Phantosmia, Parosmia, and Dysgeusia Are Prolonged and Late-Onset Symptoms of COVID-19

Schambeck, Sophia; Crowell, Claudia S.; Wagner, Klaus J.; D’Ippolito, Elvira; Burrell, Teresa; Mijočević, Hrvoje; Protzer, Ulrike; Busch, Dirk H.; Gerhard, Markus; Poppert, Holger; Beyer, H

doi:10.3390/jcm10225266

Cited by 17 publications

(20 citation statements)

References 41 publications

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“…Phantosmia has been recently described in COVID‐19 patients, 18 with a variable reported prevalence, ranging from 11.8% at 6 months of follow‐up 16 to 20.5% between 100 and 244 days following COVID‐19. 19 This symptom has also been associated with histopathological changes in the olfactory epithelium. 48 , 49 These results should be carefully interpreted, given that the presence of persistent qualitative smell symptoms may represent an ongoing regeneration process.…”

Section: Discussionmentioning

confidence: 99%

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Phantosmia May Predict Long‐Term Measurable Olfactory Dysfunction After COVID‐19

et al. 2022

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Objectives Persistent olfactory dysfunction (OD) after 6 months caused by SARS‐CoV‐2 infection has been reported with a variable prevalence worldwide. This study aimed to determine the prevalence of long‐term OD and identify predisposing factors. Methods A prospective cohort study was conducted on 100 adults with COVID‐19. Olfactory function was assessed with the University of Pennsylvania Smell Identification Test and a symptom survey at the onset of disease and 30 days later. Patients with persistent quantitative OD at the second assessment were reevaluated after 1 year. Demographic variables, symptoms, and the degree of smell loss were analyzed. Results Participants included 100 patients. The mean age was 42.2 ± 15.6 years, 55 (55%) were female, and 56 (56%) were outpatients. Baseline smell loss was identified in 75/100 (75%) patients, decreasing to 39/95 (40%) after 1 month, and persisting in 29 patients after 1 year. Phantosmia at baseline was the only risk factor identified for persistent OD after 1 year (relative risk 2.51; 95% confidence interval 1.53–4.12; p < 0.001). Regardless of the outcome in smell function, a significant decline in olfaction was associated with the presence of phantosmia at 1 month ( β = −12.39; 95% CI −19.82 to −4.95; p < 0.01). Conclusions SARS‐CoV‐2 (2019–2020 variants) produced a highly frequent OD that persisted in 29% of the patients after 1 year. The presence of phantosmia at baseline and 1 month was associated with a worse evolution, but phantosmia may interfere with the performance in an identification smell test. A longer follow‐up is required in these patients. Level of Evidence 2 Laryngoscope , 2022

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Section: Discussionmentioning

confidence: 99%

“… 13 For COVID‐19, previous reports have described the presence of parosmia and phantosmia in both acute and late disease. 14 , 15 , 16 , 17 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

Phantosmia May Predict Long‐Term Measurable Olfactory Dysfunction After COVID‐19

et al. 2022

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“…In this study, 35.1%, 26.3% and 43.9% of patients reported cacosmia, phantosmia or parosmia throughout the follow-up period, which corroborates the literature findings. The post-COVID-19 prevalence of phantosmia ranged from 20.5 to 48%, while 18–73% reported parosmia within the post-COVID-19 months [ 22 – 25 ]. Interestingly, we observed a higher proposition of phantosmia in the OT group compared to the control group.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of olfactory training in COVID-19 patients with olfactory dysfunction: a prospective study

