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Association of chemosensory dysfunction and COVID‐19 in patients presenting with influenza‐like symptoms
Open accessAbstract
Background: Rapid spread of the severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) and concern for viral transmission by ambulatory patients with minimal to no symptoms underline the importance of identifying early or subclinical symptoms of coronavirus disease 2019 (COVID‐19) infection. Two such candidate symptoms include anecdotally reported loss of smell and taste. Understanding the timing and association of smell/taste loss in COVID‐19 may help facilitate screening and early isolation of cases. Methods: A single‐institution, cross‐sectional study evaluating patient‐reported symptoms with a focus on smell and taste was conducted using an internet‐based platform on adult subjects who underwent testing for COVID‐19. Logistic regression was employed to identify symptoms associated with COVID‐19 positivity. Results: A total of 1480 patients with influenza‐like symptoms underwent COVID‐19 testing between March 3, 2020, and March 29, 2020. Our study captured 59 of 102 (58%) COVID‐19–positive patients and 203 of 1378 (15%) COVID‐19–negative patients. Smell and taste loss were reported in 68% (40/59) and 71% (42/59) of COVID‐19–positive subjects, respectively, compared to 16% (33/203) and 17% (35/203) of COVID‐19–negative patients ( p < 0.001). Smell and taste impairment were independently and strongly associated with COVID‐19 positivity (anosmia: adjusted odds ratio [aOR] 10.9; 95% CI, 5.08‐23.5; ageusia: aOR 10.2; 95% CI, 4.74‐22.1), whereas sore throat was associated with COVID‐19 negativity (aOR 0.23; 95% CI, 0.11‐0.50). Of patients who reported COVID‐19–associated loss of smell, 74% (28/38) reported resolution of anosmia with clinical resolution of illness. Conclusion: In ambulatory individuals with influenza‐like symptoms, chemosensory dysfunction was strongly associated with COVID‐19 infection and should be considered when screening symptoms. Most will recover chemosensory function within weeks, paralleling resolution of other disease‐related symptoms.
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“a symptom more specific to COVID‐19 infection is loss of taste and smell, in which loss of taste, or dysgeusia, occurs in approximately 88.8% of cases.”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [297]
In the citing paper
“recovery from COVID-related anosmia often occurs over weeks (11, 17, 18)”
From Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia (2020) · cites this paper as [18]
In the citing paper
“Any reasonable pathophysiological mechanism for COVID-19-associated anosmia must account for the high penetrance of smell disorders relative to endemic viruses (12, 91, 92), the apparent suddenness of smell loss that can precede the development of other symptoms (11, 13), and the transient nature of dysfunction in many patients (11, 17, 18); definitive identification of the disease mechanisms”
From Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia (2020) · cites this paper as [18]
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- Giacomelli A, Self‐reported olfactory and taste disorders in SARS‐CoV‐2 patients: a cross‐sectional study, Clin Infect Dis
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Does the RAAS play a role in loss of taste and smell during COVID-19 infections?
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COVID-19: what have we learned?
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“(30) carried out a cross-sectional study on 59 patients, of whom 68% had olfactory dysfunction.”
BackgroundClinical significance of smell and taste dysfunction and other related factors in COVID-19
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Self-citationFactors associated with anosmia recovery rate in COVID ‐19 patients
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“4% to 88%.(10,11) This wide TABLE 1 The patients' quantitative demographic and clinical data”
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“Nearly two-thirds of the patients in this study reported anosmia resolution at the time of resolution of COVID-19 symptoms [38].”
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“” Although the characteristic olfactory disturbance due to COVID-19 (7) improves early over time in most cases, some patients remain symptomatic, which has a significant impact on their quality of life.”
BackgroundStructures and functions of the normal and injured human olfactory epithelium
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Single-Cell Sequencing of Glioblastoma Reveals Central Nervous System Susceptibility to SARS-CoV-2
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“At initial enrollment, two self-reported VAS scores were obtained, (1) baseline VAS capturing the pre– COVID-19 olfactory rating, and (2) VAS at the time of enrollment within 3 days of COVID-19 confirmation by PCR.”
