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The aim of this study is to investigate the clinical profile of patients who developed coronavirus disease 2019 (COVID-19) after full vaccination. Demographic, epidemiological and clinical data were collected through medical records and online patient-reported outcome questionnaire from patients who developed symptomatic SARS-CoV-2 infection, confirmed by nasopharyngeal swab, at least 2 weeks after completion of vaccination. A total of 153 subjects were included. The most frequent symptoms were: asthenia (82.4%), chemosensory dysfunction (63.4%), headache (59.5%), runny nose (58.2%), muscle pain (54.9%), loss of appetite (54.3%), and nasal obstruction (51.6%). Particularly, 62.3% and 53.6% of subjects reported olfactory and gustatory dysfunction, respectively. Symptom severity was mild or moderate in almost all cases. Chemosensory dysfunctions have been observed to be a frequent symptom even in subjects who contracted the infection after full vaccination. For this reason, the sudden loss of smell and taste could continue to represent a useful and specific diagnostic marker to raise the suspicion of COVID-19 even in vaccinated subjects. In the future, it will be necessary to establish what the recovery rate is in these patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 132:419-421, 2022., (© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: The aim of this study was to evaluate the correlations between the severity and duration of olfactory dysfunctions (OD), assessed with psychophysical tests, and the viral load on the rhino-pharyngeal swab determined with a direct method, in patients affected by coronavirus disease 2019 (COVID-19)., Study Design: Prospective cohort study., Methods: Patients underwent psychophysical olfactory assessment with Connecticut Chemosensory Clinical Research Center test and determination of the normalized viral load on nasopharyngeal swab within 10 days of the clinical onset of COVID-19., Results: Sixty COVID-19 patients were included in this study. On psychophysical testing, 12 patients (20% of the cohort) presented with anosmia, 11 (18.3%) severe hyposmia, 13 (18.3%) moderate hyposmia, and 10 (16.7%) mild hyposmia with an overall prevalence of OD of 76.7%. The overall median olfactory score was 50 (interquartile range [IQR] 30-72.5) with no significant differences between clinical severity subgroups. The median normalized viral load detected in the series was 2.56E+06 viral copies/10 6 copies of human beta-2microglobulin mRNA present in the sample (IQR 3.17E+04-1.58E+07) without any significant correlations with COVID-19 severity. The correlation between viral load and olfactory scores at baseline (R 2  = 0.0007; P = .844) and 60-day follow-up (R 2  = 0.0077; P = .519) was weak and not significant., Conclusions: The presence of OD does not seem to be useful in identifying subjects at risk for being super-spreaders or who is at risk of developing long-term OD. Similarly, the pathogenesis of OD is probably related to individual factors rather than to viral load and activity., Level of Evidence: 4 Laryngoscope, 131:2312-2318, 2021., (© 2021 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: To investigate clinical and radiological features of olfactory clefts of patients with mild coronavirus disease 2019 (COVID-19)., Study Design: Prospective non controlled study., Methods: Sixteen COVID-19 patients were recruited. The epidemiological and clinical data were extracted. Nasal complaints were assessed through the 22-item Sino-Nasal Outcome Test. Patients underwent psychophysical olfactory testing, olfactory cleft examination, and computed tomography (CT) scans., Results: Sixteen anosmic patients were included. The mean Sniffin' Sticks score was 4.6 ± 1.7. The majority of patients had no endoscopical abnormality, with a mean olfactory cleft endoscopy score of 0.6 ± 0.9. The olfactory clefts were opacified in three patients on the CT scan. The mean radiological olfactory cleft score was 0.7 ± 0.8. There were no significant correlations between clinical, radiological, and psychophysical olfactory testing., Conclusions: The olfactory cleft of anosmic COVID-19 patients is free regarding endoscopic examination and imaging. The anosmia etiology is not related to edema of the olfactory cleft., Level of Evidence: 4 Laryngoscope, 130:2526-2531, 2020., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)

