High prevalence of long-term psychophysical olfactory dysfunction in patients with COVID-19
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Abstract
This study prospectively assessed the long-term prevalence of self-reported and psychophysically measured olfactory dysfunction in subjects with mild-to-moderate COVID-19. Self-reported smell or taste impairment was prospectively evaluated by SNOT-22 at diagnosis, 4-week, 8-week, and 6-month. At 6 months from the diagnosis, psychophysical evaluation of olfactory function was also performed using the 34-item culturally adapted University of Pennsylvania Smell Identification Test (CA-UPSIT). 145 completed both the 6-month subjective and psychophysical olfactory evaluation. According to CA-UPSIT, 87 subjects (60.0%) exhibited some smell dysfunction, with 54 (37.2) being mildly microsmic, 16 (11.0%) moderately microsmic, 7 (4.8%) severely microsmic, and 10 patients (6.9%) being anosmic. At the time CA-UPSIT was administered, a weak correlation was observed between the self-reported alteration of sense of smell or taste and olfactory test scores (Spearman’s r=-0.26). Among 112 patients who self-reported normal sense of smell at last follow-up, CA-UPSIT revealed normal smell in 46 (41.1%), mild microsmia in 46 (41.1%), moderate microsmia in 11 (9.8%), severe microsmia in 3 (2.3%), and anosmia in 6 (5.4%) patients; however, of those patients self-reporting normal smell but who were found to have hypofunction on testing, 62 out of 66 had self-reported reduction in sense of smell or taste at an earlier time point. Despite most patients report a subjectively normal sense of smell, we observed a high percentage of persistent smell dysfunction at 6 months from the diagnosis of SARS-CoV-2 infection, with 11.7% of patients being anosmic or severely microsmic. These data highlight a significant long-term rate of smell alteration in patients with previous SARS-CoV-2 infection.
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SciScore for 10.1101/2021.01.07.21249406: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was conducted with the approval of the institutional ethical review boards of Treviso and Belluno provinces and informed consent was obtained verbally and in written form.
Consent: The study was conducted with the approval of the institutional ethical review boards of Treviso and Belluno provinces and informed consent was obtained verbally and in written form.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data …
SciScore for 10.1101/2021.01.07.21249406: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was conducted with the approval of the institutional ethical review boards of Treviso and Belluno provinces and informed consent was obtained verbally and in written form.
Consent: The study was conducted with the approval of the institutional ethical review boards of Treviso and Belluno provinces and informed consent was obtained verbally and in written form.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are a number of limitations to this study. First, a baseline or early psychophysical evaluation of the sense of smell was not done in the present series. However, as previously discussed, despite the possibility that psychophysical tests could detect a pre-existing olfactory dysfunction not perceived by the patient, this may only partially impact on the rate of psychophysical long-term smell alteration observed in the present series. Second, a culturally adapted version of the Italian UPSIT was used to psychophysically evaluate the sense of smell. Despite this is the most reliable and accurate olfactory test available (Doty et al., 1984), it is only an identification test not testing discrimination ability and olfactory threshold. Thus, UPSIT identification test may not capture all olfactory disturbances. However, it has been observed that patients with post-infectious hyposmia performed relatively well in both threshold and discrimination but poorly in identification tests (Liu et al., 2020). Identification testing alone may therefore over-estimate the severity of loss and may in part explain the weak correlation between self-reported smell loss and the UPSIT scores reported herein. Third, a psychophysical evaluation of the sense of taste was not performed in the present study. Although the commonly reported loss of taste might largely depend on impairment of retronasal olfaction, recent subjective studies have shown that COVID-19 associated chemosensory impairment is ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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