Olfactory and taste disorder: The first and only sign in a patient with SARS-CoV-2 pneumonia

Jang, Youngeun; Son, Hyo-Ju; Lee, Seungjae; Lee, Eun Jung; Kim, Tae Hyong; Park, Se Yoon

doi:10.1017/ice.2020.151

Cited by 17 publications

(17 citation statements)

References 5 publications

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“… 8 10 11 12 13 Some published articles and a study from Daegu also reported the significance of anosmia or ageusia (loss of taste) as symptoms of COVID-19. 14 15 16 17 However, only 1.2% of the patients in the present study presented with anosmia, indicating that clinicians did not actively obtain the presence of anosmia in the early period of the outbreak. The clinical manifestations of the present study are similar to the previous reports characterized primarily by fever, cough, dyspnea, and bilateral infiltrates on chest imaging.…”

Section: Discussioncontrasting

confidence: 67%

Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020

Kim

et al. 2021

J Korean Med Sci

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Background: A coronavirus disease 2019 (COVID-19) outbreak started in February 2020 and was controlled at the end of March 2020 in Daegu, the epicenter of the coronavirus outbreak in Korea. The aim of this study was to describe the clinical course and outcomes of patients with COVID-19 in Daegu. Methods: In collaboration with Daegu Metropolitan City and Korean Center for Diseases Control, we conducted a retrospective, multicenter cohort study. Demographic, clinical, treatment, and laboratory data, including viral RNA detection, were obtained from the electronic medical records and cohort database and compared between survivors and non-survivors. We used univariate and multi-variable logistic regression methods and Cox regression model and performed Kaplan-Meier analysis to determine the risk factors associated with the 28-day mortality and release from isolation among the patients. Results: In this study, 7,057 laboratory-confirmed patients with COVID-19 (total cohort) who had been diagnosed from February 18 to July 10, 2020 were included. Of the total cohort, 5,467 were asymptomatic to mild patients (77.4%) (asymptomatic 30.6% and mild 46.8%), 985 moderate (14.0%), 380 severe (5.4%), and 225 critical (3.2%). The mortality of the patients was 2.5% (179/7,057). The Cox regression hazard model for the patients with available clinical information (core cohort) (n = 2,254) showed the risk factors for 28-day mortality: age > 70 (hazard ratio [HR], 4.219, P = 0.002), need for O 2 supply at admission (HR, 2.995; P = 0.001), fever (> 37.5°C) (HR, 2.808; P = 0.001), diabetes (HR, 2.119; P = 0.008), cancer (HR, 3.043; P = 0.011), dementia (HR, 5.252; P = 0.008), neurological disease (HR, 2.084; P = 0.039), heart failure (HR, 3.234; P = 0.012), and hypertension (HR, 2.160; P = 0.017). The median duration for release from isolation was 33 days (interquartile range, 24.0-46.0) in survivors. The Cox proportional hazard model for the long duration of isolation included severity, age > 70, and dementia. Conclusion: Overall, asymptomatic to mild patients were approximately 77% of the total cohort (asymptomatic, 30.6%). The case fatality rate was 2.5%. Risk factors, including older age, need for O 2 supply, dementia, and neurological disorder at admission, could help clinicians to identify COVID-19 patients with poor prognosis at an early stage.

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Section: Discussioncontrasting

confidence: 67%

Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020

Kim

et al. 2021

J Korean Med Sci

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“…Self-reports of diminished smell (hyposmia/anosmia) and taste (ageusia/dysguesia) led to the inclusion of chemosensory impairment as recognized COVID-19 symptoms by the World Health Organization (WHO) and Center for Disease Control (CDC) [2], fueling efforts to identify the pathobiology, particularly for the olfactory symptoms [3]. While the proportion of cases with olfactory complaints varies by assessment approach and with sample age and sex [4], there is a consensus that olfactory symptoms can present early in the course of the infection, sometimes as the only symptom [5], and appears to be a better predictor of COVID-19 positivity than other symptoms such as fever and cough [6]. Early olfactory impairment may be associated with better outcomes [7], although a recent report suggests that there may be a subgroup with COVID-19 smell loss that experiences longer duration of symptoms [6].…”

Section: Introductionmentioning

confidence: 99%

Reduced odor detection and hedonic changes in asymptomatic university students as SARS-CoV-2 emerged locally

Walsh‐Messinger

Kaouk

Manis

et al. 2020

Preprint

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Background Anosmia is a recognized symptom of COVID-19, but the relationship of SARS-CoV-2 exposure with olfactory dysfunction remains enigmatic. This report adds unique data from healthy students tested as the virus emerged locally. Methods Psychometrically validated measures assessed odor detection, identification and hedonics in healthy university students. Data from asymptomatic students (N=22), tested as SARS-CoV-2 unknowingly emerged locally, were compared to students tested just prior to local virus transmission (N=25), and our normative sample (N=272) tested over the previous 4 years. Results The exposed cohort demonstrated significantly reduced odor detection sensitivity compared to the students in the prior group (P=.01; d=0.77; CI 0.17, 1.36), with a distribution skewed towards less detection sensitivity (P=.03). Categorically, the exposed group was significantly more likely to have hyposmia (OR=7.7; CI, 3.1, 19.4), particularly the subset assessed in the final week before campus closure (OR=13.6; CI, 3.4, 35.7). The exposed group also rated odors as less unpleasant (P<.001, CLES=0.77, CI, 0.51, 1.56) and showed a similarly skewed distribution (P=.005). The groups had similar odor identification performance. Conclusion Psychometric measures of odor detection sensitivity and hedonics may detect early SARS-CoV-2 exposure in asymptomatic and pre-symptomatic persons with normal odor identification. Viral detection by nasal associated lymphoid tissue is known to trigger systemic immune effects, but its activation may also reduce smell sensitivity and shift perception of the environment towards unpleasant, increasing the social isolation that may mitigate viral infection or transmission. Regular testing of odor detection and hedonics may have value for identifying regional viral exposure.

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“…To the Editor-Among the symptoms of SARS-CoV-2 infection (or COVID-19), olfactory or gustatory dysfunction may possibly present first or may be the only symptom. 1 Three Japanese professional baseball players complained of smell and taste dysfunction. Although 2 of them had neither fever nor cough, a viral polymerase chain reaction (PCR) test revealed that all 3 were SARS-CoV-2 positive (The Chunichi Newspaper, March 27, 2020).…”

mentioning

confidence: 99%

“…We believe that epidemiological investigation is required regarding the effect of SARS-CoV-2 on the olfactory and gustatory functions in terms of the frequency, time course, and relationship with other symptoms. To the Editor-The global outbreak of coronavirus disease 2019 (COVID-19) was officially declared as a pandemic by World Health Organization (WHO) on March 11, 2020, 1 and it has imposed unprecedented, far-reaching impacts upon public health and the global ecomony. As of April 30, 2020, >3 million cases of COVID-19 have been confirmed, including >210,000 deaths.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Olfactory and gustatory dysfunction caused by SARS-CoV-2: Comparison with cases of infection with influenza and other viruses

Nakashima

Suzuki

Teranishi

2020

Infect. Control Hosp. Epidemiol.

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Olfactory and taste disorder: The first and only sign in a patient with SARS-CoV-2 pneumonia

Cited by 17 publications

References 5 publications

Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020

Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020

Reduced odor detection and hedonic changes in asymptomatic university students as SARS-CoV-2 emerged locally

Olfactory and gustatory dysfunction caused by SARS-CoV-2: Comparison with cases of infection with influenza and other viruses

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