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. 2022 Nov 3:e12798. Online ahead of print. doi: 10.1111/joss.12798

Effects of COVID‐19 on sensory and cognitive perception of mild and severe diagnosed and recovered patients versus healthy consumers

Adan Cabal‐Prieto 1, Lucía Sánchez‐Arellano 1, José Andrés Herrera‐Corredor 2, Jesús Rodríguez‐Miranda 3, Witoon Prinyawiwatkul 4, Lorena Guadalupe Ramón‐Canul 5, Filiberto Toledano‐Toledano 6,7, Ingrid Mayanin Rodríguez‐Buenfil 8, Manuel Octavio Ramírez‐Sucre 8, Gregorio Hernández‐Salinas 9, Emmanuel de Jesús de Ramírez‐Rivera 9,✉
PMCID: PMC9877580  PMID: 36718473

Abstract

The objective of this research was to analyze the effects of the SARS‐CoV‐2 virus on the sensory and cognitive perception of mild and severe COVID‐19 diagnosed and recovered consumers versus healthy consumers. Three groups of 50 consumers each (healthy vs. mild and severe COVID‐19 diagnosed with 30 days after recovery) were used for the evaluation of instant coffee stimuli in concentrations: 4.40, 2.93, 2.20, 1.76, and 1.47% weight (w)/volume (v) and determine their discriminating power, emotions, and memories. Sensory tests were performed remotely. Results indicated that healthy consumers perceived higher intensities in most of the sensory attributes (with the exception of Burnt‐A, Bitter‐T, Acid‐T, and Astringent‐T attributes) compared to consumers who presented mild and severe COVID‐19. Therefore, consumers diagnosed with mild and severe COVID‐19 had a higher discrimination power in the attributes smell, basic tastes, and flavor. Healthy consumers could only discriminate two attributes that correspond to basic flavors. Consumers with mild and severe COVID‐19 diagnosis elicited the highest number of negatives emotions (such as bored, disgusted, worried, guilty, wild, and aggressive) and negative memories (disease, pain, death, hurt, obesity, conflict personal, addiction, stench poverty, and accident) than healthy consumers. It is concluded that there were no significant differences between the consumer panels for the identification of sensory attributes. However, P‐Healthy consumers perceived the highest intensities in most sensory attributes compared to those in the PCOVID19‐Mild and PCOVID19‐Severe panels. Finally, consumers diagnosed with mild or severe COVID‐19 used a higher number of emotions and memories than those of the healthy panel.

Practical applications

Investigating the effects of COVID‐19 on sensory and cognitive perception can be useful for industry and researchers in the sensory field who wish to understand the effects of the disease in order to generate new protocols for the selection and training of people, as well as the possible development and innovation of new products focused on perception of consumers recovered from COVID‐19.

1. INTRODUCTION

As of October 13, 2022, the World Health Organization has reported 620,301,709 confirmed cases of COVID‐19 (WHO, 2022). The SARS‐CoV‐2 coronavirus pandemic has caused negative impacts on different activities, particularly in the food industry (Gómez‐Corona et al., 2021; Molina‐Montes et al., 2021). According to Alarco and Huarcaya‐Victoria (2021) the possible mechanisms of neuroinvasion of SARS‐CoV‐2 coronavirus are the transneuronal, hematogenous/lymphatic and digestive paths. Being the first path the one who explains how the SARS‐CoV‐2 coronavirus invades the peripheral nerves and extends to the axons and synaptic spaces between neurons to invade the Central Nervous System (CNS) as well as the brain resulting in sensory perception disorders (i.e., taste and smell) and neurological symptoms related to mental health risks (i.e., emotional disorders, depression, stress, mood swings, irritability, insomnia, and even suicide) (Paolini et al., 2021). COVID‐19 disease is characterized by developing hypoxemia (SpO2 < 90%), in which about 14% of patients with COVID‐19 usually require oxygen therapy whereas 81% have mild symptoms and 5% require intensive care (Hannum et al., 2020; Pozo‐Rivadeneira, Matute‐Solís, Moreno‐Castro, & Castillo‐Olvera, 2021). Loss of smell (anosmia) occurring in the short, medium or long term as well as loss of taste (ageusia) for a few days are the characteristic symptoms of COVID‐19 (Hannum et al., 2020). In this sense, Díaz‐Reyna et al. (2021) indicated that anosmia originates when the SARS‐CoV‐2 virus infects the olfactory epithelia inflaming the olfactory cleft, and the pathogenesis of taste may be caused by ACE‐2 inhibitors through the complex involving the protein G protein‐coupled sodium channel in taste buds that infects cells and blocks chemical signal information. It has been found that between 5 and 98% the cases present this symptom (Mao et al., 2020; Moein et al., 2020). In countries such as Iran, the United States, and Mexico, the prevalence of anosmia and dysgeusia has been reported (Gautier & Ravussin, 2020). In Iran, between 60 and 80% of the cases with COVID‐19 have presented anosmia and dysgeusia (Emami, Javanmardi, Pirbonyeh, & Akbari, 2020). In the United States, two groups of populations composed of 1,627 and 1,390 people were analyzed and it was reported that 52 and 43% of the analyzed populations presented olfactory and taste dysfunctions due to COVID‐19 (Tong, Wong, Zhu, Fastenberg, & Tham, 2020). In Mexico, a population of 205 patients with COVID‐19 was analyzed and it was reported that 68.7% presented anosmia and ageusia (Díaz‐Reyna et al., 2021). People infected with COVID‐19 can be classified as patients with mild disease (SpO2 > 90% with anosmia and ageusia), severe disease (SpO2 < 90%, anosmia and ageusia with dyspnea on mild exertion) or critical illness (intubation, organ failure, among others). The total or partial loss of the senses of taste and smell affects the perception of sensory properties that in turn contribute to: (a) decreased appetite and intake of essential nutrients, leading to weight change, malnutrition and a slow recovery from COVID‐19 (Chaaban, Høier, & Andersen, 2021); (b) excessive intake of salt or sugar that negatively impacts the quality of life of consumers as it increases the chances of developing diabetes or high blood pressure (Zhang et al., 2021), and (c) possible changes in emotions and memories that contribute to the well‐being and stress reduction of consumers (Oliveira, Sousa, & Pastore, 2022). Although the recovery of smell and taste and the influence of COVID‐19 severity are unclear, the existence of a correlation between the duration of olfactory and taste symptoms and the development of COVID‐19 has been found using psychophysical tests for the evaluation of chemosensitive functions (Printza et al., 2021; Vaira, Hopkins, Petrocelli, et al., 2020; Vaira, Hopkins, Salzano, et al., 2020; Vaira, Deiana, Fois, et al., 2020). The effects of COVID‐19 can affect people's mental health, in terms of emotions and cognition, where the possible development of negative emotions and memories contribute to reducing people's immune function and destroying the balance of their normal physiological mechanisms (Kiecolt‐Glaser, McGuire, Robles, & Glaser, 2002; Li, Wang, Xue, Zhao, & Zhu, 2020; Schelhorn et al., 2022). COVID‐19 survivors have been shown to develop changes in episodic memory for up to 6 months after infection (Zhao et al., 2021). From the sensory field, research on COVID‐19 has focused on the impact of confinement on eating behavior (Gómez‐Corona et al., 2021; Laguna, Fiszman, Puerta, Chaya, & Tárrega, 2020; Molina‐Montes et al., 2021; Snuggs & McGregor, 2021), and impact on appetite, sensory perception in people in acute and post‐acute phase using surveys (Chaaban et al., 2021). However, many of these investigations are of an anamnestic or observational nature and therefore objective studies are required using sensory tools to analyze the effects of COVID‐19 on people's perception. (Vaira, Salzano, Petrocelli, et al., 2020). The objective of this research was to analyze the effects of the SARS‐CoV‐2 coronavirus on the sensory and cognitive perception of recovered consumers diagnosed with mild and severe COVID‐19 in comparison with healthy consumers.

