Keywords
COVID-19
rhinosinusitis
anosmia
nasal congestion
clinical course
How to Cite
Abstract
During the COVID-19 (COronaVIrus Disease 2019) pandemic, a number of clinical symptoms and laboratory markers of inflammation specific have been identified. However, despite their widespread use in clinical practice, the clinical significance of these indicators in the course of COVID-19-associated pneumonia remains unclear. The aim of the study was to substantiate the contribution of clinical blood parameters in patients with olfactory dysfunction in the diagnosis and prediction of the course of SARS-CoV-2-associated pneumonia of varying severity. The retrospective analysis included 370 case histories of patients who were treated at the COVID-19 medical care center in Kharkiv. The analysis included an assessment of the clinical course of pneumonia, the presence of olfactory and general otolaryngological symptoms, and the level of some blood laboratory parameters. Statistical analysis included discriminant analysis with calculation of normalized Euclidean distance to determine the diagnostic significance of clinical blood parameters. Data analysis showed that 52.2% of patients reported the occurrence of olfactory dysfunction, which was most often observed in patients with mild SARS-CoV-2-associated pneumonia (68.1%) and in patients without pneumonia (88.6%). Statistical analysis showed that adding clinical blood test parameters is advisable in patients with relatively mild forms of COVID-19, as it reduces the probability of diagnostic errors to 0.03. In patients with moderate and severe SARS-CoV-2-associated pneumonia, specific COVID-19 parameters already provide high diagnostic accuracy (error less than 0.02), and the inclusion of clinical blood test parameters only increases the accuracy of the discrimination model. Thus, olfactory disorders associated with acute rhinosinusitis in COVID-19 could be a prognostic marker of a milder course of pneumonia in hospitalized patients. At the same time, clinical blood test parameters have limited additional value in advanced diagnostics.
Keywords: olfactory dysfunction, COVID-19, rhinosinusitis, anosmia, nasal congestion, clinical course.
References
Mutiawati E, Fahriani M, Mamada SS, Fajar JK, Frediansyah A, Maliga HA, et al. Anosmia and dysgeusia in SARS-CoV-2 infection: incidence and effects on COVID-19 severity and mortality, and the possible pathobiology mechanisms – a systematic review and meta-analysis. 2021;10:40. DOI: 10.12688/f1000research.28393.1. PMID: 33824716.
Amer SA, Al-Zahrani A, Imam EA, Ishteiwy EM, Djelleb IF, Abdullh LR, et al. Exploring the reported adverse effects of COVID-19 vaccines among vaccinated Arab populations: a multi-national survey study. Scientific Reports. 2024;14(1):4785. DOI: 10.1038/s41598-024-54886-0. PMID: 38413637.
Rodriguez-Morales AJ, Cardona-Ospina JA, Gutierrez-Ocampo E, Villamizar-Pena R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623. DOI: 10.1016/j.tmaid.2020.101623. PMID: 32179124.
Hussain A, Kaler J, Tabrez E, Tabrez S, Tabrez SSM. Novel COVID-19: A Comprehensive Review of Transmission, Manifestation, and Pathogenesis. Cureus. 2020;12(5):e8184. DOI: 10.7759/cureus.8184. PMID: 32566425.
Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer PY, Lepiller Q, Gendrin V, Zayet S. Features of anosmia in COVID-19. Med Mal Infect. 2020;50(5):436-9. DOI: 10.1016/j.medmal.2020.04.006. PMID: 32305563.
Hjelmesaeth J, Skaare D. Loss of smell or taste as the only symptom of COVID-19. Tidsskr Nor Laegeforen. 2020;140(7). DOI: 10.4045/tidsskr.20.0287. PMID: 32378854.
Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS. Self-reported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol. 2020;10(7):821-31. DOI: 10.1002/alr.22592. PMID: 32329222.
Izquierdo-Dominguez A, Rojas-Lechuga MJ, Chiesa-Estomba C, Calvo-Henriquez C, Ninchritz-Becerra E, Soriano-Reixach M, et al. Smell and Taste Dysfunction in COVID-19 Is Associated with Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study. J Investig Allergol Clin Immunol. 2020;30(5):346-57. DOI: 10.18176/jiaci.0595. PMID: 32554337.
Ministry of Health of Ukraine. State Expert Center. Protocol "Provision of Medical Care for the Treatment of Coronavirus Disease (COVID-19)", approved by the Order of the Ministry of Health of Ukraine No.762 of 02 Apr 2020, in force from 30 Jun 2025. State Expert Center of the Ministry of Health of Ukraine. [Internet]. Available at: https://www.dec.gov.ua/mtd/koronavirusna-hvoroba-2019-covid-19 [accessed 30 Jun 2025]. [In Ukrainian].
