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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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Cites
Presumed Asymptomatic Carrier Transmission of COVID-19
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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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“This rate was more consistent with the results from Middle East , Europe and North America [3,4,6,40,41] .”
BackgroundResultInfluentialMedical Students' Awareness of Smell Loss as a Predictor for Coronavirus Disease 2019
Aldrees, T., Almatrafi, S., Aldriweesh, T., Mokhatrish, M., Salamh, A. F., & Alkholaiwi, F. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.597897 · Cited by 4
“Patients with a combination of anosmia and flu-like symptoms have been reported to be up to 10 times more likely to test positive for COVID-19 than if this combination is not present (11, 12).”
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Vitamina D e doenças infectocontagiosas na pandemia da COVID-19
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“Considering the consistency in the COVID-19 symptoms observed, fever together with chemosensory impairment (anosmia and/or ageusia) can be used as an early detection parameters to rapidly and reliably identify and isolate patients with COVID-19.”
BackgroundResultInfluentialOlfactory nerve: from ugly duckling to swan
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“При COVID-19 возможной причиной высокой частоты нарушений обоняния и вкусового восприятия является катаральное воспаление, однако при других острых респираторных заболеваниях такой сильной связи не прослеживается [4].”
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Smell Disorder Could Warn Head and Neck Surgeons for Diagnosis of COVID-19
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“In this case, typical symptoms of COVID-19 such as fever, dry cough, and fatigue developed, but not loss of smell or taste, a symptom recently reported in more than 60% of COVID-19 patients (5, 6).”
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Fredrich, S., Greenberg, B. M., & Hatanpaa, K. J. (2020) · The Lancet Neurology · doi:10.1016/s1474-4422(20)30451-8 · Cited by 3
International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice
Asbun, H. J., Hilal, M. A., Kunzler, F., Asbun, D., Bonjer, H. J., Conlon, K. C., Demartines, N., Feldman, L. S., Morales‐Conde, S., Pietrabissa, A., et al. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000004674 · Cited by 9
Recovery of Parosmia Preferentially Influences Longitudinal Improvement of Quality of Life in C19OD
Saak, T. M., Tervo, J. P., Vilarello, B. J., Jacobson, P. T., Caruana, F. F., Gallagher, L. W., Gudis, D. A., Devanand, D. P., & Overdevest, J. B. (2026) · International Forum of Allergy & Rhinology · doi:10.1002/alr.70149 · Cited by 2
Implications for border containment strategies when COVID-19 presents atypically
Teo, W. (2020) · Public Health · doi:10.1016/j.puhe.2020.07.019 · Cited by 2
Advances in Intelligent Based Internet of Medical Things (IoMT) for COVID-19: Olfactory Disorders
Brindha, V. E., & Mary, X. A. (2020) · Studies in computational intelligence · doi:10.1007/978-981-15-8534-0_19 · Cited by 2
Costa, B. S., Moraes, G. D. A., Borges, C. T., Meneguzzo, D. T., & Corrêa, V. D. O. S. (2021) · Brazilian Journal of Health Review · doi:10.34119/bjhrv4n2-117 · Cited by 2
Olfactory testing as COVID-19 screening in school children; A prospective cross-sectional study
Gitomer, S. A., Tholen, K., Pickett, K. L., Mistry, R. D., Beswick, D. M., Kaar, J. L., & Herrmann, B. W. (2022) · PLoS ONE · doi:10.1371/journal.pone.0277882 · Cited by 2
Savoy, M., Kopp, B., Chaouch, A., Cohidon, C., Gouveia, A., Lombardo, P., Maeder, M., Payot, S., Perdrix, J., Schwarz, J., et al. (2023) · Infectious Disease Reports · doi:10.3390/idr15010012 · Cited by 2
“Whereas sore throat was previously described as negatively associated with RT-PCR test results [4,9,16,29,30], our results reported no difference between groups.”
