ABSTRACT
Background An olfactory disorder is often described as a characteristic initial symptom in patients with COVID-19 infection. The long-term olfactory disorders after a COVID-19 infection have not yet been described in detail. The aim of the study was to investigate the long-term effects of COVID-19 infections on smelling. Methods Patients with persistent, subjective smell &/ taste disorders were examined by means of questionnaires, endoscopic examinations, as well as side-separated olfactory testing using sniffin- sticks (TDI) and taste testing. After initial presentation and initiation of olfactory training, structured controls were performed for 72 patients six, 12 and 18 weeks after initial consultation. Results On average, the patient presented seven months after the onset of symptoms. 70 % of the patients were female and in average patients were 40 years old. Parosmia was reported by 64 % of the patients at this point. An at least unilateral functional anosmia was observed in 24 % and at least unilateral hyposmia in 71 % of the patients. A difference of ≥ 5 points in TDI between the respective sides could be identified in 35 %. During the first (six weeks), second (12 weeks) and third (18 weeks) control 32 %, 9 % and 14 % of the patients showed an improvement in smell of ≥ 5 points in the TDI test using sniffing sticks, respectively. Discussion Persistence of an olfactory disorder in the sense of hyp-/anosmia and parosmia can occur in young, female patients after COVID-19 infection. A side difference in smell can occur due to certain individual anatomy and the entry of the virus. A small proportion of patients with persistent olfactory disorders show regeneration.
ABSTRACT
Background Olfactory and gustatory disorders after COVID-19 vaccination have been described in the literature in case reports. These are mainly described after the Comirnaty vaccination. In this case report, the olfactory and gustatory disorders of two patients after Comirnaty vaccination are described. Methods The two affected patients with persistent subjective olfactory and/ or gustatory dysfunction after COVID-19 vaccination were evaluated using olfactory testing with Sniffin Sticks (TDI) and taste testing. Therapy was subsequently initiated and patients were followed up at regular intervals. Results 2 Patients (1 male and 1 female) with an average age of 80 years, who developed olfactory and/or gustatory disorders after the first and second vaccination respectively, were examined and tested. One case exhibited in the subjective and objective tests a functional anosmia (TDI: right 14.3, left 12.8) whilst the second case displayed hyposmia (TDI: right 18.75, left 21.75) and hypogeusia (right 4/16, left 6/16). Antibody testing showed the presence of IgG(S) but no IgG(Nc) was detected. Discussion Olfactory dysfunction in terms of hyp- or anosmia, as well as parosmia, may occur in patients after COVID-19 vaccination without previous COVID- 19-infection and should always be tested objectively. One case even exhibited hypogeusia. Despite laboratory diagnostics, previous COVID-19 infections cannot be ruled out with certainty. Age-related pre-existing disorders cannot be evaluated. Whether the course of olfactory dysfunction is comparable to that of patients after COVID-19 infection needs to be investigated in further studies.