Psychiatric outcomes in outpatients affected by long COVID: A link between mental health and persistence of olfactory complaint

Victoria Metelkina-Fernandez; Louise-Emilie Dumas; Clair Vandersteen; David Chirio; Auriane Gros; Arnaud Fernandez; Florence Askenazy; Valeria Manera

doi:10.5498/wjp.v14.i4.507

Psychiatric outcomes in outpatients affected by long COVID: A link between mental health and persistence of olfactory complaint

World J Psychiatry. 2024 Apr 19;14(4):507-512. doi: 10.5498/wjp.v14.i4.507.

Authors

Victoria Metelkina-Fernandez¹, Louise-Emilie Dumas², Clair Vandersteen³, David Chirio⁴, Auriane Gros⁵, Arnaud Fernandez^{2

6}, Florence Askenazy², Valeria Manera⁷

Affiliations

¹ Department of Psychiatry, Nice University Hospital, Nice 06000, France.
² Department of Child and Adolescent Psychiatry, Université Côte d'Azur, Nice 06200, France.
³ ENT, Head and Neck Institute, Nice 06100, France.
⁴ Department of Infectiology, Nice University Hospital, Nice 06200, France.
⁵ Department of Orthophony, Université Côte d'Azur, Nice 06100, France.
⁶ Cobtek, Université Côte d'Azur, Nice 06100, France. arnaud.fernandez@hpu.lenval.com.
⁷ Cobtek, Université Côte d'Azur, Nice 06100, France.

Abstract

Background: Anosmia was one of the main symptoms of coronavirus disease 2019 (COVID-19). A psychiatric history (i.e., depression) may be an independent contributor to the risk of COVID-19 diagnosis, and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae (bidirectional association).

Aim: To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.

Methods: We conducted a prospective case control study from March 2020 to May 2021. Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint (visual analogue scale) for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology. Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department. Psychiatric medical histories were collected by a psychiatrist during the assessments.

Results: Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study. Fifty percent of the patients were female (n = 17). The group's mean age was 40.5 ± 12.9 years. The control group included 32 participants, of which 34.4% were female (n = 11), and had a mean age of 61.2 ± 12.2 years. The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher (41.7%) than among patients without (18.8%) (χ² = 5.9, P = 0.015).

Conclusion: The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia. It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients. Further prospective, translational, and collaborative studies are needed to extrapolate these results to the general population.

Keywords: Anosmia; COVID-19; Neuroplasticity; Psychiatric history; Psychiatry; Stress.