BackgroundResultAmino Acid Metabolism in Leukocytes Showing In Vitro IgG Memory from SARS-CoV2-Infected Patients
Fanelli, G., Lelli, V., Rinalducci, S., & Timperio, A. M. (2024) · Diseases · doi:10.3390/diseases12030043 · Cited by 2
“People who have risk factors, such as advanced age, smoking, and concomitant diseases (diabetes, hypertension, cardiovascular disease, obesity, chronic lung disease, kidney disease) are more susceptible to severe acute respiratory syndrome (SARS) [13].”
BackgroundUpper Respiratory Symptoms as Long COVID: Insight from a Multicenter Cohort Study
Okada, M., Ishida, N., Kanzaki, S., Kawada, I., Nagashima, K., Terai, H., Hiruma, G., Namkoong, H., Asakura, T., Masaki, K., et al. (2024) · OTO Open · doi:10.1002/oto2.120 · Cited by 2
Diaconu, I. E. (2024) · The Medical-Surgical Journal · doi:10.22551/msj.2024.01.03 · Cited by 2
Subjective Versus Psychophysical Measures of Chemosensory Alterations Following COVID-19
Vilarello, B. J., Jacobson, P. T., Snyder, C. J., Choo, T.-H. J., Gallagher, L. W., Caruana, F. F., Tervo, J. P., Gary, J. B., Saak, T. M., Gudis, D. A., et al. (2024) · ORL · doi:10.1159/000539378 · Cited by 2
“Early reports associating olfactory loss with acute COVID-19 [6, 7] have evolved into tracking the prevalence of persistent olfactory dysfunction (OD) [8].”
SAFER PRACTICES in the COVID-19 pandemic
Silverston, P. P. (2020) · Practice Nursing · doi:10.12968/pnur.2020.31.5.194 · Cited by 2
Lehmann, J., Giesinger, J. M., Rumpold, G., Borena, W., Knabl, L., Falkensammer, B., Ower, C., Sacher, M., von Laer, D., Sperner‐Unterweger, B., et al. (2021) · Epidemiology and Infection · doi:10.1017/s0950268821000418 · Cited by 2
“This conforms with other studies in which the alterations in (or sometimes loss of) smell or taste were a key symptom to distinguish patients with flu-like symptoms from patients with COVID-19 [6,7].”
ResultInfluentialClinical, laboratory and radiological features and outcomes of moderate to severe COVID-19 patients
Nehara, H. R., Agrawal, S., Chhimpa, A. R., Sunil, I., Arakeri, A., & Sirohi, P. (2021) · Journal of Acute Disease · doi:10.4103/2221-6189.312154 · Cited by 2
Chest CT features in COVID-19 patients
Taghavi, M., Shokri, A., Niloofar, P., Poorbarat, S., Mollazadeh, S., & Milani, H. (2021) · Journal of Acute Disease · doi:10.4103/2221-6189.326907 · Cited by 2
Pang, K. W., Tham, S. Y. Y., & Ng, L. S. (2021) · Life · doi:10.3390/life11121315 · Cited by 2
“Alizadehsani [142] Altman [143] Beltrán-Corbellini [176] Bénézit [34] Bidkar [139] Boudjema [140] Carignan [177] Chas [144] Chen [149] Cho [178] Dawson [179] Dixon [180] Dreyer [150] Elimian [181] Fistera [145] Ganz-Lord [146] Gibbons [151] Gurrola [182] Izquierdo-Domínguez [183] Jeyashree (1) [141] Jeyashree (2) [141…”
BackgroundJungbauer, F., Gerhards, C., Thiaucourt, M., Behnes, M., Rotter, N., Schell, A., Haselmann, V., Neumaier, M., & Kittel, M. (2022) · Life · doi:10.3390/life12070968 · Cited by 2
Considerations for Pregnant Dental and Health Care Workers amid COVID-19
Mann, A., Dahiya, A., Souza, L. C., & Letra, A. (2020) · JDR Clinical & Translational Research · doi:10.1177/2380084420952747 · Cited by 2
“More recently, chemosensory dysfunction leading to loss of taste and smell sensation, and cutaneous reactions ranging from erythematous rash to varicellalike vesicular lesions have been reported as prominent characteristics (Marzano et al. 2020; Yan et al. 2020).”
