ABSTRACT
Background Olfactory dysfunction (OD) is associated with both post‐viral and inflammatory etiologies such as COVID‐19 and chronic rhinosinusitis/rhinitis (CRS/R) respectively, to result in reduced quality of life (QoL). However, the former typically induces a sudden‐onset OD while the latter has a gradual presentation. This study aims to establish and compare health utility values (HUVs) and olfactory‐specific QoL measurements between patients with COVID‐19 and CRS/R related OD. Methods This prospective study surveyed COVID‐19 and CRS/R patients with self‐reported OD using HUV assessments (EuroQol‐visual analog scale [EQ‐VAS], EuroQol‐5 dimension [EQ‐5D], time trade‐off [TTO]) and olfactory and sinonasal QoL measures (questionnaire of olfactory disorders –negative and positive statements [QOD‐NS + PS] and sino‐nasal outcome test [SNOT‐22]). A subgroup of subjects completed objective olfactory testing. Intergroup mean scores were compared using Mann–Whitney U tests. Results One hundred eleven subjects were enrolled: mean age ± SD (43.0 ± 15.4 years), 55.9% female. CRS/R was associated with lower HUVs as measured by EQ‐VAS (CRS/R: 0.67 ± 0.18 vs. COVID‐19: 0.74 ± 0.19, p = .03) and worse SNOT‐22 scores in both overall (CRS/R: 49.03 ± 21.04 vs. COVID‐19: 27.58 ± 18.45, p < .001) and subgroup analysis of objectively confirmed OD subjects (CRS/R: 52.40 ± 22.78 vs. COVID‐19: 29.84 ± 21.10, p = .01). On the other hand, COVID‐19 has greater burden on olfactory‐specific QoL (QOD‐NS + PS, COVID‐19: 23.19 ± 13.73 vs. CRS/R: 17.25 ± 11.38, p = .04). Both groups demonstrated a similar decrease in health using the EQ‐5D assessment. Conclusion CRS/R associated OD has a more severe impact on general health and sinonasal specific QoL outcomes, while COVID‐19 associated OD has a greater burden on olfactory‐specific QoL. Level of evidence Level 2c. This work compared multiple quality of life instruments associated with olfactory dysfunction in patients with chronic rhinosinusitis/rhinitis and COVID‐19. Utilizing health utility and olfactory‐specific quality of life measurements, our findings showed that chronic rhinosinusitis/rhinitis induced olfactory dysfunction had a more severe impact on general health utility and sinonasal specific quality of life outcomes, while COVID‐19 induced olfactory dysfunction had a greater burden on olfactory‐specific quality of life.
ABSTRACT
Background: Olfactory dysfunction (OD) is associated with both post-viral and inflammatory etiologies such as COVID-19 and chronic rhinosinusitis/rhinitis (CRS/R) respectively, to result in reduced quality of life (QoL). However, the former typically induces a sudden-onset OD while the latter has a gradual presentation. This study aims to establish and compare health utility values (HUVs) and olfactory-specific QoL measurements between patients with COVID-19 and CRS/R related OD. Methods: This prospective study surveyed COVID-19 and CRS/R patients with self-reported OD using HUV assessments (EuroQol-visual analog scale [EQ-VAS], EuroQol-5 dimension [EQ-5D], time trade-off [TTO]) and olfactory and sinonasal QoL measures (questionnaire of olfactory disorders -negative and positive statements [QOD-NS + PS] and sino-nasal outcome test [SNOT-22]). A subgroup of subjects completed objective olfactory testing. Intergroup mean scores were compared using Mann-Whitney U tests. Results: One hundred eleven subjects were enrolled: mean age ± SD (43.0 ± 15.4 years), 55.9% female. CRS/R was associated with lower HUVs as measured by EQ-VAS (CRS/R: 0.67 ± 0.18 vs. COVID-19: 0.74 ± 0.19, p = .03) and worse SNOT-22 scores in both overall (CRS/R: 49.03 ± 21.04 vs. COVID-19: 27.58 ± 18.45, p < .001) and subgroup analysis of objectively confirmed OD subjects (CRS/R: 52.40 ± 22.78 vs. COVID-19: 29.84 ± 21.10, p = .01). On the other hand, COVID-19 has greater burden on olfactory-specific QoL (QOD-NS + PS, COVID-19: 23.19 ± 13.73 vs. CRS/R: 17.25 ± 11.38, p = .04). Both groups demonstrated a similar decrease in health using the EQ-5D assessment. Conclusion: CRS/R associated OD has a more severe impact on general health and sinonasal specific QoL outcomes, while COVID-19 associated OD has a greater burden on olfactory-specific QoL. Level of evidence: Level 2c.
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.