Predictive factors of involuntary weight loss in patients with smell and taste disorders.

BACKGROUND: Chemosensory dysfunction (olfaction, taste, and trigeminal) affects quality of life, potentially impacting eating behaviors. We investigated which factors are associated with weight loss in patients with smell and taste disorders. METHODS: Retrospective study of consecutive adult patients seen in the smell and taste clinic during a 10-year period. Patients were asked about smell, flavor and taste impairment. Psychophysically, smell was assessed with Sniffin' Sticks, flavor with a retronasal test, and taste with Taste Strips. RESULTS: A total of 554 patients (313 females) were included with a median age of 51 years (IQR 23). Seventy-six (13.7%) reported involuntary weight loss (median 6 kg, IQR 6) due to chemosensory disorders. The odds of losing weight were 2.1 times higher when patients reported subjective changes in flavor perception. Parosmia was a significant predictor of weight loss. Patients with symptoms lasting longer than two years were less likely to present with weight loss. Post-traumatic chemosensory dysfunction was a significant predictor of losing weight. On psychophysical testing, the probability of a patient losing weight increased by 8% for every 1-unit reduction in Taste Strips score. CONCLUSION: Factors associated with weight loss were self-reported changes in flavor perception, parosmia, duration of symptoms for less than two years, head injury, and psychophysically measured low Taste Strips score. These data help to identify patients at risk of weight loss from smell or taste impairment.

COVID-19 related chemosensory changes in individuals with self-reported obesity.

BACKGROUND/OBJECTIVES: Self-reported smell loss is a prominent symptom of COVID-19 infection and a potentially useful clinical tool for remote pre-screening of this disease. However, pre-existing chemosensory dysfunction with obesity may diminish the usefulness of self-reported smell loss in this vulnerable group. Here we aim to compare COVID-19 related chemosensory alterations in participants with and without obesity and determine if self-reported smell loss is predictive of lab-based COVID-19 diagnosis in both groups in the context of restrictive clinical data collection. SUBJECTS/METHODS: In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to have obesity (C19+; n = 433, C19-; n = 86) or not. RESULTS: Participants with obesity and without obesity reported a similar decline in smell, taste, and chemesthesis during illness. In C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory and GI symptoms. Critically, we found that the model previously proposed also predicts C19+ diagnosis in participants with obesity. CONCLUSIONS: We conclude that COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity. In both groups self-reported chemosensory symptoms are similarly predictive of COVID-19 infection, thus highlighting the potential of collecting self-report of symptoms and comorbidities remotely when clinical observations are restrictive.

COVID-19 Related Chemosensory Changes in Individuals with Self-Reported Obesity.

BACKGROUND/OBJECTIVES: Individuals with obesity show alterations in smell and taste abilities. Smell and taste loss are also the most prominent neurological symptoms of COVID-19, yet how chemosensory ability present in individuals with obesity with a positive COVID-19 diagnosis is unknown. SUBJECTS/METHODS: In this secondary analysis of a cross-sectional global dataset, we compared self-reported chemosensory ability in participants with a respiratory illness reporting a positive (C19+; n = 5156) or a negative (C19-; n = 659) COVID-19 laboratory test outcome, who also self-reported to be obese (C19+; n = 433, C19-; n = 86) or non-obese. RESULTS: Compared to the C19- group, C19+ exhibited a greater decline in smell, taste, and chemesthesis during illness, though these symptoms did not differ between participants with obesity and without obesity. In 68% of participants who reported recovery from respiratory illness symptoms (n=3431 C19+ and n= 539 C19-), post-recovery chemosensory perception did not differ in C19+ and C19- diagnosis, and by self-reported obesity. Finally, we found that all chemosensory and other symptoms combined predicted the C19+ diagnosis in participants with obesity with a moderately good estimate (63% accuracy). However, in C19+ participants with obesity, we observed a greater relative prevalence of non-chemosensory symptoms, including respiratory as respiratory and GI symptoms. CONCLUSIONS: We conclude that despite a presumed lower sensitivity to chemosensory stimuli, COVID-19 respondents with obesity experience a similar self-reported chemosensory loss as those without obesity, and in both groups self-reported chemosensory symptoms are similarly predictive of COVID-19.