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1.
J Laryngol Otol ; 135(5): 426-435, 2021 May.
Article in English | MEDLINE | ID: covidwho-1196805

ABSTRACT

OBJECTIVE: This study aimed to measure the duration and recovery rate of olfactory loss in patients complaining of recent smell loss as their prominent symptom during the coronavirus disease 2019 outbreak. METHOD: This was a prospective telephone follow-up observational study of 243 participants who completed an online survey that started on 12 March 2020. RESULTS: After a mean of 5.5 months from the loss of smell onset, 98.3 per cent of participants reported improvement with a 71.2 per cent complete recovery rate after a median of 21 days. The chance of complete recovery significantly decreased after 131 days from the onset of loss of smell (100 per cent sensitive and 97.7 per cent specific). Younger age and isolated smell loss were associated with a rapid recovery, whereas accompanying rhinological and gastrointestinal symptoms were associated with longer loss of smell duration. CONCLUSION: Smell loss, occurring as a prominent symptom during the coronavirus disease 2019 pandemic, showed a favourable outcome. However, after 5.5 months from the onset, around 10 per cent of participants still complained of moderate or severe hyposmia.


Subject(s)
Anosmia/diagnosis , COVID-19/complications , Olfaction Disorders/etiology , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Follow-Up Studies , Humans , Iran/epidemiology , Olfaction Disorders/diagnosis , Pandemics , Pregnancy , Prospective Studies , Recovery of Function/physiology , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
2.
Am J Otolaryngol ; 42(4): 103065, 2021.
Article in English | MEDLINE | ID: covidwho-1193211

ABSTRACT

PURPOSE: To investigate the recovery of loss of smell and taste among recovered COVID-19 patients. MATERIALS AND METHODS: This cross-sectional follow-up study is a sequel to a study by Biadsee et al. Among the previous study population of 128 non-hospitalized patients, positive for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR), 97 patients participated in a survey designed for this study. Information and data regarding loss of smell and taste, rate of recovery, xerostomia, and additional symptoms; (Cough, Myalgia, Weakness, Rhinorrhea, Nasal congestion) were collected. RESULTS: A total of 43 men and 54 women were included. Mean age was 37.5 years (range 19-74). Mean follow-up was 229 days (range 191-253). Sixty-five patients reported gustatory dysfunction during the disease of which 61.5% reported full recovery, 38.5% partial recovery. Of 65 patients who reported olfactory impairment during the disease, 52% had full recovery and 48% reported partial recovery of olfactory function. Complete recovery of olfactory function was positively associated with full recovery of gustatory function (p = 0.01). Gender did not significantly affect the recovery of OD and GD (p = 0.45, p = 0.90, respectively). Patients who experienced olfactory dysfunction as an initial symptom had lower rates of olfactory complete recovery (p = 0.043). CONCLUSION: After a mean follow-up of 229 days, complete recovery of smell and taste functions occurred in 52% and 61.5%, respectively. However, dysfunction persisted in 48%-38.5% of patients.


Subject(s)
COVID-19/complications , Olfaction Disorders/virology , Taste Disorders/virology , Adult , Aged , COVID-19/diagnosis , COVID-19/therapy , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Israel , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Prevalence , Recovery of Function , Surveys and Questionnaires , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Time Factors , Young Adult
4.
Chem Senses ; 462021 01 01.
Article in English | MEDLINE | ID: covidwho-1080838

ABSTRACT

This study prospectively assessed the 6-month prevalence of self-reported and psychophysically measured olfactory dysfunction in subjects with mild-to-moderate COVID-19. Self-reported smell or taste impairment was prospectively evaluated by SNOT-22 at diagnosis, 4-week, 8-week, and 6-month. At 6 months from the diagnosis, psychophysical evaluation of olfactory function was also performed using the 34-item culturally adapted University of Pennsylvania Smell Identification Test (CA-UPSIT). 145 completed both the 6-month subjective and psychophysical olfactory evaluation. According to CA-UPSIT, 87 subjects (60.0%) exhibited some smell dysfunction, with 10 patients being anosmic (6.9%) and seven being severely microsmic (4.8%). At the time CA-UPSIT was administered, a weak correlation was observed between the self-reported alteration of the sense of smell or taste and olfactory test scores (Spearman's r = -0.26). Among 112 patients who self-reported normal sense of smell at last follow-up, CA-UPSIT revealed normal smell in 46 (41.1%), mild microsmia in 46 (41.1%), moderate microsmia in 11 (9.8%), severe microsmia in 3 (2.3%), and anosmia in 6 (5.4%) patients; however, of those patients self-reporting normal smell but who were found to have hypofunction on testing, 62 out of 66 had a self-reported reduction in sense of smell or taste at an earlier time point. Despite most patients report a subjectively normal sense of smell, we observed a high percentage of persistent smell dysfunction at 6 months from the diagnosis of syndrome coronavirus 2 (SARS-CoV-2) infection, with 11.7% of patients being anosmic or severely microsmic. These data highlight a significant long-term rate of smell alteration in patients with previous SARS-COV-2 infection.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Olfaction Disorders/etiology , Olfaction Disorders/physiopathology , Adult , Aged , COVID-19/diagnosis , Female , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Prospective Studies , Psychophysics , SARS-CoV-2/isolation & purification , Self Report , Smell , Taste
5.
Brain Behav ; 11(3): e02006, 2021 03.
Article in English | MEDLINE | ID: covidwho-1059639

