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Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement?
Laryngoscope. 2020 11; 130(11):2520-2525.L

Abstract

OBJECTIVE

The objective of this study was to determine the burden of depressed mood and anxiety in COVID-19, and associated disease characteristics.

MATERIALS AND METHODS

This is a prospective, cross-sectional study of 114 COVID-19 positive patients diagnosed using RT-PCR-based testing over a 6-week period. The two-item Patient Health Questionnaire (PHQ-2) and the two-item Generalized Anxiety Disorder questionnaire (GAD-2) were used to measure depressed mood and anxiety level, respectively, at enrollment and for participants' baseline, pre-COVID-19 state. Severity of smell loss, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough, and shortness of breath (SOB) during COVID-19 were assessed.

RESULTS

PHQ-2 and GAD-2 significantly (P < .001) increased from baseline to enrollment. PHQ-2 was associated with smell loss (adjusted incidence rate ratio [aIRR] = 1.40, 95% CI, 1.10-1.78, P = .006), age (aIRR = 1.02, 95% CI, 1.01-1.04, P = .006), and baseline PHQ-2 score (aIRR = 1.39, 95% CI, 1.09-1.76, P = .007). GAD-2 score was associated with smell loss (aIRR = 1.29, 95% CI, 1.02-1.62, P = .035), age (aIRR = 1.02, 95% CI, 1.01-1.04, P = .025) and baseline GAD-2 score (aIRR = 1.55, 95% CI, 1.24-1.93, P < .001). Loss of taste also exhibited similar associations with PHQ-2 and GAD-2. PHQ-2 and GAD-2 scores were not associated with severities of any other symptoms during the COVID-19 course.

CONCLUSIONS

Despite the occurrence of symptoms-such as SOB-associated with severe manifestations of COVID-19, only the severities of smell and taste loss were associated with depressed mood and anxiety. These results may raise the novel possibility of emotional disturbance as a CNS manifestation of COVID-19 given trans-olfactory tract penetration of the central nervous system (CNS) by coronaviruses.

LEVEL OF EVIDENCE

3 Laryngoscope, 130:2520-2525, 2020.

Authors+Show Affiliations

Department of Otolaryngology - Head and Neck Surgery, Kantonsspital Aarau, Aarau, Switzerland.Department of Otolaryngology - Head and Neck Surgery, Kantonsspital Aarau, Aarau, Switzerland.Institute for Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland.Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.Department of Otolaryngology - Head and Neck Surgery, Kantonsspital Aarau, Aarau, Switzerland.Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32617983

Citation

Speth, Marlene M., et al. "Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement?" The Laryngoscope, vol. 130, no. 11, 2020, pp. 2520-2525.
Speth MM, Singer-Cornelius T, Oberle M, et al. Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement? Laryngoscope. 2020;130(11):2520-2525.
Speth, M. M., Singer-Cornelius, T., Oberle, M., Gengler, I., Brockmeier, S. J., & Sedaghat, A. R. (2020). Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement? The Laryngoscope, 130(11), 2520-2525. https://doi.org/10.1002/lary.28964
Speth MM, et al. Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement. Laryngoscope. 2020;130(11):2520-2525. PubMed PMID: 32617983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mood, Anxiety and Olfactory Dysfunction in COVID-19: Evidence of Central Nervous System Involvement? AU - Speth,Marlene M, AU - Singer-Cornelius,Thirza, AU - Oberle,Michael, AU - Gengler,Isabelle, AU - Brockmeier,Steffi J, AU - Sedaghat,Ahmad R, Y1 - 2020/08/12/ PY - 2020/05/15/received PY - 2020/06/23/revised PY - 2020/07/01/accepted PY - 2020/7/4/pubmed PY - 2020/12/22/medline PY - 2020/7/4/entrez KW - Coronavirus, COVID-19, SARS-CoV2, SARS-CoV-2, mood, depression, anxiety, anosmia, hyposmia, olfactory dysfunction, olfactory function, gustatory dysfunction, gustatory function, olfaction, smell, taste, nasal obstruction, rhinorrhea SP - 2520 EP - 2525 JF - The Laryngoscope JO - Laryngoscope VL - 130 IS - 11 N2 - OBJECTIVE: The objective of this study was to determine the burden of depressed mood and anxiety in COVID-19, and associated disease characteristics. MATERIALS AND METHODS: This is a prospective, cross-sectional study of 114 COVID-19 positive patients diagnosed using RT-PCR-based testing over a 6-week period. The two-item Patient Health Questionnaire (PHQ-2) and the two-item Generalized Anxiety Disorder questionnaire (GAD-2) were used to measure depressed mood and anxiety level, respectively, at enrollment and for participants' baseline, pre-COVID-19 state. Severity of smell loss, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough, and shortness of breath (SOB) during COVID-19 were assessed. RESULTS: PHQ-2 and GAD-2 significantly (P < .001) increased from baseline to enrollment. PHQ-2 was associated with smell loss (adjusted incidence rate ratio [aIRR] = 1.40, 95% CI, 1.10-1.78, P = .006), age (aIRR = 1.02, 95% CI, 1.01-1.04, P = .006), and baseline PHQ-2 score (aIRR = 1.39, 95% CI, 1.09-1.76, P = .007). GAD-2 score was associated with smell loss (aIRR = 1.29, 95% CI, 1.02-1.62, P = .035), age (aIRR = 1.02, 95% CI, 1.01-1.04, P = .025) and baseline GAD-2 score (aIRR = 1.55, 95% CI, 1.24-1.93, P < .001). Loss of taste also exhibited similar associations with PHQ-2 and GAD-2. PHQ-2 and GAD-2 scores were not associated with severities of any other symptoms during the COVID-19 course. CONCLUSIONS: Despite the occurrence of symptoms-such as SOB-associated with severe manifestations of COVID-19, only the severities of smell and taste loss were associated with depressed mood and anxiety. These results may raise the novel possibility of emotional disturbance as a CNS manifestation of COVID-19 given trans-olfactory tract penetration of the central nervous system (CNS) by coronaviruses. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:2520-2525, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/32617983/Mood_Anxiety_and_Olfactory_Dysfunction_in_COVID_19:_Evidence_of_Central_Nervous_System_Involvement L2 - https://doi.org/10.1002/lary.28964 DB - PRIME DP - Unbound Medicine ER -