Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable

More Than Smell—COVID-19 Is Associated With Severe Impairment of Smell, Taste, and Chemesthesis

Correction: Chemical Senses, Volume 46, 2021, bjab050, https://doi.org/10.1093/chemse/bjab050 Published: 08 December 2021Recent 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.Peer reviewe

Modulation of cerebral activity by subliminal odours : a functional MRI study

Certaines études ont montré que des odeurs subliminales – odeurs d'intensité très faible activant le système olfactif mais non perçues consciemment – peuvent impacter le comportement alimentaire. Cependant, les mécanismes sensoriels et cognitifs impliqués dans le traitement des odeurs subliminales demeurent mal connus. Ce travail de thèse avait pour but d'explorer les activations cérébrales induites par des odeurs subliminales au moyen de l'Imagerie par Résonance Magnétique fonctionnelle. Durant les acquisitions IRM, les participants sont exposés à leur insu à deux odeurs présentées à intensité subliminale puis supraliminale. Quatre réseaux cérébraux mis en évidence par Analyse en Composantes Indépendantes s’avèrent spécifiques de la condition subliminale. Ces réseaux ne sont pas propres au traitement des odeurs et semblent liés à des processus attentionnels et de contrôle exécutif. La modulation de leur activité par des odeurs subliminales apporte des éléments nouveaux pour comprendre l’impact de ces odeurs sur le comportement, et suggère des applications possibles d'utilisation de ces odeurs pour réguler le comportement alimentaire.Some studies showed that subliminal odours – odours of very low intensity which activate the olfactory system but are not consciously perceived – can impact food behaviours. However, the sensory and cognitive mechanisms involved in subliminal odours processing remain poorly known. This work aims exploring cerebral activity induced by subliminal odours by the means of functional Magnetic Resonance Imaging. During MRI acquisitions, participants were unknowingly exposed to two odours presented at subliminal intensity and then at supraliminal intensity. Four cerebral networks highlighted by Independent Component Analysis (ICA) prove to be specific to the subliminal condition. These networks are not particular to olfactory processing and seem to be linked to attentional and executive control processes. The modulation of their activity by subliminal odours brings new elements to understand the impact of these odours on behaviour, and suggests possible applications for using these odours to regulate food behaviour

Modulation of cerebral activity by subliminal odours : a functional MRI study

Certaines études ont montré que des odeurs subliminales – odeurs d'intensité très faible activant le système olfactif mais non perçues consciemment – peuvent impacter le comportement alimentaire. Cependant, les mécanismes sensoriels et cognitifs impliqués dans le traitement des odeurs subliminales demeurent mal connus. Ce travail de thèse avait pour but d'explorer les activations cérébrales induites par des odeurs subliminales au moyen de l'Imagerie par Résonance Magnétique fonctionnelle. Durant les acquisitions IRM, les participants sont exposés à leur insu à deux odeurs présentées à intensité subliminale puis supraliminale. Quatre réseaux cérébraux mis en évidence par Analyse en Composantes Indépendantes s’avèrent spécifiques de la condition subliminale. Ces réseaux ne sont pas propres au traitement des odeurs et semblent liés à des processus attentionnels et de contrôle exécutif. La modulation de leur activité par des odeurs subliminales apporte des éléments nouveaux pour comprendre l’impact de ces odeurs sur le comportement, et suggère des applications possibles d'utilisation de ces odeurs pour réguler le comportement alimentaire.Some studies showed that subliminal odours – odours of very low intensity which activate the olfactory system but are not consciously perceived – can impact food behaviours. However, the sensory and cognitive mechanisms involved in subliminal odours processing remain poorly known. This work aims exploring cerebral activity induced by subliminal odours by the means of functional Magnetic Resonance Imaging. During MRI acquisitions, participants were unknowingly exposed to two odours presented at subliminal intensity and then at supraliminal intensity. Four cerebral networks highlighted by Independent Component Analysis (ICA) prove to be specific to the subliminal condition. These networks are not particular to olfactory processing and seem to be linked to attentional and executive control processes. The modulation of their activity by subliminal odours brings new elements to understand the impact of these odours on behaviour, and suggests possible applications for using these odours to regulate food behaviour

Modulation des activations cérébrales par des odeurs subliminales : une étude en IRM fonctionnelle

Some studies showed that subliminal odours – odours of very low intensity which activate the olfactory system but are not consciously perceived – can impact food behaviours. However, the sensory and cognitive mechanisms involved in subliminal odours processing remain poorly known. This work aims exploring cerebral activity induced by subliminal odours by the means of functional Magnetic Resonance Imaging. During MRI acquisitions, participants were unknowingly exposed to two odours presented at subliminal intensity and then at supraliminal intensity. Four cerebral networks highlighted by Independent Component Analysis (ICA) prove to be specific to the subliminal condition. These networks are not particular to olfactory processing and seem to be linked to attentional and executive control processes. The modulation of their activity by subliminal odours brings new elements to understand the impact of these odours on behaviour, and suggests possible applications for using these odours to regulate food behaviour.Certaines études ont montré que des odeurs subliminales – odeurs d'intensité très faible activant le système olfactif mais non perçues consciemment – peuvent impacter le comportement alimentaire. Cependant, les mécanismes sensoriels et cognitifs impliqués dans le traitement des odeurs subliminales demeurent mal connus. Ce travail de thèse avait pour but d'explorer les activations cérébrales induites par des odeurs subliminales au moyen de l'Imagerie par Résonance Magnétique fonctionnelle. Durant les acquisitions IRM, les participants sont exposés à leur insu à deux odeurs présentées à intensité subliminale puis supraliminale. Quatre réseaux cérébraux mis en évidence par Analyse en Composantes Indépendantes s’avèrent spécifiques de la condition subliminale. Ces réseaux ne sont pas propres au traitement des odeurs et semblent liés à des processus attentionnels et de contrôle exécutif. La modulation de leur activité par des odeurs subliminales apporte des éléments nouveaux pour comprendre l’impact de ces odeurs sur le comportement, et suggère des applications possibles d'utilisation de ces odeurs pour réguler le comportement alimentaire