ABSTRACT

BACKGROUND: Olfactory and taste disorders were reported in up to 30%-80% of COVID-19 patients. The purpose of our study was to objectively assess smell impairment in COVID-19 patients and to correlate olfactory function with viral recovery. METHODS: Between 15 and 30 April 2020, hospitalized patients with confirmed SARS-CoV-2 infection underwent an objective assessment of olfactory function with the Smell Identification subtest of the Sniffin' Sticks Test (SI-SST). Association between viral recovery and SI-SST performance was evaluated. RESULTS: 51 patients were enrolled (49% males, mean age 66.2 ± 14.6 years). At the time of test administration, 45% were clinically recovered and 39% were virus-free. Objective hyposmia/anosmia was found in 45% of the patients. Subjective olfactory disorders showed no association with the clinical or viral recovery status of the patients. On the contrary, none of the patients with anosmia and the 5% of hyposmic patients at test had viral recovery. The relative risk for hyposmic patients to be still positive at swab test was 10.323 (95% CI 1.483-71.869, p < .0001). Logistic regression analysis showed an independent and significant correlation between viral clearance and SI-SST scores (OR = 2.242; 95% CI 1.322-3.802, p < .003). ROC curve analysis confirmed that a SI-SST > 10.5 predicts viral clearance with 79% sensitivity and 87% specificity (AUC = 0.883). CONCLUSION: Hyposmia is part of COVID-19 symptoms; however, only objectively assessed olfactory function is associated with viral recovery. SI-SST is an easy and safe instrument, and further large multicentric studies should assess its value to predict infection and recovery.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Olfaction Disorders/epidemiology , Olfaction Disorders/virology , SARS-CoV-2/pathogenicity , Smell/physiology , Adult , Aged , Aged, 80 and over , Anosmia/diagnosis , Anosmia/epidemiology , Anosmia/physiopathology , Anosmia/virology , COVID-19/diagnosis , COVID-19/physiopathology , Female , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/physiopathology
6.
Eur Arch Otorhinolaryngol ; 278(2): 411-415, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1023324

ABSTRACT

OBJECTIVE: It is known that the COVID-19 disease, which has affected the whole world, causes symptoms, such as cough, fever, shortness of breath, muscle pain, fatigue, diarrhea, headache and sore throat, in addition to various clinical findings, such as loss of smell and taste. In this study, we aimed to reveal the loss of sense of taste and smell in COVID-19 patients and to investigate whether these sensory losses are permanent in the healing process of the disease. METHOD: This prospective study included 94 COVID-19 patients. Smell and taste tests were applied to all patients. Ten days after the first test, a second test was applied to the patients with an impaired sense of smell to compare the results. RESULTS: Of the 94 patients, 55.3% were male, and the mean age was 53 ± 19.6 (21-90) years. There were 67 patients with smell and taste impairment, of whom 34 (50.7%) had smell impairment only, 3 (4.4%) had taste impairment only, and 30 (44.7%) had both smell and taste impairment. It was found that the smell scores of 55 patients with smell and taste impairment in the first evaluation were significantly higher at the second measurement; and their tasting period was significantly shortened compared to the first measurement (p˂0.001). CONCLUSION: COVID-19 patients may present to medical centers with a broad variety signs and symptoms. This study shows that impairment in the senses of smell and taste is common in this disease and strongly associated with COVID-19 infection. However, smell and taste impairment is mostly temporary and improves during the recovery period.


