Chemosensation and COVID-19

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We wrote our clinical protocol for submission to IRB soon. However, through collaborations with other investigators both intramural and extramural we have published a number of manuscripts regarding this topic. 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. In collaboration, we co-authored a manuscript that confirmed in an independent cohort that chemosensory deficits are the best predictor of serologic response among individuals infected with SARS-CoV-2 (Overdest et al., 2022). Using the Global consortium for chemosensory research (GCCR) cohort, we looked at quantitative and qualitative olfactory dysfunction and other symptoms in patients recovering from COVID-19-related smell loss. At follow-up (median time since COVID-19 onset 200 days), 60% of women and 48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered (Ohla et al., 2022). Prevalence of parosmia and phantosmia was 10% of participants in Survey 1 and increased substantially in Survey 2: 47% for parosmia and 25% for phantosmia. Persistent smell impairment was associated with more symptoms, suggesting it may be a key marker of long-COVID illness. Persistent qualitative smell symptoms are emerging as common long-term sequelae of COVID-19 infection. Thus, more research into treatment options is strongly warranted, given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide must be prepared to treat post-COVID-19 secondary effects on physical and mental health. Lastly, following up on our published results from 2020 & 2021 from the GCCR studies, we confirmed that COVID-19 affects taste independently of smell by conducting a chemosensory home test and online survey from a global cohort (Nguyen et al., 2023). Assessing the smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and helps to disentangle taste loss from smell loss. However, it does not replace standardized, validated psychophysical tests. Expanding our contribution to COVID-19 effects on Alcohol Use Disorder, we co-authored a manuscript with Dr. Ramchandani that showed that COVID-related stressors disproportionately affected minority and vulnerable groups. Individuals who experienced multiple financial stressors had the greatest risk for negative health-related outcomes and may benefit from holistic interventions and community outreach. In short, the participants were 463 adults who completed the baseline assessment of the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study from June 2020 to January 2022. Three analytic methods (continuous sum score, categorical grouping, and LCA) were applied to model 17 COVID-related stressors using cross-sectional data. Regression analyses indicated higher COVID-related stress and endorsement of four or more COVID-related stressors was generally associated with worse health-related outcomes. LCA revealed four classes: Class 1: Minimal COVID-Related Impact (51.6%); Class 2: Work Interruptions (24.8%); Class 3: Family/Friends Affected by COVID (14.5%); and Class 4: Serious Financial Stress (9.1%). Racial/ethnic minorities were more likely to be in Class 3, whereas individuals with more years of education and higher income were less likely to be in Class 4. Individuals with a history of alcohol use disorder were more likely to be in Classes 2 and 4. Compared with Class 1, Class 4 reported the highest levels of perceived stress, problematic alcohol use, anxiety symptoms, depressive symptoms, alcohol craving, loneliness, drinking to cope, and the lowest levels of physical, psychological, social, and environmental quality of life (Luk et al., 2023). Intramurally, as discussed, we established collaborations during the COVID-19 pandemic. Patients with AUD are at higher risk of COVID-19. We began to evaluate the data collected in the natural history of the COVID-19 impact alcohol study led by Drs. Ramchandani and Diazgranados.