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Two and a half years into the pandemic, a clearer understanding of the natural history of COVID-19–associated smell and taste dysfunction finally is emerging. Three groups have evaluated the timeline of such dysfunction.
In a meta-analysis, researchers combined data from 18 observational studies of patients with COVID-19–associated smell and taste dysfunction to determine the time course of recovery and identify risk factors for persistence. Data from 3700 patients (collected before emergence of Omicron) were included. Included studies varied widely in methodology and setting; most relied on self-report.
Key findings were:
Among patients reporting loss of smell, the proportions who recovered by day 30, 60, 90, and 180 were 74%, 86%, 90%, and 96%, respectively.
Among patients reporting loss of taste, the proportions who recovered by day 30, 60, 90, and 180 were 79%, 88%, 90%, and 98%, respectively.
Persistent dysfunction in smell and taste at 6 months were reported in 5.6% and 4.4% of patients, respectively.
Women were less likely to recover smell and taste than were men.
Patients with nasal congestion and more-severe smell dysfunction were less likely to recover.
Tan BKJ et al. Prognosis and persistence of smell and taste dysfunction in patients with covid-19: Meta-analysis with parametric cure modelling of recovery curves. BMJ 2022 Jul 27; 378:e069503. (https://doi.org/10.1136/bmj-2021-069503)
Cardoso CC et al. Olfactory dysfunction in patients with mild COVID-19 during Gamma, Delta, and Omicron waves in Rio de Janeiro, Brazil. JAMA 2022 Aug 9; 328:582. (https://doi.org/10.1001/jama.2022.11006)
Boscolo-Rizzo P et al. Two-year prevalence and recovery rate of altered sense of smell or taste in patients with mildly symptomatic COVID-19. JAMA Otolaryngol Head Neck Surg 2022 Aug 4; [e-pub]. (https://doi.org/10.1001/jamaoto.2022.1983)
Comment
These results should help clinicians in counseling patients whose quality of life is affected by smell and taste dysfunction following COVID-19. However, the results are limited by lack of information on COVID-19 variants, vaccination status, and treatments received. Reassuringly, other studies from Brazil and Italy suggest that smell and taste dysfunction occur much less frequently with Omicron than with prior variants and that recovery can continue beyond 6 months.