Subject(s)
COVID-19 , Olfaction Disorders , Taste Disorders , Adult , Aged , Aged, 80 and over , COVID-19/complications , Female , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Prospective Studies , SARS-CoV-2 , Smell , Taste , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Taste Disorders/etiology , Young Adult
8.
Eur Arch Otorhinolaryngol ; 278(8): 2875-2881, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1002090

ABSTRACT

PURPOSE: The ongoing coronavirus disease 19 (COVID-19) pandemic is spreading at an alarming rate across the globe. Sudden onset loss of smell and/or taste has been increasingly reported as a symptom of COVID-19. However, prevalence of these symptoms, and its severity varies widely between studies, with little data on its duration and recovery rate. Since this significantly impacts the quality of life of patients, there is a need for a study to provide insight into the loss of smell or taste in terms of its correlation with other upper respiratory tract symptoms, natural history and resolution rates. METHODS: This cross-sectional study included 718 mild to moderately symptomatic adult patients (≥ 18 years), admitted consecutively to Kalinga Institute of Medical Sciences (KIMS), Odisha, India between June 25 and July 24, 2020, who tested positive for SARS-CoV-2 by polymerase chain reaction on nasopharyngeal and throat swabs. Prevalence, severity, duration and factors associated with altered smell or taste sensation, and their follow-up were recorded. RESULTS: Of the 718 patients included in the study at baseline [563 (78%) men; median age 34 years], 101 (14%) patients experienced either altered smell or taste, with 52 (7%) experiencing both altered smell and taste. Seventy-seven (10.7%) patients had altered smell and 76 patients had altered taste (10.5%). Of these, 71 (92%) and 73 (96%) regained their sense of smell and taste, respectively, by 14 days after their swab tested positive. Presence of fever (OR = 5.4, 95% CI = 2.7-10.6, p < 0.001), cough (OR = 2.3, 95% CI = 1.2-4.2, p = 0.009) and nasal obstruction (OR = 3.1, 95% CI = 1.4-6.7, p = 0.006) were independently associated with increased likelihood of experiencing both altered taste and smell in multivariable models. CONCLUSION: The prevalence of altered smell and taste in Indians was much lower compared to Europeans and similar to East Asians. Majority regained these senses by 2 weeks. Identification of these symptoms can help in early detection of the disease in suspected individuals.


Subject(s)
COVID-19 , Olfaction Disorders , Adult , Cross-Sectional Studies , Humans , India/epidemiology , Male , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Quality of Life , SARS-CoV-2 , Smell , Taste Disorders/diagnosis , Taste Disorders/epidemiology , Taste Disorders/etiology
9.
Front Med (Lausanne) ; 7: 589409, 2020.
Article in English | MEDLINE | ID: covidwho-993377

ABSTRACT

One of the most striking reported symptoms in CoViD-19 is loss of smell and taste. The frequency of these impairments and their specificity as a potential central nervous system function biomarker are of great interest as a diagnostic clue for CoViD-19 infection as opposed to other similar symptomatologic diseases and because of their implication in viral pathogenesis. Here severe CoViD-19 was investigated by comparing self-report vs. testing of smell and taste, thus the objective severity of olfactory impairment and their possible correlation with other symptoms. Because a significant discrepancy between smell and taste testing vs. self-report results (p < 0.001) emerges in our result, we performed a statistical analysis highlighting disagreement among normosmia (p < 0.05), hyposmia, severe hyposmia, and anosmia (p < 0.001) and, in hypogeusia and severe hypogeusia, while no differences are observed in normogeusia and ageusia. Therefore, we analyzed the olfactory threshold by an objective test revealing the distribution of hyposmic (34%), severe hyposmic (48%), and anosmic (13%) patients in severe CoViD-19. In severe CoViD-19 patients, taste is lost in 4.3% of normosmic individuals, 31.9% of hyposmic individuals, 46.8% of severe hyposmic individuals, and 17% of anosmic individuals. Moreover, 95% of 100 CoViD-19 patients objectively tested were affected by smell dysfunction, while 47% were affected by taste dysfunction. Furthermore, analysis by objective testing also highlighted that the severity of smell dysfunction in CoViD-19 subjects did not correlate with age and sex. In conclusion, we report by objective testing that the majority of CoViD-19 patients report severe anosmia, that most of the subjects have olfactory impairment rather than taste impairment, and, finally, that the olfactory impairment correlate with symptom onset and hospitalization (p < 0.05). Patients who exhibit severe olfactory impairment had been hospitalized for about a week from symptom onset; double time has taken place in subjects with normosmia. Our results may be limited by the relatively small number of study participants, but these suggest by objective testing that hyposmia, severe hyposmia, and anosmia may relate directly to infection severity and neurological damage. The smell test assessment could be a potential screening symptom that might contribute to the decision to test suspected cases or guide quarantine instructions, further therapeutic approach, and evaluation of neurological damage.

