ArticleAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology2026
Unique and shared patterns of chemosensory dysfunction distinguish chronic COVID-19 and aspirin-exacerbated respiratory disease.
Article in Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPersistent chemosensory dysfunction (CSD) occurs in both COVID‑19 and aspirin-exacerbated respiratory disease (AERD). The similarities and differences in the chemosensory experiences of these 2 conditions remain undefined and poorly understood.
objectiveTo compare qualitative and quantitative chemosensory alterations and quality-of-life impact in individuals with COVID-19-associated vs AERD-associated CSD.
methodsParticipants from the Brigham and Women's Hospital COVID-19 CSD registry (n = 406) and the Brigham and Women's Hospital AERD registry (n = 389) completed online questionnaires assessing CSD characteristics and sinonasal disease-related quality of life.
resultsCOVID‑19 CSD showed a distinct qualitative phenotype. Overall, 60% of COVID‑19 participants reported that odors smelled different from how they recalled them, vs 19% with AERD (P < .001). Unpleasant odor perception was experienced by more than 20% of COVID‑19 participants, but by less than 5% of AERD participants. COVID‑19 CSD involved selective impairment and unpleasant distortion of sour, bitter, and umami tastes, whereas AERD exhibited a uniform quantitative reduction across taste modalities. Flavor distortions, particularly for foods with bitter or fatty components (eg, coffee, chocolate, and nut butter) and chemesthetic flavors (eg, spicy, mint, alcohol, garlic, and ginger), were significantly more common in COVID‑19 CSD (average: 25%) than in AERD (average: 0%). Both conditions were associated with impaired quality of life, including odor and food safety-related concerns.
conclusionBoth COVID‑19 CSD and AERD cause profound chemosensory disruption. However, COVID‑19 CSD is distinguished by marked qualitative distortions in smell, taste, flavor, and chemesthesis. In contrast, AERD CSD reflects a more generalized sensory reduction. Incorporating these characteristic sensory profiles into routine evaluations may improve diagnostic accuracy and guide patient counseling for ongoing chemosensory care.
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