Covid-19: A New Cause for Taste and Smell Dysfunction

Otolaryngologia Polska, 2020

Objectives: To determine the incidence of smell and taste disorders in our health department and to analyse the factors that could be associated with these symptoms in patients with COVID-19. Methods: We conducted an observational descriptive study of all patients with COVID-19 in our health area diagnosed between 2020/03/10 and 2020/04/14. Factors related to smell and taste disorders were analysed. Results: A total of 126 patients, 63 women and 63 men, aged 16–80 years, were included. As many as 69 patients (62.7%) presented hyposmia, and 58 (46%) of them had anosmia. A total of 75 patients (59.5%) presented hypogeusia, and 57 (45.2%) of them had ageusia. The risk factors that were most commonly associated with these disorders were the female sex (adjusted odds ratio, aOR 2.43 for smell disorders and 2.44 for taste disorders), allergic rhinitis (aOR 3.34 for smell disorders) and a younger age. A protective factor was arterial hypertension (aOR 0.51 for smell disorders and 0.35 for ...

European Archives of Oto-Rhino-Laryngology

Objective It is known that the COVID-19 disease, which has affected the whole world, causes symptoms, such as cough, fever, shortness of breath, muscle pain, fatigue, diarrhea, headache and sore throat, in addition to various clinical findings, such as loss of smell and taste. In this study, we aimed to reveal the loss of sense of taste and smell in COVID-19 patients and to investigate whether these sensory losses are permanent in the healing process of the disease. Method This prospective study included 94 COVID-19 patients. Smell and taste tests were applied to all patients. Ten days after the first test, a second test was applied to the patients with an impaired sense of smell to compare the results. Results Of the 94 patients, 55.3% were male, and the mean age was 53 ± 19.6 (21-90) years. There were 67 patients with smell and taste impairment, of whom 34 (50.7%) had smell impairment only, 3 (4.4%) had taste impairment only, and 30 (44.7%) had both smell and taste impairment. It was found that the smell scores of 55 patients with smell and taste impairment in the first evaluation were significantly higher at the second measurement; and their tasting period was significantly shortened compared to the first measurement (p˂0.001). Conclusion COVID-19 patients may present to medical centers with a broad variety signs and symptoms. This study shows that impairment in the senses of smell and taste is common in this disease and strongly associated with COVID-19 infection. However, smell and taste impairment is mostly temporary and improves during the recovery period.

2023

Introduction: Infection with the new coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] was first registered in December 2019 in China and then later spread rapidly to the rest of the world. On 31 st December 2019, the World Health Organization on 11 th March 2020 declared a pandemic with this virus. In Bosnia and Herzegovina, the first infected person was registered on 5 th March 2020 in Banja Luka. Aim: To present some aspects of the olfactory and gustatory dysfunction in patients with the coronavirus disease of 2019 (COVID-19). Methods: The article has an analytical character and review of the literature. Results and Discussion: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a high similarity with SARS-CoV-1 and uses the same receptors to enter the human body [angiotensin-converting enzyme 2 (ACE2)]. 2 COVID-19 is a respiratory infection that is primarily transmitted via respiratory droplets. In the first year of the pandemic, the SARS-CoV-2 coronavirus has mutated several times, resulting in genetically different variants. The variants are named by using letters of the Greek alphabet. The Alpha variant (Wuhan, China), Beta variant (first outbreak in South Africa), the Gamma variant (first outbreak in Brazil), and the Delta variants (first outbreak in India and Omicron variant) have caused an increase in cases worldwide. Typical symptoms of COVID-19 infection can be very moderate to very severe, with severe respiratory symptoms and fatal outcomes. COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2 also penetrates the central nervous system (CNS) and apparently could be responsible for fatal outcomes in some cases. The entry of the virus into the brain can lead to different neurological and psychiatric manifestations, including headache, loss of smell (anosmia) and the loss of taste (ageusia), encephalopathy, encephalitis, paresthesia, myalgia, Guillain-Barre syndrome, and cerebrovascular diseases. Conclusion: The coronavirus disease of 2019 (COVID-19) is primarily a disease of the respiratory system, but SARS-CoV-2 also penetrates the CNS, leading to serious neurological disorders, and apparently, it is also responsible for mortality. The frequency of anosmia and ageusia in patients with COVID-19 varies widely, from 10 to 65%, being the primary symptom in about 12% of patients. Most of the analyzed subjects reported olfactory recovery. However, anosmia and ageusia can last several months or even longer. For now, the etiopathogenesis of anosmia and ageusia in SARS-CoV-2 infection is still unknown. Nasal or systemic corticosteroids were recommended in the acute phase as well as olfactory training (sniffing the smell of rose, lemon, and cloves) in the acute and chronic phases, and many other drugs as potential therapeutics.

