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in the comprehension of the questionnaire. 19,20 who scored highest on the post-COVID19
As a means to assess the reproducibility group was the only one that reported getting
of the questionnaire, we decided that the psychological help specifically because of
participants should answer the Portuguese her recent OD. With previous studies linking
version of the bvQOD-NS in two separate post-COVID19 OD with isolation, stress
occasions one month apart. The first time the and depression, psychotherapy might be
questionnaire was completed by the patients useful in such cases and should be further
was in the same moment they were submitted investigated. 25
to olfactory testing. An important limitation of the present study
Since none of the participants reported any is the small sample size, which probably
difficulty while answering the questionnaire, influences the modest internal consistency
and because some patients were not willing we found in the Portuguese version of the
to come in person to the hospital due to bvQOD-NS. Another limitation is the follow-
both time and money-consuming reasons, up period of only 1 month, which did not allow
we decided that all the participants should for an observation of changes in the olfactory
complete the questionnaire for the second specific QoL of our patients after treatment,
time by teleconsultation. Given the excellent either medical or surgical. Furthermore, our
test-retest reproducibility in our study, study did not include a control group. The
representing great temporal stability of the reason why is that the questionnaire was
questionnaire, the authors believe the score created specifically for patients with OD, so
of Portuguese version of the bvQOD-NS is the authors did not feel it was necessary to
not influenced by the way the questionnaire validate it, in concordance with other studies.
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is answered, which can be extremely useful However, it would be interesting in the future
both in follow-up after treatment and in future to compare the results of a group of patients
scientific studies. with OD to a control group in order to evaluate
However, internal consistency was not as high the discriminant validity of the questionnaire.
as expected, particularly regarding eating Future studies with bigger sample sizes,
questions (questions four and five), which were including a longer follow up and evaluation
also the ones that showed least impact in QoL. pre- and post-treatment are needed to
We believe this might be linked with the low confirm the value of the Portuguese version
socioeconomic conditions of our population, of the bvQOD-NS.
as food enjoyment does not seem to be as
related to hedonic-oriented motives (such Conclusion
as pleasure) as in higher socioeconomical Portuguese is the seventh most-spoken first
groups. 21 language in the world. It is the authors belief
Our study included patients with essentially that our translation into Portuguese of the
two different etiologies of OD: CRS and post- bvQOD-NS will allow for a rapid and valid
infectious. Since SARS-CoV-2 infection was method to better understand the struggles
established as a possible cause of OD, the sense and expectations surrounding olfactory
of smell smellthat was previously overlooked dysfunction, ultimately benefiting the patients
started to be of major importance. 22,23 In our and providing important information for the
study there were 10 patients with post-COVID19 medical community in future studies.
OD whom, in concordance with previous
reports, revealed greater impact in QoL than Conflicts of Interest
the rest of the group. 15,24 This is thought to The authors declare that there is no conflict
be due to the sudden onset of OD versus a of interests regarding the publication of this
more progressive dysfunction in patients with paper.
CRS . Also, it is noteworthy that the patient
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176 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery
