Quantitative evaluation of olfactory dysfunction in hospitalized patients with Coronavirus [2] (COVID-19)

Tsivgoulis, Georgios; Fragkou, Paraskevi C.; Delides, Alexander; Karofylakis, Emmanouil; Dimopoulou, Dimitra; Sfikakis, Petros P.; Tsiodras, Sotirios

doi:10.1007/s00415-020-09935-9

Cited by 30 publications

(42 citation statements)

References 7 publications

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“…Fourth, regional differences in the veracity of SARS‐CoV‐2 and susceptibility of local populations to infection, as well as differences in subject characteristics and recruitment strategies, could be involved. For example, in accord with most COVID‐19 studies, 28 proportionately more men (67%) were present in our sample than in the other olfactory studies in which women predominated (eg, 30%, 29 35%, 7 37.5%, 16 and 57% 26 ). Given that women generally outperform men on olfactory tests, 30 and are more likely to volunteer for studies than men, 31 these differences could reflect survey recruitment biases.…”

Section: Discussionsupporting

confidence: 84%

“…Thus, using 16‐item smell identification tests, Bocksberger et al 11 found olfactory dysfunction in 10 of 14 (71%) COVID‐19 patients and Lechien et al 25 in 53 of 86 (62%) such patients. Vaira et al 16 found deficits in 62 of 72 COVID‐19 patients (86%; 2 anosmic and 60 hyposmic) using a 10‐odor identification test of household objects and ethyl alcohol and n ‐butanol threshold tests, whereas Tsivgoulis et al 26 found smell dysfunction in 17 of 22 (77%) such patients using a 3‐odor smell test.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID‐19 patients

Moein

Hashemian

Tabarsi

et al. 2020

Int Forum Allergy Rhinol

124

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Background Considerable evidence suggests that smell dysfunction is common in coronavirus disease-COVID-Unfortunately extant data on prevalence and reversibility over time are highly variable coming mainly from self-report surveys prone to multiple biases Thus validated psychophysical olfactory testing is sorely needed to establish such parameters Methods One hundred severe acute respiratory syndrome-coronavirus-SARS-CoV-positive patients were administered the-item University of Pennsylvania Smell Identification Test UPSIT in the hospital near the end of the acute phase of the disease Eighty-two were retested or weeks later at home The data were analyzed using analysis of variance and mixed-effect regression models Results Initial UPSIT scores were indicative of severe microsmia with exhibiting measurable dysfunction were anosmic The scores improved upon retest initial test mean confidence interval CI retest mean CI-p < no patient remained anosmic A er weeks from COVIDsymptom onset the test scores of of the retested patients were normal However the mean UPSIT score at that time continued to remain below that of age-and sexmatched healthy controls p < Such scores were related to time since symptom onset sex and age Conclusion Smell loss was extremely common in the acute phase of a cohort of COVID-patients when objectively measured About one third of cases continued to exhibit dysfunction to weeks a er symptom onset These findings have direct implications for the use of olfactory testing in identifying SARS-CoV-carriers and for counseling such individuals with regard to their smell dysfunction and its reversibility © 2020 ARS-AAOA, LLC.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID‐19 patients

Moein

Hashemian

Tabarsi

et al. 2020

Int Forum Allergy Rhinol

124

View full text Add to dashboard Cite

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“…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).…”

Section: Resultsmentioning

confidence: 99%

“…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 ).…”

Section: Resultsmentioning

confidence: 99%

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

Aziz

Goyal

Haghbin

et al. 2021

The American Journal of the Medical Sciences

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Background The presence of olfactory dysfunction or “loss of smell” has been reported as an atypical symptom in patients with coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of the available literature to evaluate the prevalence of “loss of smell” in COVID-19 as well as its utility for prognosticating the disease severity. Methods An exhaustive search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, LitCovid NIH, and WHO COVID-19 database was conducted through August 6 th , 2020. All studies reporting the prevalence of “loss of smell” (anosmia and/or hyposmia/microsmia) in laboratory-confirmed COVID-19 patients were included. Pooled prevalence for cases (positive COVID-19 through reverse transcriptase (RT-PCR) and/or serology IgG/IgM) and controls (negative RT-PCR and/or serology) was compared, and the odds ratio (OR), 95% confidence interval (CI) and the p-value were calculated. A p-value of <0.05 was considered statistically significant. Results A total of 51 studies with 11074 confirmed COVID-19 patients were included. Of these, 21 studies used a control group with 3425 patients. The symptom of “loss of smell” (OR: 14.7, CI: 8.9–24.3) was significantly higher in the COVID-19 group when compared to the control group. Seven studies comparing severe COVID-19 patients with- and without “loss of smell” demonstrated favorable prognosis for patients with “loss of smell” (OR: 0.36, CI 0.27–0.48). Conclusion Olfactory dysfunction or “loss of smell” is a prevalent symptom in COVID-19 patients. Moreover, COVID-19 patients with “loss of smell” appear to have a milder course of the disease.

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“…Olfactory ability was assessed by: using validated questionnaires focused on smell dysfunction, in three studies; obtaining objective information on smell impairment through standardised chemosensitive tests with odorants, in five studies; and considering both methods, in five studies (Table 3). 18,20,[24][25][26]29,32,34,37,[40][41][42][43][47][48][49][50][51][52][53][54][55][56][57][58][59] The remaining studies assessed olfactory ability through anamnestic data collection, simple surveys and/or structured, non-validated questionnaires (Table 4). 2,16,17,19,[21][22][23]27,28,30,31,33,35,36,38,39,[44][45][46]…”

Section: Resultsmentioning

confidence: 99%

Olfactory disorders in coronavirus disease 2019 patients: a systematic literature review

et al. 2020

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Objective Recent scientific literature has widely described a possible major role of smell dysfunction as a specific symptom of coronavirus disease 2019. This systematic review may provide a more holistic approach to current knowledge of the disease. Methods A systematic review was completed using Embase, PubMed and Web of Science databases that considered original articles focused on olfactory evaluation in coronavirus disease 2019 patients, published between March and May 2020, in English language. Results From the 483 research papers initially identified, 32 original studies were selected, comprising a total of 17 306 subjects with a laboratory confirmed diagnosis of coronavirus disease 2019. Individual study sample sizes ranged from 6 to 6452 patients. This comprehensive analysis confirmed that olfactory disorders represent an important clinical feature in coronavirus disease 2019, with a prevalence of 11–100 per cent in included patients, although there was heterogeneity in terms of assessment tools and population selection criteria. Conclusion The results indicate that an accurate clinical evaluation should be carried out using structured questionnaires and tests with olfactory substances.

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Quantitative evaluation of olfactory dysfunction in hospitalized patients with Coronavirus [2] (COVID-19)

Cited by 30 publications

References 7 publications

Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID‐19 patients

Prevalence and reversibility of smell dysfunction measured psychophysically in a cohort of COVID‐19 patients

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

Olfactory disorders in coronavirus disease 2019 patients: a systematic literature review

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