Loss of smell in COVID-19 patients: is it related to clinical-radiological disease severity?

Year 2022, Volume: 4 Issue: 3, 228 - 233, 26.07.2022

Hüsnü Baykal Deniz Çelik Sertan Bulut Hasret Gizem Kurt Ayşe Füsun Ülger

https://doi.org/10.38053/acmj.1065354

Cited By: 1

Abstract

Objective: Olfactory dysfunction (OD) is one of the most prominent predictive symptoms in the early detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19), it may be the first symptom or accompany other symptoms. The predictive value of OD is unknown in terms of the overall prognosis of COVID-19. We aimed to investigate the relationship between OD and the clinical-radiological severity of the disease.
Material and Method: Data of 208 COVID-19 patients (105 inpatients and 103 outpatients) who had positive Real-Time Polymerase Chain Reaction (PCR) tests between December 1, 2020, and January 15, 2021, were collected retrospectively. Presence of OD, symptoms on admission other than OD, days of hospital stay, peripheral blood analysis values, COVID-19 disease severity [World Health Organization (WHO) 2020 “Clinical management of COVID-19”] and radiologic classifications [Radiological Society of North America Expert Consensus Statement on Reporting (RSNA) Chest CT Findings Related to COVID-19] were retrospectively collected.
Results: Analysis of 208 patients revealed that there were 105 (50.48%) inpatients and 103 (49.52%) outpatients. Among 102 patients who had OD, 68 were outpatients and 34 were inpatients. It was determined that the patients with OD were mostly followed up on an outpatient basis, and they did not need hospitalization (p<0.0001). The mean of hospital stay of 34 inpatients with OD was 7.52±4.63 days, while the mean of hospital stay of 71 patients without OD was 12.53±8.92 days, and those with OD were found to need a shorter hospital stay (p=0.001) and no relation was found between disease severity and the duration of OD (p=0.381). There was no significant difference in disease severity in relation to OD in the inpatient group (p=0.71).
Conclusion: OD is one of the most common symptoms of COVID-19. In the patients with loss of smell, the need for hospitalization is less, and hospital stay is shorter; these findings indicate that the patients with OD may experience a milder disease. The presence of OD may be used as a useful predictor by clinicians for the severity of the COVID-19 course.

Keywords

COVID-19, Loss of Smell, Disease severity

Project Number

yok

References

• van Riel D, Verdijk R, Kuiken T. The olfactory nerve: a shortcut for influenza and other viral diseases into the central nervous system. J Pathol 2015; 235: 277-87.
• Su S, Wong G, Shi W, et al. Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol 2016; 24: 490-502.
• Yıldız M, Özturk Ergur F, Uzel Senel M, Özturk A. The use of prone positioning in severe COVID-19 outside the intensive care unit. Bratisl Lek Listy 2021; 122: 590-3.
• Bagheri SH, Asghari A, Farhadi M, et al. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak in Iran. Med J Islam Repub Iran 2020; 34: 62.
• Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020; 77: 683-90.
• Damm M, Temmel A, Welge-Lüssen A, et al. Epidemiologie und Therapie in Deutschland, Osterreich und der Schweiz [Olfactory dysfunctions. Epidemiology and therapy in Germany, Austria and Switzerland]. HNO 2004; 52: 112-20. German.
• Li X, Lui F. Anosmia. [Updated 2021 Sep 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https: //www.ncbi.nlm.nih.gov/books/NBK482152/
• Suzuki M, Saito K, Min WP, et al. Identification of viruses in patients with postviral olfactory dysfunction. Laryngoscope 2007; 117: 272-7.
• Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008; 82: 7264-75.
• Lefèvre N, Corazza F, Valsamis J, et al. The Number of X Chromosomes Influences Inflammatory Cytokine Production Following Toll-Like Receptor Stimulation. Front Immunol 2019; 10: 1052.
• Gandhi RT, Lynch JB, Del Rio C. Mild or moderate COVID-19. N Engl J Med 2020; 383: 1757-66.
• Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS. Self-reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol 2020; 10: 821-31.
• Klopfenstein T, Kadiane-Oussou NJ, Toko L, et al. Features of anosmia in COVID-19. Med Mal Infect 2020; 50: 436-9.
• Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020 Aug; 277: 2251-61.
• Meini S, Suardi LR, Busoni M, Roberts AT, Fortini A. Olfactory and gustatory dysfunctions in 100 patients hospitalized for COVID-19: sex differences and recovery time in real-life. Eur Arch Otorhinolaryngol 2020; 277: 3519-23.
• Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323: 1061-9.
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.
• Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-42.
• Weinstock MB, Echenique A, Russell JW, et al. Chest x-ray findings in 636 ambulatory patients with COVID-19 presenting to an urgent care center: a normal chest x-ray is no guarantee. J Urgent Care Med 2020; 14: 13-18.
• Zhang D, Guo R, Lei L, et al. Frontline Science: COVID-19 infection induces readily detectable morphologic and inflammation-related phenotypic changes in peripheral blood monocytes. J Leukoc Biol 2021; 109: 13-22.
• Zhao Q, Meng M, Kumar R, et al. Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A systemic review and meta-analysis. Int J Infect Dis 2020; 96: 131-5.
• Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020 1; 77: 683-90.
• Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy 2020; 75: 1730-41.
• Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020; 81: 6-12.
• Kong J, Wang T, Di Z, et al. Analysis of hematological indexes of COVID-19 patients from fever clinics in Suzhou, China. Int J Lab Hematol 2020; 42: 204-6.
• Omrani-Nava V, Maleki I, Ahmadi A, Moosazadeh M, et al. Evaluation of Hepatic Enzymes Changes and Association with Prognosis in COVID-19 Patients. Hepat Mon 2020; 20: e103179.
• Yang X, Yang Q, Wang Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost 2020; 18: 1469.
• Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18: 844-7.
• Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020; 46: 846-8.
• Liu Y, Yang Y, Zhang C, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 2020; 63: 364-74.
• Mishra AK, Lal A, Sahu KK, Sargent J. Cardiovascular factors predicting poor outcome in COVID-19 patients. Cardiovasc Pathol 2020; 49: 107246.
• Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5: 667-78.