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Review
. 2023 Aug 4:17:1165329.
doi: 10.3389/fnins.2023.1165329. eCollection 2023.

Assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms

Lavandan Jegatheeswaran  1 , Shyam Ajay Gokani  2 , Louis Luke  1   2 , Gabija Klyvyte  2 , Andreas Espehana  2 , Elizabeth Mairenn Garden  2 , Alessia Tarantino  1 , Basil Al Omari  1 , Carl Martin Philpott  1   2
Affiliations
Review

Assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms

Lavandan Jegatheeswaran et al. Front Neurosci. .

Abstract

Purpose of review: To provide a detailed overview of the assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms.

Recent findings: COVID-19-related olfactory dysfunction can have a detrimental impact to the quality of life of patients. Prior to the COVID-19 pandemic, olfactory and taste disorders were a common but under-rated, under-researched and under-treated sensory loss. The pandemic has exacerbated the current unmet need for accessing good healthcare for patients living with olfactory disorders and other symptoms secondary to COVID-19. This review thus explores the associations that COVID-19 has with psychological, neuropsychiatric, and cognitive symptoms, and provide a framework and rationale for the assessment of patients presenting with COVID-19 olfactory dysfunction.

Summary: Acute COVID-19 infection and long COVID is not solely a disease of the respiratory and vascular systems. These two conditions have strong associations with psychological, neuropsychiatric, and cognitive symptoms. A systematic approach with history taking and examination particularly with nasal endoscopy can determine the impact that this has on the patient. Specific olfactory disorder questionnaires can demonstrate the impact on quality of life, while psychophysical testing can objectively assess and monitor olfaction over time. The role of cross-sectional imaging is not yet described for COVID-19-related olfactory dysfunction. Management options are limited to conservative adjunctive measures, with some medical therapies described.

Keywords: COVID-19; anosmia; hyposmia; olfaction; olfactory disorders.

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Conflict of interest statement

CP reports grants from NIHR, ESPRC, and ENT UK, personal fees from Stryker, Abbott, and Olympus, outside the submitted work, and Trustee of Fifth Sense. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flowchart explaining proposed mechanisms of destruction by SARS-CoV-2 and its effects on the limbic system and resultant effects on psychological, neuropsychiatric and cognitive symptoms.
Figure 2
Figure 2
A flowchart explaining possible mechanisms of olfactory dysfunction in acute COVID-19 infection and in long COVID with its eventual progression to transient or potential permanent olfactory dysfunction.
Figure 3
Figure 3
A flowchart illustrating a proposed algorithm for clinicians to follow when managing a patient with suspected COVID-19-related olfactory dysfunction.
See this image and copyright information in PMC

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