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      Persisting olfactory dysfunction in post-COVID-19 is associated with gustatory impairment: Results from chemosensitive testing eight months after the acute infection

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          Abstract

          Olfactory and gustatory disorders are prominent symptoms of acute COVID-19. Although both senses recover in many patients within weeks to months, persistency has been described in up to 60%. However up to now most reports on the course of chemosensitive disorders after COVID-19 are not based on psychophysical testing but only on subjective patients’ ratings. In this study we assessed both olfaction and gustation using psychophysical tests eight months after COVID-19. Validated psychophysical testing revealed hyposmia in 18% and hypogeusia in even 32% of 303 included patients. This shows that olfactory and especially gustatory disorders have to be seen as important chronic symptoms post-COVID-19. The high prevalence of gustatory dysfunction indicates that gustatory function does not recover or might even deteriorate in the months following the acute infection.

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          A clinical case definition of post-COVID-19 condition by a Delphi consensus

          Joan B Soriano, Srinivas Murthy, John C Marshall … (2021)
          People with COVID-19 might have sustained postinfection sequelae. Known by a variety of names, including long COVID or long-haul COVID, and listed in the ICD-10 classification as post-COVID-19 condition since September, 2020, this occurrence is variable in its expression and its impact. The absence of a globally standardised and agreed-upon definition hampers progress in characterisation of its epidemiology and the development of candidate treatments. In a WHO-led Delphi process, we engaged with an international panel of 265 patients, clinicians, researchers, and WHO staff to develop a consensus definition for this condition. 14 domains and 45 items were evaluated in two rounds of the Delphi process to create a final consensus definition for adults: post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction, and generally have an impact on everyday functioning. Symptoms might be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms might also fluctuate or relapse over time. A separate definition might be applicable for children. Although the consensus definition is likely to change as knowledge increases, this common framework provides a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy.
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            More than smell – COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

            Valentina Parma, Kathrin Ohla, Maria Veldhuizen … (2020)
            Abstract Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation and initial results of a multi-lingual, international questionnaire to assess self-reported quantity and quality of perception in three distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, 8 other, ages 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± SD), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell, but also affects taste and chemesthesis. The multimodal impact of COVID-19 and lack of perceived nasal obstruction suggest that SARS-CoV-2 infection may disrupt sensory-neural mechanisms.
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              COVID-19 and the chemical senses: supporting players take center stage

              Keiland W Cooper, David H Brann, Michael Farruggia … (2020)
              The main neurological manifestation of COVID-19 is loss of smell or taste. The high incidence of smell loss without significant rhinorrhea or nasal congestion suggests that SARS-CoV-2 targets the chemical senses through mechanisms distinct from those used by endemic coronaviruses or other common cold-causing agents. Here we review recently developed hypotheses about how SARS-CoV-2 might alter the cells and circuits involved in chemosensory processing and thereby change perception. Given our limited understanding of SARS-CoV-2 pathogenesis, we propose future experiments to elucidate disease mechanisms and highlight the relevance of this ongoing work to understanding how the virus might alter brain function more broadly.
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                Author and article information

                Contributors
                Constantin A. Hintschich:
                ORCID: https://orcid.org/0000-0002-5500-600X
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: VisualizationRole: Writing – original draft
                René Fischer: Role: Formal analysisRole: Writing – original draft
                Thomas Hummel: Role: Formal analysisRole: Writing – review & editing
                Jürgen J. Wenzel: Role: InvestigationRole: Writing – review & editing
                Christopher Bohr: Role: Formal analysisRole: Writing – review & editing
                Veronika Vielsmeier: Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: Supervision
                John I. Glendinning: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS One
                Journal ID (publisher-id): plos
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 23 March 2022
                Publication date Collection: 2022
                Publication date PMC-release: 23 March 2022
                Volume: 17
                Issue: 3
                Electronic Location Identifier: e0265686
                Affiliations
                [1 ] Department of Otorhinolaryngology, Regensburg University Hospital, Regensburg, Germany
                [2 ] Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
                [3 ] Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany
                Barnard College, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-5500-600X
                Article
                Publisher ID: PONE-D-21-37211
                DOI: 10.1371/journal.pone.0265686
                PMC ID: 8942205
                PubMed ID: 35320821
                SO-VID: 5832fda1-3e38-4f2a-ad45-f78d903ae322
                Copyright © © 2022 Hintschich et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 23 November 2021
                Date accepted : 6 March 2022
                Page count
                Figures: 2, Tables: 1, Pages: 10
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100005341, Bayerisches Staatsministerium für Wissenschaft, Forschung und Kunst;
                Award Recipient :
                ORCID: https://orcid.org/0000-0002-5500-600X
                Funded by: funder-id http://dx.doi.org/10.13039/501100005341, Bayerisches Staatsministerium für Wissenschaft, Forschung und Kunst;
                Award Recipient :
                Constantin A. Hintschich and Veronika Vielsmeier received funding by a grant for COVID-19 related research of the Bavarian State Ministry for Science and Art ( https://www.stmwk.bayern.de/englisch.html). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Diagnostic Medicine
                Subject: Virus Testing
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Cognitive Science
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Taste
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Taste
                Subject: Social Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Taste
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Perception
                Subject: Taste
                Subject: Biology and Life Sciences
                Subject: Physiology
                Subject: Sensory Physiology
                Subject: Gustatory System
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Systems
                Subject: Gustatory System
                Subject: Medicine and Health Sciences
                Subject: Medical Conditions
                Subject: Infectious Diseases
                Subject: Viral Diseases
                Subject: Covid 19
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Cognitive Science
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Smell
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Smell
                Subject: Social Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Smell
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Perception
                Subject: Smell
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychophysics
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychophysics
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Cognitive Science
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Psychophysics
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Psychophysics
                Subject: Social Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Psychophysics
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Perception
                Subject: Psychophysics
                Subject: Biology and life sciences
                Subject: Organisms
                Subject: Viruses
                Subject: RNA viruses
                Subject: Coronaviruses
                Subject: SARS coronavirus
                Subject: SARS CoV 2
                Subject: Biology and life sciences
                Subject: Microbiology
                Subject: Medical microbiology
                Subject: Microbial pathogens
                Subject: Viral pathogens
                Subject: Coronaviruses
                Subject: SARS coronavirus
                Subject: SARS CoV 2
                Subject: Medicine and health sciences
                Subject: Pathology and laboratory medicine
                Subject: Pathogens
                Subject: Microbial pathogens
                Subject: Viral pathogens
                Subject: Coronaviruses
                Subject: SARS coronavirus
                Subject: SARS CoV 2
                Subject: Biology and life sciences
                Subject: Organisms
                Subject: Viruses
                Subject: Viral pathogens
                Subject: Coronaviruses
                Subject: SARS coronavirus
                Subject: SARS CoV 2
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Psychometrics
                Subject: Social Sciences
                Subject: Psychology
                Subject: Psychometrics
                Custom metadata
                Data Availability All relevant data are within the manuscript.
                Outbreaks COVID-19

                ScienceOpen disciplines: Uncategorized
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