2. MATERIALS AND METHODS

2.1. Stimuli and preparation for sensory evaluation

Coffee was used as a stimulus due to its significant frequency of consumption and high intensity of aromas and flavors. It possess an adequate representative of attributes such as sweet, salty, astringent, and bitter and has currently been used in COVID‐19 research within the sensory field (Dinnella et al., 2022; Konstantinidis et al., 2020; Medina, Regalado, & Guillen, 2022; Vaira, Hopkins, Petrocelli, et al., 2020). Traditional soluble coffee brand Portales de Cordoba®, manufactured and purchased in the city of Cordoba, Veracruz, México, was used and different dilutions in water were made as shown in Table 1. Different dilutions were made to analyze consumer discrimination, this type of sample preparation has also been used in research by Vaira, Hopkins, Petrocelli, et al. (2020). The dilutions were determined via previous experimental conditions with the help of a Q‐certified panel (six men and three women with an age range between 25 and 49 years). The concentration of Stimulus 3 was determined in accordance with the guidelines of the Specialty Coffee Association of America (SCAA, 2009). The coffee evaluation was carried out in porcelain cups with a capacity of 150 ml and coded with three‐digit random code. The stimuli were prepared using 2.2 g of soluble coffee and poured in volumes of 50 (4.40% w/v), 75 (2.93% w/v), 100 (2.20% w/v), 125 (1.76% w/v), and 150 (1.47% w/v) ml of hot water (93 ± 5°C) as indicated in Table 1. The coffee samples were left to stand for 3 min and afterward, the foam layer and the particles of the coffee sample were removed manually, and the stimuli were packed in stainless steel thermo‐cans manufactured by the Running company located in Leon Guanajuato, México (Running™ brand) to maintain the temperature at 40 ± 5°C until their evaluation (Ramón‐Canul et al., 2021).

TABLE 1.

Composition of the coffee stimuli used for the evaluation of the sensory panels

Stimulus Description % (w/v)
Stimulus 1 2.2 g of soluble coffee +50 ml of water 4.40
Stimulus 2 2.2 g of soluble coffee +75 ml of water 2.93
Stimulus 3 2.2 g of soluble coffee +100 ml of water 2.20
Stimulus 4 2.2 g of soluble coffee +125 ml of water 1.76
Stimulus 5 2.2 g of soluble coffee +150 ml of water 1.47
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2.2. Ethical considerations

The study was revised and approved by the Ethics Committee of the Instituto Tecnológico Superior de Huatusco (approval number: ITSH/UEG/SEPCI/001).

2.3. Recruitment procedure and conformation of sensory panels

People were recruited using social networks (Facebook® and Twitter®). The selection of the participants and their assignment to a specific group was carried out based on data obtained from a survey according to the following inclusion criteria: (a) schedule availability (morning from 9 a.m. to 1 p.m. and afternoon from 4 p.m. to 8 p.m.) for test execution; (b) to have a desktop computer and internet service at home; (c) prior knowledge on social networks and remote connections; (d) to live in the municipality of Huatusco, Veracruz, Mexico and located at a distance no higher than 20 km (maximum 20 min) from our sensory laboratory where the samples were prepared and sent via local delivery services to each selected participant; (e) subjects over 18 years of age; (f) not having chronic‐degenerative diseases (diabetes, hypertension, cancer, among others; (g) having been infected by the COVID‐19 disease with its different clinical effects but highlighting the symptoms of anosmia and ageusia, as well as the need for oxygen or not; (h) indicate the percentage (0–100%) of loss of smell and taste that they considered during their illness process due to COVID‐19; (i). The participants were asked to provide a certificate with a positive diagnosis of COVID‐19 and to be in the recovery phase. Accordingly, three panels of 50 consumers each were formed (total of n = 150 consumers) with 25 women and 25 men in each group with age ranges between 18 and 55 years. The three groups presented the following homogeneous sociodemographic characteristics: (a) access to the public health service, (b) access to water, electricity, drainage and internet services; (c) level of education between high school and higher education; (d) middle‐class socioeconomic level and (e) inhabitants of the coffee‐producing region (urban area) located in the municipality of Huatusco, Veracruz, and Mexico. In the case of the panels with people who suffered from COVID‐19, only those who had 30 days of recovery after the disease were selected because it has been reported that around 25% of the patients evaluated 30 days after the clinical onset of COVID‐19 still has some type of serious chemosensitivity disorder (i.e., anosmia, ageusia, severe hyposmia, or severe hypogeusia) (Vaira, Hopkins, Petrocelli, et al., 2020; Vaira, Hopkins, Salzano, et al., 2020). The statistical power of the test was 0.78 for a moderate effect size (f = 0.25) for three groups with a significance level of 0.05 and a sample size of 50 (Cohen, 1988). Calculation was performed using the pwr function implemented in R version 3.2.5 programming language R Core Team, 2019). The first panel included subjects who did not present the COVID‐19 disease (P‐Healthy) at the time of this study. This group served as a reference panel to compare the results with the other two panels who presented the COVID‐19 disease. The second panel included subjects who presented mild disease without requiring the use of oxygen (PCOVID19‐mild) during the disease process and on average they mentioned that they lost their sense of smell and taste between 40 and 60% (these values were given according to how they felt they had lost their sense of smell and taste). The third panel included subjects who manifested severe disease and who required oxygen at home during the COVID‐19 process (PCOVID19‐severe). This group on average mentioned that they lost their sense of smell and taste between 70 and 100% (these values were given according to how they felt they had lost their sense of smell and taste). In order to observe the effect of COVID‐19 on consumers who manifested this disease versus healthy consumers, the experimental development was proposed for two different situations: (a) Effect of COVID‐19 on the identification and evaluation of intensity of sensory attributes and (b) Effect of COVID‐19 on the use of emotions and memories. All sensory tests were done on successive days starting with sensory attributes (identification and intensity) followed by emotions and ending with memories.

