Incomplete and late recovery of sudden olfactory dysfunction in COVID-19

Kosugi, Eduardo Macoto; Lavinsky, Joel; Romano, Fabrizio Ricci; Fornazieri, Marco Aurélio; Luz-Matsumoto, Gabriela Ricci; Lessa, Marcus Miranda; Piltcher, Otávio Bejzman; Sant'Anna, Geraldo Druck

doi:10.1016/j.bjorl.2020.05.001

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz. j. otorhinolaryngol. 86 (4) • Jul-Aug 2020 • https://doi.org/10.1016/j.bjorl.2020.05.001 copy

Incomplete and late recovery of sudden olfactory dysfunction in COVID-19^☆ ☆ Please cite this article as: Kosugi EM, Lavinsky J, Romano FR, Fornazieri MA, Luz-Matsumoto GR, Lessa MM, et al. Incomplete and late recovery of sudden olfactory dysfunction in COVID-19. Braz J Otorhinolaryngol. 2020;86:490–6. ,^☆☆ ☆☆ Peer Review under the responsibility of Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Sudden olfactory dysfunction is a new symptom related to COVID-19, with little data on its duration or recovery rate.

Objective

To characterize patients with sudden olfactory dysfunction during the COVID-19 pandemic, especially their recovery data.

Methods

An online survey was conducted by the Brazilian Society of Otorhinolaryngology and Cervico-Facial Surgery, and Brazilian Academy of Rhinology, including doctors who assessed sudden olfactory dysfunction patients starting after February 1st, 2020. Participants were posteriorly asked by e-mail to verify data on the recovery of sudden olfactory loss and test for COVID-19 at the end of the data collection period.

Results

253 sudden olfactory dysfunction patients were included, of which 59.1% were females with median age of 36 years, with a median follow-up period of 31 days. 183 patients (72.3%) had been tested for COVID-19, and of those 145 (79.2%) tested positive. Patients that tested positive for COVID-19 more frequently showed non-specific inflammatory symptoms (89.7% vs. 73.7%; p = 0.02), a lower rate of total recovery of sudden olfactory dysfunction (52.6% vs. 70.3%; p = 0.05) and a longer duration to achieve total recovery (15 days vs. 10 days; p = 0.0006) than the ones who tested negative for COVID-19. Considering only positive-COVID-19 patients, individuals with sudden hyposmia completely recovered more often than the ones with sudden anosmia (68.4% vs. 50.0%; p = 0.04).

Conclusion

Positive-COVID-19 patients with sudden olfactory dysfunction showed lower total recovery rate and longer duration than negative-COVID-19 patients. Additionally, total recovery was seen more frequently in positive-COVID-19 patients with sudden hyposmia than the ones with sudden anosmia.

Keywords
COVID-19; Anosmia; Olfactory disorders

Characteristics of tested patients (n = 183)		COVID-19 test				p-Value
Characteristics of tested patients (n = 183)		Positive (n = 145)		Negative (n = 38)		p-Value
Age (years)	Med and IQR	36	31-44	35.5	30.25-45.25	0.60
Follow-up (days)	Med and IQR	31	12-39	35.5	17-41	0.37
Female gender	n and %	77	53.1	26	68.4	0.10
Acute anosmia	n and %	126	86.9	31	81.6	0.44
Acute hyposmia	n and %	19	13.1	7	18.4	0.44
Comorbidities	n and %	47	32.4	15	39.5	0.44
Allergic rhinitis	n and %	22	15.2	8	21.1	0.46
Asthma	n and %	7	4.8	0	0.0	0.35

Symptoms of tested patients (n = 183)	COVID-19 test				p-Value
	Positive (n = 145)		Negative (n = 38)
	n	%	n	%
None	8	5.5	5	13.1	0.15
Nonspecific symptoms	130	89.7	28	73.7	0.02^a a Statistical significance.
Coughing	83	57.2	18	47.3	0.36
Headache	76	52.4	20	52.6	1.00
Fever	72	49.7	16	42.1	0.47
Myalgia/arthralgia	37	25.5	8	21.0	0.68
Fatigue	20	13.7	7	18.4	0.14
Anorexia	4	2.7	2	5.2	0.61
Nasal symptoms	62	42.7	15	39.4	0.85
Nasal obstruction	40	27.5	8	21.0	0.54
Sneezing	18	12.4	4	10.5	1.00
Coryza	31	21.3	8	21.0	1.00
Rhinorrhea	2	1.3	1	2.6	0.51
Nasal pruritus	6	4.1	2	5.2	0.67
URTIs (nose and/or throat)	66	45.5	16	42.1	0.86
Sore throat	10	6.9	4	10.5	0.56
Others
Dyspnea	7	4.8	2	5.2	1.00
Diarrhea	10	6.9	1	2.6	0.46
Ageusia	6	4.1	2	5.2	0.67

Recovery from sudden olfactory dysfunction (n = 174)		COVID-19 test				p-Value
Recovery from sudden olfactory dysfunction (n = 174)		Positive (n = 137)		Negative (n = 37)		p-Value
Full recovery	n and %	72	52.6	26	70.3	0.05^a a Statistical significance.
Partial recovery	n and %	46	33.6	10	27.0
No recovery	n and %	19	13.9	1	2.7
Time to full recovery	Med and IQR	15	10-21	10	8-12.75	0.0006^a a Statistical significance.

Recovery from sudden olfactory dysfunction (n = 137)		Positive-COVID-19				p-Value
Recovery from sudden olfactory dysfunction (n = 137)		Anosmia (n = 118)		Hyposmia (n = 19)		p-Value
Full recovery	n and %	59	50.0	13	68.4
Partial recovery	n and %	44	37.3	2	10.5	0.04^a a Statistical significance.
No recovery	n and %	15	12.7	4	21.1
Time to full recovery	Med and IQR	15.5	10.75-23	11	9-16	0.10

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. edumacoto@gmail.com