Olfactory Dysfunction in Frontline Health Care Professionals During COVID-19 Pandemic in Brazil

Abstract

Upper respiratory viral infections can decrease the sense of smell either by inflammatory restriction of nasal airflow that carries the odorant molecules or through interference in olfactory sensory neuron function. During the coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), worldwide reports of severe smell loss (anosmia/hyposmia) revealed a different type of olfactory dysfunction associated with respiratory virus infection. Since self-reported perception of smell is subjective and SARS-CoV-2 exposure is variable in the general population, we aimed to study a population that would be more homogeneously exposed to the virus. Here, we investigated the prevalence of olfactory loss in frontline health professionals diagnosed with COVID-19 in Brazil, one of the major epicenters of the disease. We also analyzed the rate of olfactory function recovery and the particular characteristics of olfactory deficit in this population. A widely disclosed cross-sectional online survey directed to health care workers was developed by a group of researchers to collect data concerning demographic information, general symptoms, otolaryngological symptoms, comorbidities, and COVID-19 test results. Of the 1,376 health professionals who completed the questionnaire, 795 (57.8%) were working directly with COVID-19 patients, either in intensive care units, emergency rooms, wards, outpatient clinics, or other areas. Five-hundred forty-one (39.3%) participants tested positive for SARS-CoV-2, and 509 (37%) were not tested. Prevalence of olfactory dysfunction in COVID-19-positive subjects was 83.9% (454 of 541) compared to 12.9% (42 of 326) of those who tested negative and to 14.9% (76 of 509) of those not tested. Olfactory dysfunction incidence was higher in those working in wards, emergency rooms, and intensive care units compared to professionals in outpatient clinics. In general, remission from olfactory symptoms was frequent by the time of responses. Taste disturbances were present in 74.1% of infected participants and were significantly associated with hyposmia. In conclusion, olfactory dysfunction is highly correlated with exposure to SARS-CoV-2 in health care professionals, and remission rates up to 2 weeks are high.

Association between chemosensory impairment with neuropsychiatric morbidity in post-acute COVID-19 syndrome: results from a multidisciplinary cohort study

“…Although these dysfunctions are common in the early stages of infection, they are often overlooked by patients as perceived as harmlessness and common, with rates of approximately 3–20% of those who are affected by COVID-19, with a large severity range [ 7 ]. COVID-19 patients present rates of olfactory and gustatory disfunction of 41.0% and 38.2% [ 8 ], respectively, with some studies presenting prevalence as high as 83.9% [ 9 ]. Although complete recovery is common, 5% of the patients report no chemosensory recovery [ 10 ].…”

Neurological complications associated with Covid‐19; molecular mechanisms and therapeutic approaches

“…Similar animal experiments using MERS‐CoV, SARS‐CoV, and SARS‐CoV‐2 support HBC and OSN infection as a precurser to reaching the CNS via olfactory nerves. 55 , 56 , 57 The majority of Covid‐19 patients experience smell or taste disorders 58 , 59 , 60 , 61 ; this neurotoxic effect of SARS‐CoV‐2 might be due to changes in phosphorylation pattern of proteins associated with axons and synapses in olfactory/gustatory neurons or injuries to any of VII, IX, X cranial nerves and the nucleus of solitary tract. 50 , 62 Moreover, the molecular mechanism of virus transportation inside PNS and brain parenchyma neurons is almost identified in the neuronal route.…”

Exploring the Clinical Utility of Gustatory Dysfunction (GD) as a Triage Symptom Prior to Reverse Transcription Polymerase Chain Reaction (RT-PCR) in the Diagnosis of COVID-19: A Meta-Analysis and Systematic Review

“…Using the Newcastle-Ottawa scale [51] to assess the risk of bias in each of the included studies, most of the studies were of moderate risk of bias except for 6 studies [34,[149][150][151][152][153] which had high risk of bias, as shown in Figure A1. Most studies utilised hospital instead of community controls, failed to control for age as a variable, failed to blind patients and interviewers to the COVID-19 test result during assessment of GD, and failed to report the non-response rate of their study.…”

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