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Recent Advances in Inflammation & Allergy Drug Discovery

Author(s): Kacem Imène*, Kahloul Mohamed, Ghenim Amal, Ajmi Mohamed, Chouchane Asma, Aloui Asma, Khalefa Wael, H. Kalboussi, El Maalel Olfa, Naija Walid, Maoua Maher and Mrizak Nejib

DOI: 10.2174/0127722708249126231006061438

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Olfactory Dysfunction in Healthcare Workers with COVID-19: Prevalence and Associated Factors

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Abstract

Background: The COVID-19 pandemic is a real global health crisis. Its clinical presentation has evolved over time with an increasing number of symptoms. Olfactory dysfunction (OD) has recently been recognized as a frequent symptom relevant to screening for COVID-19, especially in pauci-asymptomatic forms. However, the underlying mechanisms of OD are not yet fully understood.

Aim: To determine the prevalence of OD in healthcare workers with SARS-CoV-2 and to identify its associated factors.

Methods: This is a cross-sectional, analytical study, carried out during a period of six months and including all healthcare workers at Farhat Hached Academic Hospital (Tunisia) who were diagnosed with SARS-CoV-2 by PCR, RAT, or chest CT scan.

Results: A total of 474 healthcare workers were included, representing a participation rate of 85.4%. The mean age was 41.02±10.67 years with a sex ratio of 0.2. The distribution of this population by department noted that it was mainly maternity (13.9%). The most presented workstation was nursing (31.4%). OD represented 39.2% of the reasons for consultation. Hospitalization was indicated in 16 patients (3.4%). The average duration of hospitalization was 8.87 ± 7.8 days. The average time off work was 17.04 ± 11.6 days. OD persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, OD was statistically associated with female gender (p =0.001; OR 95% CI: 2.46 [1.4-4.2]) and blue-collar occupational category (p =0.002; OR IC95%:3.1 [1.5-6.5]). A significant association was also noted between OD and professional seniority and absence from work duration (p =0.019; OR 95% CI: 0.97 [0.95-0.99] and p =0.03; OR 95% CI: 0.97 [0.95-0.99]) respectively.

Conclusion: OD is common in COVID-19 patients. The identification of its associated factors may contribute to enhancing the understanding of its mechanism and drive therapeutic options.

Keywords: Persisted, therapeutic options, symptoms, pauci-asymptomatic, olfactory dysfunction, PCR.

