Correlation of the severity of olfactory disorders in predicting the severity of pneumonia caused by SARS-CoV-2

Loss of smell is one of the early and specific signs of covid infection, which makes it an important diagnostic criterion. The aim of the study was to determine the impact of olfactory disorders on the clinical course of SARS-CoV-2-associated pneumonia. For this purpose, 370 medical histories of patients of the center for providing medical care to patients with COVID-19 in Kharkiv were retrospectively processed from December 2020 to February 2022. Age, gender, length of hospital stay, clinical course of pneumonia, presence of olfactory and gustatory disorders, general otolaryngological symptoms and sequence of development of these symptoms, and the level of specific laboratory markers of inflammation (CRP, D-dimer) were analyzed. To determine the diagnostic value of specific indicators of SARS-CoV-2-associated pneumonia of varying severity, discriminant analysis was performed by calculating the normalized Euclidean distance. According to the SNOT-22 questionnaire, 193 (52.2%) patients reported olfactory dysfunction related to COVID-19 infection, and it was more common among patients with mild pneumonia (68.1%) compared to moderate and severe pneumonia (21.6% and 11.1%, respectively). Among patients without pneumonia, olfactory dysfunction was present in 89.2% of cases. Statistical analysis confirmed the significance of olfactory impairment for diagnosis in patients without pneumonia and with mild pneumonia, while in moderate and severe forms, laboratory markers and CT scan data played a key role. Thus, impaired olfactory function associated with acute rhinosinusitis in SARS-CoV-2 infection was found to be a prognostic marker for the development of a milder course of pneumonia in hospitalized patients and emphasizes the importance of olfactory assessment for predicting COVID-19 and choosing optimal treatment tactics.