Abstract
Upper respiratory viral infections can decrease the sense of smell either by inflammatory restriction of nasal airflow that carries the odorant molecules or through interference in olfactory sensory neuron function. During the coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), worldwide reports of severe smell loss (anosmia/hyposmia) revealed a different type of olfactory dysfunction associated with respiratory virus infection. Since self-reported perception of smell is subjective and SARS-CoV-2 exposure is variable in the general population, we aimed to study a population that would be more homogeneously exposed to the virus. Here, we investigated the prevalence of olfactory loss in frontline health professionals diagnosed with COVID-19 in Brazil, one of the major epicenters of the disease. We also analyzed the rate of olfactory function recovery and the particular characteristics of olfactory deficit in this population. A widely disclosed cross-sectional online survey directed to health care workers was developed by a group of researchers to collect data concerning demographic information, general symptoms, otolaryngological symptoms, comorbidities, and COVID-19 test results. Of the 1,376 health professionals who completed the questionnaire, 795 (57.8%) were working directly with COVID-19 patients, either in intensive care units, emergency rooms, wards, outpatient clinics, or other areas. Five-hundred forty-one (39.3%) participants tested positive for SARS-CoV-2, and 509 (37%) were not tested. Prevalence of olfactory dysfunction in COVID-19-positive subjects was 83.9% (454 of 541) compared to 12.9% (42 of 326) of those who tested negative and to 14.9% (76 of 509) of those not tested. Olfactory dysfunction incidence was higher in those working in wards, emergency rooms, and intensive care units compared to professionals in outpatient clinics. In general, remission from olfactory symptoms was frequent by the time of responses. Taste disturbances were present in 74.1% of infected participants and were significantly associated with hyposmia. In conclusion, olfactory dysfunction is highly correlated with exposure to SARS-CoV-2 in health care professionals, and remission rates up to 2 weeks are high.
Highlights
Clinical presentation of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies from asymptomatic infection to mild and severe systemic symptoms (Chan et al, 2020)
We excluded health professionals who did not inform a valid professional registration number, those who did not live in Brazil, those working in administrative jobs, those not in direct contact with patients, and those who reported contradictory answers related to olfactory/taste symptoms, for instance, answered “loss or reduction of smell” for one question and “I did not lose sense of smell” for a subsequent question
1https://pt.surveymonkey.com/r/ANOSMIACOVIDSAUDE 2inkscape.org 3gimp.org identified as a non-health care professional, did not provide a valid professional council number, or provided contradictory answers
Summary
Clinical presentation of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies from asymptomatic infection to mild and severe systemic symptoms (Chan et al, 2020). The studies published so far have shown a prevalence of loss of smell in SARS-CoV-2-infected patients ranging from 5.1 to 85.6% (Lechien et al, 2020; Mao et al, 2020; Menni et al, 2020; Parma et al, 2020; Spinato et al, 2020) and suggested that SARS-CoV2-related anosmia/hyposmia may differ from that associated with other respiratory virus infections, affecting patients with no other upper respiratory tract symptoms (Gane et al, 2020). We aimed to analyze the frequency of olfactory function recovery during the period of study and the particular characteristics of hyposmia/anosmia (relation to other nasal symptoms, duration, and recovery time) in this population
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