Graphical Abstract

[1]
Lehrich BM, Goshtasbi K, Raad RA, et al. Aggregate prevalence of chemosensory and sinonasal dysfunction in SARS‐CoV‐2 and related coronaviruses. Otolaryngol Head Neck Surg 2020; 163(1): 156-61.
[http://dx.doi.org/10.1177/0194599820929278] [PMID: 32423285]
[2]
COVID-19 Coronavirus Pandemic. 2022. Available from: www.worldometers.info/coronavirus/
[3]
Ministry of Health. Main numbers recorded during the week 2022. Available from: www.santetunisie.rns.tn/fr/ (Accessed on: 12/04/2022).
[4]
Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. Lancet 2020; 395(10234): e77-8.
[http://dx.doi.org/10.1016/S0140-6736(20)30970-3] [PMID: 32333843]
[5]
Aghaizu A, Elam G, Ncube F, et al. Preventing the next ‘SARS’ - European healthcare workers’ attitudes towards monitoring their health for the surveillance of newly emerging infections: Qualitative study. BMC Public Health 2011; 11(1): 541.
[http://dx.doi.org/10.1186/1471-2458-11-541] [PMID: 21740552]
[6]
Kim JH, An JAA, Min PK, Bitton A, Gawande AA. How South Korea responded to the COVID-19 outbreak in Daegu. N Engl J Med 2020; 1(4): 1-14.
[7]
Sedaghat AR, Gengler I, Speth MM. Olfactory dysfunction: A highly prevalent symptom of COVID-19 with public health significance. Otolaryngol Head Neck Surg 2020; 163(1): 12-5.
[http://dx.doi.org/10.1177/0194599820926464] [PMID: 32366160]
[8]
Hummel T, Whitcroft KL, Andrews P, et al. Position paper on olfactory dysfunction. Rhinology 2016; 56(1): 1-30.
[PMID: 28623665]
[9]
Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ. Phantom smells: Prevalence and correlates in a population-based sample of olderadults. Chem Senses 2017; 42(4): 309-18.
[http://dx.doi.org/10.1093/chemse/bjx006] [PMID: 28334095]
[10]
Hoffman HJ, Rawal S, Li CM, Duffy VB. New chemosensory component in the U.S. National Health and Nutrition Examination Survey (NHANES): First-year results for measured olfactory dysfunction. Rev Endocr Metab Disord 2016; 17(2): 221-40.
[http://dx.doi.org/10.1007/s11154-016-9364-1] [PMID: 27287364]
[11]
Landis BN, Hummel T. New evidence for high occurrence of olfactory dysfunctions within the population. Am J Med 2006; 119(1): 91-2.
[http://dx.doi.org/10.1016/j.amjmed.2005.07.039] [PMID: 16431204]
[12]
Welge-Lüssen A, Wolfensberger M. Olfactory disorders following upper respiratory tract infections. Adv Otorhinolaryngol 2006; 63: 125-32.
[http://dx.doi.org/10.1159/000093758] [PMID: 16733337]
[13]
Gaines AD. Anosmia and hyposmia. Allergy Asthma Proc 2010; 31(3): 185-9.
[http://dx.doi.org/10.2500/aap.2010.31.3357] [PMID: 20615320]
[14]
Hopkins CKN. Loss of sense of smell as marker of COVID-19 infection 2020. 2022. Available from: https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf (Accessedon: 12/05/2022).
[15]
Lechner M, Chandrasekharan D, Jumani K, et al. Anosmia as a presenting symptom of SARS-CoV-2 infection in healthcare workers – A systematic review of the literature, case series, and recom mendations for clinical assessment and management. Rhinology 2020; 0(0): 0.
[http://dx.doi.org/10.4193/Rhin20.189] [PMID: 32386285]
[16]
Slama D, Bartier S, Hautefort C, et al. Anosmia: specific criterion for COVID-19 damage “Coranosmia1». Med Mal Infect 2020; 50(6): S78.
[http://dx.doi.org/10.1016/j.medmal.2020.06.155]
[17]
Qiu C, Cui C, Hautefort C, et al. Olfactory and gustatory dysfunction as an early identifier of COVID-19 in adults and children: An international multicenter study. Otolaryngol Head Neck Surg 2020; 163(4): 714-21.
[http://dx.doi.org/10.1177/0194599820934376] [PMID: 32539586]
[18]
