Incidence of Psychiatric Illness among COVID-19-Positive Individuals with and Without Loss of Smell or Taste Symptoms in a Tertiary Care Hospital in South India - A Prospective Cohort Study

Background: COVID infection is known to cause acute and long-term neuropsychiatric presentations. Coronavirus infections are known to have neuroinvasive potential with consequent neuropsychiatric manifestations. Materials and Methods: The study was conducted in a tertiary care hospital, and COVID-19-positive individuals were grouped based on the presence or absence of loss of smell (anosmia) or taste symptoms (ageusia). Group 1 without smell or taste disturbance, and Group 2 with smell or taste disturbance. Both groups were followed up for 6 months to assess the new onset of psychiatric illness. Results: The onset of new psychiatric illness was present in 8 out of 30 (26.66%) cases in group 2 when compared with 2 out of 30 (6.66%) cases in Group 1, with a relative risk of 4 (95% confidence interval 0.9247-17.3023). In 10 cases, the pattern of psychiatric illness was depression (16.66%), anxiety (6.6%), posttraumatic stress disorder (3.33%), acute psychosis (3.33%), and acute stress disorder (3.33%). Both groups were compared in terms of socio-demographic profile, inflammatory markers, and computed tomography severity score, and no significant difference was noted between the two. A relative risk of 4 indicates that COVID-19-infected individuals who lose their sense of smell or taste are more likely to develop new-onset psychiatric illness. Conclusion: Impact of COVID-19 on the central nervous system is very evident, and loss of smell or taste symptoms could be an early marker. Early recognition and prompt treatment with immunotherapy or newer therapies will prevent the emergence of psychiatric disturbance and its disability.