Self-reported olfactory function according to the severity of COVID-19

Abstract

Background: Establishing a relationship between COVID-19 severity and olfactory dysfunction may be beneficial in patient follow-up. Thus, in this study, we aimed to evaluate the association between self-reported olfactory dysfunction and the clinical stages of COVID-19. Methods: The patients included in this study were divided into three groups according to the severity of the novel coronavirus disease as mild, severe, and critical (life-threatening) patients. Patients were then contacted by phone and asked questions with the help of structured questionnaires that evaluated their general status, sense of smell, taste and compared the data within the three groups. Results: Among the 144 subjects evaluated in the present study (mild, n = 60; moderate, n = 61, severe, n = 23), 70 of the participants were males, and 74 were females. The findings showed that olfactory loss was the most prominent feature of the COVID-19's mild clinical course and the majority of the patients with loss of smell were female and young patients. Conclusion: The findings obtained from clinically mild cases suggest that more olfactory dysfunction, indicating that the effects of viral load alone, is not decisive for olfactory dysfunction.

Keywords

• COVID-19
• olfactory dysfunction
• clinical severity
• gustatory dysfunction

References

1. Mahase E. China coronavirus: what do we know so far?. BMJ 2020; 368: m308. doi: 10.1136/bmj.m308
2. 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 (13): 1239-1242. doi:10.1001/jama.2020.2648.
3. Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome?. Rhinology 2020; 58 (3): 299-301. doi: 10.4193/Rhin20.114
4. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD 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; 277 (8): 2251-2261. doi: 10.1007/s00405-020-05965-1
5. Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS. Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol 2020; 10 (7): 806-813. doi: 10.1002/alr.22579
6. Moein ST, Hashemian SM, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol 2020; 10 (8): 944-950. doi: 10.1002/alr.22587.
7. Mao L, Jin H, Wang M, Hu Y, Chen S et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020; 77 (6): 683-690. doi: 10.1001/jamaneurol.2020.1127
8. Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M et al. Self-reported Olfactory and Taste Disorders in Patients With Severe Acute Respiratory Coronavirus 2 Infection: A Cross-sectional Study. Clin Infect Dis 2020; 71 (15): 889-890. doi:10.1093/cid/ciaa330.

9. 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 (7): 821-831. doi: 10.1002/alr.22592
10. Kim GU, Kim MJ, Ra SH, Lee J, Bae S et al. Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect 2020; 26 (7): 948.e1-948.e3. doi: 10.1016/j.cmi.2020.04.040
11. Liu W, Tao ZW, Lei W, Ming-Li Y, Kui L et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl) 2020; 133 (9): 1032-1038. doi:10.1097/CM9.0000000000000775
12. Pusswald G, Auff E, Lehrner J. Development of a brief self-report inventory to measure olfactory dysfunction and quality of life in patients with problems with the sense of smell. Chemosensory Perception. 2012; 5(3-4): 292-9. doi: 10.1007/s12078-012-9127-7
13. Menni C, Valdes A, Freydin MB, Ganesh S, Moustafa JE-S et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med 2020; 26 (7): 1037-1040. doi: 10.1038/s41591-020-0916-2
14. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382 (18): 1708-1720. doi: 10.1056/NEJMoa2002032
15. Cai H. Sex difference and smoking predisposition in patients with COVID-19 [published correction appears in Lancet Respir Med. 2020 Apr;8(4):e26]. Lancet Respir Med 2020; 8 (4): e20. doi: 10.1016/S2213-2600(20)30117-X
16. Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020; 92 (6): 577-583. doi: 10.1002/jmv.25757
17. Shim E, Tariq A, Choi W, Lee Y, Chowell G. Transmission potential and severity of COVID-19 in South Korea. Int J Infect Dis 2020; 93: 339-344. doi: 10.1016/j.ijid.2020.03.031
18. Liu Y, Yan LM, Wan L, Xiang TX, Le A et al. Liu Y, Yan LM, Wan L, et al. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis 2020; 20 (6): 656-657. doi: 10.1016/S1473-3099(20)30232-2
19. Zou L, Ruan F, Huang M, Liang L, Huang H et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med 2020; 382 (12): 1177-1179. doi: 10.1056/NEJMc2001737
20. Sungnak W, Huang N, Bécavin C, Berg M; HCA Lung Biological Network. SARS-CoV-2 Entry Genes Are Most Highly Expressed in Nasal Goblet and Ciliated Cells within Human Airways. Preprint. ArXiv. 2020;arXiv:2003.06122v1. Published 2020 Mar 13.
21. Schrödter S, Biermann E, Halata Z. Histological evaluation of age-related changes in human respiratory mucosa of the middle turbinate. Anat Embryol (Berl) 2003; 207 (1): 19-27. doi: 10.1007/s00429-003-0326-5
22. Attems J, Walker L, Jellinger KA. Olfaction and Aging: A Mini-Review. Gerontology. 2015; 61 (6): 485-90. doi: 10.1159/000381619
23. Walford RL. The immunologic theory of aging. Immunological Reviews. 1969; 2 (1): 171-171. doi: 10.1111/j.1600-065X.1969.tb00210.x
24. Poland GA, Ovsyannikova IG, Kennedy RB, Lambert ND, Kirkland JL. A systems biology approach to the effect of aging, immunosenescence and vaccine response. Curr Opin Immunol 2014; 29: 62-68. doi: 10.1016/j.coi.2014.04.005