2.4. Identification and evaluation of intensity of sensory attributes

Ten sensory attributes of aroma modalities (sweet, burnt, caramel, roasted, and earthy), and taste chemical sensation (bitter, sour, astringent, sweet, and earthy) were used. These 10 sensory attributes were selected by a Q‐certified panel (six men and three women with an age range between 25 and 49 years) based on the Specialty Coffee Association of America (2009) coffee flavor wheel. First, the Check‐All‐That‐Apply (CATA) technique was applied to determine the number of sensory attributes identified by the consumers of the different panels (P‐Healthy, PCOVID19‐mild and PCOVID19‐severe) considered in this research. This sensory technique was used due to its ease of execution and speed (Vidal, Ares, Hedderley, Meyners, & Jaeger, 2018). Subsequently, consumer discrimination was analyzed by assessing sensory attributes using a 10 cm unstructured scale, which has been used with consumers (Worch, Lê, & Punter, 2010). Consumers were asked to rate the perceived intensity of each sensory attribute per product (the sequential monadic serving mode was used) according to a Latin square experimental design. (MacFie, Bratchell, Greenhoff, & Vallis, 1989).

2.5. Determination of emotions and memories

The emotion vocabulary of the EsSense25 profile (Nestrud, Meiselman, King, Lesher, & Cardello, 2016) and the MemVOC memory vocabulary developed by Cabal‐Prieto et al. (2022) were applied to identify the type of emotions and memories used by each panel for evaluating coffee stimuli (Table 1). These vocabularies applied through the CATA technique facilitate the identification of emotions and memories (Vidal et al., 2018). Consumers were instructed to evaluate the stimuli according to a Latin square experimental design (MacFie et al., 1989).

2.6. Application of remote sensory tests

The sensory tests were carried out at the consumers' homes, using online tools for the following reasons: (a) the risks of contagion or recontagion by COVID‐19 are minimized; (b) the test can be executed with consumers without difficulty, and (c) data can be obtained in real time from any place or moment (Santiago‐Cruz et al., 2021; Vaira, Salzano, Petrocelli, et al., 2020). This practice has been used in research related to remote sensory panel training and recently applied to sensory testing during the COVID‐19 pandemic (Nogueira‐Terrones, Tinet, Curt, Trystram, & Hossenlopp, 2006; Vaira, Hopkins, Petrocelli, et al., 2020). First, the sensory analyst e‐mailed (1 day before their participation) the selected consumers to indicate the evaluation instructions: not to use perfumes, smoke, and keep oral hygiene (at least 1 hr in advance), and to have eaten their usual foods, this was with the aim of minimizing errors. Then, each selected consumer was contacted to agree on the shipment of the material to carry out the sensory tests (according to their day of participation based on having 30–40 days of recovery). For this purpose, a local delivery service was used to send (within a maximum period of 30 min): napkins, water (for palate cleansing), glasses, porcelain cups (coded with three random digits), pencils and an example of the evaluation card containing sensory attributes and intensity scale. The five stimuli (Table 1) packaged (coded with three random digits) were also sent in Running™ brand stainless steel thermocans to maintain the temperature of the stimuli (40 ± 5°C) for at least 1.5 hr (considering sending, reception and start of the tests), since this type of container keeps drinks warm for a maximum of 12 hr. The stimuli were prepared with a maximum of 40 min prior to their evaluation. Subsequently, the sensory analyst contacted each consumer remotely using Skype® to (a) explain the objective of each sensory test (15 min); (b) explain the use of the intensity scale (15 min); (c) indicate that a digital format made with the Google® Forms tool was emailed collect sensory attributes, emotions and memories using the CATA technique (5 min); and (d) to assist with doubts and ask them perform the evaluation at home in a space as quiet by as possible to allow the participant to focus on samples and their evaluation (10 min). It is worth mentioning that the sensory analyst guided the participants throughout the test, just as it is usually done in a sensory laboratory (Dinnella et al., 2022). Each participant performed the tests in the following order: (a) For each coffee stimulus, the CATA test was performed for each sensory modality in the following order: olfactory and gustatory. For each sensory modality, consumers were given the following instruction: “Read the following list for words regarding to this coffee stimulus,” then they were asked to select the sensory attributes they perceived on a yes/no scale (1/0) for each stimulus. The CATA lists of olfactory and gustatory descriptors included five descriptors each. The olfactory descriptors were: sweet, burnt, caramel, toasty and earthy. The taste descriptors were: bitter, acid, astringent, sweet, and earthy. (b) The second test was the determination of intensity by sensory modality in the following order: olfactory and gustatory. For each sensory modality, the following instruction was given to consumers; “taste the coffee stimulus and indicate the level of perceived intensity on each sensory attribute” using an intensity scale (10 cm unstructured scale). (c) In the third test, the CATA procedure was carried out and the participants were asked to select the emotions that the evaluated stimulus provoked in them, and (d) in the last test, the CATA procedure was carried out, where the participants were asked to select the memories generated by each stimulus (coffee sample). For tests 3 and 4, the following instruction was given to consumers: “read the following list of emotions/memories and select the ones that apply to this coffee stimulus.” All sensory tests (n = 150) were completed in a period of 15 working days (Monday–Friday) equivalent to 3 weeks (n = 10 tests per day). During 1 day, five tests were performed in the morning (9 a.m. to 1 p.m.) and another five in the afternoon (4 p.m. to 8 p.m.). Breakfast (7 a.m. to 8 a.m.), lunch (2 p.m. to 3 p.m.) and dinner (after 8 p.m.) times were skipped to avoid sensory biases. It is important to mention that all the personnel involved (sensory analyst, personnel in charge of preparing and sending the samples) were monitored daily to determine if they presented any symptoms of COVID‐19 (Dinnella et al., 2022).

