Prospective Study in 355 Patients With Suspected COVID‐19 Infection: Value of Cough, Subjective Hyposmia, and Hypogeusia

Abstract

To evaluate the incidence of certain symptoms in a population of health workers exposed to coronavirus disease 2019 patients. Study Design: Case-control study. Methods: The study was conducted at a tertiary care hospital from March 1 to April 7, 2020. Health workers with suspected coronavirus disease 2019 (COVID-19) infection were included. The presence of COVID-19 was detected by using real-time polymerase chain reaction (RT-PCR) methods. Positive and negative RT-PCR patients were used as case and control groups, respectively. This study analyzed the incidence of COVID-19 symptoms in both patient groups. Visual analog scales were used for selfassessment of smell and taste disorders, ranging from 0 (no perception) to 10 (excellent perception). Results: There were 215 (60.6%) patients with positive RT-PCR and 140 (39.4%) patients with negative RT-PCR. The presence of symptoms such as hyposmia hypogeusia, dysthermia, and cough were strongly associated with a positive RT-PCR. The association of cough and subjective hyposmia had 5.46 times higher odds of having a positive test. The receiver operating characteristic (ROC) analysis showed that a fever higher than 37.45 C resulted in sensitivity and specificity of 0.65 and 0.61, respectively. A total of 138 cases (64.1%) and 114 cases (53%) had subjective hyposmia and hypogeusia, respectively. The 85.4% of these patients recovered olfactory function within the first 14 days of the onset of the symptoms. Conclusion: There is a significant association between positive RT-PCR and subjective hyposmia. The association of subjective hyposmia and cough increase significantly the odds of having a positive RT-PCR. The measurement of fever as the only method for screening of COVID-19 infection resulted in a poor association.

The coronavirus disease 2019: the prevalence, prognosis, and recovery from olfactory dysfunction (OD)

“…In the current study, fever (60.6%), OD (57.2%), chill (33.8%), myalgia (32.8%), gustatory dysfunction (31.2%), and cough (26.%) were consequently the most common symptoms similar to other findings [2,14]. Although fever may present with other symptoms, screening COVID-19 by a temporal thermometer was not appropriate enough to control the initial wave of transmission at early phases of this pandemic [15], particularly, those who had only mild symptoms such as OD and sore throat in the absence of other symptoms.…”

“…In previous studies [4,10,15], the authors reported that OD frequently co-occurred with gustatory dysfunction. In the current study, gustatory dysfunction was reported in 41.5% of patients as a primary symptom along with OD.…”

The Association of “Loss of Smell” to COVID-19: A Systematic Review and Meta-Analysis

“…A total of 11074 COVID-19 patients (mean age 46.7±10.4 years and males 46.9%) were included in the final analysis ( table 1 ). 2 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 The overall prevalence of “loss of smell” in COVID-19 patients was 52.0% (CI: 42.5%-61.6%, I 2 =99.4%) ( Figure 2 ). A total of 21 studies compared these symptoms in COVID-19 patients (n=2196) and controls (n=3425).…”

“…A total of 21 studies compared these symptoms in COVID-19 patients (n=2196) and controls (n=3425). 13 , 14 , 18 , 19 , 21 , 25 , 27 , 28 , 34 , 35 , 36 , 37 , 39 , 40 , 45 , 47 , 48 , 49 , 59 , 60 , 62 “Loss of smell” was associated significantly more in the COVID-19 group compared to non-COVID-19 group (OR: 14.7, CI: 8.9–24.3, p<0.001, I 2 =83.2%) ( Figure 3 ). Among COVID-19 patients, the odds of patients with severe disease and “loss of smell” were significantly low when compared to patients with severe disease and without “loss of smell” (OR: 0.36, CI 0.27–0.48, p <0.01, I 2 =27.4% ( Figure 4 ).…”

Evaluation of effects of chronic nasal steroid use on rhinological symptoms of COVID-19 with SNOT-22 questionnaire

“…Human CoV was formerly known as a rare cause of post-viral olfactory dysfunction (PVOD) [ 12 ]. During the COVID-19 pandemic, up to 90% association with gustatory and olfactory dysfunction is reported as an indicative symptom of the virus infection [ 1 , 13 , 14 ]. In the current study, taste and smell dysfunctions were also among the main symptoms associated with COVID-19.…”