Objective evaluation and predictive value of olfactory dysfunction among patients hospitalized with COVID-19.

OBJECTIVES: Olfactory dysfunction is a frequent feature of COVID-19. Despite the growing evidence, current knowledge on the subject remains insufficient, so that data obtained with different tools, from multiple centers and in distinct scenarios are welcome. Yet, the predictive value of olfactory dysfunction in terms of the overall prognosis of COVID-19 is unknown. This study aims to evaluate the olfactory function of hospitalized patients with COVID-19 and the impact of the results on their clinical outcomes. METHODS: Patients with severe acute respiratory distress syndrome (ARDS) admitted to a university tertiary hospital were recruited and divided into those with ARDS due to COVID-19, and those with ARDS of any other cause. Sociodemographic and clinical data were collected at baseline and the patients had their objective olfactory function evaluated by the Alcohol Sniff Test on admission and during hospital stay. The participants were then followed up until reaching an endpoint: hospital discharge, endotracheal intubation, transfer to the intensive care unit, or death. Patients with COVID-19 were also subgrouped and compared according to their olfactory thresholds and to their overall clinical outcomes. The obtained data was analyzed using R software. Level of significance was set at 0.05. RESULTS: Eighty-two patients were included (of which 58 had COVID-19). 87.93% of the patients with COVID-19 had diminished olfactory dysfunction on admission. The mean length of hospital stay among patients with olfactory dysfunction was greater (7.84 vs 6.14 days) and nine individuals in this subgroup had poor overall outcomes. None of those with normal olfactory function developed critical COVID-19. The mean olfactory function was significantly worse among patients with COVID-19 and poor outcomes (3.97 vs 7.90 cm, P = .023). CONCLUSION: Objective olfactory dysfunction is frequent in ARDS caused by SARS-CoV-2 infection. Patients with longitudinal poorer outcomes present worse olfactory thresholds on admission.

Body Dysmorphic Disorder in Rhinoplasty Candidates: Prevalence and Functional Correlations.

BACKGROUND: Rhinoplasty is one of the most commonly performed aesthetic/functional procedures worldwide. Among those who seek rhinoplasty are those whose aesthetic defect is interpreted by themselves disproportionately, leading to significant suffering. These are given the diagnosis of body dysmorphic disorder (BDD). They commonly have high expectations regarding the surgical outcome and are often not satisfied postoperatively. The present study aimed to correlate BDD with the patient's self-assessment of nasal function, analysing whether BDD would have any influence on it. In addition, we verified the prevalence of the disorder in our population. METHODS: Cross-sectional, comparative and analytical study. Eighty-eight patients participated in the trial, 57 of them being candidates for rhinoplasty, rhinoplasty group (RG), and 31 from a random population, control group (CG). Through self-assessment, the BDSS, The Utrecht, SNOT-22 and NOSE questionnaires were applied. Patients with BDSS score ≥ 6 were considered as positive for BDD. Comparisons were made between the groups and among the candidates for rhinoplasty with positive or negative BDD. RESULTS: The prevalence of the disorder was 35.1% in the RG and 3.2% in the CG. Significantly, higher NOSE and SNOT-22 scores, reflecting worse nasal function, were obtained by the RG, especially in those with positive screening for BDD, when compared to those with negative screening (p < 0.05). CONCLUSIONS: BDD affects about one-third of the rhinoplasty candidate population. Their presence seems to exert a negative influence on the patients' self-assessment regarding their nasal function. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Olfactory function and findings on chest computed tomography in COVID-19: is there any correlation?

BACKGROUND: Olfactory dysfunction is frequent in COVID-19 and it might occur along with pulmonary involvement. These manifestations do not seem to share pathophysiological mechanisms, but clinical data on the subject is lacking. Aims/Objectives: This study aims to correlate the olfactory function (OF) and the radiological pulmonary involvement among in-hospital patients with COVID-19. MATERIALS AND METHODS: Patients hospitalized with severe COVID-19 were consecutively recruited. They had their objective OF evaluated by the Alcohol Sniff Test and underwent a chest computed tomography (cCT). Qualitative and quantitative analyses of the cCT scans were performed by a blinded radiologist. The quantitative assessment included both the grade of involved parenchyma and the CT severity score (CT-SS). Data obtained were then compared. RESULTS: 57 patients were included. There was no correlation between the OF and the grade of lung involvement (p-value: .884) or the CT-SS (Pearson's coefficient: -.111). Yet, patients with radiological findings on the cCT typical for COVID-19 did not present significantly different OF from the remaining (p-value: .193). Conclusions: Olfactory dysfunction does not correlate with the radiological lung involvement in patients hospitalized with COVID-19. SIGNIFICANCE: There is also clinical evidence that the olfactory disorder and the pulmonary disease in COVID-19 have distinct mechanisms.Supplemental data for this article is available online at here.