BMC medicine · 2026
Objective assessment of long-term impact of COVID-19 on multiple sensory functions.
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Odeh Ahmad, Formanek Veronica L, Smith Christina, Jha Nidhi, Tajino Junichi, Lewis Jessica H, Gastineau Lauren, Patel Shivani, Zhao Songzhu, Wei Lai, Moberly Aaron C, Merfeld Daniel M, Simons Christopher T, Kobel Megan J, Zhao Kai
Аннотация
BACKGROUND: This ongoing study investigates the impact of post-acute sequelae of SARS-CoV-2 infection (PASC) on broad sensory functions.
METHODS: Sixty subjects aged 27-78 years were recruited who had contracted COVID-19 between 1/17/2020 and 12/21/2023 and had persistent symptoms (4.3-52.9, median = 27.48 months). Quantitative sensory assessments included (1) smell: 9-Item NIH toolbox odor identification, detection threshold to phenyl-ethyl alcohol, and retronasal candy test; (2) taste: modified NIH toolbox; (3) chemesthesis: nasal menthol lateralization thresholds and oral capsaicin identification; (4) hearing: pure-tone audiometry, otoacoustic emissions, words-in-noise recognition, and Dichotic Digits Test; (5) vestibular/balance: video head impulse testing, Subjective Visual Vertical, vestibular perceptual thresholds, and modified Romberg balance test; and (6) cognitive assessment: The Self-Administered Gero-Cognitive Exam, Digit Symbol Substitution Test, and Trail-Making Test.
RESULTS: Overall, subjects self-reported high and overlapping dysfunctions: 67.3% smell, 63.6% taste, 56.5% balance and dizziness, 31.8% auditory, and 51.3% brain fog or cognitive dysfunctions, with varying discrepancy to the measured and confirmed deficits (smell 65.5%, taste 16%, vestibular 31.6%, hearing 53.4%, and cognition 19.1%). Significant associations were found between confirmed vestibular and auditory impairments (p = 0.04), and cognitive impairments with central components of vestibular (p = 0.03) and auditory (p = 0.01) impairments, but not with their peripheral components. Similarly, strong associations were found between identification components of smell and taste tests (p = 0.003), which may involve more central processing, but not with threshold tests (a more peripheral process). Hospitalization significantly associated with smell (p = 0.05), cognitive (p = 0.009), vestibular (p = 0. 001), and peripheral auditory (p = 0.01) dysfunctions. Age significantly associated with auditory (p = 0.02), vestibular (p = 0.01) and central olfactory (p = 0.03) dysfunctions.
CONCLUSIONS: COVID-19 impacts sensory systems broadly and differently, both peripherally and centrally, driven in part by aging, initial disease severity, and underlying post-COVID cognitive dysfunctions. Subjective symptoms may not always be corroborated by measured deficits.
METHODS: Sixty subjects aged 27-78 years were recruited who had contracted COVID-19 between 1/17/2020 and 12/21/2023 and had persistent symptoms (4.3-52.9, median = 27.48 months). Quantitative sensory assessments included (1) smell: 9-Item NIH toolbox odor identification, detection threshold to phenyl-ethyl alcohol, and retronasal candy test; (2) taste: modified NIH toolbox; (3) chemesthesis: nasal menthol lateralization thresholds and oral capsaicin identification; (4) hearing: pure-tone audiometry, otoacoustic emissions, words-in-noise recognition, and Dichotic Digits Test; (5) vestibular/balance: video head impulse testing, Subjective Visual Vertical, vestibular perceptual thresholds, and modified Romberg balance test; and (6) cognitive assessment: The Self-Administered Gero-Cognitive Exam, Digit Symbol Substitution Test, and Trail-Making Test.
RESULTS: Overall, subjects self-reported high and overlapping dysfunctions: 67.3% smell, 63.6% taste, 56.5% balance and dizziness, 31.8% auditory, and 51.3% brain fog or cognitive dysfunctions, with varying discrepancy to the measured and confirmed deficits (smell 65.5%, taste 16%, vestibular 31.6%, hearing 53.4%, and cognition 19.1%). Significant associations were found between confirmed vestibular and auditory impairments (p = 0.04), and cognitive impairments with central components of vestibular (p = 0.03) and auditory (p = 0.01) impairments, but not with their peripheral components. Similarly, strong associations were found between identification components of smell and taste tests (p = 0.003), which may involve more central processing, but not with threshold tests (a more peripheral process). Hospitalization significantly associated with smell (p = 0.05), cognitive (p = 0.009), vestibular (p = 0. 001), and peripheral auditory (p = 0.01) dysfunctions. Age significantly associated with auditory (p = 0.02), vestibular (p = 0.01) and central olfactory (p = 0.03) dysfunctions.
CONCLUSIONS: COVID-19 impacts sensory systems broadly and differently, both peripherally and centrally, driven in part by aging, initial disease severity, and underlying post-COVID cognitive dysfunctions. Subjective symptoms may not always be corroborated by measured deficits.