ABSTRACT
Various new clinical signs and symptoms, such as dysfunction of smell (anosmia) and taste (dysgeusia) have emerged ever since the coronavirus disease 2019 (COVID-19) pandemic begun. The objective of this study was to identify the clinical presentation and factors associated with 'new loss/change of smell (anosmia) or taste (dysgeusia)' at admission in patients positive by real time polymerase chain reaction for SARS-CoV-2 infection. All adult COVID-19 patients with new onset anosmia or dysgeusia at admission were included in study group. Equal number of age and gender matched COVID-19 patients without anosmia or dysgeusia at admission were included in the control group. A total of 261 COVID-19 patients were admitted during the study period of which 55 (21%) had anosmia and or dysgeusia. The mean (SD) age was 36 (13) years and majority were males (58%, n = 32). Comorbidity was present in 38% of cases (n = 21). Anosmia and dysgeusia were noted in more than 1/5th of the cases. Anosmia (96%, n = 53) was more common than dysgeusia (75%, n = 41). Presence of both ansomia and dysgeusia was noted in 71% of patients (n = 39). On comparing the cases with the controls, on univariate analysis, fever (higher in cases), rhinitis (lower in cases), thrombocytopenia, elevated creatinine and bilirubin (all higher in cases) were significantly associated with anosmia or dysgeusia. On multivariate analysis, only rhinitis (odds ratio [OR]: 0.28; 95% confidence interval [CI]: 0.09-0.83; p = .02) thrombocytopenia (OR: 0.99; 95% CI: 0.99-0.99; p = .01) and elevated creatinine (OR: 7.6; 95% CI: 1.5-37.6; p = .01) remained significant. In this retrospective study of COVID-19 patients, we found anosmia and dysgeusia in more than 1/5th of the cases. Absence of rhinitis, low platelet counts and elevated creatinine were associated with anosmia or dysgeusia in these patients.
Subject(s)
Anosmia/epidemiology , COVID-19/epidemiology , Dysgeusia/epidemiology , Adult , Anosmia/blood , Anosmia/physiopathology , Anosmia/virology , COVID-19/blood , COVID-19/diagnosis , COVID-19/physiopathology , Case-Control Studies , Dysgeusia/blood , Dysgeusia/physiopathology , Dysgeusia/virology , Female , Humans , India/epidemiology , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Pandemics , Platelet Count , Real-Time Polymerase Chain Reaction , Retrospective Studies , Rhinitis/epidemiology , Rhinitis/etiology , SARS-CoV-2/isolation & purification , Thrombocytopenia/epidemiology , Thrombocytopenia/etiologySubject(s)
Anemia, Hemolytic/etiology , Anosmia/etiology , COVID-19/complications , Dysgeusia/etiology , Models, Biological , Mouth Diseases/etiology , SARS-CoV-2/pathogenicity , Anosmia/blood , Burning Mouth Syndrome/blood , Burning Mouth Syndrome/etiology , COVID-19/blood , Cell Hypoxia , Dysgeusia/blood , Epithelial Cells/metabolism , Epithelial Cells/pathology , Hemolysis , Humans , Mouth Diseases/bloodABSTRACT
BACKGROUND: An association between IL-6 levels and cytokine storm syndrome in COVID-19 patients has been suggested. Cases with higher IL-6 levels have more rapid progression and a higher complication rate. On the other hand, COVID-19 cases with anosmia have a milder course of the disease. OBJECTIVE: We aimed to investigate whether there is a relationship between serum IL-6 levels and presence of anosmia in COVID-19 patients. METHODS: Patients with a confirmed diagnosis of COVID-19 based on laboratory (PCR) were stratified into two groups based on presence of olfactory dysfunction (OD). In all cases with and without anosmia; psychophysical test (Sniffin' Sticks test) and a survey on olfactory symptoms were obtained. Threshold (t) - discrimination (d) - identification (i), and total (TDI) scores reflecting olfactory function were calculated. Clinical symptoms, serum IL-6 levels, other laboratory parameters, and chest computed tomography (CT) findings were recorded. RESULTS: A total of 59 patients were included, comprising 23 patients with anosmia and 36 patients without OD based on TDI scores. Patients with anosmia (41.39 ± 15.04) were significantly younger compared to cases without anosmia (52.19 ± 18.50). There was no significant difference between the groups in terms of comorbidities, smoking history, and symptoms including nasal congestion and rhinorrhea. Although serum IL-6 levels of all patients were above normal values (7 pg/mL), patients with anosmia had significantly lower serum IL-6 levels (16.72 ± 14.28 pg/mL) compared to patients without OD (60.95 ± 89.33 pg/mL) (p = 0.026). CONCLUSION: Patients with COVID-19 related anosmia tend to have significantly lower serum levels of IL-6 compared to patients without OD, and the lower IL-6 levels is related to milder course of the disease. With the effect of low cytokine storm and IL-6 level, it may be said that anosmic cases have a milder disease in COVID-19.
Subject(s)
Anosmia/diagnosis , COVID-19/epidemiology , Interleukin-6/blood , Pandemics , SARS-CoV-2 , Smell/physiology , Adult , Aged , Aged, 80 and over , Anosmia/blood , Anosmia/etiology , Biomarkers/blood , COVID-19/blood , Female , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Surveys and Questionnaires , Young AdultABSTRACT
Coronavirus Disease-19 (COVID-19) has been in a global pandemic currently and relating symptoms were reported variously around the world. We reported a previously healthy man of COVID-19 presenting with anosmia as the obvious symptom with relevant radiological findings on brain magnetic resonance imaging.