Indian Journal of Otolaryngology and Head & Neck Surgery

This study is done to raise awareness of olfactory and taste dysfunction association in coronavirus disease, urging early detection and isolation of coronavirus positive patients thus breaking the chain of transmission of disease. This is a retrospective observational study done in outpatient department of tertiary care hospital in Mumbai, west India from 1st May 2020 to 1st August 2020 on patients who were confirmed positive for COVID-19 by real-time reverse transcription polymerase chain reaction (rRT-PCR) and having olfactory dysfunction and/or taste disorders. In study population, anosmia and ageusia occurred in 88% and 83.33% respectively. In control population, anosmia and ageusia occurred in 93% and 85.71% respectively. The mean duration of anosmia was around 2 weeks and 3 weeks for study and control group respectively. In study population 94.6% recovered from anosmia, whereas in control population 64.3% recovered from anosmia. Anosmia gradually improved to hyposmia. In the study population 94.3% hyposmia patients showed recovery, while in control population 85.2% showed recovery. Ageusia collaborated with the duration of anosmia. Recovery from taste dysfunction was 88.6% and 63.9% in study and control population respectively. Olfactory and taste dysfunction are very important clinical features of coronavirus positive patients with anosmia being the most prominent symptom. All patients presenting with smell and or taste dysfunction should be screened for coronavirus disease, helping in early detection in asymptomatic patients.

Acibadem Universitesi Saglik Bilimleri Dergisi, 2021

Aralik 2019'da Cin'in Wuhan kentinden kaynaklandigi dusunulen ve milyonlarca kisinin enfekte olmasina neden olan koronavirus bir pandemiye yol acmistir. Enfeksiyonun ilk donemlerinde siklikla gorulen semptomlar ates, miyalji ve oksuruk olarak bildirilmistir. Biz bu yazida baslangic bulgulari olarak sadece koku ve tat alma fonksiyonunda kaybolma sikayeti ile gelen iki hastayi inceledik. Testleri pozitif cikan ve pnomoni tanisi konan hastalarda oksuruk ve ates gorulmedi. Sadece tat ve koku duyularinin kayboldugu hastalarin mutlaka test ile taranmasi gerektigini dusunmekteyiz.

The Egyptian Journal of Otolaryngology, 2020

Background This study aims to find the chemosensitive dysfunction incidence in COVID-19-positive patients and its recovery. We collected the data from sixty-five patients, all COVID-19 positive, quarantined in-hospital between 5 April 2020 and 17 May 2020, by a questionnaire distributed in the quarantine ward. Results Smell dysfunction appeared in 89.23% with or without other symptoms of COVID-19. 39.66% of them recovered the sense of smell. Taste dysfunction found in 83.08% patients with other COVID-19 symptoms. Only 29.63% of them recovered. The recovery took 1–3 weeks, and most cases recovered within 1 week or less. 18.46% and 15.38% had smell and taste dysfunction, respectively, as the only symptom before COVID-19 confirmation. Most of the chemosensitive dysfunction affected the 4th decade of age in this study. Conclusion Chemosensitive dysfunction is associated with coronavirus disease and may be the only symptom that presents the disease. This makes the ENT doctors the first l...

Haya: The Saudi Journal of Life Sciences

Background: A significant proportion of people infected with COVID-19 report new onset of smell and taste loss. The duration of the chemosensory impairment and prognostic factors of recovery is still unclear. We aimed to investigate the prevalence rate and other signs and symptoms which are predictors in patients. Objective: To find out the association of Anosmia and Ageusia with COVID-19. To find out relationship of Gender with Anosmia and Ageusia in COVID-19 or other URTI. Methods: I was a cross-sectional study, participants were from CMH, Multan, Hospitals of different cities of the province of Punjab, Pakistan. The study was conducted from 1st July to 31st of August 2021. 185. All faculty members and medical Students of CMH Bahawalpur. Results: Out of 185 participants, 99 (53.5%) were male and 86 (46.5%) were female. The mean age was 23.93 ± 6.661years. Pearson correlation of covid-19 with loss of smell is 0.533 which shows that there is strong positive relationship between them...

