Chemosensory Dysfunction 3-Months After COVID-19, Medications and Factors Associated with Complete Recovery

Abstract

Objectives: To examine the longitudinal prevalence and recovery of olfactory, gustatory, and oral chemesthetic deficits in a sizable cohort of SARS-CoV-2 infected persons using quantitative testing. To determine whether demographic and clinical factors, mainly the medications used after the COVID-19 diagnosis, influence the test measures. Methods: Prospective cohort in a hospital with primary, secondary, tertiary, and quaternary care. Patients with confirmed COVID-19 were tested during the acute infection phase (within 15 days of initial symptom, n = 187) and one (n = 113) and 3 months later (n = 73). The University of Pennsylvania Smell Identification Test, the Global Gustatory Test, and a novel test for chemesthesis were administered at all visits. Results: During the acute phase, 93% were anosmic or microsmic and 29.4% were hypogeusic. No one was ageusic. A deficit in oral chemesthesis was present in 13.4%. By 3 months, taste and chemesthesis had largely recovered, however, some degree of olfactory dysfunction remained in 54.8%. Remarkably, patients who had been treated with anticoagulants tended to have more olfactory improvement. Recovery was greater in men than in women, but was unrelated to disease severity, smoking behavior, or the use of various medications prior to, or during, COVID-19 infection. Conclusions: When using quantitative testing, olfactory disturbances were found in nearly all SARS-CoV-2 infected patients during the acute infection phase. Taste or chemesthetic deficits were low. Olfactory impairment persisted to some degree in over half of the patients at the 3-month follow-up evaluation, being more common in women and less common in those who had been treated earlier with anticoagulants. Level of Evidence: 3

COVID‐19‐related chemosensory changes: Findings from a prospective national database

“…Neither the total number of comorbidities nor the number of medications used nor the use of any individual medications taken during active COVID‐19 infection queried in our survey (tylenol, nonsteroidal anti‐inflammatory drugs, zithromax, remdesivir, hydroxychloroquine, or chloroquine) were correlated with recovery status 10 . Similarly, Fornazieri et al 26 also found that the number of comorbidities, number of medications, or types of medications did not play a significant role in predicting smell recovery in 73 COVID‐19‐positive participants.…”

Clinical factors influencing olfactory performance in patients with persistent COVID‐19 smell loss longer than 1 year

“…So far, many articles have confirmed that both acute loss of sense of smell 2 , 37 following SARS‐CoV‐2 infection but also long‐term COVID‐19‐related OD 5 , 38 are more frequent in female subjects. In this regard, our study confirms that with two‐thirds of our patients (64.0%) being female and the majority of them found to be dysosmics at S'S.…”