Chemosensory deficits are best predictor of serologic response among individuals infected with SARS-CoV-2

Abstract

Objective Smell and taste alteration are closely linked to infection with SARS-CoV-2 and may be associated with a more indolent disease course. Serologic response rates among individuals with mild disease remains limited. We sought to identify whether chemosensory changes associated with COVID-19 were predictive of a serologic response. Study design Cross-sectional study. Methods The sample consisted of 306 adults (≥18 years old) volunteering for convalescent plasma donation following perceived COVID-19 illness from April-June 2020. Documentation of COVID-19 PCR status, clinical symptoms at time of illness, and treatment course occurred at the time of serologic analysis, where we assessed chemosensory function using patient-perceived deficits. We implemented previously validated ELISA screening to determine serologic status regarding anti-Spike immunoglobulins. Statistical analysis using stepwise logistic models were employed to identify predictive factors of serologic response. Results Of 306 patients undergoing serologic and chemosensory evaluation, 196 (64.1%) and 195 (63.7%) reported subjective olfactory and taste dysfunction, respectively, during the first two weeks of COVID-19 infection. In unadjusted models, the odds of developing suprathreshold IgG antibody titers were 1.98 times higher among those who reported altered smell (95% CI 1.14–3.42, p = 0.014) and 2.02 times higher among those with altered taste (95% CI 1.17–3.48, p = 0.011) compared to those with normal smell and taste. Multivariable logistic models adjusting for sex, age, race/ethnicity, symptom duration, smoking status and comorbidities index demonstrated that altered smell and taste remained significant predictors of positive anti-spike IgG response (smell OR = 1.90, 95% CI 1.05–3.44, p = 0.033; taste OR = 2.01, 95% CI = 1.12–3.61, p = 0.019). Conclusion Subjective chemosensory dysfunction, as self-reported smell or taste deficiency, is highly predictive of serologic response following SARS-CoV-2 infection. This information may be useful for patient counseling. Additional longitudinal research should be performed to better understand the onset and duration of the serologic response in these patients.

The assessment of qualitative olfactory dysfunction in COVID-19 patients: a systematic review of tools and their content validity

“…Here, descriptions of each symptom were worded in a clear manner. A similar approach was done in the study by Overdevest et al ( 2022 ), however, questions also accounted for symptoms during COVID-19 illness as well as how often the symptoms were noticed by the participants.…”

Association between clinical symptoms during the COVID‐19 infection and SARS‐CoV‐2 immunoglobulin G titers in COVID‐19 convalescent whole‐blood donors in China

“…10 Some previous studies have reported associations between demographic characteristics and clinical symptoms during the COVID-19 infection, and antibody titers in infected individuals. [11][12][13][14][15] Symptoms such as fever, [15][16][17][18] cough, 15,17 dyspnea, 15,17 loss of smell or taste, 19 and diarrhea 17 have been identified as potential predictive factors of high-titer antibodies. However, the findings are not consistent.…”