Abstract
BackgroundThe lack of objective data makes it difficult to establish the prognostic value of chemosensitive disorders in coronavirus disease 2019 (COVID-19) patients. We aimed to prospectively monitor patients diagnosed with COVID-19 to see if the severity of olfactory and gustatory dysfunction associates with subsequent disease severity.MethodsMulticentre prospective study that recruited 106 COVID-19 subjects at diagnosis. Chemosensitive functions were assessed with psychophysical tests within 4 days of clinical onset, at 10 and 20 days. Daily body temperature and oxygen saturation were recorded as markers of disease severity alongside need for hospitalisation. The correlation between olfactory and gustatory scores and disease severity was assessed with linear regression analysis.ResultsAt T0, 71 patients (67%) presented with olfactory dysfunction while gustatory impairment was detected in 76 cases (65.6%). Chemosensitive disorders gradually improved over the observation period. No significant correlations were found between T0 chemosensitive scores and final disease severity. The correlation between olfactory scores and fever proved significant at T2 (p = 0.05), while the relationship with gustatory scores was significant at T1 (p = 0.01) and T2 (p < 0.001), however neither was clinically relevant. The correlation between chemosensitive scores and oxygen saturation was significant only for taste at T2 (p < 0.001). Logistic regression analysis found significant correlations between olfactory impairment severity and need for hospitalization at T2 (OR 3.750, p = 0.005).ConclusionsInitial objective olfactory and gustatory scores do not seem to have a significant prognostic value in predicting the severity of the COVID-19 course; however, persistence of olfactory dysfunction at 20 days, associated with a more severe course. Unfortunately, olfactory and gustatory dysfunction do not seem to hold prognostic value at the time of initial diagnosis.
Highlights
A growing evidence base has established a high prevalence of olfactory and gustatory disorders in patients affected by coronavirus disease 2019 (COVID-19) [1,2,3,4,5,6,7,8,9]
Based on data collected from the medical records of 169 COVID-19 patients, Yan et al [15] reported that the presence of chemosensitive disorders is significantly associated with milder forms of COVID-19; in particular they stated that the development of anosmia was predictive of avoidance of the need hospital admission
We found that persistence of anosmia at day 20 was associated with the need for hospitalization; we believe our sample is adequate in size to address this question, it would be important to further evaluate this in larger multicentre studies
Summary
A growing evidence base has established a high prevalence of olfactory and gustatory disorders in patients affected by coronavirus disease 2019 (COVID-19) [1,2,3,4,5,6,7,8,9]. Most reports are anamnestic and few studies include psychophysical evaluation of the olfactory and gustatory functions [10,11,12,13,14] The lack of such data makes it difficult to establish the prognostic value of chemosensitive disorders in COVID-19 patients. In addition to the limitations related to its anamnestic nature, this study uses only the need for hospitalization as a clinical outcome This was a single-centre study, this severity marker is not standardized as hospitalization criteria may vary with different patient groups according to age, co-morbidities and hospital capacity. We aimed to prospectively monitor patients diagnosed with COVID-19 to see if the severity of olfactory and gustatory dysfunction associates with subsequent disease severity
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