Abstract
BackgroundLoss of smell and/or taste are cardinal symptoms of COVID-19. ‘Long-COVID’, persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. In this study we assess smell and taste loss resolution at 4–6 week follow-up, aim to identify risk factors for persistent smell loss and describe smell loss as a feature of long-COVID in a community cohort in London with known SARS-CoV-2 IgG/IgM antibody status. We also compare subjective and objective smell assessments in a subset of participants.MethodsFour hundred sixty-seven participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4–6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations.ResultsPeople with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery: 57.7% vs. 72.1%, p = 0.027. taste recovery 66.2% vs. 80.3%, p = 0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p < 0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4–6 weeks (OR 2.46, 95%CI 1.47–4.13, p = 0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (> 40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54–4.00, p < 0.001).ConclusionAlthough smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4–6 weeks follow-up, which constitute symptoms of ‘long-COVID’. Females (particularly > 40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions.Trials registrationClinicalTrials.govNCT04377815 Date of registration: 23/04/2020.
Highlights
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which results in coronavirus disease 2019 (COVID-19), emerged in 2019 resulting in a global pandemic with over 85 million cases and 1.8 million deaths reported worldwide [1]
People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative
We followed up a community cohort of people who had reported acute loss of their sense of smell and/or taste and had undergone SARS-CoV-2 immunoglobulin G (IgG)/immunoglobulin M (IgM) antibody testing 4–6 weeks earlier in order to investigate the clinical course of smell and/or taste loss
Summary
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which results in coronavirus disease 2019 (COVID-19), emerged in 2019 resulting in a global pandemic with over 85 million cases and 1.8 million deaths reported worldwide [1]. We previously reported seroprevalence of SARS-CoV-2 IgG/ IgM antibodies of 78% in a community cohort in London, UK who developed an acute loss of their sense of smell and/or taste during the peak of the first local wave of the pandemic [4]. In this study we assess smell and taste loss resolution at 4–6 week follow-up, aim to identify risk factors for persistent smell loss and describe smell loss as a feature of long-COVID in a community cohort in London with known SARS-CoV-2 IgG/IgM antibody status. We compare subjective and objective smell assessments in a subset of participants
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