Top

European Archives of Oto-Rhino-Laryngology

Published in:

01-08-2020 | Smelling Disorder | Rhinology

Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study

Authors: Jerome R. Lechien, Carlos M. Chiesa-Estomba, Daniele R. De Siati, Mihaela Horoi, Serge D. Le Bon, Alexandra Rodriguez, Didier Dequanter, Serge Blecic, Fahd El Afia, Lea Distinguin, Younes Chekkoury-Idrissi, Stéphane Hans, Irene Lopez Delgado, Christian Calvo-Henriquez, Philippe Lavigne, Chiara Falanga, Maria Rosaria Barillari, Giovanni Cammaroto, Mohamad Khalife, Pierre Leich, Christel Souchay, Camelia Rossi, Fabrice Journe, Julien Hsieh, Myriam Edjlali, Robert Carlier, Laurence Ris, Andrea Lovato, Cosimo De Filippis, Frederique Coppee, Nicolas Fakhry, Tareck Ayad, Sven Saussez

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2020

Abstract

Objective

To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection.

Methods

Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS).

Results

A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001).

Conclusion

Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.

Available only for authorised users

Guan WJ, Ni ZY, Hu Y et al (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. https://doi.org/10.1056/NEJMoa2002032 CrossRefPubMedPubMedCentral

Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M, MacLaren G, Brodie D, Shekar K (2020) Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med. https://doi.org/10.1016/s2213-2600(20)30121-1 CrossRefPubMedPubMedCentral

Wu YC, Chen CS, Chan YJ (2020) Overview of the novel coronavirus (2019-nCoV): the pathogen of severe specific contagious pneumonia (SSCP). J Chin Med Assoc. https://doi.org/10.1097/JCMA.0000000000000270 CrossRefPubMedPubMedCentral

Young BE, Ong SWX, Kalimuddin S et al (2020) Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. https://doi.org/10.1001/jama.2020.3204 CrossRefPubMedPubMedCentral

Wan S, Xiang Y, Fang W, Zheng Y et al (2020) Clinical features and treatment of COVID-19 patients in Northeast Chongqing. J Med Virol. https://doi.org/10.1002/jmv.25783 CrossRefPubMedPubMedCentral

Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S (2007) Identification of viruses in patients with postviral olfactory dysfunction. Laryngoscope 117(2):272–277CrossRefPubMedCentralPubMed

van Riel D, Verdijk R, Kuiken T (2015) The olfactory nerve: a shortcut for influenza and other viral diseases into the central nervous system. J Pathol 235(2):277–287. https://doi.org/10.1002/path.4461 CrossRefPubMed

Ayad T, Stephenson K, Smit D et al (2018) Young Otolaryngologists of International Federation of Oto-rhino-laryngological Societies (YO-IFOS) committees. Eur Ann Otorhinolaryngol Head Neck Dis 135(5S):S61–S65. https://doi.org/10.1016/j.anorl.2018.08.004 CrossRefPubMed

Mattos JL, Edwards C, Schlosser RJ, Hyer M, Mace JC, Smith TL, Soler ZM (2019) A brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 9(10):1144–1150. https://doi.org/10.1002/alr.22392 CrossRefPubMedPubMedCentral

10.

Bhattacharyya N, Kepnes LJ (2015) Contemporary assessment of the prevalence of smell and taste problems in adults. Laryngoscope 125(5):1102–1106. https://doi.org/10.1002/lary.24999 CrossRefPubMed

11.

Zou L, Ruan F, Huang M et al (2020) SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 382(12):1177–1179. https://doi.org/10.1056/NEJMc2001737 CrossRefPubMedPubMedCentral

12.

Mao L, Wang M, Chen S et al (2020) Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. MedRXiv. https://doi.org/10.1101/2020.02.22.20026500 CrossRefPubMedPubMedCentral

13.

Koyuncu OO, Hogue IB, Enquist LW (2013) Virus infections in the nervous system. Cell Host Microbe 13(4):379–393. https://doi.org/10.1016/j.chom.2013.03.010 CrossRefPubMedPubMedCentral

14.

Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S (2008) Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 82(15):7264–7275. https://doi.org/10.1128/JVI.00737-08 CrossRefPubMedPubMedCentral

15.

Gu J, Gong E, Zhang B et al (2005) Multiple organ infection and the pathogenesis of SARS. J Exp Med 202(3):415–424CrossRefPubMedCentralPubMed

16.

Li YC, Bai WZ, Hashikawa T (2020) The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. https://doi.org/10.1002/jmv.25728 CrossRefPubMedPubMedCentral

17.

Chen N, Zhou M, Dong X et al (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395(10223):507–513. https://doi.org/10.1016/S0140-6736(20)30211-7 CrossRefPubMedPubMedCentral

18.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J et al (2020) Clinical characteristics of 2019 novel coronavirus infection in China. Medrxiv

19.

Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M (2020) The 2019-new coronavirus epidemic: evidence for virus evolution. J Med Virol 92(4):455–459CrossRefPubMedCentralPubMed

20.

Chan JF, Yuan S, Kok KH et al (2020) A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395(10223):514–523. https://doi.org/10.1016/S0140-6736(20)30154-9 CrossRefPubMedPubMedCentral

21.

Li W, Zhang C, Sui J, Kuhn JH et al (2005) Receptor and viral determinants of SARS-coronavirus adaptation to human ACE2. EMBO J 24(8):1634–1643CrossRefPubMedCentralPubMed

22.

Cao Y, Li L, Feng Z, Wan S, Huang P, Sun X, Wen F, Huang X, Ning G, Wang W (2020) Comparative genetic analysis of the novel coronavirus (2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations. Cell Discov 6:11. https://doi.org/10.1038/s41421-020-0147-1 CrossRefPubMedPubMedCentral

23.

Lefèvre N, Corazza F, Valsamis J, Delbaere A, De Maertelaer V, Duchateau J, Casimir G (2019) The number of X chromosomes influences inflammatory cytokine production following toll-like receptor stimulation. Front Immunol 10:1052. https://doi.org/10.3389/fimmu.2019.01052 CrossRefPubMedPubMedCentral

24.

Hummel T, Whitcroft KL, Andrews P et al (2017) Position paper on olfactory dysfunction. Rhinol Suppl 54(26):1–30CrossRefPubMed

25.

Gudziol H, Guntinas-Lichius O (2019) Electrophysiologic assessment of olfactory and gustatory function. Handb Clin Neurol 164:247–262. https://doi.org/10.1016/B978-0-444-63855-7.00016-2 CrossRefPubMed

Title: Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study
Authors: Jerome R. Lechien
Carlos M. Chiesa-Estomba
Daniele R. De Siati
Mihaela Horoi
Serge D. Le Bon
Alexandra Rodriguez
Didier Dequanter
Serge Blecic
Fahd El Afia
Lea Distinguin
Younes Chekkoury-Idrissi
Stéphane Hans
Irene Lopez Delgado
Christian Calvo-Henriquez
Philippe Lavigne
Chiara Falanga
Maria Rosaria Barillari
Giovanni Cammaroto
Mohamad Khalife
Pierre Leich
Christel Souchay
Camelia Rossi
Fabrice Journe
Julien Hsieh
Myriam Edjlali
Robert Carlier
Laurence Ris
Andrea Lovato
Cosimo De Filippis
Frederique Coppee
Nicolas Fakhry
Tareck Ayad
Sven Saussez
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Smelling Disorder
Coronavirus
SARS-CoV-2
Smelling Disorder
COVID-19
Anosmia
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-05965-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study

Abstract

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2020

‘Good cancer gone bad’: a narrative review of HPV oropharyngeal cancer and potential poor outcomes

The prevalence of signs and symptoms of laryngopharyngeal reflux and laryngeal precancerous lesions in urban taxi drivers

Chondrolaryngoplasty for transgender patients: feasibility of a scar-free approach

Comparative analysis of rhinologic outcomes in Cushing disease and non-functioning pituitary adenoma in patients submitted to endoscopic endonasal transsphenoidal surgery

Long-term neuromusculoskeletal side effects and quality of life in nasopharyngeal cancer patients receiving radiochemotherapy

Facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery