Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study

Author:

Qiu Chenghao1,Cui Chong23,Hautefort Charlotte4,Haehner Antje5,Zhao Jun6,Yao Qi7,Zeng Hui8,Nisenbaum Eric J.9,Liu Li10,Zhao Yu23,Zhang Di11,Levine Corinna G.9,Cejas Ivette9,Dai Qi23,Zeng Mei12,Herman Philippe4,Jourdaine Clement4,de With Katja13,Draf Julia5,Chen Bing23,Jayaweera Dushyantha T.14,Denneny James C.15,Casiano Roy9,Yu Hongmeng23,Eshraghi Adrien A.9,Hummel Thomas5,Liu Xuezhong9,Shu Yilai23,Lu Hongzhou10

Affiliation:

1. Center of Stomatology, Shanghai Public Health Clinical Center, Shanghai, China

2. ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China

3. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China

4. Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France

5. Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany

6. Center of Pediatrics, Shanghai Public Health Clinical Center, Shanghai, China

7. Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

8. Department of Cardiovascularology, The Third People’s Hospital of Shenzhen, Shenzhen, China

9. Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA

10. Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China

11. Department of Otolaryngology, The Third People’s Hospital of Shenzhen, Shenzhen, China

12. Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai, China

13. Division of Infectious Diseases, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany

14. Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA

15. American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA

Abstract

Objective To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. Study Design Multicenter case series. Setting Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). Subjects and Methods In total, 394 polymerase chain reaction (PCR)–confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. Results Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. Conclusions Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.

Funder

national natural science foundation of china

University of Miami COVID-19 Rapid Response Grant

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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