10.
Ear Nose Throat J ; 100(2_suppl): 174S-179S, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-952482

ABSTRACT

OBJECTIVE: To determine taste and smell impairment rates in patients with coronavirus disease 2019 (COVID-19) who were hospitalized in the intensive care unit (ICU). METHODS: Between March 2020 and May 2020, patients with COVID-19 hospitalized in the ICU were enrolled in this study. Upon discharge, patients were telephoned and asked to complete a survey related to taste and smell impairment. Characteristics were compared between patients with and without taste and/or smell impairment. RESULTS: Fifty-two patients were enrolled (mean age, 61.32 ± 12.53 years; mean ICU stay, 10.19 ± 10.24 days). Age, sex, type/number of comorbid diseases, most ICU support modalities, and ICU stay duration did not significantly differ between groups. Patients in group B required more high-flow nasal oxygen therapy than patients in group A (P = .010). In total, 22 (42.3%) of 52 patients experienced taste and/or smell impairment. Three patients experienced isolated smell impairment and one patient experienced isolated taste impairment. Among the 21 patients who experienced smell impairment, 18 (85.78%) experienced hyposmia (mean visual analog scale [VAS] score: 6.33 ± 0.97), while 3 (14.28%) experienced anosmia. Among the 19 patients who experienced taste impairment, 16 (84.22%) experienced hypogeusia (mean VAS score: 6.43 ± 1.03) and 3 (15.78%) experienced ageuisa. Among 22 patients who experienced taste and/or smell impairment, 15 (68.18%) patients (n = 15/22) experienced smell and/or taste impairment before the ICU stay, while 7 (31.82%) patients (n = 7/22) experienced impairment during the ICU stay. Overall, 28.84% (n = 15/52) of the patients experienced taste and/or smell impairment before the ICU stay. CONCLUSIONS: Patients who were hospitalized in the ICU experienced lower rates of taste and/or smell impairment. Some patients experienced taste and/or smell impairment during the ICU stay.


Subject(s)
Ageusia/physiopathology , Anosmia/physiopathology , COVID-19/physiopathology , Intensive Care Units , Adult , Aged , Aged, 80 and over , Ageusia/etiology , Anosmia/etiology , COVID-19/complications , Critical Illness , Female , Humans , Length of Stay , Male , Middle Aged , SARS-CoV-2 , Surveys and Questionnaires
11.
Vestn Otorinolaringol ; 85(5): 93-97, 2020.
Article in Russian | MEDLINE | ID: covidwho-903096

ABSTRACT

Numerous studies have shown that loss of smell is a serious symptom that requires careful differential diagnosis. There is convincing evidence that a violation of the sense of smell is not so much a sign of the pathology of the nasal cavity and paranasal sinuses, but it can be a manifestation of neurodegenerative diseases. Some patients with the identified SARS-CoV-2 virus have neurological symptoms. Most of them are not specific - headache, dizziness, fatigue, myalgia. A small percentage of patients with COVID-19 infection have convulsions, impaired consciousness, and the presence of 2019-NCoV RNA was found in the cerebrospinal fluid. Data on the development of new symptoms of the disease, in the form of anosmia and dysgeusia, are presented.


Subject(s)
Coronavirus Infections , Olfaction Disorders , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Humans , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , SARS-CoV-2 , Smell
12.
Acta Otolaryngol ; 140(12): 1032-1035, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-741751

ABSTRACT

BACKGROUND: Smell and taste disorders occur in COVID-19 with a high prevalence, but little is known about the duration of the symptoms. In particular, studies using validated olfactory tests are very rare to date. AIMS/OBJECTIVES: The aim of this study was to determine the olfactory function of COVID-19 recoveries by a detailed olfactory test. METHODS: 91 patients with PCR-confirmed, past COVID-19 disease were included. Olfactory history was taken using a questionnaire. Olfactory function was evaluated with the sniffin' sticks test, tasting function with taste sprays. RESULTS: 80 patients had experienced sudden olfactory loss during the course of disease and at the time of testing, 33 patients subjectively still had an impaired olfactory sense. Around 8 weeks had passed since the onset of symptoms. 45.1% of the tested individuals were still hyposmic according to the olfactory test while 53.8% showed an olfactory performance within the normal range. Patients' self-assessment correlated poorly with the measured olfactory performance. CONCLUSIONS AND SIGNIFICANCE: Half of the patients with an olfactory loss as a symptom of COVID-19 still have olfactory impairments after two months, although not all of these patients subjectively notice a restriction. Long-term measurements must confirm whether all affected patients will make full recovery.


