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Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: A community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK

Lechner, Matt, Batterham, Rachel, Carnemolla, Alisia, Balogun, Nyaladzi, Firman, Chloe, Magee, Cormac, Makaronidis, Janine, Mok, Jessica

2021

Overview

Background: Loss of smell and/or taste are cardinal symptoms of COVID-19. ‘Long-COVID’, persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. We assessed COVID-19 symptoms in a community cohort in London 4-6 weeks after they initially reported acute loss of their sense of smell and/or taste, 78% of whom had SARS-CoV-2 IgG/IgM antibodies. In addition, to assess whether self-reported change in sense of smell was reliable, we compared subjective and objective smell assessments in a subset of participants. Methods: 467 participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4-6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations. Results: People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery: 57.7% vs. 72.1% , p=0.027. taste recovery 66.2% vs. 80.3%, p=0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p<0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4-6 weeks (OR 2.46, 95%CI 1.47-4.13, p=0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (>40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54-4.00, p<0.001). Conclusion: Although smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4-6 weeks follow-up, which constitute symptoms of ‘long-COVID’. Females (particularly >40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions. Trials registration: ClinicalTrials.gov NCT04377815

• Publisher: Research Square
• Subject: Antibodies / Chemosensory perception / Coronaviruses / COVID-19 / Females / Severe acute respiratory syndrome coronavirus 2 / Smell