Abstract
BackgroundOlfactory and taste disorders were reported in up to 30%–80% of COVID‐19 patients. The purpose of our study was to objectively assess smell impairment in COVID‐19 patients and to correlate olfactory function with viral recovery.MethodsBetween 15 and 30 April 2020, hospitalized patients with confirmed SARS‐CoV‐2 infection underwent an objective assessment of olfactory function with the Smell Identification subtest of the Sniffin’ Sticks Test (SI‐SST). Association between viral recovery and SI‐SST performance was evaluated.Results51 patients were enrolled (49% males, mean age 66.2 ± 14.6 years). At the time of test administration, 45% were clinically recovered and 39% were virus‐free. Objective hyposmia/anosmia was found in 45% of the patients. Subjective olfactory disorders showed no association with the clinical or viral recovery status of the patients. On the contrary, none of the patients with anosmia and the 5% of hyposmic patients at test had viral recovery. The relative risk for hyposmic patients to be still positive at swab test was 10.323 (95% CI 1.483–71.869, p < .0001). Logistic regression analysis showed an independent and significant correlation between viral clearance and SI‐SST scores (OR = 2.242; 95% CI 1.322–3.802, p < .003). ROC curve analysis confirmed that a SI‐SST > 10.5 predicts viral clearance with 79% sensitivity and 87% specificity (AUC = 0.883).ConclusionHyposmia is part of COVID‐19 symptoms; however, only objectively assessed olfactory function is associated with viral recovery. SI‐SST is an easy and safe instrument, and further large multicentric studies should assess its value to predict infection and recovery.
Highlights
Sticks Test (SI-SST) is composed of 16 pens, each one equipped with a swab soaked with a 4 ml quantity of a specific smell
Multivariable logistic regression analysis showed that a 1-point increment in SI-SST score corresponds to a 2.2-fold higher odds ratio of being virus-free in two consecutive swabs (OR = 2.242; 95% CI 1.322–3.802, p < .003), and this finding was independent from sex, age, severity of respiratory impairment, and time between recovery and test administration
We objectively assessed olfactory function by means of the SISST, which is easy and rapid to perform at bedside (8–10 minutes) and it is provided with age- and gender-adjusted normative values (Oleszkiewicz et al, 2019)
Summary
During coronavirus disease 19 (COVID-19) pandemic, several symptoms have been reported indicating a neurological involvement (Zubair et al, 2020), and among them, alteration of smell and taste perception are frequently observed (Beltrán-Corbellini et al, 2020; Giacomelli et al, 2020; Lechien et al, 2020; Printza & Constantinidis, 2020). The presence of olfactory and taste disorders (OTDs) was reported in up to 30%–80% of COVID-19 patients across different studies (Beltrán-Corbellini et al, 2020; Giacomelli et al, 2020; Lechien et al, 2020; Printza & Constantinidis, 2020). These studies are based on subjective measurements, such as self-reported questionnaires, without assessing the presence of hyposmia with validated tests. The aim of our study was to objectively evaluate smell impairment in COVID-19 patients and determine olfactory function with respect to viral recovery
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