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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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“Studies suggest loss of smell and/or taste are early symptoms of infection.(22) The clinical spectrum ranges from asymptomatic infection to mild symptoms to severe illness.”
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“This scale was developed by Zigmond and Snaith in 1983 whereas its Turkish reliability and validity study was conducted by Aydemir et al. (1997). We used HADS because it is a suitable tool for measuring the severity of anxiety and depression symptoms in nonpsychiatric patient populations (Norton et al.”
BackgroundMethodOlfactory Dysfunction in COVID-19, a Review of the Evidence and Implications for Pandemic Management
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SARS-CoV-2 infection causes transient olfactory dysfunction in micePreprint
Ye, Q., Zhou, J., Yang, G., Li, R.-T., He, Q., Zhang, Y., Wu, S., Chen, Q., Shi, J., Zhang, R., et al. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.11.10.376673 · Cited by 7
“Additionally, studies focusing on COVID-19 patients with anosmia has shown that most of them would recovery from loss of smell within a few weeks or less (Hopkins et al., 2020; Yan et al., 2020), indicating a potential mechanism of OE regeneration from injuries.”
BackgroundDear Watch, Should I Get a COVID-19 Test? Designing deployable machine learning for wearablesPreprint
Nestor, B., Hunter, J., Kainkaryam, R., Drysdale, E., Inglis, J. B., Shapiro, A. D., Nagaraj, S., Ghassemi, M., Foschini, L., & Goldenberg, A. (2021) · medRxiv · doi:10.1101/2021.05.11.21257052 · Cited by 8
Detrille, A., Huvelle, S., van Gils, M. J., Geara, T., Pascal, Q., Snitselaar, J. L., Bossevot, L., Cavarelli, M., Dereuddre‐Bosquet, N., Relouzat, F., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-58173-y · Cited by 7
Contejean, A., Leporrier, J., Canouï, É., Fourgeaud, J., Mariaggi, A., Alby‐Laurent, F., Lafont, E., Beaudeau, L., Rouzaud, C., Lecieux, F., et al. (2021) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofab054 · Cited by 6
“Anosmia and ageusia appeared to be strongly associated to SARS-CoV-2 infection as reported elsewhere [12, 13], whereas cough or rhinorrhea were not.”
BackgroundOlfactory Dysfunction in Patients Infected with 2019 Novel Coronavirus.
Bakhshaee, M., Amini, M., Motedayen, Z., Khojasteh-Taheri, R., Rafiee, M., Amini, M., Layegh, P., Hashemzadeh, K., Omidvar, D., Hwang, P. H., et al. (2021) · PubMed Central · doi:10.22038/ijorl.2021.51614.2750 · Cited by 6
Self‐reported taste and smell impairment among patients diagnosed with COVID‐19 in Brazil
Silva, F. T. D., Sperandio, M., Suzuki, S. S., Silva, H. P. V., de Oliveira, D. G., Stefenon, L., & Garcez, A. S. (2021) · Oral Diseases · doi:10.1111/odi.13951 · Cited by 8
Raza, S. A., Zhang, X., Oluyomi, A., Adepoju, O. E., King, B. T., Amos, C. I., & Badr, H. (2022) · Journal of Infection and Public Health · doi:10.1016/j.jiph.2022.03.012 · Cited by 7
“Most studies carried out on test positive COVID patients indicate an important association of both olfactory and gustatory dysfunctions, but with slightly different results for cough, sore throat, and gastrointestinal symptoms in these patients [16, 41, 42].”
Impact of Systemic Diseases on Olfactory Function in COVID-19 Infected Patients
Awwad, A. A.-E., Elhay, O. M. A., Rabie, M. M., Awad, E. A.-E., Kotb, F. M., Maghraby, H. M., Eldamarawy, R. H., Dawood, Y. M. A., Balat, M. I., Hasan, A. I., et al. (2022) · International Journal of General Medicine · doi:10.2147/ijgm.s355974 · Cited by 6
“4% to 88%.(3,12,13) Table 4 Frequency Distribution of Olfactory Dysfunction Types in Relation to Age and Sex”
BackgroundAlshehri, N. N., AlQahtani, M. A., Riaz, F., Mahmood, S. E., Ahmad, A., Abdelghaffar, N., Almakfor, A. H. A., Alahmari, F., Abdulmutal, H., & Rudainee, M. H. A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20053848 · Cited by 6
“These findings suggested that SARS-CoV-2 virus does not confine to a vast variety of respiratory illnesses [16].”
