Assessment of smell dysfunction in mild symptomatic COVID-19 patients
DOI:
https://doi.org/10.14456/dcj.2024.3Keywords:
smell, olfactory test, COVID-19Abstract
This quasi-experimental study examined smell function and was conducted at Suranaree University of Technology Hospital from April to July 2021. The study included 30 healthy participants in the control group and 125 admitted COVID-19 patients who had tested positive for SARS-CoV-2 using PCR. Subjectively, 49.6% of the COVID-19 patients reported smell loss. Olfactory assessment using phenyl ethyl alcohol (PEA) indicated smell dysfunction in 60.8% of the patients. Patients with COVID-19 were 6.2 times more likely to have smell dysfunction (95% CI 2.4-16.3). The mean duration of smell loss was 6.1 days (median 5 days, 95% CI 5.1-7.1 days, min-max: 1-21 days), which mostly followed other symptoms by 2.9 days (median 2 days, 95% CI 1.9-3.7 days, min–max: -2–13 days). The risk of smell dysfunction in COVID-19 patients were male (p=0.004) and smoking (p=0.04). No significant risk of smell dysfunction by age older than 45 years (p=0.528), BMI 25 more than kg/m2 (p=0.773) or severity of disease (pneumonia) (p=0.143) were observed.
References
World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it [Internet]. 2020 [cited 2021 May 10]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it
Oran DP, Topol EJ. The proportion of SARS-CoV-2 infections that are asymptomatic: A systematic review. ann intern med. 2021;174(5):655-62.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395(10223):507-13.
Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): A multicenter European study. Eur Arch Otorhinolaryngol. 2020;1-11.
Seiden AM. Postviral olfactory loss. Otolaryngol Clin North Am. 2004;37(6):1159-66.
Rocke J, Hopkins C, Philpott C, Kumar N. Is loss of sense of smell a diagnostic marker in COVID-19: A systematic review and meta- analysis. Clin Otolaryngol. 2020;45(6):914-22.
Lao WP, Imam SA, Nguyen SA. Anosmia, hyposmia, and dysgeusia as indicators for positive SARS-CoV-2 infection. World J Otorhinolaryngol Head Neck Surg. 2020;6(Suppl 1):S22-5.
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):1-9.
Akosua AA, Ken LC, Cornelia BL, Danny Liew, Liew D, Ofori-Asenso R. Smell and taste dysfunction in patients with COVID-19: A systematic review and meta-analysis. Mayo Clin Proc. 2020;95(8):1621-31.
Just J, Puth M, Regenold F, Weckbecker K, Bleckwenn M. Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting-a retrospective analysis based on a joint documentation standard. BMC Fam Pract. 2020;21(1):251.
Kaye R, Chang CWD, Kazahaya K, Brereton J, Denneny JC 3rd. COVID-19 anosmia reporting tool: initial findings. Otolaryngol Head Neck Surg. 2020;163(1):132-4.
Hornuss D, Lange B, Schroter N, Rieg S, Kern W, Wagner D. Anosmia in COVID-19 patients. Clin Microbiol Infect. 2020;26(10):1426-7.
Department of medical services (TH). National Institutes of Health COVID-19 treatment guidelines panel. Coronavirus disease 2019 (COVID-19) treatment guidelines version 27: update on 18 Apr 2023 [Internet]. 2023 [cited 2023 Apr 24]. Available from: https://covid19.dms.go.th/Content/Select_Landding_page?contentId=181
Doty RL, Brugger WE, Jurs PC, Orndorff MA, Snyder PJ, Lowry LD. Intranasal trigeminal stimulation from odorous volatiles: psychometric responses from anosmic and normal humans. Physiol Behav. 1978;20:175-85.
Thomas H, Basile NL, Karl BH. Smell and taste disorders. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04.