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Smell and Taste Dysfunction in Pediatric Patients With SARS-CoV-2 Infection
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Clinical Manifestations of COVID-19
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Olfactory and Gustatory Dysfunctions in COVID-19 Patients: From a Different Perspective
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“Habal, MD dysfunction showed a significant and strong correlation with testing positive for COVID-19, and a correlation between sore throat and COVID-negativity was also found.(12) Although the outpatients participating in our study mainly presented with complaints like fatigue/myalgia and headache, hospitalized patie…”
ResultOlfactory dysfunction in SARS-CoV-2 infection: Focus on odorant specificity and chronic persistence
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“Thus, admission for COVID-19 was associated with intact sense of smell and taste, increased age, diabetes, as well as respiratory failure (25,26).”
Presence of SARS-CoV-2 and Its Entry Factors in Oral Tissues and Cells: A Systematic Review
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Oral manifestations among COVID-19
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“Similar findings were also reported by Yan et al.[4] Oral ulcers may be manifestations of many systemic conditions or responses to local irritants.”
BackgroundResultInfluentialCovid-19, Anosmia, Ageusia: Prospective Observational Study, Follow-Up Three and Eight Months Later
Benhamou, Y. (2021) · Gastroenterology Medicine & Research · doi:10.31031/gmr.2021.05.000615 · Cited by 13
Coronavirus (COVID-19): A Protocol For Prevention And Treatment (Covalyse®)
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S1-Leitlinie: Neurologische Manifestationen bei COVID-19
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Yadav, V., Bhagat, S., Sharma, D. K., Sibia, R. P. S., Pandav, R., & Sandhu, V. P. (2021) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-020-02295-w · Cited by 13
Neurological complications in patient with COVID-19
Mishchenko, T. S., & Mishchenko, V. M. (2021) · Psychiatry Neurology and Medical Psychology · doi:10.26565/2312-5675-2021-16-03 · Cited by 17
COVID-19 Diagnosis based on Taste Disorders: A Case-Control Study
Adamczyk, K., Herman, M., Frączek, J., Piec, R., Szykuła-Piec, B., Zaczyński, A., Wójtowicz, R., Bojanowski, K., Rusyan, E., Król, Z. J., et al. (2021) · Journal of Environmental Science and Public Health · doi:10.26502/jesph.96120148 · Cited by 11
COVID‐19: An Overview of SARS‐CoV‐2 Variants—The Current Vaccines and Drug Development
Bostanghadiri, N., Ziaeefar, P., Mofrad, M. G., Yousefzadeh, P., Hashemi, A., & Darban‐Sarokhalil, D. (2023) · BioMed Research International · doi:10.1155/2023/1879554 · Cited by 17
Olfactory dysfunction during COVID-19 pandemic
Izquierdo-Domínguez, A., Rojas‐Lechuga, M. J., Mullol, J., & Alobid, I. (2020) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2020.06.023 · Cited by 12
Neurological manifestations of COVID-19
Sachdev, K., Agrawal, S. P., Ish, P., Gupta, N., & Raheja, K. (2020) · The Indian Journal of Medical Research · doi:10.4103/ijmr.ijmr_1395_20 · Cited by 12
Cho, J., Lee, J., Sia, C., Koo, C. S., Tan, B. Y., Hong, W.-Z., Choi, E. C.-E., Goh, X., Chai, L. Y. A., Chandran, N., et al. (2021) · Singapore Medical Journal · doi:10.11622/smedj.2021100 · Cited by 12
“Yan et al.[126] 59 USA 100 Patient‐reported via Internet platform 68 71”
BackgroundInfluentialOtolaryngologic Side Effects After COVID ‐19 Vaccination
Ahsanuddin, S., Jin, R., Dhanda, A. K., Georges, K., Baredes, S., Eloy, J. A., & Fang, C. H. (2023) · The Laryngoscope · doi:10.1002/lary.30923 · Cited by 13
“7 11 – 13 This study aims to investigate otolaryngologic adverse events of COVID-19 vaccines reported to the VAERS and their clinical relevance.”