Olfactory dysfunction (OD) was one of the most common symptom of infection with the Wuhan strain of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and could persist for several months after symptom onset. The pathogenesis of prolonged OD remains poorly understood but probably involves sustained viral replication associated with limited mucosal immune response to the virus. This prospective study was conducted to investigate the potential relationship between nasal SARS‐CoV‐2 viral load and antibody levels in patients with loss of smell. One hundred and five patients were recruited 2 weeks after presenting with confirmed coronavirus disease 2019 associated OD. Based on the identification sniffing test performed at enrollment, 52 patients were still anosmic or hyposmic and 53 were normosmic. SARS‐CoV‐2 was detectable in nasal wash of about 50% of anosmic and normosmic patients. Higher viral load was detected in anosmic patients with lower levels of SARS‐CoV‐2 specific nasal immunoglobulins (Ig) IgG and IgA. This association was not observed in normosmic patients. No relationship between nasal viral load and antibodies to endemic coronaviruses was observed. SARS‐CoV‐2 replication in the nasal cavity may be promoted by defective mucosal antibody responses in patients with OD. Boosting mucosal immunity may limit nasal SARS‐CoV‐2 replication and thereby help in the control of persistent OD. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of platelet‐rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID‐19) patients with persistent olfactory dysfunction (OD). Study Design: Controlled study. Setting: Multicenter study. Methods: From March 2022 to November 2022, COVID‐19 patients with persistent OD were recruited from three European hospitals to undergo PRP injections into the olfactory clefts. Olfactory function was evaluated at baseline and 10 weeks postinjection with the Olfactory Disorder Questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Data were compared with a control group of untreated patients. Results: Eighty‐one patients who underwent PRP injection and 78 controls were included. Sixty‐five PRP patients (80.3%) experienced subjective smell improvement after a mean duration of 3.4 ± 1.9 weeks. The parosmia, life quality statement, and ODQ sub‐ and total scores significantly decreased from pre‐ to 10‐week postinjection in the PRP group. The TDI sub‐ and total scores significantly increased 10 weeks postinjection. In controls, the ODQ score did not change over time, while the discrimination, identification, and total TDI scores significantly increase after 10 weeks of follow‐up. The 10‐week TDI and ODQ scores were significantly better in the PRP group compared with the controls. Conclusion: Patients who underwent PRP injection reported better 10‐week subjective and objective smell outcomes than controls. Future randomized‐controlled studies using saline injection into the olfactory cleft of controls are needed to determine the superiority of PRP over placebo. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and recovery of olfactory dysfunction (OD) in COVID‐19 patients 24 months after the infection. Methods: From 22 March 2020 to 5 June 2022, 251 COVID‐19 patients were followed in three European medical centres. Olfactory function was assessed with subjective patient‐reported outcome questionnaires and odour identification tests at baseline, 6, 12, 18 and 24 months postinfection. The predictive values of epidemiological and clinical data were investigated with multivariate analysis. Results: One hundred and seventy‐one patients completed the evaluations. The odour identification test revealed that 123 patients (50.8%) had OD at baseline. The prevalence of persistent psychophysical abnormalities at 6, 12, 18 and 24 months post‐COVID‐19 was 24.2%, 17.9%, 5.8% and 2.9%, respectively (p = 0.001). Parosmia occurred in 40 patients (23.4%) and lasted 60 ± 119 days. At 2 years, 51 patients (29.8%) self reported that their olfaction was unnormalised. Older patients had better odour identification evaluations at baseline (p < 0.001) but those with OD reported lower odour identification test scores at the end of the follow‐up. Parosmia occurred more frequently in young patients. The olfactory training was significantly associated with higher values of Sniffin' Sticks tests at 18 months postinfection (rs = 0.678; p < 0.001). Conclusion: Two years post‐COVID‐19, 29.8% of patients reported persistent OD, but only 2.9% had abnormal identification psychophysical evaluations. [ABSTRACT FROM AUTHOR]

The purpose of this multicenter case-control study was to evaluate a group of patients at least 1 year after coronavirus disease 2019 (COVID-19) with Sniffin' Sticks tests and to compare the results with a control population to quantify the potential bias introduced by the underlying prevalence of olfactory dysfunction (OD) in the general population. The study included 170 cases and 170 controls. In the COVID-19 group, 26.5% of cases had OD (anosmia in 4.7%, hyposmia in 21.8%) versus 3.5% in the control group (6 cases of hyposmia). The TDI score (threshold, discrimination, and identification) in the COVID-19 group was significantly lower than in the control group (32.5 [interquartile range, 29-36.5] vs 36.75 [34-39.5], P < .001). The prevalence of OD was significantly higher in the COVID-19 group, confirming that this result is not due to the underlying prevalence of OD in the general population. [ABSTRACT FROM AUTHOR]

Background and purpose: The aim was to evaluate potential predictive factors of smell recovery in a clinical series of 288 patients presenting olfactory dysfunction (OD) related to coronavirus disease 2019 (COVID‐19). Potential correlations were sought between epidemiological, clinical and immunological characteristics of patients and the persistence of OD at 60 days. Methods: COVID‐19 positive patients presenting OD were prospectively recruited from three European hospitals. Baseline clinical and olfactory evaluations were performed within the first 2 weeks after OD onset and repeated at 30 and 60 days. In a subgroup of patients, anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antibodies were measured in serum, saliva and nasal secretions at 60 days. Results: A total of 288 COVID‐19 patients with OD were included in the study. Two weeks after the onset of the loss of smell, 52.4% of patients had OD on psychophysical tests, including 113 cases (39.2%) of anosmia and 38 cases (13.2%) of hyposmia. At 60‐day follow‐up, 25.4% of the patients presented persistent OD. There was no significant correlation between sex, age, viral load on nasopharyngeal swab or COVID‐19 severity and poor olfactory outcome. In a subgroup of 63 patients, it was demonstrated that patients with poor olfactory outcomes at 60 days had lower levels of salivary and nasal immunoglobulin G (IgG) and IgG1, but similar levels of antibodies in the serum. Conclusions: No clinical markers predicted the evolution of OD at 60 days. Patients with poor olfactory outcome at 60 days had lower saliva and nasal antibodies, suggesting a role for local immune responses in the persistence of COVID‐19 related OD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the clinical features of mild‐to‐moderate coronavirus disease 2019 (COVID‐19) in a sample of Italian patients and to investigate the occurrence of smell and taste disorders. Infected individuals with suspected (clinical diagnosis) or laboratory‐confirmed COVID‐19 infection were recruited. Patients completed a survey‐based questionnaire with the aim of assessing their epidemiological and clinical characteristics, general otorhinolaryngological symptoms, and smell and taste disorders. A total of 294 patients with mild‐to‐moderate COVID‐19 completed the survey (147 females). The most prevalent general symptoms included fever, myalgia, cough, and headache. A total of 70.4% and 59.2% of patients reported smell and taste disorders, respectively. A significant association between the two above‐mentioned disorders was found (rs: 0.412; P <.001). Smell disorders occurred before the other symptoms in 11.6% of patients and was not significantly associated with nasal obstruction or rhinorrhea. Interestingly, our statistical analysis did not show any significant difference, either for general symptoms or otorhinolaryngological features, between the clinical diagnosis group and the laboratory‐confirmed diagnosis (polymerase chain reaction) group. The structural equation model confirmed significant standardized paths (P <.05) between general symptoms, comorbidities, and general otorhinolaryngological complaints in the absence of a significant correlation between these elements and smell and taste alterations. The prevalence of smell and taste disorders in mild‐to‐moderate Italian COVID‐19 patients is significant both in suspected and laboratory‐confirmed cases and reveals a strong correlation between these clinical signs regardless of the presence of general or otorhinolaryngological symptoms, such as nasal obstruction or rhinorrhea. Highlights: This study evaluates the clinical features of mild‐to‐moderate COVID‐19 in a sample of adult Italian patients. The structural equation model (SEM) built to examine the clinical characteristics of the infection, confirms significant standardised paths between all the evaluated variables and underlines the absence of a significant correlation between smell and taste disorders and all the other variables. Furthermore, the study reveals a strong correlation between smell and taste alterations with a significant prevalence of these symptoms both in suspected (clinical diagnosis) and laboratory‐confirmed (pcr) cases. [ABSTRACT FROM AUTHOR]

Keywords: anosmia; chest CT; coronavirus; COVID-19; hyposmia; olfactory; pneumonia; recovery; SARS-CoV-2; smell EN anosmia chest CT coronavirus COVID-19 hyposmia olfactory pneumonia recovery SARS-CoV-2 smell 103 107 5 12/31/21 20220101 NES 220101 INTRODUCTION The prognostic value of olfactory dysfunction (OD) in coronavirus disease 2019 (COVID-19) remains controversial, with conflicting reports of the association between OD and COVID-19 severity.1 Many of the prognostic studies published so far have important drawbacks that limit the reliability of the results; most are anamnestic studies that do not formally evaluate olfactory function with risk of recall bias, and use "need for hospitalization" alone to determine COVID-19 severity. Coronavirus, COVID-19, hyposmia, pneumonia, anosmia, chest CT, olfactory, recovery, SARS-CoV-2, smell At baseline, 35 patients (76.1%) had OD: 12 cases of anosmia (26.1%), severe hyposmia in 10 (21.7%), and moderate hyposmia in 13 cases (28.3%). [Extracted from the article]

Making scents of loss of taste in COVID-19: Is self-reported loss of taste due to olfactory dysfunction? Three clinical presentations were accepted for patient eligibility: isolated sudden loss of smell, isolated sudden loss of taste, or concomitant sudden loss of smell and taste. These results support the idea that most patients with COVID-19 tend to unconsciously conflate taste loss and olfactory loss, even when taste function is clearly defined to them beforehand as only referring to the perception of sweet, salty, sour, and bitter tastes. [Extracted from the article]