BackgroundAspectos epidemiológicos, clínicos e olfatórios de pacientes com COVID-19
Seto, I. I. C., Koury, G. V. H., Gomes, V. C. A., Silva, L. F. E., Umbelino, A. M., Yamaguchi, C. T., & Ferreira, D. B. (2021) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e6348.2021 · Cited by 2
Bohórquez-Rivero, J., Sáenz-López, J., Villamizar, K. E. T., & Sáenz, R. C. G. (2021) · Revista Ciencias Biomédicas · doi:10.32997/rcb-2021-3235 · Cited by 2
Rehabilitation challenges in COVID-19 induced acute polyradiculoneuropathies
Stănescu, I., Bulboacă, A., Cordos, A. I., Fodor, D. M., & Bulboacă, A. E. (2021) · Balneo and PRM Research Journal · doi:10.12680/balneo.2021.426 · Cited by 2
“incidences, ranging from 48 to 98% for olfactory dysfunction and to 71 to 88% for ageusia (7,8, 9, 10).”
BackgroundRegalado-Go, J. A., Tayam, M. M., Santos, R., & Gelera, J. (2021) · Philippine Journal of Otolaryngology Head and Neck Surgery · doi:10.32412/pjohns.v36i1.1649 · Cited by 3
Tsygan, N. V., Trashkov, A. P., Ryabtsev, A. V., Yakovleva, V. A., Konevega, A. L., Vasiliev, A. G., Vn, T., Odinak, M. M., & Litvinenko, I. (2021) · General Reanimatology · doi:10.15360/1813-9779-2021-3-65-77 · Cited by 2
“При COVID-19 возможной причиной высокой частоты нарушений обоняния и вкусового восприятия может являться катаральное воспаление, однако при других острых респираторных заболеваниях настолько сильной связи не прослеживается [4, 22].”
BackgroundBiswas, S., Chakraborty, C., Chawla, R., Paul, D., Sen, D., Sarkar, N., & Mukherjee, M. (2021) · International Journal of Statistics in Medical Research · doi:10.6000/1929-6029.2021.10.17 · Cited by 2
Speth, M. M., Speth, U. S., Sedaghat, A. R., & Hummel, T. R. (2022) · HNO · doi:10.1007/s00106-021-01132-y · Cited by 2
“Die Prävalenz wird in der Literatur zwischen 19 und 86% angegeben [35, 36, 37, 38, 39, 40].”
BackgroundDelgado‐Losada, M. L., Bouhaben, J., Ruiz-Huerta, C., Canto, M. V., & Delgado‐Lima, A. H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095777 · Cited by 2
Manhas, M., Koul, D., Kalsotra, G., Manhas, A., Kalsotra, P., Kumar, P., Bhat, A., Gupta, A., & Saraf, A. (2022) · International Archives of Otorhinolaryngology · doi:10.1055/s-0042-1743274 · Cited by 2
“Our fi ndings of smell and taste disturbances (60.8% and 59.6%, respectively) were similar to those of Valeria et al., 23 and Yan et al. 24 An European multi-centric study reported high percentages for both smell and taste disorders, with a female prevalence (85.6% and 88.0%, respectively).”
ResultInfluentialHafez, W., Abdelshakor, M., Gador, M., Abdelli, I., & Ahmed, S. (2022) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed7070115 · Cited by 2
“Moreover, multiple observational studies have revealed that loss of taste and/or smell is a prevalent symptom among mild-tomoderate COVID-19 patients, implying that olfactory/gustatory dysfunction could be a useful screening tool for early case identification and isolation [6,7,21].”
