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Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study.
Otolaryngol Head Neck Surg. 2020 10; 163(4):714-721.OH

Abstract

OBJECTIVE

To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients.

STUDY DESIGN

Multicenter case series.

SETTING

Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany).

SUBJECTS AND METHODS

In total, 394 polymerase chain reaction (PCR)-confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing.

RESULTS

Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation.

CONCLUSIONS

Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.

Links

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Authors+Show Affiliations

Qiu C
Center of Stomatology, Shanghai Public Health Clinical Center, Shanghai, China.
Cui C
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Hautefort C
Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France.
Haehner A
Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
Zhao J
Center of Pediatrics, Shanghai Public Health Clinical Center, Shanghai, China.
Yao Q
Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zeng H
Department of Cardiovascularology, The Third People's Hospital of Shenzhen, Shenzhen, China.
Nisenbaum EJ
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Liu L
Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China.
Zhao Y
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Zhang D
Department of Otolaryngology, The Third People's Hospital of Shenzhen, Shenzhen, China.
Levine CG
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Cejas I
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Dai Q
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Zeng M
Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China.
Herman P
Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France.
Jourdaine C
Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France.
de With K
Division of Infectious Diseases, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany.
Draf J
Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
Chen B
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Jayaweera DT
Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
Denneny JC
American Academy of Otolaryngology-Head and Neck Surgery, Alexandria, Virginia, USA.
Casiano R
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Yu H
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Eshraghi AA
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Hummel T
Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany.
Liu X
Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Shu Y
ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China. NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
Lu H
Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China.

MeSH

AdolescentAdultBetacoronavirusCOVID-19ChildChinaCoronavirus InfectionsEarly DiagnosisFemaleFranceGermanyHumansMaleOlfaction DisordersPandemicsPneumonia, ViralPrevalenceRetrospective StudiesSARS-CoV-2SmellTaste DisordersYoung Adult

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32539586

Citation

Qiu, Chenghao, et al. "Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: an International Multicenter Study." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 163, no. 4, 2020, pp. 714-721.
Qiu C, Cui C, Hautefort C, et al. Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. Otolaryngol Head Neck Surg. 2020;163(4):714-721.
Qiu, C., Cui, C., Hautefort, C., Haehner, A., Zhao, J., Yao, Q., Zeng, H., Nisenbaum, E. J., Liu, L., Zhao, Y., Zhang, D., Levine, C. G., Cejas, I., Dai, Q., Zeng, M., Herman, P., Jourdaine, C., de With, K., Draf, J., ... Lu, H. (2020). Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 163(4), 714-721. https://doi.org/10.1177/0194599820934376
Qiu C, et al. Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: an International Multicenter Study. Otolaryngol Head Neck Surg. 2020;163(4):714-721. PubMed PMID: 32539586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. AU - Qiu,Chenghao, AU - Cui,Chong, AU - Hautefort,Charlotte, AU - Haehner,Antje, AU - Zhao,Jun, AU - Yao,Qi, AU - Zeng,Hui, AU - Nisenbaum,Eric J, AU - Liu,Li, AU - Zhao,Yu, AU - Zhang,Di, AU - Levine,Corinna G, AU - Cejas,Ivette, AU - Dai,Qi, AU - Zeng,Mei, AU - Herman,Philippe, AU - Jourdaine,Clement, AU - de With,Katja, AU - Draf,Julia, AU - Chen,Bing, AU - Jayaweera,Dushyantha T, AU - Denneny,James C,3rd AU - Casiano,Roy, AU - Yu,Hongmeng, AU - Eshraghi,Adrien A, AU - Hummel,Thomas, AU - Liu,Xuezhong, AU - Shu,Yilai, AU - Lu,Hongzhou, Y1 - 2020/06/16/ PY - 2020/6/17/pubmed PY - 2020/10/21/medline PY - 2020/6/17/entrez KW - COVID-19 KW - COVID-19 screening KW - SARS-CoV-2 KW - anosmia KW - dysgeusia KW - gustatory dysfunction KW - olfactory dysfunction SP - 714 EP - 721 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 163 IS - 4 N2 - OBJECTIVE: To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. STUDY DESIGN: Multicenter case series. SETTING: Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). SUBJECTS AND METHODS: In total, 394 polymerase chain reaction (PCR)-confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. RESULTS: Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. CONCLUSIONS: Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/32539586/Olfactory_and_Gustatory_Dysfunction_as_an_Early_Identifier_of_COVID_19_in_Adults_and_Children:_An_International_Multicenter_Study_ L2 - https://journals.sagepub.com/doi/10.1177/0194599820934376?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -