Clinical Features of Parosmia Associated With COVID-19 Infection

David K. Lerner, Katherine L. Garvey, Annie E. Arrighi-Allisan, Andrey Filimonov, Peter Filip, Janki Shah, Benjamin Tweel, Anthony Del Signore, Madeleine Schaberg, Patrick Colley, Satish Govindaraj, Alfred Marc Iloreta

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Objective: To characterize the clinical features, risk factors, symptom time-course, and quality of life implications for parosmia among coronavirus disease (COVID)-related olfactory dysfunction patients. Methods: Individuals with olfactory dysfunction associated with laboratory-confirmed or clinically suspected COVID-19 infection were recruited from otolaryngology and primary care practices over a period from August 2020 to March 2021. Participants completed olfactory dysfunction and quality of life surveys. Results: A total of 148 (64.1%) of 231 respondents reported parosmia at some point. Parosmia developed within 1 week of any COVID-19 symptom onset in 25.4% of respondents, but more than 1 month after symptom onset in 43.4% of respondents. Parosmia was associated with significantly better quantitative olfactory scores on Brief Smell Identification Test (8.7 vs. 7.5, P =.006), but demonstrated worse quality of life scores, including modified brief Questionnaire of Olfactory Dysfunction—Negative Statements and Sino-Nasal Outcome Test-22 scores (12.1 vs. 8.5, P <.001; 26.2 vs. 23.2, P =.113). Participants who developed parosmia at any point were significantly younger and less likely to have history of chronic sinusitis than those who did not develop parosmia (40.2 vs. 44.9 years, P =.007; 7.2% vs. 0.7%, P =.006). Conclusion: COVID-19-associated olfactory dysfunction is frequently linked with development of parosmia, which often presents either at onset of smell loss or in a delayed fashion. Despite better quantitative olfactory scores, respondents with parosmia report decreased quality of life. A majority of respondents with persistent parosmia have sought treatment. Level of Evidence: 3 Laryngoscope, 132:633–639, 2022.

Original languageEnglish (US)
Pages (from-to)633-639
Number of pages7
Issue number3
StatePublished - Mar 2022


  • COVID-19 infection
  • Olfactory dysfunction
  • anosmia
  • parosmia
  • quality of life

ASJC Scopus subject areas

  • Otorhinolaryngology


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