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Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: a community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK.
Makaronidis, Janine; Firman, Chloe; Magee, Cormac G; Mok, Jessica; Balogun, Nyaladzi; Lechner, Matt; Carnemolla, Alisia; Batterham, Rachel L.
  • Makaronidis J; UCL Centre for Obesity Research, Division of Medicine, University College London, London, UK.
  • Firman C; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK.
  • Magee CG; National Institute of Health Research, UCLH Biomedical Research Centre, London, UK.
  • Mok J; UCL Centre for Obesity Research, Division of Medicine, University College London, London, UK.
  • Balogun N; UCL Centre for Obesity Research, Division of Medicine, University College London, London, UK.
  • Lechner M; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK.
  • Carnemolla A; National Institute of Health Research, UCLH Biomedical Research Centre, London, UK.
  • Batterham RL; UCL Centre for Obesity Research, Division of Medicine, University College London, London, UK.
BMC Infect Dis ; 21(1): 221, 2021 Feb 25.
Article in English | MEDLINE | ID: covidwho-1105700
ABSTRACT

BACKGROUND:

Loss of smell and/or taste are cardinal symptoms of COVID-19. 'Long-COVID', persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. In this study we assess smell and taste loss resolution at 4-6 week follow-up, aim to identify risk factors for persistent smell loss and describe smell loss as a feature of long-COVID in a community cohort in London with known SARS-CoV-2 IgG/IgM antibody status. We also compare subjective and objective smell assessments in a subset of participants.

METHODS:

Four hundred sixty-seven participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4-6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations.

RESULTS:

People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery 57.7% vs. 72.1%, p = 0.027. taste recovery 66.2% vs. 80.3%, p = 0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p < 0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4-6 weeks (OR 2.46, 95%CI 1.47-4.13, p = 0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (> 40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54-4.00, p < 0.001).

CONCLUSION:

Although smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4-6 weeks follow-up, which constitute symptoms of 'long-COVID'. Females (particularly > 40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions. TRIALS REGISTRATION ClinicalTrials.gov NCT04377815 Date of registration 23/04/2020.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ageusia / COVID-19 / Olfaction Disorders / Antibodies, Viral Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-05927-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Ageusia / COVID-19 / Olfaction Disorders / Antibodies, Viral Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-05927-w