More Than Smell—COVID-19 Is Associated With Severe Impairment of Smell, Taste, and Chemesthesis
Authors: Parma Valentina , Ohla Kathrin , Veldhuizen Maria G , Niv Masha Y , Kelly Christine E , Bakke Alyssa J , Cooper Keiland W , Bouysset Cédric , Pirastu Nicola , Dibattista Michele , Kaur Rishemjit , Liuzza Marco Tullio , Pepino Marta Y , Schöpf Veronika , Pereda-Loth Veronica , Olsson Shannon B , Gerkin Richard C , Rohlfs Domínguez Paloma , Albayay Javier , Farruggia Michael C , Bhutani Surabhi , Fjaeldstad Alexander W , Kumar Ritesh , Menini Anna , Bensafi Moustafa , Sandell Mari , Konstantinidis Iordanis , Di Pizio Antonella , Genovese Federica , Öztürk Lina , Thomas-Danguin Thierry , Frasnelli Johannes , Boesveldt Sanne , Saatci Özlem , Saraiva Luis R , Lin Cailu , Golebiowski Jérôme , Hwang Liang-Dar , Ozdener Mehmet Hakan , Guàrdia Maria Dolors , Laudamiel Christophe , Ritchie Marina , Havlícek Jan , Pierron Denis , Roura Eugeni , Navarro Marta , Nolden Alissa A , Lim Juyun , Whitcroft Katherine L , Colquitt Lauren R , Ferdenzi Camille , Brindha Evelyn V , Altundag Aytug , Macchi Alberto , Nunez-Parra Alexia , Patel Zara M , Fiorucci Sébastien , Philpott Carl M , Smith Barry C , Lundström Johan N , Mucignat Carla , Parker Jane K , van den Brink Mirjam , Schmuker Michael , Fischmeister Florian Ph S , Heinbockel Thomas , Shields Vonnie D C , Faraji Farhoud , Santamaría Enrique , Fredborg William E A , Morini Gabriella , Olofsson Jonas K , Jalessi Maryam , Karni Noam , D’Errico Anna , Alizadeh Rafieh , Pellegrino Robert , Meyer Pablo , Huart Caroline , Chen Ben , Soler Graciela M , Alwashahi Mohammed K , Welge-Lüssen Antje , Freiherr Jessica , de Groot Jasper H B , Klein Hadar , Okamoto Masako , Singh Preet Bano , Hsieh Julien W ,   GCCR Group Author, Abdulrahman Olagunju , Dalton Pamela , Yan Carol H , Voznessenskaya Vera V , Chen Jingguo , Sell Elizabeth A , Walsh-Messinger Julie , Archer Nicholas S , Koyama Sachiko , Deary Vincent , Roberts S Craig , Yanık Hüseyin , Albayrak Samet , Nováková Lenka Martinec , Croijmans Ilja , Mazal Patricia Portillo , Moein Shima T , Margulis Eitan , Mignot Coralie , Mariño Sajidxa , Georgiev Dejan , Kaushik Pavan K , Malnic Bettina , Wang Hong , Seyed-Allaei Shima , Yoluk Nur , Razzaghi-Asl Sara , Justice Jeb M , Restrepo Diego , Reed Danielle R , Hummel Thomas , Munger Steven D , Hayes John E 
Published: June 2020

Abstract
Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments, such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, and generally lacked quantitative measurements. Here, we report the development, implementation, and initial results of a multilingual, international questionnaire to assess self-reported quantity and quality of perception in 3 distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, and 8 others, aged 19–79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste, and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change ±100) revealed a mean reduction of smell (−79.7 ± 28.7, mean ± standard deviation), taste (−69.0 ± 32.6), and chemesthetic (−37.3 ± 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell but also affects taste and chemesthesis. The multimodal impact of COVID-19 and the lack of perceived nasal obstruction suggest that severe acute respiratory syndrome coronavirus strain 2 (SARS-CoV-2) infection may disrupt sensory-neural mechanisms.