Archetype of Olfactory and Gustatory Dysfunction in Breakthrough COVID-19 Illness

Vaccination against SARS CoV-2 has resulted in COVID-19 illness with reduced incidence and milder symptomatology. With the intent to analyze the olfactory and gustatory disturbances in breakthrough COVID-19 illness, we conducted a prospective observational study on a cohort of COVID-19 positive symptomatic otolaryngologist physicians. These doctors being well sensitized to the symptoms and signs of loss of smell and taste, reported even very mild and transient symptoms. This cohort of 25 physicians included 16 unvaccinated and 9 vaccinated otolaryngologists. The overall incidence of smell and taste disturbances reported in this cohort was 80% and 84% respectively. The incidence of olfactory dysfunction was 81% in the unvaccinated group and 78% in the vaccinated group. Similarly, the incidence of gustatory dysfunction was 81% in the unvaccinated group and 89% in the vaccinated group. However, the incidence of complete loss of smell was 54% in the unvaccinated group and 100% in the vaccinated group. Ageusia was noted in 15% of the unvaccinated physicians as compared to 25% of the vaccinated ones. The average duration of smell and taste loss were lesser in the physicians who were vaccinated with two doses than their unvaccinated counterparts. Larger studies are desirable to add further knowledge on the equal incidences and higher degree of loss of smell and taste observed in breakthrough COVID-19 illness as observed in our small prospective cohort study.