2.7. Statistical analysis

2.7.1. Comparisons of sensory panel performance

The results of each sensory panel were collected in matrices of (J*M*I) K, where J = 5 stimuli, M = 1 repetition, I = 50 consumers, and K = 10 attributes. The statistical strategy was carried out in three stages: (a) Effect of COVID‐19 on identification of sensory attributes; (b) effect of COVID‐19 on sensory attributes sensory performance between panels, and (c) effect of COVID‐19 on the frequency of emotions and memories selected.

2.7.2. Identification of sensory attributes

Cochran's Q test was used to determine differences in the sensory attributes identified (p < .05) by panel (Vidal et al., 2018). In addition, The Kruskal–Wallis (K–W) test was then used to determine possible differences in the number of identified sensory attributes (p < .05) between panels (Cabal‐Prieto et al., 2022).

2.7.3. Evaluation of intensity in sensory attributes

The performance evaluation between sensory panels (P‐Healthy, PCOVID19‐Mildly and PCOVID19‐Severe) used the following two‐factor analysis of variance model with interaction:

Yik=μ+αi+βk+αβik+eik.

where Y ik represented the result of panel I in the stimulus k; μ was the overall mean; α i was the panel type effect (consensus), β k was stimulus effect (discriminant power), αβ ik was stimulus interaction per panel type (use of intensity scale), and e ik was the error term of the model with e ik  ≈ N(0, σ 2) (Tomic, Nilsen, Martens, & Næs, 2007). Then, a one‐way analysis of variance was performed with the factor stimulus in order to separately study the discriminant power of each panel (P‐Healthy, PCOVID19‐Mild, and PCOVID19‐Severe). Subsequently, the average and standard deviation of the intensity of each sensory attribute per stimulus and per panel were calculated to verify the behavior of each sensory panel in terms of intensity. The representation of the discriminant power and the consensus effect was performed using Heat maps and the Tucker‐1‐plot technique, respectively (Bi, Qiu, & Huang, 2020; Deuscher et al., 2020; Tomic et al., 2010).

2.7.4. Evaluation of emotions and memories

The analysis was carried out as follows: (a) Cochran's Q test was conducted to determine significant emotions and memories (p < .05) by panel (Vidal et al., 2018) and (b) The K–W test was then applied to determine possible differences in the frequency of positive and negative emotions and memories (p < .05) between panels (Cabal‐Prieto et al., 2022). The analysis of variance, K–W, Cochran's Q, heat maps, Tucker‐1, Manhattan technique tests were performed with the XLSTAT software, version 2020 (Addinsoft, 2020 New York, NY).

3. RESULTS AND DISCUSSION

3.1. Effect of COVID‐19 on identification of sensory attributes

The results of the probability values of Cochran's Q test to identify the sensory attributes discriminating all five stimuli for each panel are shown in Table 2. It was observed that the healthy consumers panel (P‐Healthy) was discriminant (p < .05) in seven sensory attributes (three aromas and four basic flavors chemical sensation). Consumers from the PCOVID19‐Mild panel identified (p < .05) a total of nine attributes (four aroma, four basic tastes chemical sensation and one flavor) while consumers from the PCOVID19‐Severe panel identified a total of eight attributes (four aroma and four basic tastes chemical sensation). The results of the K–W test indicated there were no significant differences (p > .05) in the number of discriminating sensory attributes among the consumers of the different panels.

TABLE 2.

Discriminating sensory attributes identified by Cochran's Q test probability values by panel

Attribute P‐Healthy PCOVID19‐mild PCOVID19‐severe
Sweet‐A <0.05 <0.01 <0.05
Burnt‐A <0.05 <0.01 <0.05
Caramel‐A 0.681 <0.05 <0.05
Roast‐A <0.05 0.963 0.584
Earthy‐A 0.929 <0.05 <0.05
Bitter‐T <0.05 <0.05 <0.0001
Acid‐T <0.05 <0.0001 <0.05
Astringent‐T <0.05 <0.01 0.001
Sweet‐T <0.05 <0.0001 <0.0001
Earthy‐F 0.844 <0.05 0.582
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Note: A = Aroma; T = Basic taste chemical sensation and F = Flavor. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement.