WHO. Obesity and overweight 2022. Available from: www.who.int/fr/news-room/fact-sheets/detail/obesity-and-overweight (Accessed on: 13/04/2022).
[19]
WHO. 2022. Available from: https://apps.who.int/irris/bitstream/handle/10665/332931/who-2019-nCoV-Sci_Brief-Discharge_from_Isolation-2020.1fre (Accessedon: 13/04/2022).
[20]
Wynants L, Van Calster B, Collins GS, et al. Prediction models for diagnosis and prognosis of covid-19: Systematic review and critical appraisal. BMJ 2020; 369: m1328.
[http://dx.doi.org/10.1136/bmj.m1328] [PMID: 32265220]
[21]
Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss of function as a possible symptom of COVID-19. JAMA Otolaryngol Head Neck Surg 2020; 146(7): 674-5.
[http://dx.doi.org/10.1001/jamaoto.2020.0832] [PMID: 32267483]
[22]
Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology 2020; 58(3): 299-301.
[http://dx.doi.org/10.4193/Rhin20.114] [PMID: 32240279]
[23]
Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology 2020; 58(3): 295-8.
[http://dx.doi.org/10.4193/Rhin20.116] [PMID: 32277751]
[24]
Keyhan SO, Fallahi HR, Cheshmi B. Dysosmia and dysgeusia due to the 2019 Novel Coronavirus; a hypothesis that needs further investigation. Maxillofac Plast Reconstr Surg 2020; 42(1): 9.
[http://dx.doi.org/10.1186/s40902-020-00254-7] [PMID: 32289035]
[25]
Antolín Amérigo D, Cubero JL, Colás C, Alobid I, Mullol J, Valero A. High frequency of smell and taste dysfunction in health care professionals with COVID-19 working in allergy departments. J Investig Allergol Clin Immunol 2021; 31(2): 151-61.
[http://dx.doi.org/10.18176/jiaci.0670] [PMID: 33876736]
[26]
Nielsen KJ, Vestergaard JM, Schlünssen V, et al. Day-by-day symptoms following positive and negative PCR tests for SARS-CoV-2 in non-hospitalized healthcare workers: A 90-day follow-up study. Int J Infect Dis 2021; 108: 382-90.
[http://dx.doi.org/10.1016/j.ijid.2021.05.032] [PMID: 34022336]
[27]
Bussière N, Mei J, Lévesque-Boissonneault C, et al. Chemosensory dysfunctions induced by COVID-19 can persist up to 7 months: A study of over 700 healthcare workers. Chem Senses 2021; 46: bjab038.
[http://dx.doi.org/10.1093/chemse/bjab038] [PMID: 34423831]
[28]
Villarreal IM, Morato M, Martínez-RuizCoello M, et al. Olfactory and taste disorders in healthcare workers with COVID-19 infection. Eur Arch Otorhinolaryngol 2021; 278(6): 2123-7.
[http://dx.doi.org/10.1007/s00405-020-06237-8] [PMID: 32725271]
[29]
Weiss JJ, Attuquayefio TN, White EB, et al. Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection. PLoS One 2021; 16(3): e0248025.
[http://dx.doi.org/10.1371/journal.pone.0248025] [PMID: 33657167]
[30]
Lan FY, Filler R, Mathew S, et al. COVID-19 symptoms predictive of healthcare workers’ SARS-CoV-2 PCR results. PLoS One 2020; 15(6): e0235460.
[http://dx.doi.org/10.1371/journal.pone.0235460] [PMID: 32589687]
[31]
Carrillo-Larco RM, Altez-Fernandez C. Anosmia and dysgeusia in COVID-19: A systematic review. Wellcome Open Res 2020; 5: 94.
[http://dx.doi.org/10.12688/wellcomeopenres.15917.1] [PMID: 32587902]
[32]
Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T. The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: a systematic review and meta-analysis. Otolaryngol Otolaryngol Head Neck Surg 2020; 163(1): 3-11.
[http://dx.doi.org/10.1177/0194599820926473] [PMID: 32369429]
[33]
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061-9.
[http://dx.doi.org/10.1001/jama.2020.1585] [PMID: 32031570]
[34]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[35]
Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[36]
