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

Document Type : Original

Authors

1 Department of ENT, JJM Medical College, Davanagere, Karnataka, India.

2 Department of General Medicine, SS Institute of Medical Sciences and Research Centre, Davanagere, Karnataka, India.

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.

Keywords

Main Subjects

References

  1. Speth MM, Singer-Cornelius T, Oberle M, Gengler I, Brockmeier SJ, Sedaghat AR. Olfactory dysfunction and sinonasal symptomatology in COVID-19: prevalence, severity, timing, and associated characteristics. Otolaryngol Head Neck Surg. 2020 Jul;163(1): 114-120. doi: 10.1177/ 0194599820929185.
  2. Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: What we know. Int J Infect Dis. 2020;94: 44-48. doi:10.1016/j.ijid.2020.03.004
  3. Guo YR et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak—an update on the status. Mil Med Res. 2020 Mar 13;7(1):11. doi:10.1186/s40779-020-00240-0.
  4. Chan JYK, Wong EWY, Lam W. Practical aspects of otolaryngologic clinical services during the 2019 novel coronavirus epidemic: an experience in Hong Kong. JAMA Otolaryngol Head Neck Surg. 2020;146:519. doi: 10.1001/jamaoto. 2020. 0488.
  5. Sun P, Qie S, Liu Z, Ren J, Li K, Xi J. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis. J Med Virol. 2020 Jun;92(6):612-617. doi: 10.1002/jmv. 25735.
  6. Guan WJ et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056 /NE JMoa2002032. 
  7. Whitcroft KL, Hummel T. Olfactory Dysfunction in COVID-19: Diagnosis and Management. JAMA. 2020 Jun 23;323(24):2512-2514. doi: 10.1001/ jama. 2020.8391.
  8. Huang C et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
  9. Wang D et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama. 2020. 1585.
  10. Lovato A, de Filippis C. Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms. Ear Nose Throat J. 2020 Nov; 99(9):569-576. doi: 10.1177/0145561320920762.
  11. Rodriguez-Morales AJ et al. Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020 Mar-Apr;34:101623. doi: 10.1016/j.tmaid.2020.101623.
  12. Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020 Jun 1;58(3):295-298. doi: 10.4193/ Rhin20.116.
  13. 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): 113-18.
  14. Dalton P. Olfaction and anosmia in rhinosinusitis. Curr Allergy Asthma Rep. 2004 May;4(3):230-6. doi: 10.1007/s11882-004-0031-3.
  15. Desforges M et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportu nistic Pathogens of the Central Nervous System? Viruses. 2019 Dec 20; 12(1):14. doi: 10. 3390/v12010014.
  16. Meyerholz DK, 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;7264-7275.
  17. Philpott C, DeVere R. Post-infectious and post-traumatic olfactory loss. In Welge-Luessen A, Hummel T, editors, Management of Smell and Taste Disorders: A Practical Guide for Clinicians. Thieme. 2013.
  18. Hummel T et al. Position paper on olfactory dysfunction. Rhinology. 2016 Jan 31;56(1):1-30. doi: 10.4193/Rhino16.248.
  19. Government of India Ministry of Health & Family Welfare Directorate General of Health Services (EMR Division) (March 2020). Revised Guidelines on Clinical Management of COVID – 19. https:// www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf
  20. Borsetto D et al. 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 Oct 1;58(5):430-436. doi: 10.4193/Rhin20.185.
  21. Moein ST, Hashemian SM, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol. 2020 Aug;10(8):944-950. doi: 10. 1002/alr.22587.
  22. Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS. Self-reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol. 2020 Jul;10(7):821-831. doi: 10.1002/alr.22592.
  23. Vaira LA et al. 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 Aug 6;49(1):56. doi: 10.1186/s40463-020-00449-y.
  24. Klopfenstein T et al. Features of anosmia in COVID-19. Med Mal Infect. 2020 Aug;50(5):436-439. doi: 10.1016/j.medmal.2020.04.006.
  25. Whitcroft KL, Hummel T. Clinical Diagnosis and Current Management Strategies for Olfactory Dysfunction: A Review. JAMA Otolaryngol Head Neck Surg. 2019 Sep 1;145(9):846-853. doi: 10. 1001/jamaoto.2019.1728.
  26. Addison AB et al. Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction. J Allergy Clin Immunol. 2021 May; 147(5):1704-1719. doi: 10. 1016/j. jaci.2020.12.641.
  27. Tan BKJ et al. Prognosis and persistence of smell and taste dysfunction in patients with covid-19: meta-analysis with parametric cure modelling of recovery curves. BMJ. 2022 Jul 27;378:e069503. doi: 10.1136/ bmj-2021-069503.
  28. Vaira LA et al. The Effects of Persistent Olfactory and Gustatory Dysfunctions on Quality of Life in Long-COVID-19 Patients. Life (Basel). 2022 Jan 19;12(2):141. doi: 10.3390/life12020141.
Iranian Journal of Otorhinolaryngology
Volume 36, Issue 3
May and June 2024
Pages 459-466

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