BackgroundAirborne aerosol olfactory deposition contributes to anosmia in COVID-19
Workman, A. D., Jafari, A., Xiao, R., & Bleier, B. S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0244127 · Cited by 13
de Torres, L. Á. P., González-Lama, J., García, C. J., Montero, R. S., Garrido, F. R., López, Y. O., Conde, D. P., Baena, M. R., Martínez, I. P., & Rodríguez, E. M. R. (2021) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2020.12.024 · Cited by 12
Effects of Inspiratory Muscle Training in Patients with post-COVID-19
Sarı, F., Bayram, S., Pala, G. G., Çömçe, F., Küçük, H., & Oskay, D. (2022) · Harran Üniversitesi Tıp Fakültesi Dergisi · doi:10.35440/hutfd.1136549 · Cited by 11
The COVID-19 may help enlightening how emotional food is
Coppin, G. (2020) · npj Science of Food · doi:10.1038/s41538-020-00071-2 · Cited by 11
Rajkumar, I., Anand, K. H., Revathishree, K., Shoba, K., & Srinivasan, K. (2020) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-020-02175-3 · Cited by 12
Swain, S. K. (2020) · International Journal of Otorhinolaryngology and Head and Neck Surgery · doi:10.18203/issn.2454-5929.ijohns20205650 · Cited by 11
“This happened when the virus entered to the central nervous system via the olfactory epithelium.(21) Previously the research has already confirmed the expression of the ACE2 receptors in the nervous tissue like glia and neurons.”
BackgroundKoul, D., Begh, R. A., & Kalsotra, P. (2021) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-021-02397-z · Cited by 11
Capelli, M., & Gatti, P. (2021) · The Journal of Laryngology & Otology · doi:10.1017/s0022215121000670 · Cited by 13
Sharma, S., Jagadeesh, H., Saxena, A., Chakravarthy, H., & Devanathan, V. (2021) · Journal of Biosciences · doi:10.1007/s12038-021-00232-9 · Cited by 11
“Among COVID-19 patients, approximately 66–80% display anosmia, but demonstrate spontaneous improvement and reach a complete resolution of this symptom within 7–10 days from the clinical onset of disease (Vaira et al. 2020; Yan et al. 2020; Hopkins et al. 2020; Lechien et al. 2020b).”
BackgroundSheen, F., Tan, V. W. K., Lim, A. J., Haldar, S., Sengupta, S., Allen, D. M., Somani, J., Chen, H. Y., Tambyah, P. A., & Forde, C. G. (2021) · Food Quality and Preference · doi:10.1016/j.foodqual.2021.104482 · Cited by 12
“…Received 18 May 2021; Received in revised form 31 August 2021; Accepted 21 November 2021 Food Quality and Preference 97 (2022) 104482 2020; Klopfenstein et al., 2020; Lechien, Chiesa-Estomba, De Siati, et al., 2020; Lechien, Chiesa-Estomba, Hans, et al., 2020; Parma et al., 2020; Yan et al., 2020).”
Guidelines for Triage of COVID-19 Patients Presenting With Multisystemic Symptoms
Alemi, F., Guralnik, E., Vang, J., Wojtusiak, J., Peterson, R., Roess, A., & Jain, P. (2022) · Quality Management in Health Care · doi:10.1097/qmh.0000000000000398 · Cited by 12
Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review
Gupta, A., Shrivastav, K., Agrawal, A., Purohit, A., & Chanchlani, R. (2023) · Osong Public Health and Research Perspectives · doi:10.24171/j.phrp.2023.0033 · Cited by 11
“The detailed computation of the risk of bias, using the JBI Critical Appraisal Tools, is presented in Tables S1 − S4 [ 5, 6 ,8,9,12 −86 ].”
Norris, M. C., Kalustian, A., & Salavati, S. (2020) · A&A Practice · doi:10.1213/xaa.0000000000001303 · Cited by 11
Neurologic Compromise in COVID-19: A Literature Review
de Mello, L. J. V., Silva, E. G., Rabelo, G. O. C., Leite, M. E., Vieira, N. R., Bahadori, M., Seifi, A., & Godoy, D. A. (2020) · Journal of Neurology Research · doi:10.14740/jnr619 · Cited by 12
“The hematogenous route seems to be the most probable way for SARSCoV-2 to reach the brain, but the other route to the CNS which is through the cribriform plate on the ethmoid bone, near the olfactory bulb, needs to be taken into account in the early-stage cases.”
