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Sekine R, Hernandez AK, Overbeck C, Hofer MK, Mori E, Hähner A, Hummel T. Comparison of Patient Characteristics and Olfactory Sensitivity for Trigger Odorants in Parosmia and Phantosmia. Laryngoscope 2024. [PMID: 38578016 DOI: 10.1002/lary.31379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/30/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aimed to determine the characteristics of patients with qualitative olfactory dysfunction (qualOD) and whether individuals with parosmia exhibit increased olfactory sensitivity to previously reported odorous triggers of parosmia. METHODS This study included individuals aged ≥18 years, divided into quantitative OD only, parosmia, and phantosmia groups. Data collected included: clinical-demographic data, "Sniffin' Sticks" scores, questionnaires (depression scale, importance of olfaction), and information about parosmia and phantosmia. A proportion of patients underwent trigger odor threshold testing for 2-Furfurylthiol [FFT] found in coffee and 2,6-nonadienal [Nonadienal] found in cucumber. RESULTS Those with parosmia were typically younger women, with shorter OD duration due to post-viral OD (PVOD), hyposmic/normosmic, and experienced parosmia more severely. Parosmia was 3.5 times more likely in PVOD. Those with phantosmia were older, with longer OD duration due to idiopathic OD, hyposmic/anosmic, and experienced phantosmia less severely. There were no significant differences between FFT and Nonadienal threshold scores in patients with parosmia, phantosmia, or only quantitative OD, but all groups had significantly increased olfactory sensitivity for trigger odors compared to phenyl ethyl alcohol (PEA). CONCLUSION Parosmia and phantosmia patients have distinct characteristics. This may provide clinicians with a better understanding of possible olfactory outcomes in these patients. The higher olfactory sensitivity of all groups to trigger odors compared to PEA raises interesting points about parosmia triggers and odors in the context of warning for danger, in relation to the pathophysiology of parosmia that may be worth exploring in future studies. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Rumi Sekine
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Anna Kristina Hernandez
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
- Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
| | - Clara Overbeck
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marlise K Hofer
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eri Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Vaira LA, De Riu G, Mayo-Yáñez M, Boscolo-Rizzo P, Lechien JR. The importance of identifying risk factors for the persistence of COVID-19 related olfactory disorders. Am J Otolaryngol 2024; 45:104114. [PMID: 38029533 DOI: 10.1016/j.amjoto.2023.104114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/21/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy.
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Miguel Mayo-Yáñez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of A Coruña (CHUAC), A Coruña, Spain
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
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Schepens EJA, Boek WM, Boesveldt S, Stokroos RJ, Stegeman I, Kamalski DMA. One-year psychophysical evaluation of COVID-19-induced olfactory disorders: a prospective cohort study. BMC Med 2023; 21:490. [PMID: 38066629 PMCID: PMC10709885 DOI: 10.1186/s12916-023-03205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Olfactory disorders are common in COVID-19. While many patients recover within weeks, a notable number of patients suffer from prolonged olfactory disorders. Much research has focused on the acute phase of olfactory disorders in COVID-19; however, there is still inconsistency regarding the prognosis. We aim to assess both objective and subjective olfactory function in patients with persisting olfactory disorders following COVID-19, 1 year after diagnosis. METHODS We objectively measured olfactory function in 77 patients who initially had COVID-19-induced smell disorders, 1 year after confirmed diagnosis. These patients previously underwent two objective measurements at approximately 3 and 6 months after COVID-19, in the context of the COCOS trial (COrticosteroids for COvid-19-induced loss of Smell). The main outcome measurement was TDI score (threshold-discrimination-identification) on Sniffin' Sticks Test (SST). Secondary outcomes included objective gustatory function on Taste Strip Test (TST), self-reported olfactory, gustatory and trigeminal function on a visual analogue scale (VAS) and outcomes on questionnaires about quality of life, and nasal symptoms. RESULTS The findings of this study show that 1 year following COVID-19, the median TDI score increased to 30.75 (IQR 27.38-33.5), regarded as normosmia. The median TDI score started at 21.25 (IQR 18.25-24.75) at baseline and increased to 27.5 (IQR 23.63-30.0) at 6 months following COVID-19. The increase of 9.5 points on the TDI score between baseline and 1 year after COVID-19 marks a clinically relevant improvement. Regarding the self-reported VAS score (1-10) on sense of smell, it increased from 1.2 (IQR 0.4-3.0) at baseline to 3.2 (IQR 1.4-6.0) at 6 months and further improved up to 6.1 (IQR 2.7-7.5) after 1 year. Objective gustatory function increased with 2 points on TST a year after diagnosis. Self-reported olfactory, gustatory, and trigeminal functions also improved over time, as did quality of life. CONCLUSIONS Objective and self-reported olfactory function continued to improve 1 year after COVID-19. The median TDI score of 30.75 (IQR 27.38-33.5) is regarded as normosmia, which is a favorable outcome. However, the rate of improvement on TDI score reduces over time.
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Affiliation(s)
- Emma J A Schepens
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, P.O. Box 85500, Utrecht, 3508 GA, The Netherlands.
