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Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients.
Int Forum Allergy Rhinol. 2020 Aug 06 [Online ahead of print]IF

Abstract

BACKGROUND

Considerable evidence suggests that smell dysfunction is common in coronavirus disease-2019 (COVID-19). Unfortunately, extant data on prevalence and reversibility over time are highly variable, coming mainly from self-report surveys prone to multiple biases. Thus, validated psychophysical olfactory testing is sorely needed to establish such parameters.

METHODS

One hundred severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-positive patients were administered the 40-item University of Pennsylvania Smell Identification Test (UPSIT) in the hospital near the end of the acute phase of the disease. Eighty-two were retested 1 or 4 weeks later at home. The data were analyzed using analysis of variance and mixed-effect regression models.

RESULTS

Initial UPSIT scores were indicative of severe microsmia, with 96% exhibiting measurable dysfunction; 18% were anosmic. The scores improved upon retest (initial test: mean, 21.97; 95% confidence interval [CI], 20.84-23.09; retest: mean, 31.13; 95% CI, 30.16-32.10; p < 0.0001); no patient remained anosmic. After 5 weeks from COVID-19 symptom onset, the test scores of 63% of the retested patients were normal. However, the mean UPSIT score at that time continued to remain below that of age- and sex-matched healthy controls (p < 0.001). Such scores were related to time since symptom onset, sex, and age.

CONCLUSION

Smell loss was extremely common in the acute phase of a cohort of 100 COVID-19 patients when objectively measured. About one third of cases continued to exhibit dysfunction 6 to 8 weeks after symptom onset. These findings have direct implications for the use of olfactory testing in identifying SARS-CoV-2 carriers and for counseling such individuals with regard to their smell dysfunction and its reversibility.

Authors+Show Affiliations

School of Biological Sciences, Institute for Research in Fundamental Sciences, Tehran, Iran.Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Smell & Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32761796

Citation

Moein, Shima T., et al. "Prevalence and Reversibility of Smell Dysfunction Measured Psychophysically in a Cohort of COVID-19 Patients." International Forum of Allergy & Rhinology, 2020.
Moein ST, Hashemian SM, Tabarsi P, et al. Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients. Int Forum Allergy Rhinol. 2020.
Moein, S. T., Hashemian, S. M., Tabarsi, P., & Doty, R. L. (2020). Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients. International Forum of Allergy & Rhinology. https://doi.org/10.1002/alr.22680
Moein ST, et al. Prevalence and Reversibility of Smell Dysfunction Measured Psychophysically in a Cohort of COVID-19 Patients. Int Forum Allergy Rhinol. 2020 Aug 6; PubMed PMID: 32761796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID-19 patients. AU - Moein,Shima T, AU - Hashemian,Seyed MohammadReza, AU - Tabarsi,Payam, AU - Doty,Richard L, Y1 - 2020/08/06/ PY - 2020/07/13/received PY - 2020/07/31/revised PY - 2020/08/03/accepted PY - 2020/8/8/pubmed PY - 2020/8/8/medline PY - 2020/8/8/entrez KW - COVID-19 KW - SARS-CoV-2 KW - UPSIT KW - anosmia KW - hyposmia KW - odor identification KW - olfaction KW - virus JF - International forum of allergy & rhinology JO - Int Forum Allergy Rhinol N2 - BACKGROUND: Considerable evidence suggests that smell dysfunction is common in coronavirus disease-2019 (COVID-19). Unfortunately, extant data on prevalence and reversibility over time are highly variable, coming mainly from self-report surveys prone to multiple biases. Thus, validated psychophysical olfactory testing is sorely needed to establish such parameters. METHODS: One hundred severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-positive patients were administered the 40-item University of Pennsylvania Smell Identification Test (UPSIT) in the hospital near the end of the acute phase of the disease. Eighty-two were retested 1 or 4 weeks later at home. The data were analyzed using analysis of variance and mixed-effect regression models. RESULTS: Initial UPSIT scores were indicative of severe microsmia, with 96% exhibiting measurable dysfunction; 18% were anosmic. The scores improved upon retest (initial test: mean, 21.97; 95% confidence interval [CI], 20.84-23.09; retest: mean, 31.13; 95% CI, 30.16-32.10; p < 0.0001); no patient remained anosmic. After 5 weeks from COVID-19 symptom onset, the test scores of 63% of the retested patients were normal. However, the mean UPSIT score at that time continued to remain below that of age- and sex-matched healthy controls (p < 0.001). Such scores were related to time since symptom onset, sex, and age. CONCLUSION: Smell loss was extremely common in the acute phase of a cohort of 100 COVID-19 patients when objectively measured. About one third of cases continued to exhibit dysfunction 6 to 8 weeks after symptom onset. These findings have direct implications for the use of olfactory testing in identifying SARS-CoV-2 carriers and for counseling such individuals with regard to their smell dysfunction and its reversibility. SN - 2042-6984 UR - https://www.unboundmedicine.com/medline/citation/32761796/Prevalence_and_Reversibility_of_Smell_Dysfunction_Measured_Psychophysically_in_a_Cohort_of_COVID-19_patients L2 - https://doi.org/10.1002/alr.22680 DB - PRIME DP - Unbound Medicine ER -
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