BackgroundInfluentialPérdida del sentido del olfato durante la pandemia COVID-19
Izquierdo-Domínguez, A., Rojas‐Lechuga, M. J., Mullol, J., & Alobid, I. (2020) · Medicina Clínica · doi:10.1016/j.medcli.2020.06.006 · Cited by 13
Proposed mechanism for anosmia during COVID-19: The role of local zinc distribution
Equils, O., Lekaj, K., Fattani, S., Wu, A., & Liu, G. C. (2021) · Journal of Translational Science · doi:10.15761/jts.1000397 · Cited by 11
“Yan CH and colleagues from University of California San Diego observed that patients with anosmia were less likely to require hospitalization and that COVID-19 resolved together with the resolution of anosmia [26].”
BackgroundClinical, sinonasal, and long‐term smell and taste outcomes in mildly symptomatic COVID‐19 patients
Tarifi, A. A., Shdaifat, A. A., Al-Shudifat, A.-E., Azab, M. A., Ismail, J., Bashir, R., Amro, A., Altarifi, A., & Khader, Y. S. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14260 · Cited by 11
Horzov, L. F., Goncharuk-Khomyn, M., Hema-Bahyna, N., Yurzhenko, A. V., & Melnyk, V. S. (2021) · Pesquisa Brasileira em Odontopediatria e Clínica Integrada · doi:10.1590/pboci.2021.109 · Cited by 11
Olfactory and gustatory disorders caused by COVID-19: How to regain the pleasure of eating?
de Oliveira, W. Q., de Sousa, P. H. M., & Pastore, G. M. (2022) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2022.01.022 · Cited by 12
“The importance of sensory properties for the hedonic perception of food is evident and proven by a wide range of studies and models (Aguayo-Mendoza, Chatonidi, Piqueras-Fiszman, & Stieger, 2021; Jürkenbeck & Spiller, 2021; Yang et al., 2021).”
Esmaeili, M., Abdi, F., Shafiee, G., Rastad, H., Asayesh, H., Abdar, Z. E., Baygi, F., & Qorbani, M. (2021) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_484_20 · Cited by 10
“Self‐ report could be done through different ways: an online questionnaire,[12,19,27,30,34,37] non‐online questionnaire,[18,32,35,39,42,43] online checklist,[17] the COVID RADAR Symptom Tracker app,[16] visual analogue scale (VAS),[25] archived medical records,[11,40] or verbally.”
BackgroundMethodInfluentialComparison of Different Kits for SARS-CoV-2 RNA Extraction Marketed in BrazilPreprint
Eisen, A. K. A., Demoliner, M., Gularte, J. S., Hansen, A. W., Schallenberger, K., Mallmann, L., Hermann, B. S., Heldt, F. H., de Almeida, P. R., Fleck, J. D., et al. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.05.29.122358 · Cited by 11
Anosmia e disgeusia no paciente com coronavírus: revisão narrativa
Cardoso, M. D. C., Guimarães, L. S., de Andrade, I. J. M., Silva, A. H. G., Souza, G. C., Castro, L. A. M., Cruz, J. C., Couto, L. M., Martins, L. M. N., & Zanúncio, A. V. (2020) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e4226.2020 · Cited by 10
Neurological symptoms in COVID-19 patients
Altunışık, E., Sayıner, H. S., Aksöz, S., Çil, E., & Ozgenc, G. (2021) · Bratislavské lekárske listy/Bratislava medical journal · doi:10.4149/bll_2021_004 · Cited by 10
“In a study, it was presented as a hypothesis that viral spread was limited in the nasal epithelium and did not cause pulmonary invasion in patients with a mild course with olfactory dysfunction (21).”
