More than smell - COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

Abstract

Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, generally lacked quantitative measurements, were mostly restricted to data from single countries. Here, we report the development, implementation and initial results of a multi-lingual, international questionnaire to assess self-reported quantity and quality of perception in three distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, 8 other, ages 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± SD), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell, but also affects taste and chemesthesis. The multimodal impact of COVID-19 and lack of perceived nasal obstruction suggest that SARS-CoV-2 infection may disrupt sensory-neural mechanisms.

Evolution of Olfactory Disorders in COVID‐19 Patients

“…It could suggest that there were trigeminal effects of SARS-CoV-2 on nasal cavities in those subjects. By contrast, a reduction of chemesthesis (like burning, cooling, or tingling) in the mouth was reported in about 46% of subjects in Parma et al 26 The limitations of our study are: 1) recall bias due to retrospective phone call; 2) lack of objective olfactory assessment because of the high risk of COVID-19 exposure to healthcare workers; 3) short follow-up; and 4) unknown prevalence of olfactory disorders in patients with serious conditions. In order to minimize the selection bias by selfselected group using internet or the app such as online surveys, we tried to call all patients from the database of our hospital.…”

Proteomics Insights Into the Molecular Basis of SARS-CoV-2 Infection: What We Can Learn From the Human Olfactory Axis

“…Apart from the respiratory system, other tissues such as the small intestine, renal tubules, and arterial smooth muscle cells are vulnerable to SARS-CoV-2 infection because of their high expression of ACE2 (Zou et al, 2020). Among other symptoms, olfactory loss is the early predominant neurological symptom (Baig et al, 2020;Lechien et al, 2020;Moein et al, 2020;Parma et al, 2020). The nasal cavity is one of the routes of SARS-CoV-2 entry, where the presence of ACE2 and TMPRSS2 in stem cells and olfactory epithelial support cells is higher than that in olfactory sensory neurons (Brann et al, 2020;Ueha et al, 2020), suggesting that the first group may be partially responsible for the olfactory dysfunction observed in patients with COVID-19.…”

“…Since the outbreak of the pandemic in Wuhan (China) in December 2019, coronavirus infectious disease 2019 (COVID-19) has spread globally, causing a crisis not only in our healthcare systems but also in the world economy (Dong et al, 2020;Wu et al, 2020c;Zhou et al, 2020). Among other symptoms, patients with COVID-19 present with anosmia, fever, cough, and dyspnea (Parma et al, 2020;Wu et al, 2020b). Unfortunately, specific treatments are still lacking and the scientific community is struggling to develop new therapeutic combinations and discover effective vaccines.…”

Manifestaciones Orales de la Infección por COVID-19

“…La quimioestesis detecta otros químicos, encontrados en hierbas o especias, que evocan sensaciones como ardor, enfriamiento u hormigueo. A menudo, estas modalidades se combinan y transfieren una experiencia única de sabor durante la comida, por ello es frecuente que, al existir una pérdida del olfato retronasal y alteración en el sistema somatosensorial, que transmite quimioestesis, se informe como una pérdida de gusto (Parma et al, 2020). Las alteraciones quimiosensoriales de estos sistemas pueden resultar en cambios del gusto y olfato cuantitativos (anosmia, hiposmia; ageusia, hipogeusia) y cualitativos (disgeusia, parosmia) respectivamente (Sepúlveda et al, 2020).…”