A follow-up on quantitative and qualitative olfactory dysfunction and other symptoms in patients recovering from COVID-19 smell loss

Ohla, Kathrin, Veldhuizen, Maria G., Green, Tomer, Hannum, Mackenzie E., Bakke, Alyssa J., Moein, Shima T., Tognetti, Arnaud, Postma, Elbrich M., Pellegrino, Robert, Hwang, Daniel Liang Dar, Albayay, Javier, Koyama, Sachiko, Nolden, Alissa A., Thomas-Danguin, Thierry, Mucignat-Caretta, Carla, Menger, Nick S., Croijmans, Ilja, Öztürk, Lina, Yanık, Hüseyin, Pierron, Denis, Pereda-Loth, Veronica, Nunez-Parra, Alexia, Martinez Pineda, Aldair M., Gillespie, David, Farruggia, Michael C., Cecchetto, Cinzia, Fornazieri, Marco A., Philpott, Carl ORCID: https://orcid.org/0000-0002-1125-3236, Voznessenskaya, Vera, Cooper, Keiland W., Dominguez, Paloma Rohlfs, Calcinoni, Orietta, de Groot, Jasper, Boesveldt, Sanne, Bhutani, Surabhi, Weir, Elisabeth M., Exten, Cara, Joseph, Paule V., Parma, Valentina, Hayes, John E. and Niv, Masha Y. (2022) A follow-up on quantitative and qualitative olfactory dysfunction and other symptoms in patients recovering from COVID-19 smell loss. Rhinology, 60 (3). pp. 207-217. ISSN 0300-0729

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Abstract

Background: Sudden smell loss is a specific early symptom of COVID-19, which, prior to the emergence of Omicron, had estimated prevalence of ~40% to 75%. Chemosensory impairments affect physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery. The aim of this cohort study was to characterize smell function and recovery up to 11 months post COVID-19 infection. Methods: This longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial survey (S1) about respiratory symptoms, chemosensory function and COVID-19 diagnosis between April and September 2020, were invited to complete a follow-up survey (S2). Between September 2020 and February 2021, 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness. Results: At follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID illness. The ability to smell during COVID-19 was rated slightly lower by those who did not eventually recover their pre-illness ability to smell at S2. Conclusions: While smell ability improves for many individuals who lost it during acute COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is associated with broader persistent symptoms of COVID-19, and may last for many months following acute COVID-19. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long-term sequelae; more research into treatment options is strongly warranted given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health. Trial registration: This project was pre-registered at OSF 1.

Item Type: Article
Additional Information: Funding Information: This work was supported by the following grants: NIH T32 (DC000014) and F32 (DC020100) to M.E. Hannum; NSF DGE1839285 to K.W. Cooper; EXTREM-O (CNRS, CNES) to D. Pierron, A.M. Martinez Peneda, and V. Pereda-Loth; NIH NI­AAA Z01AA000135, NIH Distinguished Scholar program, and Rockefeller University Heilbrunn Nurse Scholar Award to P.V. Joseph; NIH T32 DC000014-40 and F32 (DC020380) to R. Pel­legrino; Edmond de Rothschild Foundation grant to M.Y. Niv; 2232 International Fellowship for Outstanding Researchers Program of TÜBİTAK 118C299 to M.G. Veldhuizen; Deployment of both surveys by the Penn State Sensory Evaluation Center was supported by discretionary funds controlled by Prof. Hayes, including an unrestricted gift from James and Helen Zallie in support of Sensory Science. Funding Information: This work was supported by the following grants: NIH T32 (DC000014) and F32 (DC020100) to M.E. Hannum; NSF DGE1839285 to K.W. Cooper; EXTREM-O (CNRS, CNES) to D. Pierron, A.M. Martinez Peneda, and V. Pereda-Loth; NIH NI- of both surveys by the Penn State Sensory Evaluation Center was supported by discretionary funds controlled by Prof. Hayes, including an unrestricted gift from James and Helen Zallie in Funding Information: Acknowledgments AAA Z01AA000135, NIH Distinguished Scholar program, and We thank all members of the Global Consortium for Chemo-Rockefeller University Heilbrunn Nurse Scholar Award to P.V. sensory Research (GCCR) for the core survey and for help with Joseph; NIH T32 DC000014-40 and F32 (DC020380) to R. Pel-translations. We thank Danielle R. Reed and Thomas Hummel for legrino; Edmond de Rothschild Foundation grant to M.Y. Niv; their valuable contributions in the initial stages of this work. 2232 International Fellowship for Outstanding Researchers Program of TÜBİTAK 118C299 to M.G. Veldhuizen; Deployment Publisher Copyright: © 2022, International Rhinologic Society. All rights reserved.
Uncontrolled Keywords: long covid,olfaction disorders,parosmia,phantosmia,post-covid,public health,smell,otorhinolaryngology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2733
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 15 Dec 2022 04:09
Last Modified: 15 Dec 2022 04:09
URI: https://ueaeprints.uea.ac.uk/id/eprint/90160
DOI: 10.4193/Rhin21.415

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