Neurocognitive & neuropsychiatric impact of chemosensory alterations: Implications of olfactory dysfunction in COVID-19

PROJECT SUMMARY Smell loss is a common neurosensory disability accompanying infection with SARS-CoV-2 novel coronavirus. The frequency and persistence of alteration in the ability to smell, or olfactory dysfunction (OD), observed during the COVID-19 pandemic highlight a knowledge gap, where risk factors predicting post-viral OD and subsequent neurological dysfunction remain poorly understood. This K23 proposal will characterize epidemiological risk factors associated with OD following COVID-19 infections, which in turn may signify risk for neurocognitive and neuropsychological impairment in daily functioning and quality of life. As a career development award, this proposal will provide Dr. Jonathan Overdevest, MD, PhD, an Assistant Professor in the Department of Otolaryngology-Head and Neck Surgery at Columbia University Irving Medical Center (CUIMC) with structured training to establish an independent career in the study of olfactory dysfunction and neurocognition. Under the guidance of his primary mentor, D.P. Devanand, and an experienced team of experts, Dr. Overdevest will develop domain expertise in the design and analysis of chemosensory-focused neuroepidemiologic studies using patient-oriented research (POR) methodology. Building upon preliminary data evaluating prevalence and persistence of OD in a vulnerable minority population served by CUIMC, Dr. Overdevest will develop the framework for a longitudinal cohort study within this multi-ethnic population. The research in Aim 1 will investigate epidemiologic risk factors for primary and persistent OD following COVID-19 infection by evaluating OD with subjective functional domain and test-based objective tools. In Aim 2, he will study the relationship between persistent OD and neurological, neurocognitive, and neuropsychiatric functioning using validated measures from the multilingual NIH Toolbox assessment battery. He will then extend this preliminary work into the realm of neuroimaging by leveraging existing local research infrastructure and the expertise of his mentorship team to develop pilot data correlating features of OD and neurologic outcomes with anatomic and inflammatory changes in the brain. These studies will inform strategies for counseling the public about demographic risk factors for experiencing COVID-19 related OD, associate risks for additional neurological disabilities, and provide the foundation for future investigation into imaging modalities to evaluate the central processing of olfaction and monitor outcomes of clinical trials for OD interventions.