Association of subjective olfactory dysfunction and 12‐item odor identification testing in ambulatory COVID‐19 patients

Abstract

Background Acute loss of smell and taste are well‐recognized symptoms of coronavirus disease 2019 (COVID‐19), yet the correlation between self‐reported and psychophysical olfactory function remains unclear. Understanding the reliability of self‐reported smell loss in ambulatory cases can assess the utility of this screening measure. Methods A prospective, longitudinal study evaluating patient‐reported and measured olfactory function using the validated 12‐item Brief Smell Identification Test (BSIT) was conducted on adult outpatients with COVID‐19. Patient‐reported olfaction scores using a visual analog scale (VAS) were obtained at baseline, time of COVID‐19 testing, and time of BSIT completion. Linear associations between VAS and BSIT were evaluated using Spearman's correlation coefficient and the sensitivity, specificity, and accuracy of VAS scores were calculated. Logistic regression identified characteristics associated with accurate assessment of olfactory function. Results A total of 81 polymerase chain reaction (PCR)‐confirmed COVID‐19 positive subjects, of whom 54 self‐reported smell loss, were prospectively recruited ≤5 days from diagnosis date between May 8, 2020, and July 8, 2020. Self‐reported smell loss had good discriminative ability in identifying abnormal BSIT (area under receiver operating curve [AUC] 0.82, 95% confidence interval [CI], 0.71 to 0.92). A VAS <5 demonstrated sensitivity of 0.62 and specificity of 0.94 for predicting hyposmia (BSIT ≤8) with accuracy of 82.7%, whereas a VAS <9 had highest sensitivity at 0.86. Moderate bivariate linear associations were found between VAS and BSIT scores (rs = 0.59, p < 0.001). Conclusion Self‐reported olfactory loss associated with COVID‐19 has a strong ability to predict abnormal olfactory function though the 2 measures are moderately correlated. Subjective olfactory assessment is useful in screening olfactory dysfunction at early disease time points when psychophysical testing cannot be conducted.

Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: a community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK

“…Our results show that objectively assessed smell function using UPSIT correlates well with perceived smell function in this population, which highlights the reliability of our subjective patient-reported data on smell function following COVID-19. This finding is in line with a study conducted in ambulatory COVID-19 patients using the 12-item Brief Smell Identification Test (BSIT) which also concluded that self-reported olfactory loss is a strong predictor of abnormal olfactory function [39]. Furthermore, this highlights that in this subsample, tested 21.6 ± 4.7 weeks since the onset of their symptoms, 20% of participants had ongoing loss of their sense of smell, who would meet diagnostic criteria for both long-COVID and chronic COVID-19.…”

Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: A community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK

“…Our results show that objectively assessed smell function using UPSIT correlates well with perceived smell function in this population, which highlights the reliability of our subjective patient-reported data on smell function following COVID-19. This nding is in line with a study conducted in ambulatory COVID-19 patients using the 12-item Brief Smell Identi cation Test (BSIT) which also concluded that self-reported olfactory loss is a strong predictor of abnormal olfactory function [38]. Furthermore, this highlights that in this subsample, tested 21.6 ±4.7 weeks since the onset of their symptoms, 20% of participants had ongoing loss of their sense of smell, who would meet diagnostic criteria for both long-COVID and chronic COVID-19.…”

International consensus statement on allergy and rhinology: rhinosinusitis 2021

“…The prevalence of olfactory dysfunction has varied widely between 15% and 96% based on self‐reported and quantitatively measured data 115–117 . The ability to accurately recognize one's olfactory impairment is debated, 115,2476–2479 but self‐reported olfactory assessment is valuable for initial screenings when psychophysical testing cannot be conducted 2476 . Clinical implications of olfactory dysfunction as a prognostic marker for the disease also remain controversial 2480–2484 .…”