3.2. Effect of COVID‐19 on sensory attributes sensory performance between panels

The results of the two‐factor of analysis variance model with interaction for monitoring the general performance of the consumers of the different panels are shown in Table 3. It was observed that the discrimination was significant (p < .05) in seven (Sweet‐A, Burnt‐A, Earthy‐A, Bitter‐T, Acid‐T, Astringent‐T, and Sweet‐T) of 10 attributes. The consensus among the consumers of the different panels was significant (p < .05) in eight (Sweet‐A, Caramel‐A, Roasted‐A, Earthy‐A, Bitter‐T, Acid‐T, Sweet‐T, and Earthy‐F) of 10 sensory attributes evaluated, which indicates discrepancies between the panels. This was confirmed with the results shown in Figure 1 from different perspectives: (a) in all the attributes with the exception of Caramel‐A, Roasted‐A, and Earthy‐F, none of the panels was located in the inner ellipse, which means that all of them have more than 50% of systematic variation of the variation explained by PC1 and PC2 (Tomic et al., 2010); (b) a separation was observed between the consumers of the PCOVID19‐Mild panel and the other two panels (P‐Healthy and PCOVID19‐Severe) in the evaluation of the sensory attributes Sweet‐A, Caramel‐A, Roast‐A, Earthy‐A, Astringent‐T, and Earthy‐F. In the case of interaction (Stimulus*Panel), the positioning of the stimuli on the intensity scale for all attributes was similar (p > .05) between the panels. These results indicate good discrimination, consensus, and use of the intensity scale between panels (Tomic et al., 2010). Table 4 shows the intensity results for each sensory attribute organized by stimulus and sensory panel. In general, it was observed that consumers of P‐Healthy perceived the highest intensities in most sensory attributes (with the exception of the Burnt‐A, Bitter‐T, Acid‐T, and Astringent‐T attributes) compared to those from the PCOVID19‐Mild and PCOVID19‐Severe panels. This shows that the effect of COVID‐19 could cause a reduction in sensitivity in consumers and therefore require higher concentrations of coffee to perceive the sensory attributes. For the analysis of discrimination by panel (Table 5), it was found that consumers of P‐Healthy were discriminating (p < .05) in the attributes Bitter‐T and Acid‐T. PCOVID19‐Mild consumers were discriminant (p < .05) in the Burnt‐A, Bitter‐T, Acid‐T, Astringent‐T, and Sweet‐T attributes while PCOVID19‐severe consumers were discriminant (p < .05) in sensory attributes Caramel‐A, Earthy‐A, Bitter‐T, Astringent‐T, and Sweet‐T. These results show that consumers who presented COVID‐19 (Mild and Severe) discriminated more attributes of basic taste (Bitter‐T, Acid‐T, Astringent‐T, and Sweet‐T) than smell attributes (Burnt‐A, Caramel‐A, and Earthy‐A). This result may be due to the fact that taste functions have a faster recovery compared to those of smell (Vaira, Hopkins, Petrocelli, et al., 2020). The heat maps (Figure 2) indicated that the consumers of the P‐Healthy panel strongly perceived the attributes Astringent‐T (2.3 ± 3.0), Bitter‐T (6.7 ± 2.5), Acid‐T (3.2 ± 3.0), Burnt‐A (2.8 ± 3.1), Roast‐A (4.2 ± 2.8), and Earthy‐F (1.7 ± 2.5) for Stimulus 1 and Sweet‐A (2.7 ± 2.6) and Earthy‐A (1.5 ± 2.8) for Stimulus 2 and Stimuli 4 and 5 were perceived as Sweet‐T (1.3 ± 2.4 and 1.2 ± 2.2, respectively) and Caramel‐A (2.3 ± 2.9 and 2.8 ± 4.7, respectively), respectively. The PCOVID19‐Mild participants perceived the attributes Burnt‐A (2.6 ± 2.8), Earthy‐A (0.9 ± 2.1), Earthy‐F (0.6 ± 1.6), and Acid‐T (2.7 ± 3.4) for Stimulus 1. For Stimulus 2 they perceived Bitter‐T (5.2 ± 3.0) and Roast‐A (2.6 ± 3.2) while Caramel‐A (2.3 ± 2.9) and Astringent‐T (2.0 ± 3.1) for Stimulus 3 and Sweet‐A (1.9 ± 2.4) and Sweet‐T (1.2 ± 2.3) for Stimulus 5. For consumers of the PCOVID19‐Severe panel, Stimulus 1 was perceived as Bitter‐T (5.0 ± 3.1), Acid‐T (1.3 ± 2.9) and Earthy‐A (0.9 ± 2.0) and Stimulus 2 as Sweet‐A (1.3 ± 2.2) and Astringent‐T (2.7 ± 3.4). Stimulus 3 was perceived as Burnt‐A (2.5 ± 2.7) while Stimulus 4 as Caramel‐A (1.1 ± 2.5), Sweet‐T (0.9 ± 2.2) and particularly Earthy‐F (0.7 ± 2.1), where this last attribute (Earthy‐F = 0.7 ± 1.8) was also perceived in Stimulus 5. These results show that the consumers of the PCOVID19‐Mild and PCOVID19‐Severe panels after the COVID‐19 disease showed a perception similar to the panel of healthy consumers (and in some cases higher than P‐Healthy) as they perceived sensory attributes in the stimuli with the highest coffee dilution (Stimuli 4 and 5). These results can be explained in different ways: (a) the recovery of smell and taste in patients who presented COVID‐19 recovered these senses within a period of 30–60 days (Printza et al., 2021; Vaira, Hopkins, Petrocelli, et al., 2020); (b) the recovery of smell and taste is related to local inflammatory aspects, interference of the virus in taste and smell receptors more than with the invasion of the CNS and permanent neuronal damage (Vaira, Salzano, Deiana, & De Riu, 2020; Vaira, Salzano, Fois, Piombino, & De Riu, 2020); (c) chemosensitive taste and smell disorders are more common in the early stages of COVID‐19 disease (Konstantinidis et al., 2020; Vaira, Hopkins, Petrocelli, et al., 2020).

TABLE 3.

Values of the F test for the stimulus, panel type and stimulus‐by‐panel type interaction factors

Attribute Stimulus Panel type Stimulus*panel type
Sweet‐A 2.40* 40.61*** 0.71ns
Burnt‐A 6.21* 4.12ns 1.00ns
Caramel‐A 0.36ns 23.6** 1.39ns
Roast‐A 0.85ns 73.75** 0.71ns
Earthy‐A 1.18* 15.63** 1.27ns
Bitter‐T 14.68*** 10.1** 1.21ns
Acid‐T 6.68** 16.69** 1.73ns
Astringent‐T 3.76** 2.24ns 1.72ns
Sweet‐T 11.61*** 11.76** 0.62ns
Earthy‐F 0.58ns 25.78* 0.90ns
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Note: A = Aroma; T = Basic taste and F = Flavor. * = <0.05; ** < 0.01; *** < 0.001. ns = not significant.

