Taste and Smell Disorders in COVID-19 Patients: Role of Interleukin-6

Angela P Cazzolla, Roberto Lovero, Lorenzo Lo Muzio, Nunzio F Testa, Annalisa Schirinzi, Giuseppe Palmieri, Pietro Pozzessere, Vito Procacci, Mariasevera Di Comite, Domenico Ciavarella, Maria Pepe, Caterina De Ruvo, Vito Crincoli, Francesca Di Serio, Luigi Santacroce, Angela P Cazzolla, Roberto Lovero, Lorenzo Lo Muzio, Nunzio F Testa, Annalisa Schirinzi, Giuseppe Palmieri, Pietro Pozzessere, Vito Procacci, Mariasevera Di Comite, Domenico Ciavarella, Maria Pepe, Caterina De Ruvo, Vito Crincoli, Francesca Di Serio, Luigi Santacroce

Abstract

The rapid recovery of smell and taste functions in COVID-19 patients could be attributed to a decrease in interleukin-6 levels rather than central nervous system ischemic injury or viral damage to neuronal cells. To correlate interleukin-6 levels in COVID-19 patients with olfactory or gustatory dysfunctions and to investigate the role of IL-6 in the onset of these disorders, this observational study investigated 67 COVID-19 patients with taste or smell disorders or both, who did not require intensive care admission, admitted at COVID Hospital of Policlinico of Bari from March to May 2020. Interleukin-6 was assayed in COVID-19 patients with taste or smell disturbances at the time of admission and at the time of swab negativization. At the same time, patients have been given a specific survey to evaluate the severity of taste and smell disturbances. Of 125 patients with smell or taste dysfunctions at onset of disease, 67 fulfilled the inclusion criteria, while 58 were excluded because 35 of them required intensive care admission, 5 were unable to answer, 5 died, 7 had finished chemotherapy recently, and 5 refused to participate. The evaluation of taste and smell disorders was carried out using a survey performed at the time of admission and at the time of swab negativization. Sinonasal outcome test 22 (SNOT-22) was used as a reference for olfactory function assessment, and Taste and Smell Questionnaire Section of the US NHANES 2011-2014 protocol (CDC 2013b) was used as reference for gustatory function assessment. A venous blood sample was taken for each patient to measure IL-6 levels upon entry and at swab negativization. Interleukin-6 levels in COVID-19 patients in relation to olfactory or gustatory disorders were correlated from the time of their admission to the time of swab negativization. Statistically significant correlations were obtained between the decrease of interleukin-6 levels and the improvement of smell (p value < 0.05) and taste (p = 0.047) functions at swab negativization. The acquired results demonstrate the key role of interleukin-6 in the pathogenesis of chemosensitive disorders in COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; anosmia; dysgeusia; immune-mediated neurological syndromes; interleukin-6 (IL-6).

Conflict of interest statement

The authors declare no competing financial interest.

Figures

Figure 1
Figure 1
(a) Sex distribution of IL-6 levels at the first evaluation; (b) sex distribution of IL-6 levels at the second evaluation; (c) sex distribution of the delta (values at the first evaluation minus values at the second evaluation) value of IL-6 levels; (d) sex distribution of the delta score of smell; (e) sex distribution of the delta score of taste.
Figure 2
Figure 2
(a) IL-6 and (b) smell and (c) taste score distributions in COVID-19 patients at first and second evaluation.

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