Conference paper
CLINICAL FEATURES IN RUSSIAN PATIENTS WITH COVID-ASSOCIATED PAROSMIA/PHANTHOSMIA
Svetlana Kopishinskaia
; Department of Neurology, Neurosurgery and Neurorehabilitation, Kirov State Medical University, Kirov, Russia ; International Center for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
Daria Lapshova
; Department of Neurology, Central Clinical Health Unit named after V. A. Egorov, Ulyanovsk, Russia
Mikhail Sherman
; Department of Neurology, Neurosurgery and Neurorehabilitation, Kirov State Medical University, Kirov, Russia
Ivan Velichko
; Department of Neurology, Kuban State Medical University, Krasnodar, Russia
Nikolai Voznesensky
; A.N.Severtsov Institute of Ecology & Evolution, Russian Academy of Sciences, Moscow, Russia
Vera Voznesenskaia
; A.N.Severtsov Institute of Ecology & Evolution, Russian Academy of Sciences, Moscow, Russia
Abstract
Background: Olfactory dysfunction is a typical symptom of COVID-19 infection. While COVID-associated anosmia is welldescribed,
knowledge of parosmia (olfactory distortions) and phanthosmia (olfactory hallucinations) is relatively lacking. We
undertook a clinical study of the parosmia/phanthosmia phenotype, aiming to support improved prediction and management of
these symptoms.
Subjects and methods: In a cross-sectional study between September 2020 and May 2021, we recruited 187 COVID-19 patients
with parosmia/phanthosmia via social media and a matched healthy control group from neurologists. The patients received an online
video-consultation with a neurologist trained in olfactory research and completed a questionnaire to assess the nature of their
subjective olfactory disorder.
Results: In the acute period of COVID-19 parosmia/phanthosmia, patients often experienced comorbid manifestations such as
fatigue, fever, headache, myalgia, and "brain fog". Isolated phanthosmia was observed in 13.9% of acute COVID-19 patients, as
compared to 34.2% in the long term. Parosmia was described in 89.8% of patients in the long-term course of the disease. COVIDassociated
parosmia/phanthosmia was more common in women (81.3%) than men (18.7%). Almost all parosmia/phanthosmia
patients had an acute history of anosmia, which often progressed to hyposmia. A third of the patients had a history of taste
disturbance The long-term COVID-19 sequelae such as fatigue, brain fog, and dizziness are significantly more common among
patients with parosmia/phanthosmia, as were autonomic symptoms such as awareness of heartbeat and rapid pulse. The incidence of
migraine with aura was significantly higher in the parosmia/phanthosmia group than in the control group (8% versus 0.9%). The
allergy was reported significantly more frequent in the study group compared to the control group.
Conclusions: Qualitative olfactory disorders occur frequently in COVID-19 patients. Those with the parosmia/phanthosmia
phenotype have a higher risk for other symptoms, notably headache (including migraine with aura), fatigue, brain fog, dizziness, and
cardiovascular/autonomic manifestations, as well as allergy. We suppose that further investigation of this phenomenon will reveal
phenotypic variants depending on particular symptoms cluster; improved nosology of qualitative olfactory disorders in COIVD-19 is
a prerequisite for establishing appropriate treatments.
Keywords
COVID-associated olfactory dysfunction; parosmia; phanthosmia; migraine; brain fog
Hrčak ID:
274187
URI
Publication date:
16.9.2021.
Visits: 508 *