Early recovery patterns of olfactory disorders in COVID-19 patients; a clinical cohort study

Amer, Mohamed; Elsherif, Hossam S.; Abdelhamid, Ahmed S.; Elzayat, Saad

doi:10.1016/j.amjoto.2020.102725

Cited by 42 publications

(50 citation statements)

References 19 publications

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“…Therefore, we did not perform a subgroup analysis regarding the olfactory recovery, but descriptive statistics suggest similar patterns of recovery in patients with allergic rhinitis and chronic rhinosinusitis with those recorded in the whole cohort of patients with smell loss. Most studies found no association of comorbidities with the persistence of olfactory dysfunction [ 5 , 7 ], but a recent study reported an association of comorbidities with a worse olfactory recovery in patients with allergic rhinitis, smoking, and hypertension [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The duration of the smell and taste disorders in COVID-19 disease is still unclear. Many studies reported a quick recovery in the majority of patients [ 1 , 8 , 9 ]. However, chronic symptoms after COVID-19 disease, including persisting fatigue and loss of taste and smell, have been reported by patients even several months after the onset of the disease [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity

Printza

Katotomichelakis

Valsamidis

et al. 2021

JCM

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A significant proportion of people infected with SARS-CoV-2 report a new onset of smell or taste loss. The duration of the chemosensory impairment and predictive factors of recovery are still unclear. We aimed to investigate the prevalence, temporal course and recovery predictors in patients who suffered from varying disease severity. Consecutive adult patients diagnosed to be infected with SARS-CoV-2 via reverse-transcription–polymerase chain reaction (RT-PCR) at two coronavirus disease-2019 (COVID-19) Reference Hospitals were contacted to complete a survey reporting chemosensory loss, severity, timing and duration, nasal symptoms, smoking, allergic rhinitis, chronic rhinosinusitis, comorbidities and COVID-19 severity. In a cross-sectional study, we contacted 182 patients and 150 responded. Excluding the critically ill patients, 38% reported gustatory and 41% olfactory impairment (74% severe/anosmia). Most of the patients (88%) recovered their sense of smell by two months (median: 11.5 days; IQR: 13.3). For 23%, the olfactory loss lasted longer than a month. There were no significant differences in the prevalence and duration of chemosensory loss between groups of varying COVID-19 severity, and sexes (all p > 0.05). Moderate hyposmia resolved quicker than more severe loss (p = 0.04). Smell and taste loss are highly prevalent in COVID-19. Most patients recover fast, but nearly one out of ten have not recovered in two months.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity

Printza

Katotomichelakis

Valsamidis

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…New-onset taste and smell disorders are well-recognized symptoms of COVID-19, affecting over 60% of patients [ 15 , 16 ]. SARS-CoV-2 entry is mediated via Angiotensin Coverting Enyzme 2 (ACE-2) and Transmembrane serine protease 2 (TMPRSS-2) receptors present throughout the olfactory cleft, with associated inflammatory disruption of the nervous system via nasal olfactory fibers [ 17 ].…”

Section: Taste and Smellmentioning

confidence: 99%

COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Pandian

Brodsky

Brigham

et al. 2021

American Journal of Otolaryngology

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“…The consensus from these questionnaire-based reports is that olfactory function in hospitalized patients generally normalizes after 2 weeks ( 17 ). Interestingly, total recovery was seen more frequently in COVID-19 patients with sudden hyposmia than the ones with sudden anosmia ( 33 , 34 ). In a study using the UPSIT, a 40-odorant psychophysical smell test, it was determined that 8 weeks after symptom-onset, 61.0% patients had regained normal function, and that in 39.0% of cases, a degree of microsmia was retained ( 17 ).…”

Section: Introductionmentioning

confidence: 95%

“…Recovery of smell loss has been assessed primarily through self-reporting and, like with prevalence reports, there is variation between reports. One study reported that 74.0% of patients experienced a resolution of anosmia at recovery ( 25 ) or within 1–3 weeks after the onset of COVID-19 symptoms ( [31] , [32] , [33] ). An approximately 80.0% recovery rate was found within 4 weeks of symptom onset ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Olfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence

Rebholz

Pfaffeneder-Mantai

Knoll

et al. 2021

American Journal of Otolaryngology

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Background Smell dysfunction has been recognized as an early symptom of SARS-CoV-2 infection, often occurring before the onset of core symptoms of the respiratory tract, fever or muscle pain. In most cases, olfactory dysfunction is accompanied by reduced sense of taste, is partial (microsmia) and seems to normalize after several weeks, however, especially in cases of virus-induced complete smell loss (anosmia), there are indications of persisting deficits even 2 months after recovery from the acute disease, pointing towards the possibility of chronic or even permanent smell reduction for a significant part of the patient population. To date, we have no knowledge on the specificity of anosmia towards specific odorants or chemicals and about the longer-term timeline of its persistence or reversal. Methods In this longitudinal study, 70 participants from a community in Lower Austria that had been tested positive for either IgG or IgM SARS-CoV-2 titers in June 2020 and a healthy control cohort ( N = 348) underwent smell testing with a 12-item Cross-Cultural Smell Identification Test (CC-SIT), based upon items from the University of Pennsylvania Smell Identification Test (UPSIT). The test was performed in October 2020, i.e. 4 months after initial diagnosis via antibody testing. Results were analyzed using statistical tests for contingency for each smell individually in order to detect whether reacquisition of smell is dependent on specific odorant types. Results For all odorants tested, except the odor “smoke”, even 4 months or more after acute SARS-CoV-2 infection, participants with a positive antibody titer had a reduced sense of smell when compared to the control group. On average, while the control cohort detected a set of 12 different smells with 88.0% accuracy, the antibody-positive group detected 80.0% of tested odorants. A reduction of accuracy of detection by 9.1% in the antibody-positive cohort was detected. Recovery of the ability to smell was particularly delayed for three odorants: strawberry (encoded by the aldehyde ethylmethylphenylglycidate), lemon (encoded by citronellal, a monoterpenoid aldehyde), and soap (alkali metal salts of the fatty acids plus odorous additives) exhibit a sensitivity of detection of an infection with SARS-CoV-2 of 31.0%, 41.0% and 40.0%, respectively. Conclusion Four months or more after acute infection, smell performance of SARS-CoV-2 positive patients with mild or no symptoms is not fully recovered, whereby the ability to detect certain odors (strawberry, lemon and soap) is particularly affected, suggesting the possibility that these sensitivity to these smells may not only be lagging behind but may be more permanently affected.

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Early recovery patterns of olfactory disorders in COVID-19 patients; a clinical cohort study

Cited by 42 publications

References 19 publications

Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity

Smell and Taste Loss Recovery Time in COVID-19 Patients and Disease Severity

COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Olfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence

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