Medscape. Sudden Loss of Taste and Smell Should Be Part of COVID-19 Screen. 2022. Available from: https://www.medscape.com/viewarticle/929116?src=soc_fb_200422_mscpedt_news_mdscp_coronavirus&faf=1 (Accessed on:12/05/2022).
[37]
Proclaim Cauca and Valle. Smell test to check coronavirus symptoms 2022. Available from: https://www.proclamadelcauca.com/prueba-de-olfato-paracomprobar-sintomas-de-coronavirus/ (Accessed on: 14/05/2022).
[38]
Xydakis MS, Dehgani-Mobaraki P, et al. Smell and taste dysfunction in patients with COVID-19. Lancet Infect Dis 2020; 20(9)
[39]
Moein ST, Hashemian SM, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: A biomarker for COVID-19. Int Forum Allergy Rhinol 2020; 10(8): 944-50.
[http://dx.doi.org/10.1002/alr.22587] [PMID: 32301284]
[40]
Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to moderate forms of the coronavirus disease (COVID-19): A multicenter European study. Eur Arch Otorhinolaryngol 2020; 277(8): 2251-61.
[http://dx.doi.org/10.1007/s00405-020-05965-1] [PMID: 32253535]
[41]
La Torre G, Massetti AP, Antonelli G, et al. Anosmia and ageusia as predictive signs of COVID-19 in healthcare workers in Italy: A prospective case-control study. J Clin Med 2020; 9(9): 2870.
[http://dx.doi.org/10.3390/jcm9092870] [PMID: 32899778]
[42]
Vaira LA, Hopkins C, Salzano G, et al. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter‐study. Head Neck 2020; 42(7): 1560-9.
[http://dx.doi.org/10.1002/hed.26269] [PMID: 32437022]
[43]
Lechner M, Counsell N, Liu J, et al. Anosmia and hyposmia in health-care workers with undiagnosed SARS-CoV-2 infection. Lancet Microbe 2020; 1(4): e150.
[http://dx.doi.org/10.1016/S2666-5247(20)30096-3] [PMID: 33521715]
[44]
Menni C, Valdes A, Freydin MB, Ganesh S, et al. Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection. medRxiv 2020; 20048421.
[http://dx.doi.org/10.1101/2020.04.05.20048421]
[45]
Beltran-Corbellini A, Chico-Garcıa JL, Martinez-Poles J, Rodríguez-Jorge F, Natera-Villalba E, Gómez-Corral J. et al. Acute-onset smell and taste disorders in the context of Covid19: A pilot multicenter PCR-based case-control study. Eur J Neurol 2020; 27(9): 1738-41.
[http://dx.doi.org/10.1111/ene.14273] [PMID: 32320508]
[46]
Wee LE, Chan YFZ, Teo NWY, et al. The role of self-reported olfactory and gustatory dysfunction as a screening criterion for suspected COVID-19. Eur Arch Otorhinolaryngol 2020; 277(8): 2389-90.
[http://dx.doi.org/10.1007/s00405-020-05999-5] [PMID: 32328771]
[47]
Sun Y, Koh V, Marimuthu K, et al. Epidemiological and clinical predictors of COVID-19. Clin Infect Dis 2020; 71(15): 786-92.
[http://dx.doi.org/10.1093/cid/ciaa322] [PMID: 32211755]
[48]
Spinato G, Fabbris C, Polesel J, et al. Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection. JAMA 2020; 323(20): 2089-90.
[http://dx.doi.org/10.1001/jama.2020.6771] [PMID: 32320008]
[49]
Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS. Self reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol 2020; 10(7): 821-31.
[http://dx.doi.org/10.1002/alr.22592] [PMID: 32329222]
[50]
Boscolo-Rizzo P, Guida F, Polesel J, et al. Self-reported smell and taste recovery in coronavirus disease 2019 patients: a one-year prospective study. Eur Arch Otorhinolaryngol 2022; 279(1): 515-20.
[http://dx.doi.org/10.1007/s00405-021-06839-w] [PMID: 33963433]
[51]
Wei G, Gu J, Gu Z, Du C, Huang X, Xing H, et al. Olfactory dysfunction in patients with coronavirus disease. Front Neurol 2019 2019.
[52]
Jain A, Kumar L, Kaur J, et al. Olfactory and taste dysfunction in coronavirus disease 2019 patients: its prevalence and outcomes. J Laryngol Otol 2020; 134(11): 987-91.