Javed, A., Karki, S., Sami, Z., Khan, Z., Shree, A., Sah, B. K., Ghosh, S., & Saxena, S. (2022) · BioMed Research International · doi:10.1155/2022/9346939 · Cited by 10
“It is produced by di ff erent in fl ammatory cells like macrophages, T cells, and epithelial cells, and it functions to recruit neutrophils at the site of in fl ammation-causing airway in fl ammation 7 BioMed Research International and hyperreactivity [51].”
Johnson, B. J., Salonen, B. R., O'Byrne, T. J., Choby, G. W., Ganesh, R., Stokken, J. K., & O’Brien, E. K. (2022) · Laryngoscope Investigative Otolaryngology · doi:10.1002/lio2.911 · Cited by 10
“Smell and taste dysfunction are common symptoms in COVID-19 patients.(1,2) One systemic review and meta-analysis of smell and taste dysfunction in nearly 20,000 COVID-19 patients places olfactory dysfunction at 48% and gustatory dysfunction at 41%.”
BackgroundResultExploring the research landscape of COVID-19-induced olfactory dysfunction: A bibliometric study
Yang, Z., Ma, Y., Bi, W., & Tang, J.-Q. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1164901 · Cited by 11
Santos, J. C., Rabelo, M. X., Sebben, L. M., Carneiro, M. V. D. S., Botelho, J. B. L., Neto, J. C., Barbosa, A. N., de Carvalho, D. M., & Pontes, G. S. (2023) · Viruses · doi:10.3390/v15040899 · Cited by 10
“The onset of olfactory dysfunction in the context of COVID-19 is typically observed around four days after the emergence of the initial symptoms and has a close association with taste loss [22,23].”
BackgroundTaziki, M. H., Vakili, M. A., Saeidi, M., Tabarraei, A., & Hosseini, S. M. (2020) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-020-00623-3 · Cited by 10
Reopening Dental Offices for Routine Care Amid the COVID-19 Pandemic: Report From Palestine
Kateeb, E. T., Juniedi, R. N., & Warren, J. J. (2021) · International Dental Journal · doi:10.1016/j.identj.2021.01.017 · Cited by 10
“This may be because that the first study to link loss of taste and smell to COVID-19, based on empirical data, was published in mid-April.(34) In general, the literature found that knowledge about respiratory diseases and their causative agents was lower in dentists(35) than other health care providers.”
Clinical significance of olfactory dysfunction in patients of COVID-19
Chang, C.-C., Yang, M., Chang, S.-M., Hsieh, Y., Lee, C., Chen, Y. A., Yuan, C., Chen, Y., Ho, S., & Tyan, Y. (2021) · Journal of the Chinese Medical Association · doi:10.1097/jcma.0000000000000560 · Cited by 10
Metadata
- Authors
- Yan, C. H., Faraji, F., Prajapati, D. P., Boone, C. E., & DeConde, A. S.
- Affiliations
- UC San Diego Health System (US)
- Corresponding author
- Yan, Carol H.
- Venue
- International Forum of Allergy & Rhinology
- Publisher
- Wiley
- Published
- 2020-06
- Volume
- 10
- Issue
- 7
- Pages
- 806-813
- ISSN
- 2042-6976 (ISSN-L)
- 2042-6984
- PMC
- PMC7262089
- OpenAlex
- W3015631092
- Cited by
- 754
- References
- 13
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 19 · 2023: 60 · 2022: 94 · 2021: 248 · 2020: 317
- FWCI
- 63.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Forum of Allergy & Rhinology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Center for Advancing Translational Sciences (UL1TR001442)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Dermatology › Dermatological and COVID-19 studies
- Keywords
- COVID-19 pandemic, SARS-CoV-2, anosmia, ageusia, chemosensory dysfunction, flu-like symptoms, subclinical symptoms, symptom screening, sore throat, symptom resolution, virus transmission, asymptomatic transmission, outpatients, patient-reported symptoms, COVID-19 testing, COVID-19 isolation, COVID-19 recovery
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Aged, 80 and over, Olfaction Disorders, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Taste Disorders, Prevalence, Coronavirus Infections, Young Adult, Pandemics
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