Unraveling Dysgeusia in SARS-CoV-2 Infection: Clinical and Laboratory Insights from Hospitalized COVID-19 Patients in Romania.

Introduction: Dysgeusia has been regarded as a clinical feature associated with SARS-CoV-2 infection since the onset of the pandemic. The initial circulating variants were linked to the presence of dysgeusia; however, with the emergence of the Omicron variant, the incidence of dysgeusia has decreased. The aim of this study was to identify the incidence and characteristics of patients with dysgeusia from the onset of the pandemic to the Omicron variant. Methods: We conducted a retrospective study from March 2020 to December 2021, among adult patients hospitalized with COVID-19 in the main infectious diseases hospital in Romania. Clinical and laboratory data were collected and interpreted in relation to the presence or absence of dysgeusia. Results: The incidence of dysgeusia was 32.0%, with the majority of cases (44.2%) occurring in patients with the Beta SARS-CoV-2 variant. Dysgeusia has been predominantly observed in mild to moderate cases of the disease. The presence of obesity and hypertension has been shown to be negatively associated with the development of dysgeusia (OR = 0.45, OR = 0.39, respectively). In patients with dysgeusia, inflammatory changes such as lymphopenia were significantly less frequently identified (OR = 0.22, p < 0.001), as were increased C-reactive protein (OR = 0.12, p < 0.001) and increased interleukin-1 (OR = 0.42, p = 0.002), increased fibrinogen (OR = 0.31, p < 0.001), and increased ferritin (OR = 0.27, p < 0.001) compared to patients without dysgeusia. The incidence of acute respiratory failure was higher in the dysgeusia group (71.2% vs. 28.8%, p < 0.001). This was accompanied by a milder management of patients with dysgeusia and a median duration of hospitalization that was two days shorter. Conclusions: The presence or absence of dysgeusia in patients with COVID-19 appears to correlate with both the inflammatory response and outcome. In the context of evolving circulating viral variants, which seem to be associated with a lower incidence of dysgeusia, continuous monitoring of patients who develop this disorder remains essential to clarify the pathophysiologic mechanisms involved and to assess the potential of dysgeusia as a predictor of the course of SARS-CoV-2 infection.