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Evaluation of subjective and tested olfactory dysfunction as a screening tool for COVID-19 in children
Laura Marie Aalkjær Danielsen1,2, Alexander Wieck Fjældstad1,2, Therese Ovesen1,2
1Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Department of Otorhinolaryngology, Regional Hospital Gødstrup, Central Denmark Region.
Insights
Olfactory dysfunction is not a dominant symptom in children with SARS-CoV-2 infection. Objective and subjective smell tests are not reliable for diagnosing COVID-19 in pediatric patients.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Olfactory dysfunction (OD) is a common symptom in adult COVID-19 patients.
- Pediatric symptomatology, particularly OD, is understudied and relies heavily on subjective reports.
- Questionnaires are the primary method for assessing OD in children, with limited objective data.
Purpose of the Study:
- Evaluate the prevalence of OD in children with SARS-CoV-2 infection.
- Assess the utility of olfactory testing in predicting COVID-19 in pediatric cases.
- Investigate the correlation between subjective smell perception and objective olfactory testing results in children.
Main Methods:
- Children aged 6-12 years undergoing SARS-CoV-2 PCR testing were invited to participate.
- Objective olfactory function was assessed using the Sniffin' Sticks 16 Identification Kit.
- Participants provided subjective smell assessments and reported confounding factors.
Main Results:
- No significant correlation was found between SARS-CoV-2 status and olfactory test scores (p = 0.500).
- Previous self-reported infection also showed no correlation with objective olfactory function.
- There was no significant correlation between subjective smell perception and objective olfactory test results (p = 0.109).
Conclusions:
- Olfactory dysfunction does not appear to be a dominant symptom of SARS-CoV-2 infection in children.
- Olfactory testing is not recommended as a screening tool for COVID-19 in pediatric populations.
- Subjective smell assessment is unreliable for evaluating olfactory function in children.
Introduction:
Olfactory dysfunction (OD) is an extremely frequent symptom of SARS-CoV-2 infection in adults. However, the symptomatology in the paediatric population remains understudied and heavily reliant on questionnaires. The aims of this study were to evaluate the prevalence of OD in children with SARS-CoV-2 infection and to assess the use of olfactory testing in predicting COVID-19 in children. Furthermore, we aimed to investigate the correlation between subjective and objective sense of smell in children.
Methods:
Children aged 6-12 years presenting at Test Centre Aarhus for a reverse transcription PCR for SARS-CoV-2 were invited to participate during the study period (from 8 January to 22 February 2022). They underwent olfactory testing with Sniffin' Sticks 16 Identification Kit and they were asked about their subjective assessment of smell and any confounding factors.
Results:
A total of 78 children completed inclusion of whom 51 had a positive SARS-CoV-2 PCR test. We found no correlation between either current SARS-CoV-2 status and Sniffin' Sticks Identification score (p = 0.500) or previous self-reported infection. We also found no correlation between subjective and objective sense of smell (p = 0. 109).
Conclusion:
The lack of correlation between SARS-CoV-2 infection and OD may indicate that OD is not a dominant symptom in children. Therefore, olfactory testing is not recommended as a screening method for SARS-CoV-2 as was suggested in adults. Likewise, subjective questioning is not a reliable tool in assessing olfactory function in children.
Funding:
Laura Danielsen received funding for salary from Forskningsfond Hospitalsenheden Vest (now Forskningsfond Regionshospitalet Gødstrup). Alexander Wieck Fjældstad wishes to acknowledge research salary funding for other projects from Velux Fonden. The sponsors had no say, roles or responsibilities in relation to the study, including (but not limited to) the study design, data collection, management, analysis or decision to publish.
Trial Registration:
Not relevant.
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