Objective To prospectively assess the rate and timing of recovery of olfactory (OD) and gustatory (GD) dysfunction in patients affected by COVID-19. Study Design Cohort study. Setting Population-based evaluation in a COVID-19 high-prevalence region. Subjects and Methods We analyzed the clinical course of OD and GD in a cohort of home-quarantined SARS-CoV-2–positive patients from Northern Italy. Physicians administered a survey-based questionnaire at recruitment (T0). During follow-up, patients responded to online dedicated surveys modulated according to symptoms at T0. Results A total of 151 patients completed the follow-up survey. OD and/or GD were observed in 83% and 89% of subjects, respectively. Resolution rates of OD and GD at 30 days from onset were 87% and 82%, respectively. Risk factors for late resolution were grade of dysfunction at onset (total vs partial), gender, and presence of nasal congestion. Three (2%) patients previously reporting complete resolution of symptoms complained of subsequent recurrence of OD and/or GD after a mean of 19 days from resolution of the previous episode. Conclusion COVID-19–related OD and GD had high rate of resolution in the first month from onset of symptoms. However, in 10% to 15% of patients, these symptoms showed only partial improvement after this period.

Background: Olfactory (OD) and gustatory (GD) dysfunction have been proven to be a typical symptom of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. However, their prevalence in different patient populations still needs to be clarified. Methods: A cross-sectional study was performed from March 27 to April 1, 2020, in Northern Italy. Physicians administered a survey-based questionnaire to SARS-CoV-2positive patients with the aim of assessing symptoms, focusing on OD and GD. Two groups were studied: group A, patients hospitalized at Azianda Socio Sanitaria Territoriale (ASST) Spedali Civili University Hospital of Brescia; and group B, home-quarantined subjects. Results: A total of 508 patients were enrolled: 295 in group A and 213 in group B. Mean age ± standard deviation (SD) was 55 ± 15 years; 56% were men. Overall, OD and GD were present in 56% (95% confidence interval [CI], 51% to 60%) and 63% (95% CI, 59% to 67%) of cases, respectively. In group A, the prevalence of OD and GD was 44% (95% CI, 38% to 50%) and 52% (95% CI, 46% to 58%), respectively. In group B, the prevalence of OD and GD was 72% (95% CI, 65% to 79%) and 79% (95% CI, 73% to 84%), respectively. In the entire cohort, total loss of olfaction and taste was reported in 64% and 60% of cases, respectively. OD and GD occurred as the first symptom in 10% and 11% of cases, respectively; in the remaining cases, they occurred a er a mean of 4 ± 3 days following the first symptom. At the time of the questionnaire, complete resolution of OD and GD was reported in 52% and 55% of cases, respectively (mean duration, 9 ± 5 days in both). Conclusion: OD and GD are more prevalent in homequarantined subjects, and they are independently associated with younger age and female gender. C 2020 ARS-AAOA, LLC.

Microvascular reconstruction in the elderly can be performed with high success rates, even though medical complications can occur more frequently compared to younger patients. Minor and major surgical complications in the elderly appear to be comparable to those in the younger population and do not affect final outcome or the perioperative mortality rate. Flap outcome does not seem to be significantly affected by age. Careful preoperative assessment and postoperative monitoring are mandatory to prevent adverse events, and prompt management is warranted whenever present.