Abstract
Background: Sudden olfactory loss is a major symptom of SARS-CoV-2 infection and has a negative impact on daily life quality. Almost 80% of disorders regress spontaneously. No precise characterization of the medium- and long-term olfactory symptoms has been carried out yet, apart from self-assessments. The main objective of this work was to characterize persistent smell disorders in this population. Methodology: Consecutive patients consulting to the ENT department with post-Covid19 olfactory loss were included. The clinical examination included an analog scale for the self-assessment of olfactory recovery), a nasofibroscopy, the Sniffin’ Stick Test and the short version of the Questionnaire of olfactory disorders. Results: Among the 34 patients included, based on the Sniffin’ Sticks Test, 29.4% (n=10) could be classified as normosmic, 55.9% (n=19) as hyposmic and 14.7% (n=5) as functional anosmic). Only olfactory identification impairment was significantly correlated with olfactory complaint and daily anxiety and annoyance related to lack of olfaction recovery. This identification disorder seemed to worsen over time. Conclusions: It is crucial to assess odor identification disorders in case of persistent olfactory complaints after COVID-19. It is fundamental to target this disorder, as it does not improve spontaneously and negatively impact quality of life.
Highlights
COVID-19 infection symptoms initially described were fever and cough in respectively 44 and 65% of cases[1]
Demographic and clinical features Thirty-four patients consulting the ENT department of Nice University Hospitals (CHU) for olfactory complaints after a COVID-19 infection were included in the study
A previous study showed that 6% of patients infected with COVID-19 who presented an olfactory complaint after 12 days from onset of symptoms were normosmic on the Sniffin’ Stick test . [14] Subdomain Sniffin’ Stick test analyses employing recent normative data[33] highlights a predominant disorder on the identification (I) of the odorant, which is more important than the odor discrimination (D) or the detection threshold (T)
Summary
COVID-19 infection symptoms initially described were fever and cough in respectively 44 and 65% of cases[1]. Olfactory and taste loss are respectively reported, with great heterogenicity, in 25% to 98% and 15% to 85% of cases in COVID-19 patients[2,8,9], especially because physicians used auto-questionnaires sent by e-mail, apps and mobiles to avoid obvious contagious situations. They are severe in 50% cases (22 to 80% of anosmia and 20% of ageusia[8,10]) and is more common in women over 50(2,3,11–13). Psychophysical testing these acute COVID-19 patients allowed Lechien et al[14] to specify the extent of the acute olfactory loss to 80% of patients, 50% and 20% of them being respectively anosmic and hyposmic. The main objective of this work was to characterize persistent smell disorders in this population
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