European Archives of Oto-Rhino-Laryngology

Purpose The ongoing coronavirus disease 19 (COVID-19) pandemic is spreading at an alarming rate across the globe. Sudden onset loss of smell and/or taste has been increasingly reported as a symptom of COVID-19. However, prevalence of these symptoms, and its severity varies widely between studies, with little data on its duration and recovery rate. Since this significantly impacts the quality of life of patients, there is a need for a study to provide insight into the loss of smell or taste in terms of its correlation with other upper respiratory tract symptoms, natural history and resolution rates. Methods This cross-sectional study included 718 mild to moderately symptomatic adult patients (≥ 18 years), admitted consecutively to Kalinga Institute of Medical Sciences (KIMS), Odisha, India between June 25 and July 24, 2020, who tested positive for SARS-CoV-2 by polymerase chain reaction on nasopharyngeal and throat swabs. Prevalence, severity, duration and factors associated with altered smell or taste sensation, and their follow-up were recorded. Results Of the 718 patients included in the study at baseline [563 (78%) men; median age 34 years], 101 (14%) patients experienced either altered smell or taste, with 52 (7%) experiencing both altered smell and taste. Seventy-seven (10.7%) patients had altered smell and 76 patients had altered taste (10.5%). Of these, 71 (92%) and 73 (96%) regained their sense of smell and taste, respectively, by 14 days after their swab tested positive. Presence of fever (OR = 5.4, 95% CI = 2.7-10.6, p < 0.001), cough (OR = 2.3, 95% CI = 1.2-4.2, p = 0.009) and nasal obstruction (OR = 3.1, 95% CI = 1.4-6.7, p = 0.006) were independently associated with increased likelihood of experiencing both altered taste and smell in multivariable models. Conclusion The prevalence of altered smell and taste in Indians was much lower compared to Europeans and similar to East Asians. Majority regained these senses by 2 weeks. Identification of these symptoms can help in early detection of the disease in suspected individuals.

International Forum of Allergy & Rhinology, 2020

Background: Olfactory (OD) and gustatory (GD) dysfunction have been proven to be a typical symptom of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. However, their prevalence in different patient populations still needs to be clarified. A cross-sectional study was performed from March 27 to April 1, 2020, in Northern Italy. Physicians administered a survey-based questionnaire to SARS-CoV-2positive patients with the aim of assessing symptoms, focusing on OD and GD. Two groups were studied: group A, patients hospitalized at Azianda Socio Sanitaria Territoriale (ASST) Spedali Civili University Hospital of Brescia; and group B, home-quarantined subjects. Results: A total of 508 patients were enrolled: 295 in group A and 213 in group B. Mean age ± standard deviation (SD) was 55 ± 15 years; 56% were men. Overall, OD and GD were present in 56% (95% confidence interval [CI], 51% to 60%) and 63% (95% CI, 59% to 67%) of cases, respectively. In group A, the prevalence of OD and GD was 44% (95% CI, 38% to 50%) and 52% (95% CI, 46% to 58%), respectively. In group B, the prevalence of OD and GD was 72% (95% CI, 65% to 79%) and 79% (95% CI, 73% to 84%), respectively. In the entire cohort, total loss of olfaction and taste was reported in 64% and 60% of cases, respectively. OD and GD occurred as the first symptom in 10% and 11% of cases, respectively; in the remaining cases, they occurred a er a mean of 4 ± 3 days following the first symptom. At the time of the questionnaire, complete resolution of OD and GD was reported in 52% and 55% of cases, respectively (mean duration, 9 ± 5 days in both). OD and GD are more prevalent in homequarantined subjects, and they are independently associated with younger age and female gender. C 2020 ARS- AAOA, LLC.

Chemical Senses, 2020

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19–79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (−79.7 ± 28.7, mean ± standard deviation), taste (−69.0 ± 32.6), and chemesthetic (−37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms.

Indian Journal of Otolaryngology and Head &amp; Neck Surgery, 2021

Olfactory and/or taste dysfunction are potential neurological manifestations of coronavirus disease-2019 (COVID-19). The aim of the study was to document the prevalence of anosmia in COVID-19 positive patients and analyze the effect of various factors on the occurrence of these chemosensory dysfunction in the local population. Tertiary referral center. Prospective Study. 250 subjects who tested positive for SARS-CoV-2, by real-time polymerase chain reaction (RT-PCR) and admitted in Isolation ward were enrolled for the study. Data was collected from the subjects via oral questionnaire method, based on the AAO-HNS Anosmia Reporting Tool. Data was collected regarding the age, gender, olfactory or gustatory disturbances, history of recent travel or contact with a positive case, smoking, any associated symptoms, any co-morbid conditions and recovery time of sense of olfaction. Out of 250, 179 (71.6%) subjects were diagnosed with Olfactory dysfunction out of which majority were males, 105 (58.6%). Most of the patients were above 40 years of age (n = 184, 73.6%). Majority of the individuals (88 patients) had close contact with a positive case in recent past, followed by 67 patients who were health care workers, hence proving that risk of infection increases with exposure. Anosmia was present in 68.5% of all the 127 non-smokers. 66.4% had both olfactory as well as gustatory dysfunction whereas 18 patients (7.2%) were found to be totally asymptomatic. Mostly patients recovered their sense of smell within 1-2 weeks from the day of onset of anosmia. Presence of olfactory dysfunction of any degree with or without alteration in taste sensation should raise a suspicion of COVID-19 infection, especially when other classical signs are not present. In such conditions, swabs should be sent for confirmation by RT-PCR testing and till results are awaited, the individual should be shifted to quarantine facilities or advised strict self-isolation.

