Abstract
Introduction: To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients.Methods: Adults with confirmed COVID-19 and self-reported sudden LOS were prospectively recruited through a public call from the University of Mons (Belgium). Epidemiological and clinical data were collected using online patient-reported outcome questionnaires. Patients benefited from objective olfactory evaluation (Sniffin-Sticks-test) and were invited to attend for repeated evaluation until scores returned to normal levels.Results: From March 22 to May 22, 2020, 88 patients with sudden-onset LOS completed the evaluations. LOS developed after general symptoms in 44.6% of cases. Regarding objective evaluation, 22 patients (25.0%) recovered olfaction within 14 days following the onset of LOS. The smell function recovered between the 16th and the 70th day post-LOS in 48 patients (54.5%). At the time of final assessment at 2 months, 20.5% of patients (N = 18) had not achieved normal levels of olfactory function. Higher baseline severity of olfactory loss measured using Sniffin-Sticks was strongly predictive of persistent loss (p < 0.001).Conclusion: In the first 2 months, 79.5% of patients may expect to have complete recovery of their olfactory function. The severity of olfactory loss, as detected at the first Sniffin-Sticks-test, may predict the lack of mid-term recovery.
Highlights
To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients
Recovery was fairly evenly distributed across the time points, such that at the time of final assessment at 2 months, 70 patients (79.5%) had achieved normal levels of olfactory function
We identified a positive association between postnasal drip and Sniffin-Stickstest data in patients who had early olfactory recovery
Summary
To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients. The infection may be associated with neurological complaints, including cerebrovascular disease, peripheral nervous system symptoms, neuromuscular symptoms, or loss of smell (LOS) [1,2,3]. Prevalence of LOS appears to vary according to clinical setting, with rates as high as 70% in mild-to-moderate disease [3, 4]. There is, to date, a paucity of studies prospectively evaluating recovery rates early reports suggest encouraging self-reported improvement rates in over 80% at only 1 week follow-up [2]. There will be a surge in patients presenting to primary care, ear, nose, and throat (ENT) and neurology physicians with anosmia following the pandemic. It is essential to be able to counsel patients regarding the likelihood of recovery, and to identify those at risk of persistent LOS, such that therapeutic strategies can be targeted appropriately
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