(1218) Impact of Psychological Disorder Burden at Baseline on Persistence of Anosmia: Pre- Versus Post-COVID-19

Introduction: Post the emergence of COVID-19, persistent anosmia symptoms following resolution of acute infection increased, with 85-98% of COVID patients presenting with olfactory dysfunction. It has been shown that anosmia can have significant psychological impacts; this study investigates the impact of preexisting psychological disorders on the risk of anosmia diagnosis in pre and post-COVID cohorts.

Methods: Records from 1,369 adult patients at a single center institution who presented for evaluation of decreased smell pre-COVID (prior to March 2020) and post-COVID (post-March 2020) were analyzed. Patients were stratified based on diagnosis of anosmia, pre vs post-COVID, demographic and clinical variables, including age, race, sex, and cardiovascular disease risk. Univariate and multicollinearity analyses were performed to measure correlations and interactions. Significant univariate variables were utilized in a generalized linear model.

Results: In the pre-COVID cohort, preexisting psychological disorders significantly predicted anosmia diagnosis (p = 0.0086). Other significant factors in this cohort included history of nasal trauma (p = 0.027), upper respiratory infection (URI) (p < 0.0001), head and neck cancer (p < 0.0001), traumatic brain injury (TBI) (p < 0.0001), age (p = 0.004), smoking (p < 0.0001), and non-English primary language (p = 0.0018). Post-COVID anosmia was not significantly associated with psychological disorders (p = 0.0714). Significant factors included URI (p < 0.0001), head and neck cancer (p < 0.0001), and TBI (0.0384).

Conclusions: The results highlight that despite the increased psychological burden during the pandemic, anosmia diagnosis is not seem to be significantly influenced by preexisting psychological disorders. These findings should inform further research in differentiating mental health burden on COVID and non-COVID anosmia etiologies clinically. Regardless of baseline psychological history, this may support more liberal screening recommendations for risk of post-COVID-19 anosmia, and mental health focused screenings for non-COVID-19 anosmia etiologies.