Quick Olfactory Sniffin' Sticks Test (Q-Sticks) for the detection of smell disorders in COVID-19 patients

Diego Bagnasco; Giovanni Passalacqua; Fulvio Braido; Elena Tagliabue; Filippo Cosini; Marta Filauro; Alessandro Ioppi; Andrea Carobbio; Davide Mocellin; Anna Maria Riccio; Frank Rikki Canevari

doi:10.1016/j.waojou.2020.100497

Quick Olfactory Sniffin' Sticks Test (Q-Sticks) for the detection of smell disorders in COVID-19 patients

World Allergy Organ J. 2021 Jan;14(1):100497. doi: 10.1016/j.waojou.2020.100497. Epub 2021 Jan 20.

Authors

Diego Bagnasco^{1

2}, Giovanni Passalacqua^{1

2}, Fulvio Braido^{1

2}, Elena Tagliabue^{1

2}, Filippo Cosini^{1

2}, Marta Filauro^{3

2}, Alessandro Ioppi^{3

2}, Andrea Carobbio^{3

2}, Davide Mocellin^{3

2}, Anna Maria Riccio^{1

2}, Frank Rikki Canevari^{3

2}

Affiliations

¹ Allergy and Respiratory Diseases, IRCCS Policlinico San Martino - Department of Internal Medicine (DIMI), University of Genoa, Italy.
² IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.
³ Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.

Abstract

Background: Coronavirus disease (COVID-19) infection represents a worldwide critical health burden from the sanitary perspective. This disease's symptoms range from a mild flu-like form to a severe life-threatening respiratory disease and respiratory failure. Several patients, however, remain paucisymptomatic. Among the symptoms that seem relevant are the changes in taste and smell, regardless of the disease's severity.

Methods: Data from patients affected by COVID-19 infection, hospitalized from 15 to 29 April, 2020, were analyzed. Questionnaires about smell, taste, and nasal function were administered to all, and a proportion also received the Quick olfactory Sniffin' Sticks Test (q-Sticks) to objectivate the presence of anosmia or hyposmia. The results of instruments and Q-Sticks were then compared.

Results: Thirty-seven patients (20 males, 54.1%), with a mean age 0f 69.19 years (SD = 17.96; median 76, IQR: 63-82) were evaluated. Among the patients, 8 (22%) were asymptomatic. Out of the remaining 29 patients, 28 (97%) had fever, 19 (66%) asthenia, 11 (38%) dry cough, 10 (34%) dyspnea, and 6 (21%) gastroenteric symptoms. The q-Sticks test was performed on 27 patients and showed that 6 with anosmia, and 16 patients had hyposmia, where only 5 (14%) patients complained of loss of smell by conducting the questionnaires.

Conclusion: Although olfactory disturbances may be secondary to other factors, a sudden onset of anosmia or hyposmia should be assessed as a possible symptom of COVID-19 infection. The use of questionnaires or anamnestic collection is sometimes not enough, while adding to them a simple test such as the q-Sticks test can provide more accurate and reliable data. A simple, easy-to-perform, and reliable tool (q-Sticks) for olfactory disorders assessment can be administered to identify the real size of anosmia in patients with COVID-19 infection and detect the early stage of infection or paucisymptomatic patients, therefore becoming important to reduce the spreading of the pandemic.

Keywords: ACE-2, angiotensin-converting enzyme 2; Anosmia; COVID-19; COVID-19, coronavirus disease 2019; ENT; Hyposmia; Q-stick test; UPSIT, University of Pennsylvania Smell Identification Test.