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Wilbert M Boek
- Department of Otorhinolaryngology- Head and Neck Surgery, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, P.O. Box 85500, Utrecht, 3508 GA, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, P.O. Box 85500, Utrecht, 3508 GA, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Digna M A Kamalski
- Department of Otorhinolaryngology- Head and Neck Surgery, University Medical Center Utrecht, P.O. Box 85500, Utrecht, 3508 GA, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Boscolo-Rizzo P, Spinato G, Hopkins C, Marzolino R, Cavicchia A, Zucchini S, Borsetto D, Lechien JR, Vaira LA, Tirelli G. Evaluating long-term smell or taste dysfunction in mildly symptomatic COVID-19 patients: a 3-year follow-up study. Eur Arch Otorhinolaryngol 2023; 280:5625-5630. [PMID: 37715807 DOI: 10.1007/s00405-023-08227-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION No studies have reported data on 3-year prevalence and recovery rates of self-reported COVID-19-related olfactory and gustatory dysfunction. The aim of the present study was to estimate the 3-year prevalence and recovery rate of self-reported COVID-19-related chemosensory dysfunction in a cohort of patients with antecedent mild COVID-19. METHODS This is a prospective observational study, measuring the prevalence of altered sense of smell or taste at follow-up and their variation from baseline, on adult patients consecutively assessed at Treviso and Trieste University Hospitals, who tested positive for SARS-CoV-2 RNA by polymerase chain reaction during March 2020. RESULTS Overall, out of 403 respondents, 267 patients (66.3%) reported an altered sense of smell or taste (SNOT-22 > 0) at baseline, while 56 (13.9%), 29 (7.2%), and 21 (5.2%) reported such alterations at 6-24 months, 2 years, and 3 years, respectively. Among the 267 patients with COVID-19-associated smell or taste dysfunction at baseline, 246 (92.1%) reported complete resolution at 3 years. Of the patients who still experienced smell or taste dysfunction 2 years after COVID-19, 27.6% and 37.9% recovered completely and partially, respectively, at the 3-year follow-up. CONCLUSION Among subjects with antecedent mildly symptomatic SARS-CoV-2 infection, the 3-year prevalence and recovery rate of COVID-19-related alteration in sense of smell or taste was 5% and 92%, respectively. In approximately two-thirds of patients experiencing chemosensory dysfunction still 2 years after COVID-19, it is still possible to observe a delayed complete or partial recovery after a period of 3 years, while the remaining one-third of individuals continues to have unchanged persistent chemosensory alteration.
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Affiliation(s)
- Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy.
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
| | | | - Riccardo Marzolino
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
| | - Angelo Cavicchia
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
| | - Simone Zucchini
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jerome R Lechien
- Department of Laryngology, EpiCURA Hospital, Mons School of Medicine, University of Mons, Mons, Belgium
| | - Luigi Angelo Vaira
- Department of Medicine, Surgery and Pharmacy, Maxillofacial Surgery Operative Unit, University of Sassari, Sassari, Italy
- PhD School of Biomedical Sciences, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada Di Fiume 447, 34149, Trieste, Italy
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Cancellieri E, Hernandez AK, Degkwitz H, Kahre E, Blankenburg J, Horst TS, Czyborra P, Boscolo-Rizzo P, Hummel T. Subjective Perception of Recovery and Measured Olfactory Function in COVID-19 Patients. Viruses 2023; 15:1418. [PMID: 37515106 PMCID: PMC10386638 DOI: 10.3390/v15071418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
This cross-sectional study aimed to investigate self-rated olfactory dysfunction in relation to measured olfactory function after partial or complete subjective recovery in individuals with a history of coronavirus disease 2019 (COVID-19) infection. A total of 186 individuals (aged 5-62 years) with a history of COVID-19 infection were included. Visual analogue scale (VAS) ratings for olfactory function (before, during, and after infection) and age-appropriate psychophysical olfactory test scores (odor threshold and odor identification: "Sniffin' Sticks" for adults and both "Sniffin' Sticks" and "U-Sniff" for children) were determined. Participants were assigned to four "age groups" and three "recovery classes" (incomplete recovery, complete recovery, no smell loss). Surprisingly, there were no significant differences in odor threshold and adult identification scores between the "recovery classes". However, children with "incomplete recovery" had lower identification scores than those with "complete recovery" (p = 0.033) and those with "no smell loss" (p = 0.022). The pediatric age groups had significantly higher VAS ratings during and after COVID-19 compared to older participants. Older individuals experienced greater magnitude of changes in their sense of smell after COVID-19 infection, but those with parosmia were 3.5 times more likely to report "incomplete recovery" of olfaction after COVID-19. The general prognosis for olfactory recovery after COVID-19 is good but appears to be particularly confounded by the presence of parosmia, leading patients to subjectively report incomplete olfactory recovery. Although it is of high significance to monitor recovery using validated psychophysical olfactory tests, subjective measures of olfaction help provide specific insight, especially for qualitative olfactory dysfunction.
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Affiliation(s)
- Emilia Cancellieri
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy
| | - Anna Kristina Hernandez
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Department of Otolaryngology, Head and Neck Surgery, Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines
- Department of Otolaryngology, Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa 1780, Philippines
| | - Helena Degkwitz
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Elisabeth Kahre
- Department of Pediatric Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Judith Blankenburg
- Department of Pediatric Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Theresa S Horst
- Department of Pediatric Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Paula Czyborra
- Department of Pediatric Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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