Older and young adults experience similar long-term olfactory habituation

International audienceOlfactory habituation corresponds to a decreased behavioral or perceptual response to an odor after a prolonged exposure to this odor. Our aim was to investigate whether long-term olfactory habituation and its recovery are similar in young (<35 years old) and older adults (>50). Fifty-seven participants were recruited for a 5-week longitudinal study. They were exposed to one of the two odors (manzanate alpha [MA], irone alpha [IA]) for 2 weeks at home. Olfactory detection thresholds for both odors were measured before and after exposure. Results showed that the two age groups behaved similarly. The long-term exposure to an odor led to a temporary increase of its detection threshold (lower sensitivity to the odor). IA thresholds were more sensitive to the duration of exposure with the odor than MA thresholds. One week after termination of exposure, participants fully recovered and even became more sensitive to both odors. No cross-habituation was found between the two odors. Our findings highlight that long-term habituation is specific to the odor exposed, behaves the same in young and older adults, and is fully reversible in both age groups after 1 week

Effects of desensitization on odors varying in concentration and pleasantness

International audienceBackground: Desensitization in response to repetitive odorous stimulations is a common and well-investigated process, but it has been a matter of discussion in which way this process relates to odor valence. Our goal was to investigate changes of intensity and pleasantness induced by desensitization in odors in relation to their valence and concentration

Olfactory adaptation: recordings from the human olfactory epithelium

International audienceAbstract Purpose Olfactory adaptation is a peripheral (at the epithelium level) or a central (at the brain level) mechanism resulting from repeated or prolonged odorous exposure that can induce a perceptual decrease. The aim of this study was to assess whether a peripheral adaptation occurs when an odor is repeated ten times. Moreover, the specificity of the peripheral adaptation to the nature of the odorant was investigated. Methods Four odorants (eugenol, manzanate, ISO E Super and phenylethanol) were presented using precisely controlled air-dilution olfactometry. They differed in terms of their physicochemical properties. Electrophysiological recordings were made at the level of the olfactory mucosa, the so-called electro-olfactogram (EOG). Thirty-five right-handed participants were recruited. Results Sixty-nine percent of the participants presented at least one EOG, whatever the odor condition. The EOG amplitude did not significantly decrease over 10 repeated exposures to any odorant. The intensity ratings tended to decrease over stimulations for manzanate, PEA, and eugenol. No correlation was found between the mean EOG amplitudes and the mean intensity ratings. However, the presence of EOG amplitude decreases over stimulations for few subjects suggests that peripheral adaptation might exist. Conclusion Overall, our results did not establish a clear peripheral adaptation measured with EOG but indicate the eventuality of such an effect

Interictal osmophobia is associated with longer migraine disease duration

Background: Sensitization to sensory stimuli is an essential feature of migraine attacks. The relationship between the clinical course of migraine and increased sensitivity to olfactory stimuli has been little studied so far. - Methods: We analyzed the frequency and quality of osmophobia depending on the phase of migraine in patients with episodic and chronic migraine treated in an tertiary headache center with regard to gender, age, medical history and migraine disability assessment score (MIDAS). Standardized diagnostic questions were used for the assessment of osmophobia. - Results: In our cross-sectional investigation (n = 113), 38.1% of the patients showed an increased preictal hypersensitivity to odors, whereas 61.9% described ictal and 31.9% interictal hypersensitivity to odors, odor-triggered migraine was described in 30.1%. Median migraine disease duration has been statistically significantly longer in patients who suffered from interictal hypersensitivity to odors (28.5 years vs. 20 years; p = 0.012). There was a significant correlation between interictal hypersensitivity and higher age (54.50 vs. 45; p = 0.015). Patients with higher migraine disability in MIDAS experienced more frequently preictal and interictal olfactory sensitization and odor triggered migraine attacks. - Conclusions: In patients with longer migraine disease duration and higher migraine-related impairment, osmophobia was more frequently observed. These results might support the hypothesis of increasing sensitization with increasing burden of migraine

Migraine with aura : less control over pain and fragrances?

BackgroundAccumulating data emphasizes the importance of olfaction in migraine pathophysiology. However, there are only a few studies evaluating how the migraine brain processes olfactory stimulation, and virtually no studies comparing patients with and without aura in this context.MethodsThis cross-sectional study recorded event-related potentials from 64 electrodes during a pure olfactory or pure trigeminal stimulus in females with episodic migraine with aura (n = 13) and without aura (n = 15), to characterize the central nervous processing of these intranasal stimuli. Patients were tested in interictal state only. Data were analyzed in the time domain and in the time-frequency domain. Source reconstruction analysis was also performed.ResultsPatients with aura had higher event-related potentials amplitudes for left-sided trigeminal and left-sided olfactory stimulations, and higher neural activity for right-sided trigeminal stimulation in brain areas related to trigeminal and visual processing. Following olfactory stimulations patients with aura displayed decreased neural activity in secondary olfactory structures compared to patients without aura. Oscillations in the low frequency bands (< 8 Hz) differed between patient groups.ConclusionsAltogether this may reflect hypersensitivity to nociceptive stimuli in patients with aura relative to patients without aura. Patients with aura have a bigger deficit in engaging secondary olfactory-related structures, possibly leading to distorted attention and judgements towards odors. The cerebral overlap between trigeminal nociception and olfaction might explain these deficits