BackgroundSmell and taste alterations in COVID-19 patients: a systematic review
Gonçalves, L. F., Gonzáles, A. I., de Paiva, K. M., Patatt, F. S. A., Stolz, J. V., & Haas, P. (2020) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.66.11.1602 · Cited by 5
Smell dysfunction in patients with COVID-19
Artemenko, A. R., Danilov, A. B., & Plieva, A. M. (2021) · Russian neurological Journal · doi:10.30629/2658-7947-2020-25-6-4-11 · Cited by 6
COVID-19 in children: A single center experience from Istanbul, Turkey
Besli, G. E., Demi̇r, S. Ö., Girit, S., Arman, T., Duyu, M., & Arslanoğlu, S. (2021) · Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy · doi:10.5222/bmj.2021.60490 · Cited by 6
Lal, P., Chamoli, P., Tuli, I. P., Jaitly, S., Sneha, S., Sharma, S., & Trehan, S. (2021) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-021-02752-0 · Cited by 6
Poerbonegoro, N. L., Reksodiputro, M. H., Sari, D. P., Mufida, T., Rahman, M. A., Reksodiputro, L. A., Audindra, S., & Yosia, M. (2021) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2021.102909 · Cited by 6
Unmasking the ‘Asymptomatic’ COVID-19: A Nose Question
Mazzatenta, A., Berardi, A., Novarria, G. A., & Neri, G. (2022) · Life · doi:10.3390/life12081248 · Cited by 6
Chela, H. K., Pasha, S. B., Wan, X., & Ghouri, Y. A. (2020) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15241 · Cited by 6
It’s in the Bag? The Effect of Plastic Carryout Bag Bans on Where and What People Purchase to EatPreprint
Taylor, R. (2020) · SSRN Electronic Journal · doi:10.2139/ssrn.3608691 · Cited by 6
COVID-19: experiences of roadside logistics from a UK air ambulance service
Mohrsen, S. A. (2020) · Journal of Paramedic Practice · doi:10.12968/jpar.2020.12.7.263 · Cited by 5
MANIFESTASI KLINIS NEUROLOGIS PADA COVID-19
Vania, A., Yuliani, D., & Sumada, I. K. (2020) · Callosum Neurology · doi:10.29342/cnj.v3i3.118 · Cited by 6
Dhaundiyal, S., Anand, J., & Rai, N. (2021) · Journal of Microbiology Biotechnology and Food Sciences · doi:10.15414/jmbfs.4069 · Cited by 5
“Olfactory and gustatory impairment is strongly associated with COVID-19 infection and is recovered within weeks in most patients (Yan et al., 2020).”
BackgroundElsherief, H., Amer, M., Abdelhamid, A. S., El‐Deeb, M. E., Negm, A., & Elzayat, S. (2021) · International Archives of Otorhinolaryngology · doi:10.1055/s-0041-1730303 · Cited by 5
Smell Disturbance among Saudi COVID-19 Patients
Alroqi, A. S., Alothaim, L. O., Albugami, S. J., Alothaim, N. O., Alqabbani, A. A., Alromaih, S., Alharbi, S. O., Alangari, F. S., Saja, D. K., & Almutawa, S. S. (2021) · Journal of Nature and Science of Medicine · doi:10.4103/jnsm.jnsm_148_20 · Cited by 5
Alcas, O., Saldaña, D., Triveño, A., Salazar, M., & Mejía, P. B. (2021) · Ear Nose & Throat Journal · doi:10.1177/01455613211066691 · Cited by 5
“5,11,22”
A review on oral manifestations of COVID-19 disease
Kumar, H., Nishat, R., & Desai, A. S. (2022) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_205_22 · Cited by 6
“8% for taste disturbances in patients with COVID‐19.[10,11] This altered taste perception is usually temporary and the normal sensations return within 4–6 weeks after recovery from acute illness.”
