Prognostic Value of Olfactory and Gustatory Dysfunction As Initial Symptoms of COVID-19 Infection

Abstract

Introduction: Olfactory and gustatory chemosensory dysfunctions are very prevalent in COVID-19 infection, our aim is to further explore chemosensory recovery among these patients.Methods: This is a cross-sectional follow-up study, which serves as a sequel to a study by Biadsee, et al. Among the previous study population of 128 non-hospitalized patients, who were tested positive for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR). Ninety-seven patients participated in a telephone survey designed for this study. Recovery of olfactory and gustatory functions were defined when a score is greater or equal to that reported before the disease. Persistent hyposmia and hypogeusia were defined as lower scores reported during follow-up, compared with scores before the disease. Results: A total of 43 men and 54 women were included. Mean age was 37 years (range 18-73). Mean follow-up was 59.2 days (range 21-83). At follow-up, 72 (74.2%) patients reported normalization of gustatory function and 63 (64.9%) reported normalization of olfactory function. No patient reported nasal obstruction at follow-up. Recovery of olfactory function was positively correlated with gustatory recovery (p=0.003). Twenty-three (23.7%) reported persistent xerostomia. Women who reported persistent xerostomia had higher rates of olfactory and gustatory dysfunction (p=0.006 and p=0.008, respectively) than those who did not. Olfactory and gustatory disorders as initial symptoms were negative prognostic factors for recovery. Conclusion: Olfactory and/or gustatory dysfunction as a presenting symptom of COVID-19 infection may be a negative prognostic factor for full recovery of olfactory and gustatory function.

Lesões orais em pacientes com COVID-19: uma síntese de evidências atuais

“…Com este estudo, evidenciou-se que as lesões orais foram descritas em poucos relatos de casos, apresentando controversas quanto ao fato de serem causadas diretamente pelo SARS-CoV-2 ou se representam manifestações secundárias. As manifestações apresentavam aspectos clínicos diversos, como úlceras, bolhas e máculas, variando em quantidade, coloração e localização 2,5,7,8,12 . Estudos registraram coinfecções bacterianas e fúngicas em muitos casos fatais de COVID-19 4,19,20 .…”

“…Além dos sintomas mais comuns, como tosse seca, pirexia, dispneia, fadiga e algia muscular, estudos têm evidenciado algumas manifestações orais em pacientes com COVID-19 [5][6][7][8][9] . Ainda não se sabe se essas manifestações são resultantes da infecção viral direta ou mesmo da debilidade sistêmica, uma vez que são susceptíveis à infecções oportunistas e também a reações adversas aos tratamentos medicamentosos 2,10 .…”

Relationship between initial symptoms and the prognosis, sex, and demographic area of patients with COVID-19

“…Since the start of the pandemic, the symptoms described have varied greatly, from asymptomatic to severe pneumonia and death. Symptoms are highly non-specific, with initial symptoms including fever, dry cough, asthenia, expectoration, dyspnea, sore throat, headache, myalgia or arthralgia, chills, nausea or vomiting, nasal congestion, diarrhea, hemoptysis, and conjunctival congestion (5)(6)(7)(8). Subsequent studies added new symptoms such as neurological disorders and cardiological, otorhinolaryngological, dermatological, and hematological symptoms (9)(10)(11).…”