tetano
Editor, Senior Moderator
Pathogens
. 2021 Jan 12;10(1):E62.
doi: 10.3390/pathogens10010062.
Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients
Luigi Angelo Vaira[SUP] 1 2 3 [/SUP], Jerome R Lechien[SUP] 1 4 5 6 [/SUP], Mohamad Khalife[SUP] 1 7 [/SUP], Marzia Petrocelli[SUP] 8 [/SUP], Stephane Hans[SUP] 1 5 [/SUP], Lea Distinguin[SUP] 1 5 [/SUP], Giovanni Salzano[SUP] 9 [/SUP], Marco Cucurullo[SUP] 10 [/SUP], Piero Doneddu[SUP] 2 [/SUP], Francesco Antonio Salzano[SUP] 11 [/SUP], Federico Biglioli[SUP] 10 [/SUP], Fabrice Journe[SUP] 4 [/SUP], Andrea Fausto Piana[SUP] 3 12 [/SUP], Giacomo De Riu[SUP] 1 2 3 [/SUP], Sven Saussez[SUP] 1 4 6 [/SUP]
Affiliations
Abstract
Background: The objective evaluation of the olfactory function of coronavirus disease 2019 patients is difficult because of logistical and operator-safety problems. For this reason, in the literature, the data obtained from psychophysical tests are few and based on small case series.
Methods: A multicenter, cohort study conducted in seven European hospitals between March 22 and August 20, 2020. The Sniffin-Sticks test and the Connecticut Chemosensory Clinical Research Center orthonasal olfaction test were used to objectively evaluate the olfactory function.
Results: This study included 774 patients, of these 481 (62.1%) presented olfactory dysfunction (OD): 280 were hyposmic and 201 were anosmic. There was a significant difference between self-reported anosmia/hyposmia and psychophysical test results (p = 0.006). Patients with gastroesophageal disorders reported a significantly higher probability of presenting hyposmia (OR 1.86; p = 0.015) and anosmia (OR 2.425; p < 0.001). Fever, chest pain, and phlegm significantly increased the likelihood of having hyposmia but not anosmia or an olfactory disturbance. In contrast, patients with dyspnea, dysphonia, and severe-to-critical COVID-19 were significantly more likely to have no anosmia, while these symptoms had no effect on the risk of developing hyposmia or an OD.
Conclusions: Psychophysical assessment represents a significantly more accurate assessment tool for olfactory function than patient self-reported clinical outcomes. Olfactory disturbances appear to be largely independent from the epidemiological and clinical characteristics of the patients. The non-association with rhinitis symptoms and the high prevalence as a presenting symptom make olfactory disturbances an important symptom in the differential diagnosis between COVID-19 and common flu.
Keywords: COVID-19; SARS-CoV-2; anosmia; hyposmia; olfaction; olfactory dysfunction; parosmia; smell.
. 2021 Jan 12;10(1):E62.
doi: 10.3390/pathogens10010062.
Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients
Luigi Angelo Vaira[SUP] 1 2 3 [/SUP], Jerome R Lechien[SUP] 1 4 5 6 [/SUP], Mohamad Khalife[SUP] 1 7 [/SUP], Marzia Petrocelli[SUP] 8 [/SUP], Stephane Hans[SUP] 1 5 [/SUP], Lea Distinguin[SUP] 1 5 [/SUP], Giovanni Salzano[SUP] 9 [/SUP], Marco Cucurullo[SUP] 10 [/SUP], Piero Doneddu[SUP] 2 [/SUP], Francesco Antonio Salzano[SUP] 11 [/SUP], Federico Biglioli[SUP] 10 [/SUP], Fabrice Journe[SUP] 4 [/SUP], Andrea Fausto Piana[SUP] 3 12 [/SUP], Giacomo De Riu[SUP] 1 2 3 [/SUP], Sven Saussez[SUP] 1 4 6 [/SUP]
Affiliations
- PMID: 33445604
- DOI: 10.3390/pathogens10010062
Abstract
Background: The objective evaluation of the olfactory function of coronavirus disease 2019 patients is difficult because of logistical and operator-safety problems. For this reason, in the literature, the data obtained from psychophysical tests are few and based on small case series.
Methods: A multicenter, cohort study conducted in seven European hospitals between March 22 and August 20, 2020. The Sniffin-Sticks test and the Connecticut Chemosensory Clinical Research Center orthonasal olfaction test were used to objectively evaluate the olfactory function.
Results: This study included 774 patients, of these 481 (62.1%) presented olfactory dysfunction (OD): 280 were hyposmic and 201 were anosmic. There was a significant difference between self-reported anosmia/hyposmia and psychophysical test results (p = 0.006). Patients with gastroesophageal disorders reported a significantly higher probability of presenting hyposmia (OR 1.86; p = 0.015) and anosmia (OR 2.425; p < 0.001). Fever, chest pain, and phlegm significantly increased the likelihood of having hyposmia but not anosmia or an olfactory disturbance. In contrast, patients with dyspnea, dysphonia, and severe-to-critical COVID-19 were significantly more likely to have no anosmia, while these symptoms had no effect on the risk of developing hyposmia or an OD.
Conclusions: Psychophysical assessment represents a significantly more accurate assessment tool for olfactory function than patient self-reported clinical outcomes. Olfactory disturbances appear to be largely independent from the epidemiological and clinical characteristics of the patients. The non-association with rhinitis symptoms and the high prevalence as a presenting symptom make olfactory disturbances an important symptom in the differential diagnosis between COVID-19 and common flu.
Keywords: COVID-19; SARS-CoV-2; anosmia; hyposmia; olfaction; olfactory dysfunction; parosmia; smell.