Vaira LA, De Vito A, Deiana G, Pes C, Giovanditto F, Fiore V, et al. Systemic inflammatory markers and psychophysical olfactory scores in coronavirus disease 2019 patients: is there any correlation? J Laryngol Otol. 2021;135(8):723-28. DOI: 10.1017/S0022215121001651. PMID: 34184623.
Nosova Y, Avrunin O, Semenets V. Biotechnical system for integrated olfactometry diagnostics. Innovative technologies and scientific solutions for industries. 2017;1(1):64-8. DOI: 10.30837/2522-9818.2017.1.064.
Avrunin О, Shushlyapina N, Nosova Y, Bogdan О. Olfactometry diagnostic at the modern stage. Bulletin of NTU KhPI. Series: New solutions in modern technologies. 2016;12(1184):95-100. DOI: 10.20998/2413-4295.2016.12.13.
Pavlov SV, Avrunin OG, Zlepko SM, Bodiansky EV, Kolisnyk PF, Lysenko OM, et al. Intelligent technologies in medical diagnostics, treatment and rehabilitation. Vinnytsia: PP "TD "Edelweiss and K"; 2019. 260 p. [In Ukrainian].
Avrunin OG, Nosova YaV, Semenets VV, Filatov VO, Shushlyapina NO. Modern methods of diagnosing respiratory-olfactory function. Kharkiv: KhNURE; 2021. 150 p. [In Ukrainian].
Tymkovych M, Gryshkov O, Avrunin O, Selivanova K, Nosova Y, Mutsenko V, et al. Application of SOFA Framework for Physics-Based Simulation of Deformable Human Anatomy of Nasal Cavity. In: Jarm T, Cvetkoska A, Mahnic-Kalamiza S, Miklavcic D (eds). Proceedings of the 8th European Medical and Biological Engineering Conference (EMBEC 2020). Springer Science and Business Media Deutschland GmbH; 2021. P. 112-20. (IFMBE Proceedings). DOI: 10.1007/978-3-030-64610-3_14.
Selivanova KG, Avrunin OG, Tymkovych MY, Manhora TV, Bezverkhyi OS, Omiotek Z, et al. 3D visualization of human body internal structures surface during stereo-endoscopic operations using computer vision techniques. Przeglad Elektrotechniczny [Electrical Inspection]. 2021;9:30-3. DOI: 10.15199/48.2021.09.06.
Avrunin OH, Bodyanskyi YeV, Semenets VV, Filatov VO, Shushlyapina NO. Information Technologies for Decision Support in the Diagnosis of Nasal Breathing Disorders. Kharkiv: KhNURE; 2018. 125 р. [In Ukrainian].
Avrunin OH, Bodyanskyi YeV, Kalashnyk MV, Semenets VV, Filatov VO. Modern Intelligent Technologies of Functional Medical Diagnostics. Kharkiv: KhNURE; 2018. 248 с. [In Ukrainian].
Avrunin OG, Nosova YV, Abdelhamid IY, Kalizhanova A. Possibilities of automated diagnostics of odontogenic sinusitis according to the computer tomography data. Sensors. 2021;21(4):1-22. DOI: 10.3390/s21041198.
Piccirillo JF. SNOT-20. St. Louis, Missouri: Washington University School of Medicine; 1996. Available at: https://www.canvasc.ca/pdf/SNOT22.pdf
Shkorbotun Y. Evaluation of the ukrainian version of SNOT-22 questionnaire validity for assessing the quality of life in patients with chronic rhinosinusitis and nasal septum deviation. Georgian Med News. 2020;(308):43-7. PMID: 33395639.
Foster KJ, Jauregui E, Tajudeen B, Bishehsari F, Mahdavinia M. Smell loss is a prognostic factor for lower severity of coronavirus disease 2019. Ann Allergy Asthma Immunol. 2020;125(4):481-3. DOI: 10.1016/j.anai.2020.07.023. PMID: 32717301.
Benkirane H, Heikel J, Laamiri FZ, Bouziani A, Lahmam H, Al-Jawaldeh A, et al. Study of Clinical and Biological Characteristics of Moroccan COVID-19 Patients with and without Olfactory and/or Gustatory Dysfunction. Front Physiol. 2020;11:595005. DOI: 10.3389/fphys.2020.595005. PMID: 33329044.
Golnaz V, Marjan M, Raheleh K, Kiyan H, Paria R, Mahfam S, Shaghayegh H. Inflammatory markers in COVID-19 patients: a systematic review and meta-analysis. MedRxiv. 2020.04.29.20084863. DOI: 10.1101/2020.04.29.20084863.
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