Chaiyasate S, Roongrotwattanasiri K, Hanprasertpong N, Fooanant S. Normal smell identification score and N-butanol threshold in Thai adults. J Med Assoc Thai. 2013;96(3):324-8.
Riyaparn K. Olfaction and influencing factors in Thai elderly. Chiangrai medical journal. 2019;11(2):100-5.
Pinkeaw B, Assanasen P, Bunnag C. Smell discrimination and identification score in Thai adults with normosmia. Asian Biomedicine. 2015;9:789-95.
World Health Organization in Thailand. WHO Thailand situation report - 221; update on 2 February 2022 [Internet]. [cited 2023 Apr 24]. Available from: https://cdn.who.int/media/docs/default-source/searo/thailand/2022_02_02_tha-sitrep-221-covid-19-th.pdf?sfvrsn=97f3bf7b_5
World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020 [Internet]. Geneva: World Health Organization; 2020 [cited 2023 Apr 24]. Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-80.
Bertram S, Heurich A, Lavender H, Gierer S, Danisch S, Perin P, et al. Influenza and SARS-coronavirus activating proteases TMPRSS2 and HAT are expressed at multiple sites in human respiratory and gastrointestinal tracts. PLoS One. 2012;7(4):e35876.
Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M, et al. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med. 2020;26(5):681-7.
Sims AC, Baric RS, Yount B, Burkett SE, Collins PL, Pickles RJ. Severe acute respiratory syndrome coronavirus infection of human ciliated airway epithelia: role of ciliated cells in viral spread in the conducting airways of the lungs. J Virol. 2005;79(24):15511-24.
Khan M, Yoo SJ, Clijsters M, Backaert W, Vanstapel A, Speleman K, et al. Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb. Cell. 2021;184(24):5932-49.
Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C. Alterations in smell or taste in mildly symptomatic outpatients with SARS-COV-2 infection. JAMA. 2020;323(20):2089-90.
Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A, et al. Objective evaluation of anosmia and ageusia in COVID-19 patients: Single-center experience on 72 cases. Head Neck. 2020;42(6):1252-8.
Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V. Features of anosmia in COVID-19. Med Mal Infect. 2020;50(5):436-9.
Lee Y, Min P, Lee S, Kim SW. Prevalence and duration of acute loss of smell or taste in COVID-19 patients. J Korean Med Sci. 2020;35(18):e174.
Moein ST, Hashemian SM, Tabarsi P, Doty RL. Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients. Int Forum Allergy Rhinol. 2020;10(10):1127-35.
Bocksberger S, Wagner W, Hummel T, Guggemos W, Seilmaier M, Hoelscher M. Temporire Hyposmie bei COVID-19-Patienten [Temporary hyposmia in COVID-19 patients]. HNO. 2020;68(6):440-3.
Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS. Self-reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol. 2020;10(7):821-31.
Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-8.
Doty RL. Age-related deficits in taste and smell. Otolaryngol Clin North Am. 2018;51(4):815-25.
World Health Organization. Novel coronavirus. Coronavirus disease 2019 (COVID-19) Situation Report -73 [Internet]. [cited 2023 Apr 24]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf
Wu Y, Kang L, Guo Z, Liu J, Liu M, Liang W. Incubation period of COVID-19 caused by unique SARS-CoV-2 strains: A systematic review and meta-analysis. JAMA Netw Open. 2022;5(8):e2228008.
Rahman S, Montero MTV, Rowe K, Kirton R, Kunik F Jr. Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: A review of current evidence. Expert Rev Clin Pharmacol. 2021;14(5):601-21.
Gao Z, Xu Y, Sun C, Wang X, Guo Y, Qiu S. A systematic review of asymptomatic infections with COVID-19. J Microbiol Immunol Infect. 2021;54(1):12-6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Disease Control Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the Disease Control Journal are considered as academic work, research or analysis of the personal opinion of the authors, not the opinion of the Thailand Department of Disease Control or editorial team. The authors must be responsible for their articles.
.png){kind=logo}
