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Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19.
ORL J Otorhinolaryngol Relat Spec. 2020; 82(4):175-180.OJ

Abstract

INTRODUCTION

Recent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an outpatient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom "sudden smell loss" for screening procedures.

METHODS

In this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria completed a standardized diagnostic questionnaire which included the patients' main symptoms, time course, and an additional self-assessment of the patients' current smell, taste function, and nasal breathing compared to the level before the onset of symptoms.

RESULTS

Out of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only 12 out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom "sudden smell loss" in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom "sudden smell loss" can be attested a high specificity (97%) and a sensitivity of 65% with a positive predictive value of 63% and negative predictive value of 97% for COVID-19.

CONCLUSION

Considering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be recognized as an early symptom of the disease and should be tested for on a regular basis. In contrast to other acute viral smell impairment, COVID-19-associated smell loss seems to be only rarely accompanied by a severely blocked nose.

Authors+Show Affiliations

Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany, antje.haehner@uniklinikum-dresden.de.Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.Division of Infectious Diseases, TU Dresden, Dresden, Germany.Division of Infectious Diseases, TU Dresden, Dresden, Germany.Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32526759

Citation

Haehner, Antje, et al. "Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19." ORL; Journal for Oto-rhino-laryngology and Its Related Specialties, vol. 82, no. 4, 2020, pp. 175-180.
Haehner A, Draf J, Dräger S, et al. Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. ORL J Otorhinolaryngol Relat Spec. 2020;82(4):175-180.
Haehner, A., Draf, J., Dräger, S., de With, K., & Hummel, T. (2020). Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. ORL; Journal for Oto-rhino-laryngology and Its Related Specialties, 82(4), 175-180. https://doi.org/10.1159/000509143
Haehner A, et al. Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. ORL J Otorhinolaryngol Relat Spec. 2020;82(4):175-180. PubMed PMID: 32526759.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19. AU - Haehner,Antje, AU - Draf,Julia, AU - Dräger,Sarah, AU - de With,Katja, AU - Hummel,Thomas, Y1 - 2020/06/11/ PY - 2020/04/23/received PY - 2020/06/03/accepted PY - 2020/6/12/pubmed PY - 2020/8/4/medline PY - 2020/6/12/entrez KW - COVID-19 KW - Diagnostic accuracy KW - Olfactory loss KW - SARS-CoV-2 KW - Smell SP - 175 EP - 180 JF - ORL; journal for oto-rhino-laryngology and its related specialties JO - ORL J Otorhinolaryngol Relat Spec VL - 82 IS - 4 N2 - INTRODUCTION: Recent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an outpatient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom "sudden smell loss" for screening procedures. METHODS: In this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria completed a standardized diagnostic questionnaire which included the patients' main symptoms, time course, and an additional self-assessment of the patients' current smell, taste function, and nasal breathing compared to the level before the onset of symptoms. RESULTS: Out of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only 12 out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom "sudden smell loss" in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom "sudden smell loss" can be attested a high specificity (97%) and a sensitivity of 65% with a positive predictive value of 63% and negative predictive value of 97% for COVID-19. CONCLUSION: Considering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be recognized as an early symptom of the disease and should be tested for on a regular basis. In contrast to other acute viral smell impairment, COVID-19-associated smell loss seems to be only rarely accompanied by a severely blocked nose. SN - 1423-0275 UR - https://www.unboundmedicine.com/medline/citation/32526759/Predictive_Value_of_Sudden_Olfactory_Loss_in_the_Diagnosis_of_COVID_19_ L2 - https://www.karger.com?DOI=10.1159/000509143 DB - PRIME DP - Unbound Medicine ER -