Loss of smell in patients with aspirin-exacerbated respiratory disease impacts mental health and quality of life
Funding information
This work was supported by the National Institutes of Health (NIH grant nos U19AI095219, K23AI139352, R01HL128241 and T32AI007306), and by generous contributions from the Vinik and Kaye Families. M Lundberg has received funds from the Finnish Medical Society, Finnish ORL-HNS Foundation, Finnish Society of Allergology and Immunology and Mjolbolsta Foundation
Abstract
Background
The impact of anosmia on quality-of-life (QoL) for patients with aspirin-exacerbated respiratory disease (AERD) is poorly understood. We aimed to investigate how the severity of smell loss and olfactory dysfunction (OD) in patients with AERD affects their QoL, mental health and physical well-being.
Methods
Five validated QoL questionnaires (Sinonasal Outcome Test-22, Asthma Control Test, Healthy Days Core Module-4, Short Form-36 and Patient Health Questionnaire-4) and two newly developed questionnaires assessing severity and consequences of OD were electronically sent to all 2913 patients in the Brigham and Women's Hospital AERD registry. Responses were received from 853 participants for analysis.
Results
Overall, 85% of participants reported a present diminished sense of smell and/or taste, and 30% categorized their OD severity was, “as bad as it can be.” There were significant relationships between the severity of self-reported OD and both psychological distress and general health scores, even after adjusting for asthma control. Additionally, incidence rates for physically and mentally unhealthy days in the prior month were higher for patients with moderate or severe OD than for normosmic patients. Patients with diminished smell responded that they could not identify spoiled food (86%), did not enjoy food (71%), felt unsafe (63%) and had encountered dangerous situations (51%) as consequences of their OD.
Conclusions
Anosmia and hyposmia severely impact the physical, emotional and mental health of AERD patients, and lead to safety concerns in their daily lives. The importance of olfaction and the relevance of OD to patients’ QoL should be acknowledged and evaluated by clinicians caring for these patients.
Graphical Abstract
Survey responses from 853 patients with AERD demonstrate that most report diminished sense of smell/taste and 30% categorize it as a severe problem. The severity of olfactory dysfunction correlates with more psychological distress, worse general health scores, and increased negative consequences on quality-of-life. The relevance of smell loss to patients’ quality-of-life, and the safety concerns that may result from it, should be acknowledged and evaluated by clinicians caring for these patients.
CONFLICT OF INTEREST
TM Laidlaw has served on scientific advisory boards for GlaxoSmithKline and Sanofi-Genzyme, Novartis and Regeneron. KM Buchheit has served on scientific advisory boards for AstraZeneca, Regeneron, Sanofi-Genzyme and GlaxoSmithKline. JC Bensko has served on scientific advisory boards for GlaxoSmithKline. M Lundberg has served on scientific advisory boards for Sanofi-Genzyme and Chordate LTD and has received lecture honoraria from Sanofi-Genzyme and Smith+Nephew.
