Clinical Features of Parosmia Associated With COVID‐19 Infection

Abstract

Objective To characterize the clinical features, risk factors, symptom time‐course, and quality of life implications for parosmia among coronavirus disease (COVID)‐related olfactory dysfunction patients. Methods Individuals with olfactory dysfunction associated with laboratory‐confirmed or clinically suspected COVID‐19 infection were recruited from otolaryngology and primary care practices over a period from August 2020 to March 2021. Participants completed olfactory dysfunction and quality of life surveys. Results A total of 148 (64.1%) of 231 respondents reported parosmia at some point. Parosmia developed within 1 week of any COVID‐19 symptom onset in 25.4% of respondents, but more than 1 month after symptom onset in 43.4% of respondents. Parosmia was associated with significantly better quantitative olfactory scores on Brief Smell Identification Test (8.7 vs. 7.5, P = .006), but demonstrated worse quality of life scores, including modified brief Questionnaire of Olfactory Dysfunction—Negative Statements and Sino‐Nasal Outcome Test‐22 scores (12.1 vs. 8.5, P < .001; 26.2 vs. 23.2, P = .113). Participants who developed parosmia at any point were significantly younger and less likely to have history of chronic sinusitis than those who did not develop parosmia (40.2 vs. 44.9 years, P = .007; 7.2% vs. 0.7%, P = .006). Conclusion COVID‐19‐associated olfactory dysfunction is frequently linked with development of parosmia, which often presents either at onset of smell loss or in a delayed fashion. Despite better quantitative olfactory scores, respondents with parosmia report decreased quality of life. A majority of respondents with persistent parosmia have sought treatment. Level of Evidence 3 Laryngoscope, 132:633–639, 2022

In Response to Clinical Features of Parosmia Associated with COVID‐19 Infection

“…Such evidences fit with the results detected by Lerner et al 1 and may explain the fact that the onset of parosmia is not generally immediate and may be associated with a quantitatively normal olfactory function. Precisely, it is important to underline the importance of this latest finding.…”

“…We have read with interest the recent article by Lerner et al, 1 which analyzed the clinical features of parosmia following coronavirus disease 2019 (COVID‐19). Congratulating the authors for the quality of their study, we would like to discuss some important points regarding pathogenetic hypotheses and the epidemiological implications emerging from their results.…”

“…In the future, it will be appropriate to deepen the threshold‐discriminative‐identification assessment with the evaluation of qualitative perception so as to identify patients with parosmia, which is a fundamental determinant in the reduction of the quality of life of patients with POD, even more than purely quantitative disorders. 1 , 13 …”

Parosmia—a common consequence of covid-19

“…The dominant viral pathogen of late has been covid-19, and parosmia has been encountered as a common sequelae. When the early phase of illness is associated with loss of smell, parosmia is a late onset symptom in the majority of patients who report it, developing on average three months after infection 45. Many patients who experience anosmia have a short period of apparent recovery with a return in their sense of smell, which is then followed by the development of parosmia; others, however, develop parosmia without any preceding apparent smell loss.…”

The Role of Social Media in Improving Patient Recruitment for Research Studies on Persistent Post-Infectious Olfactory Dysfunction

“…The challenge of using social networks to recruit patients with OD mainly relies on the subjectivity in which patients perceive their smell impairment in the absence of an objective (measurable) OD [ 9 ]. Moreover, OD may vary widely within affected subjects with some patients referring to only a qualitative olfactory impairment (e.g., parosmia– distorted sense of smell) in the absence of a reduced sense of smell [ 10 ]. Therefore, this high variability in the OD presentation must be taken into account when polling participants to avoid inclusion of potentially noneligible subjects.…”