Lechien

Vaira

Saussez

2022

Eur Arch Otorhinolaryngol

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Objectives To investigate effectiveness of olfactory training (OT) in COVID-19 patients with persistent olfactory dysfunction (OD). Methods From March 2020 to March 2022, COVID-19 patients with OD were prospectively followed in three European medical centers for a period of 18 months. A standardized OT protocol were recommended to patients. Patient-reported outcome questionnaires and psychophysical evaluations were used to evaluate olfaction at baseline, 6, 12, and 18 months after the start of OT. The evolution of olfactory outcome was compared according to the adherence to the OT protocol. Results Fifty-seven patients completed the evaluations. Thirty-two patients fully adhered to the OT, while 25 did not adhere. The psychophysical scores significantly improved from baseline to 6-month post-infection in both groups. In the OT group, the psychophysical scores continued to significantly improve from 6 to 12 months after the start of OT ( p = 0.032). The mean duration of OT was 15.4 weeks. The mean delay of patient recovery perception was comparable between groups (27.4 weeks). The occurrence of cacosmia (35.1%) and parosmia (43.9%) throughout the follow-up period was comparable between groups. There proportion of phantosmia was higher in training (34.4%) compared with no-OT (16.0%; p = 0.007) group. The baseline Sniffin’Sticks tests was positively associated with the 6-month Sniffin’Sticks tests ( r s = 0.685; p < 0.001) and negatively associated with the time of recovery ( r s = − 0.369; p = 0.034). Conclusions The adherence to an OT protocol was associated with better mid-term improvement of psychophysical scores. Future large-cohort randomized-controlled studies are needed to confirm the effectiveness of OT in COVID-19 patients.

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“…Although it can persist for much longer and it is yet to be determined if COVID-19 can cause permanent hyposmia or dysgeusia. In one study, 14/44 (31%) patients had impaired smell or taste at 244 days post infection [179].…”

Section: Epidemiology and Presentationmentioning

confidence: 98%

“…Phantosmia, or detecting smells that are not really present, as well as parosmia, alteration in smell, occur frequently Neuro-PASC patients [179]. It is unclear if phantosmia and parosmia are due to initial damage or signs of early recovery, as these symptoms may be reported later in the disease course.…”

Section: Epidemiology and Presentationmentioning

confidence: 99%

Therapeutic Approaches to the Neurologic Manifestations of COVID-19

2022

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As of May 2022, there have been more than 527 million infections with severe acute respiratory disease coronavirus type 2 (SARS-CoV-2) and over 6.2 million deaths from Coronavirus Disease 2019 (COVID-19) worldwide. COVID-19 is a multisystem illness with important neurologic consequences that impact long-term morbidity and mortality. In the acutely ill, the neurologic manifestations of COVID-19 can include distressing but relatively benign symptoms such as headache, myalgias, and anosmia; however, entities such as encephalopathy, stroke, seizures, encephalitis, and Guillain-Barre Syndrome can cause neurologic injury and resulting disability that persists long after the acute pulmonary illness. Furthermore, as many as one-third of patients may experience persistent neurologic symptoms as part of a Post-Acute Sequelae of SARS-CoV-2 infection (Neuro-PASC) syndrome. This Neuro-PASC syndrome can affect patients who required hospitalization for COVID-19 or patients who did not require hospitalization and who may have had minor or no pulmonary symptoms. Given the large number of individuals affected and the ability of neurologic complications to impair quality of life and productivity, the neurologic manifestations of COVID-19 are likely to have major and long-lasting personal, public health, and economic consequences. While knowledge of disease mechanisms and therapies acquired prior to the pandemic can inform us on how to manage patients with the neurologic manifestations of COVID-19, there is a critical need for improved understanding of specific COVID-19 disease mechanisms and development of therapies that target the neurologic morbidities of COVID-19. This current perspective reviews evidence for proposed disease mechanisms as they inform the neurologic management of COVID-19 in adult patients while also identifying areas in need of further research.

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Phantosmia, Parosmia, and Dysgeusia Are Prolonged and Late-Onset Symptoms of COVID-19

Cited by 17 publications

References 41 publications

Phantosmia May Predict Long‐Term Measurable Olfactory Dysfunction After COVID‐19

Phantosmia May Predict Long‐Term Measurable Olfactory Dysfunction After COVID‐19

Effectiveness of olfactory training in COVID-19 patients with olfactory dysfunction: a prospective study

Therapeutic Approaches to the Neurologic Manifestations of COVID-19

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