Methods:
Adults (33-88 years old) with severe COVID-19 were recruited from the
Department of Medicine of the EpiCURA Hospital (Hornu, Belgium; Ethics
Committee: EpiCURA-2020-2303). The disease was confirmed through
nasopharyngeal swab (RT-PCR). Patients were defined as severe COVID-19
if they required continuous care (oxygenotherapy, blood pressure
monitoring) in internal medicine or intensive care units.
Patients with neurological disorder, chronic rhinosinusitis or history
of nasal surgery prior the pandemic were excluded. Epidemiological and
clinical data were collected at the hospital discharge. Details of the
patient-reported outcome questionnaire used for data collection are
reported in a previous study.3 Briefly: 1) olfactory and
gustatory questions were based on the smell and taste component of the
National Health and Nutrition Examination Survey; 2) symptoms were
evaluated through a 4-point scale ranging from 0 (no symptom) to 4
(severe symptoms);3 3) nasosinusal symptoms were evaluated
through the French sino-nasal outcome test-22 (SNOT-22).6Patients benefited from psychophysical olfactory evaluation through
sniffin’stick tests (Medisense, Groningen, Netherlands): 16 pens were
presented to patients every 30 seconds. The patient had to choose the
adequate term describing the smell between 4 given options. The test was
scored on a total of 16 points and allowed categorization into in 3
groups: normosmia (score between 12-16), hyposmia (score between 9-11)
and anosmia (score <9).3 Moreover, the following
hospitalization outcomes were recorded: duration of hospitalization
(days); admission biology (D-dimer; hemoglobin; leucocyte count;
lymphocyte count; CRP; creatitin; bilirubin; platelet count; LDH;
Na+; K+; Cl-);
1-month serology (IgG) and chest computed tomography findings.
Subjective and objective evaluations were made meanwhile.
The relationship between clinical and olfactory outcomes was analyzed
through multiple linear regression between scale variables and through
Mann-Whitney test and boxplot representation for groups versus scale
variables (SPSS, v22,0; IBM-Corp, Armonk, NY, USA).