Olfactory and gustative disorders for the diagnosis of COVID-19

Boudjema, Sophia; Finance, Julie; Coulibaly, Fatoumata; Meddeb, Line; Tissot‐Dupont, Hervé; Michel, M. C.; Lagier, Jean-Christophe; Million, Matthieu; Radulesco, Thomas; Michel, J.; Brouqui, Philippe; Raoult, Didier; Fénollar, Florence; Parola, Philippe

doi:10.1016/j.tmaid.2020.101875

Cited by 14 publications

(21 citation statements)

References 5 publications

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“…Involvement of the olfactory tracts was also reported, with evidence of bilateral T2 FLAIR and fat suppression hyperintensities and DWI abnormalities 159 , 167 , suggestive of olfactory tract inflammatory neuropathy.…”

Section: Discussionmentioning

confidence: 93%

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Boscutti

Delvecchio

Pigoni

et al. 2021

Brain, Behavior, & Immunity - Health

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Background Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Methods A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. Results After the selection process, 155 studies were included, with a total of 70920 patients and 105291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0% - 98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. Conclusions OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.

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Section: Discussionmentioning

confidence: 93%

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Boscutti

Delvecchio

Pigoni

et al. 2021

Brain, Behavior, & Immunity - Health

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“…The cause of this asymptomatic hypoxia is not yet clear. Anosmia-hyposmia has been reported as a frequent clinical sign in COVID (Boudjema et al, 2020), but whether SARS-CoV-2 has access to the brain and contributes to the association between dyspnea and anosmiahyposmia remain to be determined (Tobin et al, 2020). Some have links of happy hypoxemia with the development of thrombi within the pulmonary vasculature (Couzin-Frankel, 2020).…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic hypoxia in COVID-19 is associated with poor outcome

Brouqui

Amrane

Million

et al. 2021

International Journal of Infectious Diseases

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115

126

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Highlights Two third of COVID-19 patients do not complaint of a shortness of breath at admission The LDCT scan showed signs compatible with pneumonia in two third of them. Hypoxemia and hypocapnia (Happy hypoxemia) were present in one third of them at admission. Patient with happy hypoxemia have a very poor outcome. The absence of shortness of breath is not a sign of wellbeing in patient with COVID-19 and it merits a particular surveillance of blood gas and pulmonary imaging.

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“…In Marseille, 3,497 adults who underwent SARS-CoV-2 PCR testing between 24 March and 25 April 2020 were asked the following question before being tested: 'Have you lost your sense of smell or taste in the past 2 months?' The prevalence of the loss of smell and/or taste in COVID-19 patients was 356/673 (53%) and the positive predictive value (PPV) for the diagnosis of COVID-19 by PCR was 67% when smell and taste disorders were reported [6]. Asking patients and healthcare workers (HCWs) about loss of smell and taste could be useful in areas where testing for SARS-CoV-2 is politically or technically limited or impossible.…”

Section: Introductionmentioning

confidence: 99%

Natural history of COVID-19 and therapeutic options

Gautret

Million

Jarrot

et al. 2020

Expert Review of Clinical Immunology

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122

109

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Introduction: COVID-19 presents benign forms in young patients who frequently present with anosmia. Infants are rarely infected, while severe forms occur in patients over 65 years of age with comorbidities, including hypertension and diabetes. Lymphopenia, eosinopenia, thrombopenia, increased lactate dehydrogenase, troponin, C-reactive protein, D-dimers and low zinc levels are associated with severity.Areas covered: The authors review the literature and provide an overview of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19. Expert opinion: Diagnosis should rely on PCR and not on clinical presumption. Because of discrepancies between clinical symptoms, oxygen saturation or radiological signs on CT scans, pulse oximetry, and radiological investigation should be systematic. The disease evolves in successive phases: an acute virological phase, and, in some patients, a cytokine storm phase; an uncontrolled coagulopathy; and an acute respiratory distress syndrome. Therapeutic options include antivirals, oxygen therapy, immunomodulators, anticoagulants and prolonged mechanical treatment. Early diagnosis, care, and implementation of an antiviral treatment; the use of immunomodulators at a later stage; and the quality of intensive care are critical regarding mortality rates. The higher mortality observed in Western countries remains unexplained. Pulmonary fibrosis may occur in some patients. Its future is unpredictable.

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Olfactory and gustative disorders for the diagnosis of COVID-19

Cited by 14 publications

References 5 publications

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Asymptomatic hypoxia in COVID-19 is associated with poor outcome

Natural history of COVID-19 and therapeutic options

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