Covid-19 affects taste independently of smell: results from a combined chemosensory home test and online survey from a global cohort (N=10,953)
2023
Nguyen, Ha | Albayay, Javier | Höchenberger, Richard | Bhutani, Surabhi | Boesveldt, Sanne | Busch, Niko, A. | Croijmans, Ilja | Cooper, Keiland, W. | de Groot, Jasper, H. B. | Farruggia, Michael, C. | Fjaeldstad, Alexander, W. | Hayes, John, E. | Hummel, Thomas | Joseph, Paule, V. | Laktionova, Tatiana, K. | Thomas-Danguin, Thierry | Veldhuizen, Maria, G. | Voznessenskaya, Vera, V. | Parma, Valentina | Pepino, M. Yanina | Ohla, Kathrin | Monell Chemical Senses Center | Università degli Studi di Trento (UNITN) | Modèles et inférence pour les données de Neuroimagerie (MIND) ; IFR49 - Neurospin - CEA ; Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Inria Saclay - Ile de France ; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria) | Université Paris-Saclay | San Diego State University (SDSU) | Wageningen University and Research [Wageningen] (WUR) | Westfälische Wilhelms-Universität Münster = University of Münster (WWU) | Radboud University [Nijmegen] | University of California [Irvine] (UC Irvine) ; University of California (UC) | Yale University [New Haven] | Aarhus University [Aarhus] | Pennsylvania State University (Penn State) ; Penn State System | University of Dresden Medical School | National Institutes of Health [Bethesda] (NIH) | A.N. Severtsov Institute of Ecology and Evolution ; Russian Academy of Sciences [Moscow] (RAS) | Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA) ; Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Dijon ; Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro) | Mersin University | University of Illinois at Urbana-Champaign [Urbana] ; University of Illinois System | Helmut Schmidt University, University of the Armed Forces Hamburg | Firmenich SA | This work was supported, in part, by the National Science Foundation [grand number DGE-1839285 to C.K.]; the National Institute on Alcohol Abuse and Alcoholism [grant number Z01AA000135 to P.V.J], the National Institute of Nursing Research [grant number 1ZIANR000035-01 to P.V.J], the National Institute of Deafness and Other Communication Disorders [grant number U01DC019573 to J.E.H.], and the National Institute of Food and Agriculture via Hatch Act funds [grant number 698-921 to M.Y.P.; PEN04708 to J.E.H.].
Abstract People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with ten household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 3,356 self-reported a positive and 602 a negative COVID-19 diagnosis (COVID+ and COVID-, respectively); 1,267 were awaiting test results (COVID?). The rest reported no respiratory illness and were grouped by symptoms: sudden smell/taste changes (STC, N=4,445), other symptoms excluding smell or taste loss (OthS, N=832), and no symptoms (NoS, N=416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% Confidence Interval (CI): 15-28%), 47% in smell (95%-CI: 37-56%), and 17% in oral irritation (95%-CI: 10-25%) intensity. In all groups, perceived intensity of smell (r=0.84), taste (r=0.68), and oral irritation (r=0.37) was correlated. Our findings suggest most reports of taste dysfunction with COVID-19 were genuine and not due to misinterpreting smell loss as taste loss (i.e., a classical taste-flavor confusion). Assessing smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and helps to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.
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