[http://dx.doi.org/10.1017/S0022215120002467] [PMID: 33190657]
[53]
Speth MM, Singer-Cornelius T, Oberle M, Gengler I, Brockmeier SJ, Sedaghat AR. Olfactory dysfunction and sinonasal symptomatology in COVID-19: Prevalence, severity, timing, and associated characteristics. Otolaryngol Head Neck Surg 2020; 163(1): 114-20.
[http://dx.doi.org/10.1177/0194599820929185] [PMID: 32423357]
[54]
Lechien JR, Cabaraux P, Chiesa-Estomba CM, et al. Objective olfactory evaluation of self‐reported loss of smell in a case series of 86 COVID-19 patients. Head Neck 2020; 42(7): 1583-90.
[http://dx.doi.org/10.1002/hed.26279] [PMID: 32437033]
[55]
Delgado-Losada ML, Bouhaben J, Ruiz-Huerta C, Canto MV, Delgado-Lima AH. Long-lasting olfactory dysfunction in hospital workers due to COVID-19: Prevalence, clinical characteristics, and most affected odorants. Int J Environ Res Public Health 2022; 19(9): 5777.
[http://dx.doi.org/10.3390/ijerph19095777] [PMID: 35565169]
[56]
Castillo-López IY, Govea-Camacho LH, Rodríguez-Torres IA, Recio-Macías DA, Alobid I, Mullol J. Olfactory dysfunction in a Mexican population outside of COVID-19 pandemic: prevalence and associated factors (the OLFAMEX Study). Curr Allergy Asthma Rep 2020; 20(12): 78.
[http://dx.doi.org/10.1007/s11882-020-00975-9] [PMID: 33161494]
[57]
Andrews PJ, Pendolino AL, Ottaviano G, et al. Olfactory and taste dysfunction among mild-to-moderate symptomatic COVID-19 positive health care workers: An international survey. Laryngoscope Investig Otolaryngol 2020; 5(6): 1019-28.
[58]
Lombardi A, Consonni D, Carugno M, et al. Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clin Microbiol Infect 2020; 26(10): 1413.e9-1413.e13.
[59]
Agyeman AA, Chin KL, Landersdorfer CB, Liew D, Ofori-Asenso R. Smell and taste dysfunction in patients with COVID-19: A systematic review and meta-analysis. Mayo Clin Proc 2020; 95(8): 1621-31.
[http://dx.doi.org/10.1016/j.mayocp.2020.05.030] [PMID: 32753137]
[60]
von Bartheld CS, Hagen MM, Butowt R. Prevalence of chemosensory dysfunction in COVID-19 patients: A systematic review and meta-analysis reveals significant ethnic differences. ACS Chem Neurosci 2020; 11(19): 2944-61.
[http://dx.doi.org/10.1021/acschemneuro.0c00460] [PMID: 32870641]
[61]
Cavazzana A, Larsson M, Münch M, Hähner A, Hummel T. Postinfectious olfactory loss: A retrospective study on 791 patients. Laryngoscope 2018; 128(1): 10-5.
[http://dx.doi.org/10.1002/lary.26606] [PMID: 28556265]
[62]
Karamali K, Elliott M, Hopkins C. COVID-19 related olfactory dysfunction. Curr Opin Otolaryngol Head Neck Surg 2022; 30(1): 19-25.
[http://dx.doi.org/10.1097/MOO.0000000000000783] [PMID: 34889850]
[63]
Meinhardt J, Radke J, Dittmayer C, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19. Nat Neurosci 2021; 24(2): 168-75.
[http://dx.doi.org/10.1038/s41593-020-00758-5] [PMID: 33257876]
[64]
Brann DH, Tsukahara T, Weinreb C, Lipovsek M, Van den Berge K, Gong B, et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv 2020; 6: eabc5801.
[65]
Libby P, Lüscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J 2020; 41(32): 3038-44.
[http://dx.doi.org/10.1093/eurheartj/ehaa623] [PMID: 32882706]
[66]
Siddiqi HK, Libby P, Ridker PM. COVID-19 – A vascular disease. Trends Cardiovasc Med 2021; 31(1): 1-5.
[http://dx.doi.org/10.1016/j.tcm.2020.10.005] [PMID: 33068723]
[67]
Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Hypertension, thrombosis, kidney failure, and diabetes: Is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basicevidence. J Clin Med 2020; 9(5): 1417.
[http://dx.doi.org/10.3390/jcm9051417] [PMID: 32403217]