More Than Smell—COVID-19 Is Associated With Severe Impairment of Smell, Taste, and Chemesthesis
Valentina Parma, Kathrin Ohla, Maria G. Veldhuizen, Masha Y. Niv, Christine E Kelly, Alyssa J. Bakke, Keiland W Cooper, Cédric Bouysset, Nicola Pirastu, Michele Dibattista, Rishemjit Kaur, Marco Tullio Liuzza, Marta Yanina Pepino, Veronika Schöpf, Veronica Pereda‐Loth, Shannon B. Olsson, Richard C. Gerkin, Paloma Rohlfs Domínguez, Javier Albayay, Michael C. Farruggia, Surabhi Bhutani, Alexander Wieck Fjældstad, Ritesh Kumar, Anna Menini, Moustafa Bensafi, Mari Sandell, Iordanis Konstantinidis, Antonella Di Pizio, Federica Genovese, Lina Öztürk, Thierry Thomas‐Danguin, Johannes Frasnelli, Sanne Boesveldt, Özlem Saatçi, Luís R. Saraiva, Cailu Lin, Jérôme Golebiowski, Liang‐Dar Hwang, Mehmet Hakan Özdener, María Dolors Guárdia, Christophe Laudamiel, Marina Ritchie, Jan Havlı́ček, Denis Pierron, E. Roura, Marta Navarro, Alissa A. Nolden, Juyun Lim, Katherine L. Whitcroft, Lauren R Colquitt, Camille Ferdenzi, Evelyn V Brindha, Aytuğ Altundağ, Alberto Macchi, Alexia Nunez-Parra, Zara M. Patel, Sébastien Fiorucci, Carl Philpott, Barry Smith, Johan N. Lundström, Carla Mucignat‐Caretta, Jane K. Parker, Mirjam van den Brink, Michael Schmuker, Florian Ph. S. Fischmeister, Thomas Heinbockel, Vonnie D. C. Shields, Farhoud Faraji, Enrique Santamaría, William Fredborg, Gabriella Morini, Jonas Olofsson, Maryam Jalessi, Noam Karni, Anna D’Errico, Rafieh Alizadeh, Robert Pellegrino, Pablo Meyer, Caroline Huart, Ben Chen, Graciela M Soler, Mohammed K Alwashahi, Antje Welge–Lüssen, Jessica Freiherr, Jasper H. B. de Groot, Hadar Klein, Masako Okamoto, Preet Bano Singh, Julien Wen Hsieh, GCCR Group Author, Olagunju Abdulrahman, Pamela Dalton, Carol H. Yan, Vera V. Voznessenskaya, Jingguo Chen, Elizabeth Sell, Julie Walsh‐Messinger, Nicholas Archer, Sachiko Koyama, Vincent Deary
Abstract
Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (-79.7 ± 28.7, mean ± standard deviation), taste (-69.0 ± 32.6), and chemesthetic (-37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms.