RESUMEN
BACKGROUND: Magnetic resonance imaging (MRI) is the gold standard in the etiological assessment of a persistent olfactory dysfunction (OD). While the utility of imaging in COVID-19-related OD has yet to be established, MRI is recommended in all patients with persistent OD. The high prevalence of the latter after SARS-CoV-2 infection means evaluating this strategy is an important public health matter. METHODS: The main objective was to examine the impact of systematic MRI on the management of patients with OD. All adult patients consulting for persistent OD (>2 months) after primary SARS-COV-2 infection (PCR) between March 2020 and December 2021 were included (n = 67). The secondary objective was to evaluate the relationship between the severity of the OD as measured by psychophysical testing (ETOC) and the volume of the olfactory bulb (OB) measured by MRI. RESULTS: All patients underwent MRI, and none led to a change in diagnosis or treatment. Among them, 82% (55/67) were considered normal by the radiologist on initial interpretation. There were no significant differences (visual analysis or OB volume) between groups (mild, moderate, and severe hyposmia). CONCLUSION: Systematic MRI may be unnecessary in patients whose persistent OD began soon (a few days) after confirmed SARS-CoV-2 infection.
RESUMEN
Résumé Près d’un français sur cinq souffre de troubles de l’odorat (TO), ou dysosmie. Cette prévalence a augmenté depuis l’apparition de la COVID-19 dont la dysosmie est un symptôme très fréquent et possiblement persistant. Pourtant, la prise en soin des personnes dysosmiques reste insuffisante. Cet article ouvre des pistes pour développer les rééducations olfactives (RO) sur la base de protocoles déjà éprouvés, mais aussi pour améliorer l’accompagnement des patients dysosmiques. Pour cela, une stratégie de prise en charge pluri-professionnelle est préconisée, alliant l’intervention de scientifiques, de médecins (généralistes, ORL) et de professions paramédicales. Summary Nearly one in five French people suffer from olfactory disorders (TO), or dysosmia. This prevalence has increased since the onset of COVID-19, for which dysosmia is a very common and possibly persistent symptom. However, the care of people with dysosmia remains insufficient. This article opens up avenues for developing olfactory rehabilitation (OR) on the basis of existing protocols, but also for improving support for dysosmic patients. For this purpose, a multi-professional care strategy is recommended, combining the intervention of scientists, doctors (general practitioners, ENT) and paramedical professions.
RESUMEN
Although olfactory disorders (OD) are among the most significant symptoms of COVID-19, recovery time from COVID-19-related OD and their consequences on the quality of life remain poorly documented. We investigated the characteristics and behavioral consequences of COVID-19-related OD using a large-scale study involving 3111 French respondents (78% women) to an online questionnaire over a period of 9 months covering different epidemic waves (from 8 April 2020 to 13 January 2021). In the patients who subjectively recovered from COVID-19-related OD (N = 609), recovery occurred on average after 16 days and most of the time within 1 month ("normal" recovery range); 49 subjectively recovered in 1-2.5 months, and several cases took up to 6.5 months. Among the patients with ongoing OD (N = 2502), 974 were outside the "normal" recovery range (persistent OD) and reported OD for 1-10 months. Developing a persistent OD was more likely with increasing age and in women and was more often associated with parosmia and phantosmia. The deleterious impact of COVID-19-related OD on the quality of life was significantly aggravated by OD duration and was more pronounced in women. Because persistent OD is not infrequent after COVID-19, has deleterious consequences on the quality of life, and receives few solutions from the health practitioners, it would be beneficial to implement screening and treatment programs to minimize the long-term behavioral consequences of COVID-19-related OD.