Impairments in odour detection and hedonic ratings of unpleasant smells in asymptomatic university students as SARS-Cov-2 emerged locally.

Abstract

Sudden olfactory loss in the absence of concurrent nasal congestion is now a well-recognized symptom of COVID-19. We examined olfaction using standardized objective tests of odour detection, identification and hedonics collected from asymptomatic university students before and as SARS-CoV-2 emerged locally. Olfactory performance of students who were tested when the virus is known to be endemic (n= 22) was compared to students tested in the month prior to viral circulation (n= 25), a normative sample assessed during the previous 4 years (n= 272) and those tested in prior years during the same time period. Analyses showed significantly reduced odour detection for the virus exposed cohort compared to students tested before (t= 2.60; P= .01; d=0.77; CI 0.17, 1.36) and to the normative sample (D=0.38; P= .005). Odour identification scores were similar, but the exposed cohort rated odours as less unpleasant (P< .001, CLES =0.77). Hyposmia increased 4.4-fold for students tested 2 weeks before school closure (N= 22) and increased 13.6-fold for students tested in the final week (N= 11). While the unavailability of COVID-19 testing is a limitation, this naturalistic study demonstrates week-by-week increase in hyposmia in asymptomatic students as a virus was circulating on campus, consistent with increasing airborne viral loads. The specific hedonic deficit in unpleasantness appraisal suggests a deficit in the TAAR olfactory receptor class, which conveys the social salience of odours. Assessment of odour detection and hedonic ratings may aid in early detection of SARS-CoV-2 exposure in asymptomatic and pre-symptomatic persons.