Self-reported olfactory and gustatory dysfunctions in COVID-19 patients: a 1-year follow-up study in Foggia district, Italy

Francesca Fortunato, Domenico Martinelli, Giuseppina Iannelli, Marica Milazzo, Umberto Farina, Gabriella Di Matteo, Rosella De Nittis, Leonardo Ascatigno, Michele Cassano, Pier Luigi Lopalco, Rosa Prato, Francesca Fortunato, Domenico Martinelli, Giuseppina Iannelli, Marica Milazzo, Umberto Farina, Gabriella Di Matteo, Rosella De Nittis, Leonardo Ascatigno, Michele Cassano, Pier Luigi Lopalco, Rosa Prato

Abstract

Background: From the initial stages of the pandemic in early 2020, COVID-19-related olfactory and gustatory dysfunctions have been widely reported and are emerging as one of the most frequent long-term sequelae of SARS-CoV-2 infection. However, data regarding the long-term recovery of the sense of smell and taste are lacking. This study aimed to characterize the evolution up to one year after the diagnosis of self-reported olfactory and gustatory dysfunctions in COVID-19 cases.

Methods: Based on the data of the active surveillance platform of the Apulia region, Italy, we selected the residents of Foggia district who were confirmed positive for SARS-CoV-2 from March 1st to June 16th, 2020, and home-quarantined with paucisymptomatic-to-mild clinical presentation. Self-reported olfactory and gustatory dysfunctions were recorded at baseline through a survey of dichotomous questions. The evolution of these symptoms at approximately one year was prospectively assessed via telephone by the validated sino-nasal outcome test 22 (SNOT-22, Italian version).

Results: Among the 1,175 COVID-19 cases notified in the Foggia district during the first epidemic wave, 488 had paucisymptomatic-to-mild clinical presentation. Of these, 41.2% (n = 201, 95% confidence interval [CI] 36.8-45.7%) reported at least one sensory dysfunction. A total of 178 to 201 (88.5%) patients agreed to participate in the follow-up survey. According to the SNOT-22 results, the persistence of a sensory dysfunction was observed in the 29.8% (n = 53, 95% CI 23.2-37.1%) of them. Particularly, loss of smell persisted in 25.8% (n = 46, 95% CI 19.6-32.9%), loss of taste in 21.3% (n = 38, 95% CI 15.6-28.1%), loss of both in 17.4% (n = 31, 95% CI 12.2-23.8%) of participants in the follow-up. The rates of full recovery increased over time: from 59% at 30 days to 71.9% at 90 days for the sense of smell; from 61.3% at 30 days to 74.7% at 90 days for the sense of taste.

Conclusions: The persistence of COVID-19-related olfactory and gustatory dysfunctions up to 12 months after the disease onset in a noteworthy proportion (approximately 3 out of 10) of patients with paucisymptomatic-to-mild clinical presentation deserves further investigations due to its possible pathophysiological implications and impact on the quality of life.

Keywords: Ageusia; Anosmia; COVID-19; Long COVID, Italy; Prevalence; Recovery; Sensory dysfunctions.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of the study of self-reported olfactory and gustatory dysfunctions in COVID-19 cases. District of Foggia (Apulia region, Italy), March 1st, 2020—June 16th, 2021
Fig. 2
Fig. 2
Kaplan–Meier estimates showing the rate of complete recovery of self-reported olfactory A and gustatory B dysfunctions in COVID-19 cases. District of Foggia (Apulia region, Italy), March 1st, 2020—June 16th, 2021

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