Clinical Features of Parosmia Associated With COVID-19 Infection

David K Lerner, Katherine L Garvey, Annie E Arrighi-Allisan, Andrey Filimonov, Peter Filip, Janki Shah, Benjamin Tweel, Anthony Del Signore, Madeleine Schaberg, Patrick Colley, Satish Govindaraj, Alfred Marc Iloreta, David K Lerner, Katherine L Garvey, Annie E Arrighi-Allisan, Andrey Filimonov, Peter Filip, Janki Shah, Benjamin Tweel, Anthony Del Signore, Madeleine Schaberg, Patrick Colley, Satish Govindaraj, Alfred Marc Iloreta

Abstract

Objective: To characterize the clinical features, risk factors, symptom time-course, and quality of life implications for parosmia among coronavirus disease (COVID)-related olfactory dysfunction patients.

Methods: Individuals with olfactory dysfunction associated with laboratory-confirmed or clinically suspected COVID-19 infection were recruited from otolaryngology and primary care practices over a period from August 2020 to March 2021. Participants completed olfactory dysfunction and quality of life surveys.

Results: A total of 148 (64.1%) of 231 respondents reported parosmia at some point. Parosmia developed within 1 week of any COVID-19 symptom onset in 25.4% of respondents, but more than 1 month after symptom onset in 43.4% of respondents. Parosmia was associated with significantly better quantitative olfactory scores on Brief Smell Identification Test (8.7 vs. 7.5, P = .006), but demonstrated worse quality of life scores, including modified brief Questionnaire of Olfactory Dysfunction-Negative Statements and Sino-Nasal Outcome Test-22 scores (12.1 vs. 8.5, P < .001; 26.2 vs. 23.2, P = .113). Participants who developed parosmia at any point were significantly younger and less likely to have history of chronic sinusitis than those who did not develop parosmia (40.2 vs. 44.9 years, P = .007; 7.2% vs. 0.7%, P = .006).

Conclusion: COVID-19-associated olfactory dysfunction is frequently linked with development of parosmia, which often presents either at onset of smell loss or in a delayed fashion. Despite better quantitative olfactory scores, respondents with parosmia report decreased quality of life. A majority of respondents with persistent parosmia have sought treatment.

Level of evidence: 3 Laryngoscope, 132:633-639, 2022.

Keywords: COVID-19 infection; Olfactory dysfunction; anosmia; parosmia; quality of life.

© 2021 The American Laryngological, Rhinological and Otological Society, Inc.

Figures

Fig 1
Fig 1
Time from initial symptom onset to parosmia. [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]
Fig 2
Fig 2
Time from initial olfactory symptoms to any improvement. [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]