BackgroundUtomo, N. P., & Iswarini, A. D. (2022) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-022-00271-5 · Cited by 2
“One symptom allegedly becomes the most prevalent of all chemosensory symptoms, olfactory dysfunction [1].”
BackgroundPerepi, R., Santhi, K., Saraswathi, R., & Bég, O. A. (2022) · Computer Methods in Biomechanics and Biomedical Engineering Imaging & Visualization · doi:10.1080/21681163.2022.2120829 · Cited by 2
Post-Viral Olfactory Loss: What We Learned from the SARS-CoV-2 Pandemic
Vaira, L. A., Deiana, G., Maglitto, F., & Salzano, G. (2022) · Life · doi:10.3390/life12111868 · Cited by 2
“During the pandemic, many researchers bravely evaluated patients within isolation departments, and for the first time, we were able to estimate the prevalence of olfactory dysfunctions during an infection [16–18] and study the diagnostic [19,20] and prognostic value of these symptoms [21–23].”
BackgroundCOVID-19 w otorynolaryngologii
Męczkowska, K., & Niedzielski, A. (2020) · Wiedza Medyczna · doi:10.36553/wm.49 · Cited by 2
“Stwierdzono, że zaburzenia węchu i smaku znacznie częściej występowały u pacjentów z wynikiem pozytywnym (68 i 71%) niż negatywnym (16 i 17%) (23).”
Neurological Manifestations of COVID-19 (Severe Acute Respiratory Syndrome Coronavirus 2)
Suri, V., Suri, K., Jain, S., & Suri, K. (2020) · Apollo Medicine · doi:10.4103/am.am_63_20 · Cited by 2
“[15] Another report from a large cohort of 10,069 patients from Iran, employing a online questionnaire-based survey, observed an incidence of anosmia/hyposmia in 48.2% of respondents, whereas 83.38% had loss or reduced sense of taste.”
InfluentialSubjective Smell Assessment as An Office-based Rapid Procedure In COVID-19 Era
Abdel‐Aziz, M., Abdel‐Aziz, N. M., Abdel‐Aziz, D. M., & Azab, N. A. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007245 · Cited by 2
“In a USA study carried out on patients with influenza-like symptoms, loss of smell was found in 68% of COVID-19-positive patients compared to 16% of COVID-19 negative subjects.(4) A multicenter study carried out in 4 European countries showed smell disorder in 85.”
ResultMattiuzzi, C., & Lippi, G. (2020) · Acta bio-medica dell'Ateneo parmense/Acta biomedica · doi:10.23750/abm.v92i1.11070 · Cited by 2
“Mountain View, CA, US), with the search term “COVID-19” together with the most common symptoms reported in patients with SARSCoV-2 infection, especially in the US, as summarized in Table 1 (4,5).”
BackgroundNeurological Manifestations of COVID-19
Farhat, S. M. (2021) · Life and Science · doi:10.37185/lns.1.1.162 · Cited by 2
Fasunla, A. J., Thairu, Y., Salami, H., & Ibekwe, T. (2021) · PubMed Central · Cited by 2
Speth, M. M., Speth, U. S., Sedaghat, A. R., & Hummel, T. R. (2022) · DGNeurologie · doi:10.1007/s42451-022-00434-x · Cited by 2
Covid-19 and Other Viruses in Brazil: Can the New Pandemic Influence Epidemiological Records?Preprint
Fernandes, H. S. (2020) · Preprints.org · doi:10.20944/preprints202005.0138.v1 · Cited by 2
The usefulness of a quantitative olfactory test for the detection of COVID-19Preprint
Lessa, M. A., Cotta-Pereira, S. M., Ferreira, F. A., Castiñeiras, T. M. P. P., Galliez, R. M., Faffe, D. S., Leitão, I. D. C., Mariani, D., Nascimento, É. R. D. S., Lessa, F., et al. (2021) · medRxiv · doi:10.1101/2021.01.20.21250173 · Cited by 2
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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