Gustatory and olfactory dysfunctions in hospitalised patients with COVID-19 pneumonia: a prospective study

Abstract

ImportanceIdentifying undetected clinical signs is imperative in the prevention of SARS-CoV-2.ObjectiveTo establish the prevalence of clinical gustatory and olfactory dysfunctions in patients with COVID-19 pneumonia. Clinical outcomes and recovery rates associated with gustatory and olfactory dysfunctions were also assessed.DesignA prospective study was performed in 80 patients admitted to Hospital Clínic of Barcelona (Spain) for COVID-19 pneumonia. Patients were re-evaluated in the ward daily until discharge. Gustatory and olfactory dysfunction symptoms were retrospectively collected from emergency room (ER) charts after first assessments. Follow-up was performed in telemedicine consultation.SettingThe single-centre study was performed in a hospitalisation ward at a university hospital.ParticipantsConsecutive patients meeting hospitalisation criteria for COVID-19 pneumonia were eligible. Study exclusion criteria were patients who could not speak, had previous gustatory and olfactory dysfunctions or whose PCR tests for SARS-CoV-19 were negative.InterventionsSystematic assessment of gustatory and olfactory symptoms with standardised questions.Outcome(s)Prevalence of gustatory and olfactory dysfunctions in patients with COVID-19 pneumonia.ResultsOf the 80 study subjects, 62.5% were male and the median age was 57 years. Half of the cohort (n=40) presented with comorbidities. The prevalence of chemosensitive disorder was 73.8% (n=59) (95% CI: 63.8 to 83.8), although self-reported symptoms were recorded in only 26.3% (n=21) of patients in the ER. Gustatory and olfactory dysfunctions were observed in 58.8% (n=47) and 55% (n=44) of cases, respectively. They were also the first symptoms in 25% (n=20) of patients. Anosmia was associated with ageusia, OR: 7, 95% CI: 2.3 to 21.8, p=0.001). No differences in clinical outcomes were observed when patients with and without gustatory and olfactory dysfunctions were compared. Recovery rates were 20% (n=10) and 85% (n=42) at days 7 and 45, respectively.ConclusionThe prevalence of gustatory and olfactory dysfunctions in COVID-19 pneumonia was much higher than in self-report. Presence of gustatory and olfactory dysfunctions was not a predictor of clinical outcomes.

COVID-19 related olfactory dysfunction

“…The authors speculate that short lived olfactory dysfunction may simply be overlooked in more severe disease due to over-riding respiratory symptoms and associated anorexia leading to reduced dietary intake and they suggest that any association between OD and a milder course is an artefact. Similar findings were reported by an independent research group in Spain [13]…”

“…The authors speculate that short lived olfactory dysfunction may simply be overlooked in more severe disease due to over-riding respiratory symptoms and associated anorexia leading to reduced dietary intake and they suggest that any association between OD and a milder course is an artefact. Similar findings were reported by an independent research group in Spain [13] One study has suggested that anosmia may be more frequent among women (72.4%; 95% CI, 62.8%-80.7%) than among men (55.7%; 95% CI, 45.2%-65.8%; P ¼ 0.02) [14]. A systematic review suggested a lower reporting of OD with increasing age [15], in keeping with age dependent reduced expression of Angiotensin-converting enzyme 2.…”

The Prevalence and Implications of Olfactory/Gustatory Dysfunctions among Adult COVID-19 Patients: A Retrospective Cohort Multiethnic Populations Study

“…Previous research has shown that olfactory and gustatory impairment can occur alone or in combination with other COVID-19 symptoms [ 48 , 49 ]. Inciarte et al demonstrated a significant association between olfactory and gustatory dysfunction and the development of additional symptoms such as cough and hyporexia [ 50 ]. While numerous studies have found no link between olfactory/gustatory dysfunction and rhinorrhea or nasal blockage development, others have reported a possible association [ 24 , 51 ].…”

Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile

“…Necropsies have confirmed brain edema and neuronal degeneration in patients who died because of COVID-19 [7]. Headache, myalgia, hypogeusia, hyposmia, dizziness, and fatigue are the most common neurological manifestations [6,[8][9][10][11].…”