FIGURE 1.

FIGURE 1

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Representation of consensus between panels using Tucker‐1‐plot. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement

TABLE 4.

Average intensity values and standard deviation for each attribute, stimulus and sensory panel

Stimulus Sweet‐A Burnt‐A Caramel‐A Roast‐A Earthy‐A Bitter‐T Acid‐T Astringent‐T Sweet‐T Earthy‐F
P‐Healthy
Stimulus 1 2.4 ± 2.7 2.8 ± 3.1 2.5 ± 3.0 4.2 ± 2.8 1.3 ± 2.2 6.7 ± 2.5 3.2 ± 3.0 2.3 ± 3.0 0.5 ± 1.4 1.7 ± 2.5
Stimulus 2 2.7 ± 2.6 2.0 ± 2.6 2.2 ± 2.9 3.3 ± 3.0 1.5 ± 2.8 5.3 ± 3.0 3.0 ± 3.2 2.2 ± 2.7 0.8 ± 2.0 1.3 ± 2.2
Stimulus 3 2.1 ± 2.5 2.5 ± 2.8 2.1 ± 2.6 3.5 ± 2.8 1.1 ± 2.1 4.9 ± 2.9 2.6 ± 3.0 1.4 ± 2.3 0.7 ± 1.7 1.2 ± 2.2
Stimulus 4 2.4 ± 2.7 1.6 ± 2.5 2.3 ± 2.9 3.5 ± 3.3 1.4 ± 2.1 4.4 ± 3.1 1.9 ± 2.5 1.4 ± 2.2 1.3 ± 2.4 1.2 ± 2.0
Stimulus 5 2.5 ± 2.7 1.9 ± 2.6 2.8 ± 4.7 3.6 ± 3.1 1.2 ± 2.3 3.9 ± 3.1 1.6 ± 2.5 1.1 ± 2.1 1.2 ± 2.2 1.2 ± 2.0
PCOVID19‐mild
Stimulus 1 0.6 ± 1.5 2.6 ± 2.8 1.3 ± 2.6 2.1 ± 2.8 0.9 ± 2.1 4.5 ± 3.8 2.7 ± 3.4 1.5 ± 2.8 0.04 ± 0.3 0.6 ± 1.6
Stimulus 2 1.5 ± 2.6 2.0 ± 2.4 1.1 ± 2.1 2.6 ± 3.2 0.1 ± 0.6 5.2 ± 3.0 2.3 ± 2.9 1.1 ± 2.5 0.4 ± 1.6 0.2 ± 0.7
Stimulus 3 1.2 ± 2.4 1.4 ± 2.6 2.3 ± 2.9 1.7 ± 2.5 0.5 ± 1.3 4.7 ± 3.5 0.6 ± 1.6 2.0 ± 3.1 0.5 ± 1.5 0.3 ± 1.5
Stimulus 4 1.3 ± 2.1 0.9 ± 1.9 1.7 ± 2.3 2.1 ± 2.5 0.8 ± 1.9 3.6 ± 3.3 1.0 ± 1.9 1.2 ± 2.4 0.9 ± 1.8 0.5 ± 1.5
Stimulus 5 1.9 ± 2.4 0.8 ± 1.8 1.4 ± 2.4 1.9 ± 2.6 0.3 ± 1.2 2.1 ± 2.4 0.2 ± 0.8 0.1 ± 0.7 1.2 ± 2.3 0.4 ± 0.8
PCOVID19‐severe
Stimulus 1 0.9 ± 2.0 2.2 ± 2.9 0.4 ± 1.3 1.3 ± 2.2 0.9 ± 2.0 5.0 ± 3.1 1.3 ± 2.9 2.3 ± 3.3 0.02 ± 0.1 0.2 ± 0.6
Stimulus 2 1.3 ± 2.2 2.5 ± 2.8 0.7 ± 1.7 1.3 ± 2.3 0.6 ± 1.5 4.3 ± 2.9 0.9 ± 2.3 2.7 ± 3.4 0.2 ± 1.1 0.5 ± 1.7
Stimulus 3 0.9 ± 1.7 2.5 ± 2.7 0.3 ± 1.2 1.4 ± 2.1 0.2 ± 1.0 4.0 ± 2.5 0.9 ± 2.3 1.4 ± 2.3 0.1 ± 0.4 0.3 ± 0.8
Stimulus 4 0.8 ± 1.6 1.6 ± 2.1 1.1 ± 2.5 1.3 ± 2.2 0.0 ± 0.2 3.0 ± 2.9 0.4 ± 1.1 1.2 ± 2.1 0.9 ± 2.2 0.7 ± 2.1
Stimulus 5 1.0 ± 1.8 1.3 ± 1.7 0.2 ± 0.9 0.9 ± 1.5 0.2 ± 0.8 2.4 ± 2.8 0.5 ± 1.6 1.0 ± 2.3 0.4 ± 1.3 0.7 ± 1.8
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Note: Stimulus 1(ST1) = 2.2 g of soluble coffee +50 ml of water; Stimulus 2 (ST2) = 2.2 g of soluble coffee +75 ml of water; Stimulus 3 (ST3) = 2.2 g of soluble coffee +100 ml of water; Stimulus 4 (ST4) = 2.2 g of soluble coffee +125 ml of water; Stimulus 5 (ST5) = 2.2 g of soluble coffee +150 ml of water. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement.

TABLE 5.

Values of the F test and probability by panel of consumers

P‐Healthy PCOVID19‐mild PCOVID19‐severe
Attribute F p F p F p
Sweet‐A 0.288 .886 2.347 .055 0.678 .608
Burnt‐A 1.437 .222 4.936 .001 2.370 .053
Caramel‐A 0.378 .824 1.734 .143 2.623 .035
Roast‐A 0.632 .640 0.825 .510 0.505 .732
Earthy‐A 0.305 .874 2.214 .068 3.652 .007
Bitter‐T 6.552 <.0001 6.946 <.0001 6.604 <.0001
Acid‐T 3.039 .018 10.979 <.0001 1.559 .186
Astringent‐T 2.226 .067 3.872 .005 3.743 .006
Sweet‐T 1.426 .226 3.989 .004 4.176 .003
Earthy‐F 0.445 .776 0.986 .416 1.323 .262
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Note: A = Aroma; T = Basic taste and F = Flavor. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement.

