Olfactory dysfunction as an early predictor for post-COVID condition at 1-year follow-up

Brain Behav. 2024 Jun;14(6):e3574. doi: 10.1002/brb3.3574.

Abstract

Background: Olfactory dysfunction together with neurological and cognitive symptoms are common after COVID-19. We aimed to study whether performance on olfactory and neuropsychological tests following infection predict post-COVID condition (PCC), persisting symptoms, and reduced health-related quality of life.

Methods: Both hospitalized (N = 10) and non-hospitalized individuals (N = 56) were enrolled in this prospective cohort study. Participants were evaluated 1-3 months after infection with an olfactory threshold test and neuropsychological tests, which was used as predictors of PCC. A questionnaire outlining persisting symptoms and the validated instrument EuroQol five-dimension five-level for health-related quality of life assessment were used as outcome data 1 year after infection (N = 59). Principal component analysis was used to identify relevant predictors for PCC at 1 year.

Results: Objectively assessed olfactory dysfunction at 1-3 months post infection, but not subjective olfactory symptoms, predicted post-COVID condition with reduced health-related quality of life (PCC+) at 1 year. The PCC+ group scored more often below the cut off for mild cognitive impairment on the Montreal Cognitive Assessment (61.5% vs. 21.7%) and higher on the Multidimensional Fatigue Inventory-20, compared to the group without PCC+.

Conclusion: Our results indicate that objectively assessed, olfactory dysfunction is a predictor for PCC+. These findings underscore the importance of objective olfactory testing. We propose that olfactory screening in the early post-acute phase of COVID-19 infection might identify individuals that are at higher risk of developing long-term health sequalae.

Keywords: COVID‐19; health‐related quality of life; long covid; olfactory dysfunction; post‐COVID condition (PCC).

MeSH terms

  • Adult
  • Aged
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • Cognitive Dysfunction / diagnosis
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Olfaction Disorders* / diagnosis
  • Olfaction Disorders* / etiology
  • Olfaction Disorders* / physiopathology
  • Post-Acute COVID-19 Syndrome
  • Prospective Studies
  • Quality of Life*
  • SARS-CoV-2