BackgroundInfluentialSung, S., Jung, H., & Kim, Y. (2023) · CIN Computers Informatics Nursing · doi:10.1097/cin.0000000000001048 · Cited by 5
SARS-CoV-2 and Brain Health: New Challenges in the Era of the Pandemic
Ahmed, W., Jia, F., Zhang, Y., & Chen, L. (2023) · Microorganisms · doi:10.3390/microorganisms11102511 · Cited by 5
“Hyposmia and hypogeusia were noted as symptoms observed in individuals diagnosed with COVID-19, with reported prevalence rates varying from approximately 5% [28,128] to as high as 70% [129] or even exceeding 79% [130,131].”
BackgroundSamaranayake, L. P., Fakhruddin, K. S., & Panduwawala, C. (2020) · BDJ · doi:10.1038/s41415-020-1732-2 · Cited by 5
Olfactory dysfunction and COVID-19 — current state of the problem
Самвеловна, К. Л., & Свистушкин, В. М. (2020) · Russian Bulletin of Otorhinolaryngology · doi:10.17116/otorino202085061100 · Cited by 5
New coronavirus infection in the practice of an otolaryngologist
Егоров, В. И., Мустафаев, Д. М., Kochneva, A. O., & Komarova, Z. E. (2020) · Russian otorhinolaryngology · doi:10.18692/1810-4800-2020-4-8-12 · Cited by 8
Simple Disposable Odor Identification Tests for Predicting SARS-CoV-2 Positivity
Ziuzia-Januszewska, L., Dobrzyński, P., Ślączka, K., Ciszek, J., Krawiec, Ł., Wierzba, W., & Zaczyński, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910185 · Cited by 6
Loss of Smell in COVID-19 Patients: New Biomarkers
Bal, K. K., Alagöz, S., Özdaş, T., Ekici, N. Y., Kuran, G., & Görgülü, O. (2021) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-021-02892-3 · Cited by 5
Mahmoud, M. S., Taha, M. S., Mansour, O., Amir, M., Hamdy, T. A. E., Ezzat, W. F., Mohamed, A., Rezk, M., Saleeb, M. F., & Nassif, M. M. (2022) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-022-00207-z · Cited by 5
“Olfactory/gustatory dysfunctions have been reported as being significantly higher in SARS-CoV-2-infected patients versus patients with no SARS-CoV-2 infection with influenza-like symptoms (68% and 71% vs 16 and 17%, respectively) [21].”
ResultCranial nerve involvement among COVID-19 survivors
Heidari, M. E., Nazemi, P., Feizabad, E., Beiranvand, F., & Afzali, M. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1182543 · Cited by 6
Temporal Profile of Olfactory Dysfunction in COVID‐19
Loftus, P. A., Roland, L. T., Gurrola, J. G., Cheung, S. W., & Chang, J. L. (2020) · OTO Open · doi:10.1177/2473974x20978133 · Cited by 5
Neurological damage in SARS-CoV-2 infections
Vega-Fernández, J. A., Suclupe-Campos, D. O., & Aguilar–Gamboa, F. R. (2021) · Revista de la Facultad de Medicina Humana · doi:10.25176/rfmh.v21i1.3062 · Cited by 8
Temporal patterns of nasal symptoms in patients with mild severity SARS-CoV-2 infection
Raad, R. A., Ganti, A., Goshtasbi, K., Lehrich, B. M., Papagiannopoulos, P., LoSavio, P., Mahdavinia, M., Kuan, E. C., Batra, P. S., & Tajudeen, B. A. (2021) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2021.103076 · Cited by 5
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 · doi:10.1016/j.medcli.2020.12.015 · Cited by 6
Encephalopathy at admission predicts adverse outcomes in patients with SARS‐CoV‐2 infection
Tang, L., Liu, S., Xiao, Y., Tran, T. M. L., Choi, J. W., Wu, J., Halsey, K., Huang, R. Y., Boxerman, J. L., Patel, S. H., et al. (2021) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.13687 · Cited by 5
Amirudin, A., Saputra, J., Afrizal, T., Latip, M., & Tarmizi, Α. (2021) · WSEAS TRANSACTIONS ON ENVIRONMENT AND DEVELOPMENT · doi:10.37394/232015.2021.17.58 · Cited by 5
“The COVID-19 pandemic is severely impending world public health and bringing considerable human suffering [3].”
BackgroundSinghavi, H. R., Pai, A., Mair, M. D., Singhavi, J., Gandhi, P., Baker, A., Das, S. K., Kumar, S., & Conboy, P. (2021) · VirusDisease · doi:10.1007/s13337-021-00699-y · Cited by 5
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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