Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2023; 12(3): 133-150
Published online Jun 9, 2023. doi: 10.5409/wjcp.v12.i3.133
Evaluation of children and adults with post-COVID-19 persistent smell, taste and trigeminal chemosensory disorders: A hospital based study
Sherifa Ahmed Hamed, Eman Bahaa Kamal-Eldeen, Mohamed Azzam Abdel-Razek Ahmed
Sherifa Ahmed Hamed, Department of Neurology and Psychiatry, Assiut University, Faculty of Medicine, Assiut 71516, Egypt
Eman Bahaa Kamal-Eldeen, Department of Pediatrics, Assiut University, Faculty of Medicine, Assiut 71516, Egypt
Mohamed Azzam Abdel-Razek Ahmed, Department of ENT, Assiut University, Faculty of Medicine, Assiut 71516, Egypt
Author contributions: Hamed SA, Kamal-Eldeen EB and Ahmed MAA designed the conception, did data collection and physical examinations. Ahmed MAA did ear, nose and throat evaluation; Kamal-Eldeen EB and Ahmed MAA referred the patients to the neurologist (Hamed SA) and critically reviewed the manuscript; Hamed SA applied the objective measurements for smell and taste and the final statistical analyses, wrote the manuscript and had the final responsibility to submit the manuscript for publication; All authors had full access to raw data and verified the underlying data and interpretation of the results and final approval of the manuscript.
Institutional review board statement: The protocol of the study was in accordance to the revised Helsinki Declaration (2013) and approved by the medical research ethics committees of the Faculty of Medicine, Assiut University, Assiut, Egypt, No. AUH_SARS-CoV2_SAH/2019.
Informed consent statement: All study participants, or their guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sherifa Ahmed Hamed, MD, Professor, Department of Neurology and Psychiatry, Assiut University, Faculty of Medicine, Assiut University Street, Assiut 71516, Egypt. hamedsherifa@aun.edu.eg
Received: February 27, 2023
Peer-review started: February 27, 2023
First decision: March 15, 2023
Revised: March 16, 2023
Accepted: April 20, 2023
Article in press: April 20, 2023
Published online: June 9, 2023
Processing time: 100 Days and 10.8 Hours
Abstract
BACKGROUND

Smell disorders are the most frequent persistent coronavirus disease 2019 (COVID-19) complications.

AIM

To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.

METHODS

Assessment was done to 185 patients (adults = 150, age: 31.41 ± 8.63 years; children = 35; age: 15.66 ± 1.63 years). Otolaryngology and neuropsychiatric evaluations were done. Measurements included: A clinical questionnaire (for smell and taste); sniffin' odor, taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS).

RESULTS

Duration of disorders was 11.53 ± 3.97 ms (6-24 ms). Parosmia (n = 119; 64.32%) was developed months after anosmia (3.05 ± 1.87 ms). Objective testing showed anosmia in all, ageusia and flavor loss in 20% (n = 37) and loss of nasal and oral trigeminal sensations in 18% (n = 33) and 20% (n = 37), respectively. Patients had low scoring of sQOD-NS (11.41 ± 3.66). There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.

CONCLUSION

The course of small and taste disorders are supportive of the nasal and oral neuronal compromises. Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders. Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders. There were no demographics, clinical variables at onset or specific profile of these disorders in children compared to adults.

Keywords: Post-COVID-19 complications; Anosmia; Ageusia; Trigeminal sensory loss; Parosmia; Quality of life

Core Tip: Smell loss is the most frequent acute manifestation of coronavirus disease 2019 (COVID-19) infection with an estimated prevalence of 40%-86% in adults and 16%-20% in children. Smell disorders (loss or distortion) are also the most frequent long-lasting complications of COVID-19 infection with an estimated prevalence of 20%-40% in adults. Compared to smell, taste disorders are less frequent acute manifestation of viral infection (occurring in 10%-42% of adults) and long-lasting complications of COVID-19 infection. Reports about the prevalence and prognosis of these disorders in children are few or even lacking compared to adults. Also the mechanisms and treatment of these persistent disorders are still challenges. Evidence from experimental studies suggested that injury and degeneration of the neuronal olfactory and gustatory sensory epithelia by severe peripheral viral infection and its immunopathology and the delay or lack of neuronal regeneration might contribute to these disorders. Here, we tried to determine the predictors for persistent disorders and distinguish their differences in children compared to adults.