Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Psychiatric outcomes in outpatients affected by long COVID: A link between mental health and persistence of olfactory complaint
Victoria Metelkina-Fernandez, Louise-Emilie Dumas, Clair Vandersteen, David Chirio, Auriane Gros, Arnaud Fernandez, Florence Askenazy, Valeria Manera
Victoria Metelkina-Fernandez, Department of Psychiatry, Nice University Hospital, Nice 06000, France
Louise-Emilie Dumas, Arnaud Fernandez, Florence Askenazy, Department of Child and Adolescent Psychiatry, Université Côte d’Azur, Nice 06200, France
Clair Vandersteen, ENT, Head and Neck Institute, Nice 06100, France
David Chirio, Department of Infectiology, Nice University Hospital, Nice 06200, France
Auriane Gros, Department of Orthophony, Université Côte d’Azur, Nice 06100, France
Arnaud Fernandez, Valeria Manera, Cobtek, Université Côte d’Azur, Nice 06100, France
Author contributions: Askenazy F, Dumas LE, Vandersteen C and Metelkina-Fernandez V initiated the project and designed the experiment; Dumas LE, Chirio D, Gros A, Fernandez A and Metelkina-Fernandez V conducted clinical data collection; Manera V conducted several collation and statistical analyses; Metelkina-Fernandez V wrote the original manuscript; Chirio D, Gros A, Manera V, Metelkina-Fernandez V and Fernandez A revised the paper; and all authors reviewed and approved the paper and approved the final manuscript.
Institutional review board statement: The study was approved by the institutional review board of Nice University Hospital (CNIL number: 412).
Informed consent statement: This study was carried out as part of routine care. Patients were informed of their inclusion in this study and gave their informed consent to participate. Patients’ non-objection to study participation was requested orally and recorded in the patient’s medical record. Patients were informed that they could refuse to participate or withdraw their consent at any time during the study. Data were anonymized before the analyses.
Conflict-of-interest statement: Authors declare no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at fernandez.v@chu-nice.fr.
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: Arnaud Fernandez, MD, PhD, Assistant Professor, Department of Child and Adolescent Psychiatry, Université Côte d’Azur, 57 avenue de la Californie, Nice 06200, France. arnaud.fernandez@hpu.lenval.com
Received: December 3, 2023
Peer-review started: December 3, 2023
First decision: January 15, 2024
Revised: January 28, 2024
Accepted: March 21, 2024
Article in press: March 21, 2024
Published online: April 19, 2024
BACKGROUND
Anosmia was one of the main symptoms of coronavirus disease 2019 (COVID-19). A psychiatric history (i.e., depression) may be an independent contributor to the risk of COVID-19 diagnosis, and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae (bidirectional association).
AIM
To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.
METHODS
We conducted a prospective case control study from March 2020 to May 2021. Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint (visual analogue scale) for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology. Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department. Psychiatric medical histories were collected by a psychiatrist during the assessments.
RESULTS
Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study. Fifty percent of the patients were female (n = 17). The group’s mean age was 40.5 ± 12.9 years. The control group included 32 participants, of which 34.4% were female (n = 11), and had a mean age of 61.2 ± 12.2 years. The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher (41.7%) than among patients without (18.8%) (χ2 = 5.9, P = 0.015).
CONCLUSION
The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia. It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients. Further prospective, translational, and collaborative studies are needed to extrapolate these results to the general population.
Core Tip: Our study reveals a significant association between a psychiatric history and persistent anosmia in post-coronavirus disease 2019 (COVID-19) patients. With a higher rate of psychiatric disorder observed in individuals experiencing long-COVID symptoms, our findings underscore the need for reinforced health monitoring of at-risk patients. This emphasizes the importance of considering psychiatric factors in the assessment and management of post-COVID-19 sequelae. This study will thus contribute to a broader understanding of the multifaceted impact of the virus on mental health.
