Retronasal olfactory testing in early diagnosed and suspected COVID-19 patients: a 7-week follow-up study

Eur Arch Otorhinolaryngol. 2022 Jan;279(1):257-265. doi: 10.1007/s00405-021-06826-1. Epub 2021 May 13.

Abstract

Objectives: Olfactory dysfunction (OD) constitutes a major symptom in Coronavirus Disease 2019 (COVID-19). Yet, most data on smell loss rely on the evaluation of orthonasal olfactory performance. Therefore, we aimed to assess retronasal olfactory function (ROF) over a period of several weeks in proven and suspected COVID-19 patients.

Methods: One hundred and one subjects with suspected or laboratory-proven COVID-19 participated in this study. In patients with OD no longer than 4 weeks after initial symptom onset, ROF was measured with the 7-item Candy Smell Test ten times over 7 weeks.

Results: Olfactory function was decreased in the investigated patients and remained decreased over the course of 7 weeks. One-way repeated-measures ANOVA revealed no significant difference of ROF between different measurement time points. However, self-assessment of smell and flavour improved significantly (p = 0.013 and p = 0.043), but did not show complete recovery.

Conclusion: The current investigation revealed significant improvements in subjective smell and flavour perception over the course of 7 weeks in proven and suspected COVID-19 patients suffering from acute OD. However, objectively measured ROF based on a screening test revealed no improvements within the same time period.

Keywords: Anosmia; COVID-19; Flavor; Olfaction; Retronasal.

MeSH terms

  • COVID-19*
  • Follow-Up Studies
  • Humans
  • Olfaction Disorders* / diagnosis
  • Olfaction Disorders* / etiology
  • SARS-CoV-2
  • Smell