Citation Information :
Meher R, Kumar V, Goel P, Wadhwa V, Sahoo AK, Singh I, Rathore PK. Olfactory and Taste Dysfunctions and Their Implications in Cases of Severe Acute Respiratory Syndrome Coronavirus 2: A Single-institute Study of 58 Cases. Int J Otorhinolaryngol Clin 2022; 14 (2):56-59.
Importance: There is a need to identify the implications of the loss of smell and taste in cases of coronavirus disease-2019 (COVID-19).
Objective: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing isolated anosmia in adult population and whether there is a role of intranasal corticosteroids (INCs) in cases of olfactory dysfunctions (ODs).
Design: This was a prospective, cross-sectional, questionnaire-based study of 416 patients diagnosed with COVID-19 in a single institute.
Setting: Dedicated COVID-19 facility.
Participants: All patients had been tested for COVID-19 using a reverse transcription–polymerase chain reaction (RT-PCR)-based test. Patients who were hospitalized were approached in person. All patients who were discharged were then contacted by telephone up to two times to complete the study. Patients who were not reachable with two telephone calls were excluded. Demographic characteristics of the participants—age, sex, and smoking history—were collected. A standardized questionnaire was given to participants.
Result: Olfactory dysfunctions (ODs) was observed in 58 patients and isolated anosmia in 3.6% of patients; 82.7% showed complete recovery of smell, and 6.9% had partial recovery following INCs.
Conclusion: Patients reporting recent onset of anosmia should be considered positive for SARS-CoV-2 infection until proven otherwise by a screening polymerase chain reaction test. Also, ear, nose, and throat (ENT) surgeons in particular who see patients with new-onset anosmia during the COVID-19 pandemic must take safety measures to reduce the risk of exposure and infection of healthcare workers and recommend such patients for RT-PCR test. Females and young adults are more prone to SARS-CoV-2 infection. Early intervention by INCs could be beneficial in improving olfactory and taste dysfunctions (OTDs) and other post-viral neurological manifestations. It could be beneficial in improving the quality of life of elderly patients who are at a higher risk of permanent OTDs. Smokers are at a higher risk of OTDs, but this could be reversible after smoking cessation. There is a need to put SARS-CoV-2 as a differential diagnosis in cases of sudden isolated OTDs.
Zahra SA, Iddawela S, Pillai K, et al. Can symptoms of anosmia and dysgeusia be diagnostic for COVID-19? Brain Behav 2020;10(11):e01839. DOI: 10.1002/brb3.1839.
Vaira LA, Deiana G, Fois AG, et al. Objective evaluation of anosmia and ageusia in COVID-19 patients: single-center experience on 72 cases. Head Neck 2020;42(6):1252–1258. DOI: 10.1002/hed.26204.
Rai SK, Gupta TP, Kashid M, et al. Can self-perceived easy fatigability be a predictor of vitamin D deficiency in young Indian women? J Family Med Prim Care 2020;9(2):997–1002. DOI: 10.4103/jfmpc.jfmpc_862_19.
Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;356:i6583. DOI: 10.1136/bmj.i6583.
Suzuki M, Saito K, Min WP, et al. Identification of viruses in patients with postviral olfactory dysfunction. Laryngoscope 2007;117(2): 272–277. DOI: 10.1097/01.mlg.0000249922.37381.1e.
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579(7798):270–273. DOI: 10.1038/s41586-020-2012-7.
Ohkubo K, Lee CH, Baraniuk JN, et al. Angiotensin-converting enzyme in the human nasal mucosa. Am J Respir Cell Mol Biol 1994;11(2): 173–180. DOI: 10.1165/ajrcmb.11.2.8049077.
Moein ST, Hashemian SM, Mansourafshar B, et al. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol 2020;10(8):944–950. DOI: 10.1002/alr.22587.
Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020;94:91–95. DOI: 10.1016/j.ijid.2020.03.017.
Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology 2020;58(3): 299–301. DOI: 10.4193/Rhin20.114.
Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology 2020;58(3):295–298. DOI: 10.4193/Rhin20.116.
Mehraeen E, Behnezhad F, Salehi MA, et al. Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence. Eur Arch Otorhinolaryngol 2021;278(2):307–312. DOI: 10.1007/s00405-020-06120-6.
Jafek BW, Hartman D, Eller PM, et al. Postviral olfactory dysfunction. Am J Rhinol 1990;4(3):91–100. DOI: 10.2500/105065890782009497.
Mueller C, Temmel AF, Quint C, et al. Olfactory function in HIV-positive subjects. Acta Otolaryngol 2002;122(1):67–71. DOI: 10.1080/00016480252775760.
Bearer EL, Breakefield XO, Schuback D, et al. Retrograde axonal transport of herpes simplex virus: evidence for a single mechanism and a role for tegument. Proc Natl Acad Sci U S A 2000;97(14): 8146–8150. DOI: 10.1073/pnas.97.14.8146.
Diefenbach RJ, Miranda-Saksena M, Douglas MW, et al. Transport and egress of herpes simplex virus in neurons. Rev Med Virol 2008;18(1):35–51. DOI: 10.1002/rmv.560.
Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: a literature review. J Clin Neurosci 2020;77:8–12. DOI: 10.1016/j.jocn.2020.05.017.
Becker Y. HSV-1 brain infection by the olfactory nerve route and virus latency and reactivation may cause learning and behavioral deficiencies and violence in children and adults: a point of view. Virus Genes 1995;10(3):217–226. DOI: 10.1007/BF01701811.
Daval M, Corré A, Palpacuer C, et al. Efficacy of local budesonide therapy in the management of persistent hyposmia in COVID-19 patients without signs of severity: a structured summary of a study protocol for a randomised controlled trial. Trials 2020;21(1):666. DOI: 10.1186/s13063-020-04585-8.
Doty RL, Shaman P, Applebaum SL, et al. Smell identification ability: changes with age. Science 1984;226(4681):1441–1443. DOI: 10.1126/science.6505700.
Meisami E, Mikhail L, Baim D, et al. Human olfactory bulb: aging of glomeruli and mitral cells and a search for the accessory olfactory bulb. Ann N Y Acad Sci 1998;855:708–715. DOI: 10.1111/j.1749-6632.1998.tb10649.x.
Ajmani GS, Suh HH, Wroblewski KE, et al. Smoking and olfactory dysfunction: a systematic literature review and meta-analysis. Laryngoscope 2017;127(8):1753–1761. DOI: 10.1002/lary.26558.
Ramos EM, De Toledo AC, Xavier RF, et al. Reversibility of impaired nasal mucociliary clearance in smokers following a smoking cessation programme. Respirology 2011;16(5):849–855. DOI: 10.1111/j.1440-1843.2011.01985.x.
Rodrigues FM, Ramos D, Xavier RF, et al. Nasal and systemic inflammatory profile after short term smoking cessation. Respir Med 2014;108(7):999–1006. DOI: 10.1016/j.rmed.2014.04.020.
Whitcroft KL, Hummel T. Olfactory dysfunction in COVID-19: diagnosis and management. Journal of the American Medical Association 2020;323(24):2512–2514. DOI: 10.1001/jama.2020.8391.
Hummel T, Rissom K, Reden J, et al. Effects of olfactory training in patients with olfactory loss. Laryngoscope 2009;119(3):496–499. DOI: 10.1002/lary.20101.
Konstantinidis I, Tsakiropoulou E, Bekiaridou P, et al. Use of olfactory training in post-traumatic and postinfectious olfactory dysfunction. Laryngoscope 2013;123(12):E85–E90. DOI: 10.1002/lary.24390.