2021

Introduction/Aim: With the COVID-19 pandemic chemosensory dysfunction are among the most prevalent symptoms. Most reports are subjective evaluations, which has been suggested to be unreliable. The objective is to test chemosensory dysfunction and recovery based on extensive psychophysical tests in COVID-19 during the course of the disease. Methods/Patients: Patients from several centers participated in the study. All tested positive for SARS-COV-2 with RT-PCR. They were tested within three days of diagnosis and 28 to 169 days after infection. Testing included extensive olfactory testing with the Sniffin' Sticks test for threshold, discrimination and identification abilities, and with the Taste Sprays and Taste Strips for gustatory function for quasi-threshold and taste identification abilities. Results: There was a significant difference in olfactory function during and after infection. During infection 21% were anosmic, 51% hyposmic and 28% normosmic. After infection only 1% were anosmic, 26% hyposmic and 73% normosmic. 26% had gustatory dysfunction during infection and 6.5% had gustatory dysfunction after infection. Discussion: Chemosensory dysfunction is very common in COVID-19, either as isolated smell or taste dysfunction or a combined dysfunction. Most people regain their chemosensory function within the first 28 days, but a quarter of the patients show persisting dysfunction, which should be referred to specialist smell and taste clinics for rehabilitation of chemosensory function.

European Archives of Oto-Rhino-Laryngology

Purpose At the time of writing, there is a pandemic affecting virtually every country on Earth. There is considerable discussion amongst clinicians as well as lay people about anosmia and ageusia in COVID-19 sufferers. We aimed to report the results from comprehensive olfactory and gustatory testing in a series of hospital in-patients. Methods The prospective study evaluated 81 individuals with a COVID-19 infection, as confirmed by 2019 n-cov Real-Time PCR laboratory testing. The control group consisted of forty individuals with COVID-19 negative. Olfactory and gustatory testings were carried out by an examiner utilizing stringent safety standards and wearing full personal protective equipment. The results obtained in the case group were then compared with those obtained for the controls. Results In the case group, 41(50.6%) of patients were male and 40 (49.4%) were female, mean age of 54.16 ± 16.98 years (18-95). In the control group, 21 (52.5%) of subjects were male and 19 (47.5%) were female, and mean age was 55 ± 15.39 years (18-90). Fifty (61.7%) COVID-19-positive patients had complaints related to olfaction. The distribution of olfactory symptoms in the case group differed at the level of statistical significance from the control group (p < 0.001). Turning to gustatory abnormalities, within the case group, 22 individuals (27.2%) had taste malfunction. A statistically significant difference was found in the distribution of gustatory abnormalities between cases and controls (p < 0.001). Conclusions Olfactory and gustatory dysfunctions are strongly associated with SARS-CoV-2 infection. Hyposmia with or without hypogeusia is potentially a reliable indicator of latent COVID-19.

Asian Pacific Journal of Allergy and Immunology

During the initial pandemic wave of COVID-19, apart from common presenting symptoms (cough, fever, and fatigue), many countries have reported a sudden increase in the number of smell and taste dysfunction patients. Smell dysfunction has been reported in other viral infections (parainfluenza, rhinovirus, SARS, and others), but the incidence is much lower than SARS-CoV-2 infection. The pathophysiology of post-infectious olfactory loss was hypothesized that viruses may produce an inflammatory reaction of the nasal mucosa or damage the olfactory neuroepithelium directly. However, loss of smell could be presented in COVID-19 patients without other rhinologic symptoms or significant nasal inflammation. This review aims to provide a brief overview of recent evidence for epidemiology, pathological mechanisms for the smell, and taste dysfunction in SARS-CoV-2 infected patients. Furthermore, prognosis and treatments are reviewed with scanty evidence. We also discuss the possibility of using "smell and taste loss" as a screening tool for COVID-19 and treatment options in the post-SARS-CoV-2 infectious olfactory loss.