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Abstract Details

COVID-19 Induced Elimination of First Taste Phenomenon
Infectious Disease
P5 - Poster Session 5 (11:45 AM-12:45 PM)
First Taste Phenomenon, whereby perception of flavor occurs at  first bite and then dissipates is associated with chemosensory loss (Hirsch, 2018). Elimination of this Phenomenon associated with COVID-19 has not been described.

Correlation of First Taste Phenomenon elimination with COVID-19 infection

This 62 year old right handed man presented with upper respiratory tract infection induced chemosensory loss that resolved after treatment of 9 g of phosphatidylcholine. His smell declined to 50% of normal. Taste was lost but he retained his first taste phenomenon. He tested positive for COVID-19 presenting with loss of chemosensation which did not resolve despite treatment with nirmatrelvir/ ritonavir. Symptoms of COVID-19 improved after infection resolution, but First Taste Phenomenon never returned. 

Neurological Abnormalities: Gustatory Testing: Taste threshold: Hypogeusia of 10-30% to sucrose. Electrogustometry Testing: left (L) posterior tongue: 34 (abnormal), right (R) posterior tongue: 34 (abnormal), L anterior tongue: 34 (abnormal), R anterior tongue: 30 (abnormal). Right palate: >32 (abnormal), left palate: >32 (abnormal). Taste Quadrant Testing: Front to back: decreased anteriorly to Sodium Chloride, Sucrose, Quinine Hydrochloride.
The semiology of First Taste Phenomenon includes Classic First Taste Syndrome with full flavor of food followed by rapid, less than 1 minute, decrement in flavor of food (Hirsch, 2018).Retronasal smell inducing flavor perception as nidus to First Taste Syndrome (Djordjevic, 2004) could be eliminated after COVID-19 infection, which reduces retronasal smell, and induce perceived taste loss (Parma, 2020). This First Taste Phenomenon attributes to temporal decrement in saliva as a consequence of persisted mandibulation- reducing  taste threshold sensitivity (Weiffenbach, 1995). COVID-19 worsens such hyposalivation (da Mota Santana, 2021). COVID-19 may eliminate first taste and cause CNS dysfunction via ACE type 2 taste receptor cells dysfunction, (Mastrangelo, 2021) and cytokine storm respectively (Hintschich, 2021). Those with preexisting chemosensory dysfunction, association of COVID on remaining chemosensation is warranted.
Drushti Deepak Birwatkar
Miss Birwatkar has nothing to disclose.
Shweta Kalita Mrs. Kalita has nothing to disclose.
Alan R. Hirsch, MD, FACP (Illinois Center for Neurologial and Behavioral Medicine, Ltd.) Dr. Hirsch has nothing to disclose.