"I Can Taste It, But Sometimes It's Disgusting" Cross-sectional Study on the Influence of SARS-CoV-2 Infections, Both Acute and Postinfection, in Comparison to Other Respiratory Infections on Taste and Smell Perception.

BACKGROUND

Subjective smell and taste disorders were frequently reported during and after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (SCI), but mostly investigated by interviews/questionnaires.

METHODS

We examined from 07/2021 to 10/2022 objective (U-Sniff/Taste Strips) and subjective (questionnaire-based) impairment in children with (1) acute SCI (AC; n = 30) and other upper respiratory tract infection (n = 34), (2) children with (PI+; n = 28)/without (PI-; n = 13) remaining symptoms ≥12 weeks after SCI and (3) as control 18 noninfected children. Children with acute infections were examined blinded regarding the results of their SARS-CoV-2 polymerase chain reaction. Statistics: X², F test, Kruskal-Wallis, P < 0.05.

RESULTS

Abnormal test results occurred in up to a fifth of children. Severe hyposmia was detected in 17% of children with upper respiratory tract infection and 21% in PI+, severe hypogeusia was mostly in AC children (18%), followed by both postinfection groups (PI+ 12%, PI- 10%). Subjective smell impairment was significantly more frequent in PI+ (32% vs. ≤7% in all other groups), similar for taste (PI+ = 29%, AC = 14% vs. ≤10% in all other groups). Children in PI+ and PI- reported significantly more negative sensory affects ("tastes/smells disgusting," 14% each), without correlation with abnormal test results.

CONCLUSION

In the omicron era, hyposmia and hypogeusia are not pathognomonic for acute SARS-CoV-2 infections. In a subgroup, SARS-CoV-2 can cause long-lasting taste and smell impairment, mostly aversive changes, which are not detected by the validated tests. It is therefore essentially necessary to apply objective and subjective methods at the same time to improve the detection of hyposmia and hypogeusia in children.