Subject(s)
COVID-19/complications , Olfaction Disorders/etiology , SARS-CoV-2 , Sensory Thresholds/physiology , Smell/physiology , Adult , COVID-19/epidemiology , COVID-19/physiopathology , Female , Humans , Male , Middle Aged , Olfaction Disorders/diagnosis , Pandemics
13.
Neurol Sci ; 41(9): 2331-2338, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-639224

ABSTRACT

BACKGROUND: Olfactory dysfunction has shown to accompany COVID-19. There are varying data regarding the exact frequency in the various study population. The outcome of the olfactory impairment is also not clearly defined. OBJECTIVE: To find the frequency of olfactory impairment and its outcome in hospitalized patients with positive swab test for COVID-19. METHODS: This is a prospective descriptive study of 100 hospitalized COVID-19 patients, randomly sampled, from February to March 2020. Demographics, comorbidities, and laboratory findings were analyzed according to the olfactory loss or sinonasal symptoms. The olfactory impairment and sinonasal symptoms were evaluated by 9 Likert scale questions asked from the patients. RESULTS: Ninety-two patients completed the follow-up (means 20.1 (± 7.42) days). Twenty-two (23.91%) patients complained of olfactory loss and in 6 (6.52%) patients olfactory loss was the first symptom of the disease. The olfactory loss was reported to be completely resolved in all but one patient. Thirty-nine (42.39%) patients had notable sinonasal symptoms while rhinorrhea was the first symptom in 3 (3.26%). Fifteen patients (16.3%) had a taste impairment. Patients with sinonasal symptoms had a lower age (p = 0.01). There was no significant relation between olfactory loss and sinonasal symptoms (p = 0.07). CONCLUSIONS: Sudden olfactory dysfunction and sinonasal symptoms have a considerable prevalence in patients with COVID-19. No significant association was noted between the sinonasal symptoms and the olfactory loss, which may suggest that other mechanisms beyond upper respiratory tract involvement are responsible for the olfactory loss.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Hospitalization/trends , Olfaction Disorders/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Adult , Aged , COVID-19 , Coronavirus Infections/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Olfaction Disorders/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Prospective Studies , SARS-CoV-2 , Treatment Outcome
14.
Front Public Health ; 8: 243, 2020.
Article in English | MEDLINE | ID: covidwho-613017

ABSTRACT

Introduction: Since the beginning of the Covid-19 epidemic produced by SARS2-Cov virus, olfactory alterations have been observed at a greater frequency than in other coronavirus epidemics. While olfactory alterations may be observed in patients with rhinovirus, influenza virus, or parainfluenza virus infection, they are typically explained by nasal obstruction with mucus or direct epithelial damage; in the case of SARS-CoV-2, olfactory alterations may present without nasal congestion with mucus. We performed a study of patients presenting olfactory/gustatory alterations in the context of SARS-CoV-2 infection in order to contribute to the understanding of this phenomenon. Material and Methods: We performed a descriptive, cross-sectional, observational study of the clinical characteristics of olfactory/gustatory alterations using a self-administered, anonymous online questionnaire. Results: A total of 909 patients with SARS-CoV-2 infection and olfactory/gustatory alterations responded to the questionnaire in the 4-day data collection period; 824 cases (90.65%) reported simultaneous olfactory and gustatory involvement. Patients' responses to the questionnaire revealed ageusia (581, 64.1% of respondents), hypogeusia (256, 28.2%), dysgeusia (22, 2.4%), anosmia (752 82.8%), hyposmia (142, 15.6%), and dysosmia (8, 0.9%). Fifty-four percent (489) did not report concomitant nasal congestion or mucus. Conclusion: Olfactory alterations are frequent in patients with SARS-CoV-2 infection and is only associated with nasal congestion in half of the cases.


Subject(s)
COVID-19/complications , Olfaction Disorders/etiology , Taste Disorders/etiology , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
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