Onset, duration, and persistence of taste and smell changes and other COVID-19 symptoms: longitudinal study in Israeli patients

Abstract

Objectives: The multifaceted disease manifestation of COVID-19 requires longitudinal characterization of symptoms, to aid with screening and disease management. Methods: Phone interviews and follow-ups were completed with 112 mild COVID-19 RT-PCR-positive adult patients, over a 6 week period. Results: More than one symptom at disease onset was experienced by ~70 of the patients. Over one third of patients experienced fever, dry cough, headache, or muscle ache as the first symptom. If fatigue was reported, it was usually the first symptom to appear. Smell and taste changes had occurred 3.9 ± 5.4 and 4.6 ± 5.7 days (mean ± SD) since disease onset and emerged as first symptoms in 15% and 18% of patients, respectively. Fever was the shortest lasting symptom (5.8 ± 8.6 days (mean ± SD), and smell and taste changes were the most long-lasting symptoms (24.3 ± 22.9 days and 19.4 ± 19.1 (mean ± SD), respectively), with longer smell recovery correlated with smell change severity. In one third of patients who reported cough, smell and taste changes, these symptoms persisted after negative RT-PCR tests. Conclusions: Each symptom can occur as first or later, though some are more likely to appear as firsts, and typically more than one symptom occurs at disease onset. The severity of olfactory change is associated with its recovery time. Lack of chemosensory recuperation in recovered patients is common. These findings can aid patients through their illness and provide expected recovery patterns.

Longitudinal symptom dynamics of COVID-19 infection

“…In children, the result was not statistically significant, possibly due to a small sample size. Although anosmia and ageusia were initially less described as COVID-19 symptoms 3,6 , and were not part of the Israeli testing policy throughout the study period, they further emerged as the most predictive symptoms for COVID-19 in this study and others 10,12,22 , and were also found to be the most prolong symptoms in infected individuals 23 . Health organizations worldwide have gradually added it to the list of COVID-19 related symptoms including the USA CDC 24 , the UK 25 and Israel 26 .…”

Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review

“…In a study of European multiple sites, 9.4% of patients reported gustatory dysfunction after a mean follow-up of 63 days from the first consultation [ 96 ]. A longitudinal study showed that taste alteration of Israeli patients lasts long with the mean duration of 17.2 days [ 113 ]. Boscolo-Rizzo et al [ 144 ] followed up symptoms of mildly symptomatic COVID-19 patients from baseline to four and eight weeks.…”

The temporal course of COVID-19 anosmia and relation to other clinical symptoms

“…Available literature supports spontaneous improvement with a mean duration of 2-3 weeks [23,24]. However, cases with symptoms lasting more than 1 month, so called persistent anosmia, have also been reported [25][26][27]. Considering the fact that olfactory epithelium undergoes regeneration over 6-8 weeks, SARS-COV2 may result in anosmia longer than 2-3 weeks due to the epithelia damage caused [28].…”