Author: Prajapati, Divya P.; Shahrvini, Bita; Said, Mena; Srinivas, Shanmukha; DeConde, Adam S.; Yan, Carol H.
Title: Assessment of patient recognition of coronavirus disease 2019 (COVIDâ€19)â€associated olfactory loss and recovery: a longitudinal study Cord-id: afmmnas1 Document date: 2021_6_6
ID: afmmnas1
Snippet: BACKGROUND: The clinical course of coronavirus disease 2019 (COVIDâ€19) olfactory dysfunction remains poorly characterized, often limited by selfâ€reported measures. Given the logistical challenges of psychophysical testing, understanding the longitudinal relationship between selfâ€reported and quantitative measures can help accurately identify patients with persistent olfactory dysfunction. This study aimed to longitudinally correlate measured and subjective olfactory function in COVIDâ€19
Document: BACKGROUND: The clinical course of coronavirus disease 2019 (COVIDâ€19) olfactory dysfunction remains poorly characterized, often limited by selfâ€reported measures. Given the logistical challenges of psychophysical testing, understanding the longitudinal relationship between selfâ€reported and quantitative measures can help accurately identify patients with persistent olfactory dysfunction. This study aimed to longitudinally correlate measured and subjective olfactory function in COVIDâ€19 subjects. METHODS: A prospective, longitudinal study evaluating subjective and measured olfaction was conducted on ambulatory COVIDâ€19 subjects. Olfaction scores were obtained using a visual analogue scale (VAS) (0 = anosmia, 10 = normosmia) and the validated 12â€item Brief Smell Identification Test (BSIT). Weekly testing was performed until recovery (BSIT ≥ 9/12 and/or VAS = 10/10) or study completion. RESULTS: Eightyâ€six polymerase chain reaction (PCR)â€positive COVIDâ€19 subjects were recruited ≤3 days from diagnosis and 52 completed longitudinal testing. Among those with selfâ€reported smell loss at recruitment, similar levels (75.8%) of objective (BSIT ≥ 9/12) and subjective recovery were obtained using a VAS cutoff ≥8, yet only 30.3% reported complete subjective recovery (VAS = 10). Median times to objective and complete subjective olfactory recovery were 12 ± 2.3 and 24 ± 3.5 days, respectively. Although both measures showed chemosensory improvement, the distributions of objective and full subjective olfactory recovery differed significantly (log rank test χ(2) = 6.46, degrees of freedom [df] = 1, p = 0.011). Overall correlation between BSIT and VAS scores was moderate to strong across longitudinal followâ€up (r (s) = 0.41–0.65). CONCLUSION: Selfâ€reported and psychophysically measured COVIDâ€19 olfactory dysfunction improve at similar levels and are moderately correlated longitudinally, yet there is a significant delay in complete subjective recovery. Psychophysical testing in conjunction with qualitative assessments may be considered for counseling and followâ€up of patients with COVIDâ€19 smell loss.
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