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A tool for the psychophysical assessment of olfactory dysfunction in patients with COVID-19.

ABSTRACT: Numerous studies have reported that patients with coronavirus disease 2019 (COVID-19) experience alterations in the sense of smell. Therefore, there is an increased need for a psychophysical evaluation tool for olfactory dysfunction in patients with COVID-19 without increasing the risk of virus spread. We applied a single-use sniffing-bead system, which consisted of small beads and a disposable plastic handpiece, to patients with COVID-19 presenting with olfactory dysfunction. The bead sets contained eight concentrations of 2-phenylethyl alcohol (PEA), which has been used in olfactory function tests for many years, and the lowest concentration at which the participant detected the PEA odor was recorded as the PEA threshold. The test was easily administered at the clinic during the consultation with the doctor without increasing the risk of virus spread. Based on the test results, anosmia was objectively confirmed in a patient with subjective anosmia, and another patient with subjective hyposmia was diagnosed with normosmia. Both patients started olfactory training after diagnosis. In conclusion, we present a system to psychophysically assess olfactory dysfunction in patients with COVID-19 using a universal odorant without the risk of virus spread, and suggest that this system might enable early diagnosis and management of patients with COVID-19.

SUBMITTER: Kim KS

PROVIDER: S-EPMC9168555 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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A tool for the psychophysical assessment of olfactory dysfunction in patients with COVID-19.

Kim Kyung Soo KS Min Hyun Jin HJ

Ear, nose, & throat journal 20220329 1_suppl

Numerous studies have reported that patients with coronavirus disease 2019 (COVID-19) experience alterations in the sense of smell. Therefore, there is an increased need for a psychophysical evaluation tool for olfactory dysfunction in patients with COVID-19 without increasing the risk of virus spread. We applied a single-use sniffing-bead system, which consisted of small beads and a disposable plastic handpiece, to patients with COVID-19 presenting with olfactory dysfunction. The bead sets cont ...[more]

PMID: 35348400

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Project description:BackgroundOlfactory and gustatory dysfunctions are early symptoms of SARS-CoV-2 infection. Between 20-80% of infected individuals report subjective altered sense of smell and/or taste during infection. Up to 2/3 of previously infected experience persistent olfactory and/or gustatory dysfunction after 6 months. The aim of this study was to examine subjective and psychophysical olfactory and gustatory function in non-hospitalized individuals with acute COVID-19 up to 6 months after infection.MethodsIndividuals aged 18-80-years with a positive SARS-CoV-2 PCR test no older than 10 days, were eligible. Only individuals able to visit the outpatient examination facilities were included. Gustatory function was tested with the Burgharts Taste Strips and olfactory function was examined with the Brief Smell Identifications test (Danish version). Subjective symptoms were examined through an online questionnaire at inclusion, day 30, 90 and 180 after inclusion.ResultsFifty-eight SARS-CoV-2 positive and 56 negative controls were included. 58.6% (34/58) of SARS-CoV-2 positive individuals vs. 8.9% (5/56) of negative controls reported subjective olfactory dysfunction at inclusion. For gustatory dysfunction, 46.5% (27/58) of positive individuals reported impairment compared to 8.9% (5/56) of negative controls. In psychophysical tests, 75.9% (46/58) had olfactory dysfunction and 43.1% (25/58) had gustatory dysfunction among the SARS-CoV-2 positive individuals at inclusion. Compared to negative controls, SARS-CoV-2 infected had significantly reduced olfaction and gustation. Previously infected individuals continued to report lower subjective sense of smell 30 days after inclusion, whereafter the difference between the groups diminished. However, after 180 days, 20.7% (12/58) positive individuals still reported reduced sense of smell and taste.ConclusionOlfactory and gustatory dysfunctions are prevalent symptoms of SARS-CoV-2 infection, but there is inconsistency between subjective reporting and psychophysical test assessment of especially olfaction. Most individuals regain normal function after 30 days, but approximately 20% report persistent olfactory and gustatory dysfunction 6 months after infection.

Project description:BackgroundCOVID-19 threatens the global community because a large fraction of infected people are asymptomatic, yet can effectively transmit SARS-CoV-2. Finding and isolating these silent carriers is a crucial step in confining the spread of the disease. A sudden loss of the sense of smell has been self-reported by COVID-19 patients across different countries, consistent with expression of the molecular factors mediating SARS-CoV-2 uptake into human olfactory epithelial supporting cells. However, precise quantification of olfactory loss in asymptomatic COVID-19 carriers is missing to date.MethodsTo quantify olfactory functions in asymptomatic COVID-19 patients, we designed an olfactory-action meter that determines detectability indices at different odor concentrations and an olfactory matching accuracy score using monomolecular odors. The optimization of test parameters allowed us to reliably and accurately assess olfactory deficits in a patient within 20 minutes.FindingsMeasurement of detection indices at low concentrations revealed a 50% reduction in asymptomatic COVID-19 carriers. Further, patients with better detection scores showed significantly reduced olfactory matching accuracies compared to normal healthy subjects. Our quantification of olfactory loss, considering all parameters, identified 82% of the asymptomatic SARS-CoV-2 carriers with olfactory deficits. However, on subjective evaluation, only 15% of the patients noticed a compromised ability to smell.InterpretationCompromised olfactory fitness can serve as a strong basis for identifying asymptomatic COVID-19 patients. Detailed design specifications and protocols provided here should enable the development of a sensitive, fast, and economical screening strategy that can be administered to large populations to prevent the rapid spread of COVID-19.FundingThis work was supported by the DBT - Wellcome Trust India Alliance intermediate grant (IA/I/14/1/501,306 to N.A.) and UGC NET Fellowship (A.B.). All the funding sources played no roles in the study.

Dataset Information

A tool for the psychophysical assessment of olfactory dysfunction in patients with COVID-19.

Publications

A tool for the psychophysical assessment of olfactory dysfunction in patients with COVID-19.

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