References

    1. Vaira LA, Salzano G, Deiana G, De Riu G. Anosmia and ageusia: common findings in COVID‐19 patients. Laryngoscope 2020;130:1787. 10.1002/lary.28692.
    1. Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The prevalence of olfactory and gustatory dysfunction in COVID‐19 patients: a systematic review and meta‐analysis. Otolaryngol Head Neck Surg 2020;163:3–11. 10.1177/0194599820926473.
    1. Moein ST, Hashemian SMR, Mansourafshar B, Khorram‐Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for COVID‐19. Int Forum Allergy Rhinol 2020;10:944–950. 10.1002/alr.22587.
    1. Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss of function as a possible symptom of COVID‐19. JAMA Otolaryngol Head Neck Surg 2020;146:674–675. 10.1001/jamaoto.2020.0832.
    1. Meng X, Deng Y, Dai Z, Meng Z. COVID‐19 and anosmia: a review based on up‐to‐date knowledge. Am J Otolaryngol 2020;41:102581. 10.1016/j.amjoto.2020.102581.
    1. Brelie LF, Becker C, Brelie CV. Parosmia as an early symptom of acute SARS‐CoV‐2 infection. Dtsch Arztebl Int 2020;117:328. 10.3238/arztebl.2020.0328.
    1. Whitcroft KL, Hummel T. Olfactory dysfunction in COVID‐19: diagnosis and management. JAMA 2020;323:2512–2514. 10.1001/jama.2020.8391.
    1. Pierron D, Pereda‐Loth V, Mantel M, et al. Smell and taste changes are early indicators of the COVID‐19 pandemic and political decision effectiveness. Nat Commun 2020;11:5152. 10.1038/s41467-020-18963-y.
    1. Gerkin RC, Ohla K, Veldhuizen MG, et al. Recent smell loss is the best predictor of COVID‐19 among individuals with recent respiratory symptoms. Chem Senses 2021;46:1–12. 10.1093/chemse/bjaa081.
    1. Parma V, Ohla K, Veldhuizen MG, et al. More than smell—COVID‐19 is associated with severe impairment of smell, taste, and chemesthesis. Chem Senses 2020;45:609–622. 10.1093/chemse/bjaa041.
    1. Leopold D. Distortion of olfactory perception: diagnosis and treatment. Chem Senses 2002;27:611–615. 10.1093/chemse/27.7.611.
    1. DeVere R. Disorders of taste and smell. Continuum (Minneap Minn) 2017;23:421–446. 10.1212/CON.0000000000000463.
    1. Spinato G, Fabbris C, Polesel J, et al. Alterations in smell or taste in mildly symptomatic outpatients with SARS‐CoV‐2 infection. JAMA 2020;323:2089–2090. 10.1001/jama.2020.6771.
    1. Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS. Association of chemosensory dysfunction and COVID‐19 in patients presenting with influenza‐like symptoms. Int Forum Allergy Rhinol 2020;10:806–813. 10.1002/alr.22579.
    1. Giacomelli A, Pezzati L, Conti F, et al. Self‐reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross‐sectional study. Clin Infect Dis 2020;71:889–890. 10.1093/cid/ciaa330.
    1. Bagheri SH, Asghari A, Farhadi M, et al. Coincidence of COVID‐19 epidemic and olfactory dysfunction outbreak in Iran. Med J Islam Repub Iran 2020;34:62. 10.34171/mjiri.34.62.
    1. Lechien JR, Chiesa‐Estomba CM, de Siati DR, 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;277:2251–2261. 10.1007/s00405-020-05965-1.
    1. Mehraeen E, Behnezhad F, Salehi MA, Noori T, Harandi H, SeyedAlinaghi SA. Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID‐19): a review of current evidence. Eur Arch Otorhinolaryngol 2021;278:307–312. 10.1007/s00405-020-06120-6.
    1. Mueller A, Rodewald A, Reden J, Gerber J, von Kummer R, Hummel T. Reduced olfactory bulb volume in post‐traumatic and post‐infectious olfactory dysfunction. NeuroReport 2005;16:475–478. 10.1097/00001756-200504040-00011.
    1. Rombaux P, Potier H, Markessis E, Duprez T, Hummel T. Olfactory bulb volume and depth of olfactory sulcus in patients with idiopathic olfactory loss. Eur Arch Otorhinolaryngol 2010;267:1551–1556. 10.1007/s00405-010-1230-2.
    1. Iannilli E, Leopold DA, Hornung DE, Hummel T. Advances in understanding parosmia: an fMRI study. ORL J Otorhinolaryngol Relat Spec 2019;81:185–192. 10.1159/000500558.
    1. Leopold DA, Schwob JE, Youngentob SL, Hornung DE, Wright HN, Mozell MM. Successful treatment of phantosmia with preservation of olfaction. Arch Otolaryngol Head Neck Surg 1991;117:1402–1406. 10.1001/archotol.1991.01870240094016.
    1. Mattos JL, Edwards C, Schlosser RJ, et al. A brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 2019;9:1144–1150. 10.1002/alr.22392.
    1. Reiter ER, Coelho DH, Kons ZA, Costanzo RM. Subjective smell and taste changes during the COVID‐19 pandemic: short term recovery. Am J Otolaryngol 2020;41:102639. 10.1016/j.amjoto.2020.102639.
    1. Bonfils P, Avan P, Faulcon P, Malinvaud D. Distorted odorant perception: analysis of a series of 56 patients with parosmia. Arch Otolaryngol Head Neck Surg 2005;131:107–112. 10.1001/archotol.131.2.107.
    1. Ciurleo R, de Salvo S, Bonanno L, Marino S, Bramanti P, Caminiti F. Parosmia and neurological disorders: a neglected association. Front Neurol 2020;11:543275. 10.3389/fneur.2020.543275.
    1. Hawkes C. Parosmia: treatment, mechanism, and types. BMJ 2020;371:m4739. 10.1136/bmj.m4739.
    1. Boesveldt S, Postma EM, Boak D, et al. Anosmia—a clinical review. Chem Senses 2017;42:513–523. 10.1093/chemse/bjx025.
    1. Doty RL. Age‐related deficits in taste and smell. Otolaryngol Clin North Am 2018;51:815–825. 10.1016/j.otc.2018.03.014.
    1. Scangas GA, Bleier BS. Anosmia: differential diagnosis, evaluation, and management. Am J Rhinol Allergy 2017;31:3–7. 10.2500/ajra.2017.31.4403.
    1. Vennemann MM, Hummel T, Berger K. The association between smoking and smell and taste impairment in the general population. J Neurol 2008;255:1121–1126. 10.1007/s00415-008-0807-9.
    1. Fjaeldstad AW, Ovesen T, Hummel T. The association between smoking on olfactory dysfunction in 3,900 patients with olfactory loss. Laryngoscope 2021;131:E8–E13. 10.1002/lary.28552.
    1. Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life—an updated review. Chem Senses 2014;39:185–194. 10.1093/chemse/bjt072.
    1. Neuland C, Bitter T, Marschner H, Gudziol H, Guntinas‐Lichius O. Health‐related and specific olfaction‐related quality of life in patients with chronic functional anosmia or severe hyposmia. Laryngoscope 2011;121:867–872. 10.1002/lary.21387.
    1. Klopfenstein T, Kadiane‐Oussou NJ, Toko L, et al. Features of anosmia in COVID‐19. Med Mal Infect 2020;50:436–439. 10.1016/j.medmal.2020.04.006.
    1. Liu DT, Sabha M, Damm M, et al. Parosmia is associated with relevant olfactory recovery after olfactory training. Laryngoscope 2021;131:618–623. 10.1002/lary.29277.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel