Olfactory Dysfunction in COVID-19 Patients in a Tertiary Care Hospital; A Cross-Sectional Observational Study

Overview

Journal Iran J Otorhinolaryngol

Publisher Mashhad University of Medical Sciences

Specialty Otorhinolaryngology

Date 2024 May 15

PMID 38745684

Authors

Sreedevi Nunkappa Thippeswamy

Kamalesh Thagadur Nataraju

Affiliations

Soon will be listed here.

Abstract

Introduction: Sudden onset of olfactory dysfunction (OD) manifesting as hyposmia and/or anosmia occurred in many COVID-19 patients, with a frequency as high as 85.6%. Given the morbidity and mortality of COVID-19, it is important to recognize the symptoms early so that the infected person can be diagnosed, isolated and treated early. Hence, this study was undertaken to know the prevalence of Sino-nasal symptoms with special reference to olfactory dysfunction in COVID-19 patients.

Materials And Methods: It is a cross sectional observational study involving 160 COVID-19 patients aged 18 to 100 years selected by universal sampling. OD was analyzed and compared with various inflammatory markers and Sino-nasal symptoms. Patients were followed up until their discharge from the hospital or until death due to COVID-19 related health issues.

Results: Out of 160 subjects included in the study, 61.88 % of the study participants were males and 38.13% were females. The mean age was 44.50 ± 16.43 years. A total of 51 patients (31.87%) developed OD. Fifty one (31.87%) patients developed OD (anosmia/hyposmia). Among the individuals with anosmia/hyposmia, majority of patients (n=26) (50.98%) complained of more than 75% loss of smell sensation. Mean duration of anosmia/hyposmia was 9.92 ± 3.71 days. OD correlated with serum ferritin levels (p=0.0453).

Conclusion: Anosmia/hyposmia was found in significant proportion of patients with covid-19 which correlated with the disease severity and serum ferritin levels and hence can serve as surrogate marker of disease severity.

References

Klopfenstein T, Kadiane-Oussou N, Toko L, Royer P, Lepiller Q, Gendrin V . Features of anosmia in COVID-19. Med Mal Infect. 2020; 50(5):436-439. PMC: 7162775. DOI: 10.1016/j.medmal.2020.04.006. View

Guo Y, Cao Q, Hong Z, Tan Y, Chen S, Jin H . The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020; 7(1):11. PMC: 7068984. DOI: 10.1186/s40779-020-00240-0. View

Netland J, Meyerholz D, Moore S, Cassell M, Perlman S . Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008; 82(15):7264-75. PMC: 2493326. DOI: 10.1128/JVI.00737-08. View

Hopkins C, Surda P, Kumar N . Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020; 58(3):295-298. DOI: 10.4193/Rhin20.116. View

Wu D, Wu T, Liu Q, Yang Z . The SARS-CoV-2 outbreak: What we know. Int J Infect Dis. 2020; 94:44-48. PMC: 7102543. DOI: 10.1016/j.ijid.2020.03.004. View

Whitcroft K, Hummel T . Clinical Diagnosis and Current Management Strategies for Olfactory Dysfunction: A Review. JAMA Otolaryngol Head Neck Surg. 2019; 145(9):846-853. DOI: 10.1001/jamaoto.2019.1728. View

Vaira L, Hopkins C, Petrocelli M, Lechien J, Soma D, Giovanditto F . Do olfactory and gustatory psychophysical scores have prognostic value in COVID-19 patients? A prospective study of 106 patients. J Otolaryngol Head Neck Surg. 2020; 49(1):56. PMC: 7406962. DOI: 10.1186/s40463-020-00449-y. View

Yan C, Faraji F, Prajapati D, Ostrander B, DeConde A . Self-reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol. 2020; 10(7):821-831. PMC: 7264572. DOI: 10.1002/alr.22592. View

Dalton P . Olfaction and anosmia in rhinosinusitis. Curr Allergy Asthma Rep. 2004; 4(3):230-6. PMC: 7088987. DOI: 10.1007/s11882-004-0031-3. View

10.

Lovato A, de Filippis C . Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms. Ear Nose Throat J. 2020; 99(9):569-576. DOI: 10.1177/0145561320920762. View

11.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J . Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-1069. PMC: 7042881. DOI: 10.1001/jama.2020.1585. View

12.

Desforges M, Le Coupanec A, Dubeau P, Bourgouin A, Lajoie L, Dube M . Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System?. Viruses. 2019; 12(1). PMC: 7020001. DOI: 10.3390/v12010014. View

13.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J . Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18):1708-1720. PMC: 7092819. DOI: 10.1056/NEJMoa2002032. View

14.

Hummel T, Whitcroft K, Andrews P, Altundag A, Cinghi C, Costanzo R . Position paper on olfactory dysfunction. Rhinology. 2017; 56(1):1-30. DOI: 10.4193/Rhino16.248. View

15.

Moein S, Hashemian S, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty R . Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol. 2020; 10(8):944-950. PMC: 7262123. DOI: 10.1002/alr.22587. View

16.

Whitcroft K, Hummel T . Olfactory Dysfunction in COVID-19: Diagnosis and Management. JAMA. 2020; 323(24):2512-2514. DOI: 10.1001/jama.2020.8391. View

17.

Borsetto D, Hopkins C, Philips V, Obholzer R, Tirelli G, Polesel J . Self-reported alteration of sense of smell or taste in patients with COVID-19: a systematic review and meta-analysis on 3563 patients. Rhinology. 2020; 58(5):430-436. DOI: 10.4193/Rhin20.185. View

18.

Vaira L, Gessa C, Deiana G, Salzano G, Maglitto F, Lechien J . The Effects of Persistent Olfactory and Gustatory Dysfunctions on Quality of Life in Long-COVID-19 Patients. Life (Basel). 2022; 12(2). PMC: 8878431. DOI: 10.3390/life12020141. View

19.

Yamagishi M, Fujiwara M, Nakamura H . Olfactory mucosal findings and clinical course in patients with olfactory disorders following upper respiratory viral infection. Rhinology. 1994; 32(3):113-8. View

20.

Addison A, Wong B, Ahmed T, Macchi A, Konstantinidis I, Huart C . Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction. J Allergy Clin Immunol. 2021; 147(5):1704-1719. DOI: 10.1016/j.jaci.2020.12.641. View