FIGURE 2.

FIGURE 2

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Heat maps by panel. (a) P‐Healthy; (b) PCOVID19‐Mild; (c) PCOVID19‐Severe. ST1 = Stimulus 1; ST2 = Stimulus 2; ST3 = Stimulus 3; ST4 = Stimulus 4; ST5 = Stimulus 5. See Table 1 for samples description. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement. Values close to 0 (blue color) indicate low discrimination while values close to 1 (yellow color) indicate high discrimination

3.3. Effect of COVID‐19 on the frequency of emotions and memories

Results from emotions used by panels are shown in Table 6. Consumers from P‐Healthy panel significantly elicited a total of 10 positive emotions, 5 negative, and unclassified emotions. Consumers from the PCOVID19‐Mild and PCOVID19‐Severe panels elicited 14 positive emotions and 6 negative or unclassified emotions. For the case of memories, consumers in the P‐Healthy panel chose 10 positive memories and 5 negative memories. Consumers from the PCOVID19‐Mild panel and PCOVID19‐Severe panel generated 13 positive memories and 8 negative memories (Table 7). In both emotions and memories, consumers of the PCOVID19‐Mild and PCOVID19‐Severe panels elicited more positive and negative emotions and memories compared to the consumers of the P‐Healthy panel. This result can be attributed to the consumers recent COVID‐19 process, although the temporality (times higher than 30 days) of the elicited emotions and memories due to a COVID‐19 traumatic event is unknown. These results could also be an effect of regulation of the mood of people who suffered from the COVID‐19 disease (Aizpurua, Migueles, & Aranberri, 2021). According to Johnson, Saletti‐Cuesta, and Tumas (2020), positivity during the COVID‐19 pandemic may be a tendency to value social ties that are the cause of the demand for empathy and awareness to maintain health measures, especially the isolation that generates greater responsibility on the part of the population. Schelhorn et al. (2022) explained that people with fewer feelings of restraint, higher self‐efficacy, and not living alone tended to have stronger increases in joy. In the case of negativity (emotions and memories) it can be explained by the Behavioral Immune System (BIS) theory, in which people tend to develop more negative emotions and memories for self‐protection (Li et al., 2020). According to stress theory and perceived risk theory (Norris, Friedman, & Watson, 2002; Slovic, 1987), health emergencies contribute to the development of negative emotions and memories, which in the long‐term contribute to minimizing the immune function of people (Johnson et al., 2020). Schelhorn et al. (2022) explained that the negativity is caused by factors such as living alone, changes in finances, among others. Li et al. (2020) mentioned that events such as preventive policies and regulations in terms of restriction and lack of control caused by COVID‐19 can also contribute to the generation of negative emotions and memories in people who had the COVID‐19 disease. Schelhorn et al. (2022) mentioned that the Dynamic Model of Affect as highly negative events such as the pandemic evoke a stressful context that is perceived as uncertainty or threat. In the case of positive emotions, the word happiness and joy have been reported by Li et al. (2020) and Schelhorn et al. (2022). Regarding negative emotions, the PCOVID19‐mild and PCOVID19‐severe panels evoked all the negative emotions (Bored, Disgusted, Worried, Guilty, Wild, and Aggressive) compared to P‐Healthy who evoked all negative emotions except Guilty (Table 6). This result can be compared with the findings of Johnson et al. (2020), Li et al. (2020), and Schelhorn et al. (2022) who determined the emotional impact when COVID‐19 was declared a pandemic and reported that people evoked negative emotions such as frustration, anguish, boredom, feelings of isolation, anxiety, depression, and indignation. The use of positive memories by consumers of the PCOVID19‐mild and PCOVID19‐severe panels may be due to the fact that memory uses adaptive cognitive processes for the reconstruction of reality, based on pre‐existing knowledge, beliefs, expectations, and desires that can generate distortions such as positivity bias that help improve mood and minimize emotional disorders (Aizpurua et al., 2021). For example, the selection of the family and friendship memory could be due to the fact that during confinement and suffering from COVID‐19, people strengthen interpersonal ties by generating support with their family and friends to carry out physical activities (i.e., Sport) and disease prevention activities (Li et al., 2020). In the case of the positive memories of summer, winter, rainy weather, cold weather, and temperate weather, these could be associated with the moment in which consumers suffered from COVID‐19 during a certain season of the year and climate and that could coincide with social events, such as family reunions, trips, among other events that have taken place during the years that the pandemic has been. In the case of negative memories, a possible interpretation of the results is that the COVID‐19 disease causes different clinical conditions (i.e., head, throat, among others) that are interpreted as pain (Vaira, Hopkins, Petrocelli, et al., 2020), and that caused a person to experience anxiety and fear of death (Johnson et al., 2020), and that can be considered as Hurt. In the case of the Obesity (uniquely identified by the panel of healthy consumers) and personal conflict (uniquely identified by the panel of consumers with severe COVID‐19) memory, these could be associated with the effects of confinement such as limitation of physical activity, changes in eating behavior patterns that involve food addiction, as well as the generation of irritability, stress, and anger (Sahoo et al., 2020). However, Li et al. (2020) mentioned that from the impact of the confinement of people, a greater concern for health is generated, which opens the way to the positive effects. In the case of the stench memory, it could be related to the sensory atrophy of smell generated in people by parosmia or phantosmia as sequelae caused by COVID‐19 (Hopkins et al., 2021). According to Parker et al. (2022) the People frequently mentioned the words rotten, chemical and burned to describe the odors they perceive under the effect of parosmia. Therefore, this effect is characterized by the crosslinking of regenerating olfactory receptors and the glomeruli or olfactory bulb (Cooper et al., 2020). In the case of memory poverty, it may be because when financial income decreases, people become more insecure (Schelhorn et al., 2022). These results are consistent with the research by Gómez‐Corona et al. (2021) who reported that the fear of consumers during the COVID‐19 pandemic are related to social, emotional, food supply, government, basic needs, food delivery, overeating, immunity, and family conflicts. The limitations of the present investigation lie mainly in the comparison of the words of emotions and memories against the results of other investigations where instruments from the health area or open text surveys are applied (Aizpurua et al., 2021; Johnson et al., 2020; Schelhorn et al., 2022; Zhao et al., 2021). However, these results give a guideline for the use of vocabularies of emotions and memories generated by the sensory field for their application within the health area in order to study cognitive changes in people with different diseases. In the same way, the results obtained from sensory perception can be useful for the food industry in order to identify the possible sensory changes in people whom suffered from COVID‐19 for decision making for its use in consumer studies or for the formation of sensory panels for training purposes with people who suffered from the COVID‐19 disease.

