Appropriate management of smell disturbances in COVID-19 patients must focus on the underlying mechanisms and the assessment of neurosensorial pathways. This article aims to review the aspects of olfactory impairment, including its pathophysiology, epidemiology, and clinical management in post-acute COVID-19 syndrome (PACS).
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