Olfactory and Oral Manifestations of COVID‐19: Sex‐Related Symptoms—A Potential Pathway to Early Diagnosis

Abstract

Objective The coronavirus disease 2019 (COVID-19) pandemic poses a threat to global health. Early diagnosis is an essential key to limit the outbreak of the virus. Study Design Case series, study conducted between March 25, 2020, and April 15, 2020. Setting Ambulatory, nonhospitalized patients who were quarantined in a designated hotel for COVID-19 patients and were recruited by an advertisement at the hotel. Subjects and Methods In total, 140 patients participated in a web-based questionnaire assessing initial symptoms of common viral diseases, olfactory and taste functions, xerostomia, and orofacial pain. Results A total of 58 men and 70 women participated. Initial symptoms were cough (59.4%), weakness (47.7%), myalgia (46.9%), fever (42.2%), headache (40.6%), impaired sense of smell (38.3%), impaired sense of taste (32.8%), sore throat (26.6%), runny nose (26.6%), and nasal congestion (22.7%). All symptoms were more frequent among women; however, only runny nose was statistically significant ( P = .018). The most common combination of symptoms was cough and weakness (37.5%). A total of 25.8% reported olfactory and taste dysfunctions in the absence of other symptoms. In a comparison between the sexes, cough and runny nose were the most common combination in women ( P = .018). A total of 38.3% of patients reported olfactory dysfunction as an initial symptom. Anosmia and facial pain were more common among women ( P < .001 and P = .01, respectively), and 56% of patients reported xerostomia. Conclusion A considerable number of patients presented with olfactory and oral disorders. Interestingly, women presented with a different cluster of symptoms than men, which may suggest a new clinical approach to diagnosing COVID-19 disease.

Neuromuscular presentations in patients with COVID-19

“…We identified 2 meta-analyses of 24 and 21 studies/case reports respectively that described patients with olfactory/ gustatory dysfunction [69,70]. In addition, we describe 11 studies that evaluated olfactory/gustatory dysfunction in COVID-19 patients (Table 6) [71][72][73][74][75][76][77][78][79][80][81].…”

“…They found that the use of intranasal or oral steroids enhanced the recovery of COVID-19related olfactory/gustatory dysfunction [70]. We found 11 studies that specifically evaluated gustatory and olfactory functions in patients with COVID-19 infection [71][72][73][74][75][76][77][78][79][80][81]. Majority of patients had olfactory/gustatory dysfunction in addition to other symptoms like fever, cough, sore throat, and headache.…”

Frequency and Clinical Utility of Olfactory Dysfunction in COVID-19: a Systematic Review and Meta-analysis

“… 11. Summary item on the overall risk of study bias Altin, 2020 [ 45 ] 0 1 1 1 1 1 0 1 1 1 Low 8 Barillari, 2020 [ 46 ] 1 1 0 0 1 1 0 1 1 1 Moderate 7 Beltrán-Corbellini, 2020 [ 47 ] 0 1 0 1 1 1 0 1 1 1 Low 7 Bénézit, 2020 [ 27 ] 0 1 1 0 1 1 0 1 1 1 Moderate 7 Biadsee, 2020 [ 48 ] 0 0 0 0 1 1 0 1 1 1 High 5 Brandstetter, 2020 [ 28 ] 0 1 1 1 1 1 0 1 1 1 Low 8 Carignan, 2020 [ 29 ] 0 1 1 1 1 1 0 1 1 1 …”

Xerostomia, gustatory and olfactory dysfunctions in patients with COVID-19

“…This was followed by dysgeusia which was reported by 54.3% ( n = 76) of patients, and xerostomia reported by 51.4% ( n = 72) patients. The onset time for dysgeusia and xerostomia was not recorded [ 16 ]. Another study investigated ear, nose and throat symptoms in a cohort of 50 patients affected by COVID-19 using a standardized questionnaire that assessed olfactory, gustatory, and auditory data, as well as xerostomia and eye dryness.…”