TABLE 6.

Cochran's Q test probability values by panel for emotions

Positive emotions P‐Healthy PCOVID19‐mild PCOVID19‐severe Negative and unclassified emotions P‐Healthy PCOVID19‐mild PCOVID19‐severe
Active <0.05 <0.05 <0.05 Bored <0.05 <0.05 <0.05
Adventurous ns ns <0.05 Disgusted <0.05 <0.05 <0.05
Calm <0.05 ns <0.05 Worried <0.05 <0.05 <0.05
Enthusiastic ns <0.05 ns Guilty ns <0.05 <0.05
Free <0.05 <0.05 <0.05 Wild <0.05 <0.05 <0.05
Good <0.05 <0.05 <0.05 Aggressive <0.05 <0.05 <0.05
Good nature ns <0.05 <0.05
Hapy ns <0.05 <0.05
Interested ns <0.05 ns
Joyful ns <0.05 ns
Loving <0.05 <0.05 ns
Mild <0.05 <0.05 <0.05
Nostalgic ns ns <0.05
Pleasant ns ns ns
Satisfied <0.05 <0.05 <0.05
Secure <0.05 ns <0.05
Tame ns <0.05 <0.05
Warm <0.05 <0.05 <0.05
Understanding <0.05 <0.05 <0.05
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Note: ns = not significant. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement.

TABLE 7.

Cochran's Q test probability values by panel for memories

Positive memory P‐Healthy PCOVID19‐mild PCOVID19‐severe Negative memory P‐Healthy PCOVID19‐mild PCOVID19‐severe
Traditional food ns <0.05 <0.05 Disease <0.05 <0.05 <0.05
Party <0.05 <0.05 <0.05 Pain ns <0.05 <0.05
Family <0.05 ns ns Hurt <0.05 <0.05 <0.05
Birthplace ns <0.05 <0.05 Obesity <0.05 ns ns
Childhood <0.05 ns <0.05 Stench <0.05 <0.05 <0.05
Friendship ns <0.05 <0.05 Addiction <0.05 <0.05 ns
Sport ns <0.05 <0.05 Poverty ns <0.05 <0.05
Alive ns <0.05 <0.05 Death ns <0.05 <0.05
Gift <0.05 <0.05 <0.05 Interpersonal conflict ns ns <0.05
Spring <0.05 ns <0.05 Accident ns <0.05 <0.05
Summer <0.05 <0.05 <0.05
Fall <0.05 ns ns
Winter ns <0.05 <0.05
Rainy weather <0.05 <0.05 <0.05
Cold weather ns <0.05 <0.05
Hot weather <0.05 <0.05 ns
Mild weather <0.05 <0.05 <0.05
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Note: ns = not significant. P‐Healthy = Panel of healthy consumers; PCOVID19‐Mild = Panel of consumers with COVID‐19 who did not require oxygen; PCOVID19‐Severe = Panel of consumers with COVID‐19 with oxygen requirement.

4. CONCLUSIONS

There were no significant differences between healthy consumers and consumers who suffered mild or severe COVID‐19 with a recovery stage of 30 days for the identification of sensory attributes. Consumers of P‐Healthy perceived the highest intensities in most sensory attributes (with the exception of the Burnt‐A, Bitter‐T, Acid‐T, and Astringent‐T attributes) compared to those from the PCOVID19‐Mild and PCOVID19‐Severe panels. However, regarding discrimination, it was found that consumers diagnosed with COVID‐19 discriminated 5 sensory attributes (smell, basic tastes, and flavor) compared to the panel of healthy consumers who could only discriminate in two attributes (basic tastes). Likewise, consumers diagnosed with mild or severe COVID‐19 used a higher number of emotions (14 positive and 6 negative) and memories (14 positive and 8 negative) than those from the healthy panel who used 10 positive emotions, 5 negative emotions, 10 positive memories and 5 negative memories. A trend was found in the use of negative emotions (boring, disgusted, worried, guilty, wild, and aggressive) and memories (disease, pain, death, hurt, personal conflict, addiction, stench, poverty, and accident). However, it is unknown if in periods longer than 30 days the discrimination recovery can be improved and the elicitation of emotions and memories, mainly negative, can be considered as traumatic events that influence their consumption habits and consumer preferences or whether it exists. a future change from negative to positive emotions and memories.

CONFLICTS OF INTEREST

The authors have no conflicts of interest to disclose.

Cabal‐Prieto, A. , Sánchez‐Arellano, L. , Herrera‐Corredor, J. A. , Rodríguez‐Miranda, J. , Prinyawiwatkul, W. , Ramón‐Canul, L. G. , Toledano‐Toledano, F. , Rodríguez‐Buenfil, I. M. , Ramírez‐Sucre, M. O. , Hernández‐Salinas, G. , & de Ramírez‐Rivera, E. d. J. (2022). Effects of COVID‐19 on sensory and cognitive perception of mild and severe diagnosed and recovered patients versus healthy consumers. Journal of Sensory Studies, e12798. 10.1111/joss.12798

Adan Cabal‐Prieto and José Andrés Herrera‐Corredor are the first authors.

DATA AVAILABILITY STATEMENT

Research data are not shared.

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