Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study
Open accessAbstract
Objective To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection.Methods Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS).Results A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001).Conclusion Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.
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COVID-related anosmia has been reported to occur in at least some cases in the absence of significant nasal inflammation or coryzal symptoms.
“in at least some cases COVID-related anosmia has been reported to occur in the absence of significant nasal inflammation or coryzal symptoms (11, 14-16).”
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 [11]
Clinical reports indicate that SARS-CoV-2 infection is associated with high rates of disturbances in smell and taste perception, including anosmia.
“Clinical reports suggest that infection with CoV-2 is associated with high rates of disturbances in smell and taste perception, including anosmia (8-13).”
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 [11]
Recovery from COVID-related anosmia often occurs over weeks.
“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 [11]
Dysfunction of smell in many COVID-19 patients is transient.
“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 [11]
Smell loss in COVID-19 can be sudden and precede development of other symptoms.
“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 [11]
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- Authors
- Lechien, J. R., Chiesa-Estomba, C. M., De Siati, D. R., Horoi, M., Le Bon, S. D., Rodriguez, A., Dequanter, D., Blecic, S., El Afia, F., Distinguin, L., Chekkoury-Idrissi, Y., Hans, S., Delgado, I. L., Calvo-Henriquez, C., Lavigne, P., Falanga, C., Barillari, M. R., Cammaroto, G., Khalife, M., Leich, P., Souchay, C., Rossi, C., Journe, F., Hsieh, J., Edjlali, M., Carlier, R., Ris, L., Lovato, A., De Filippis, C., Coppee, F., Fakhry, N., Ayad, T., & Saussez, S.
- Affiliations
- University of Mons (BE)
- Donostiako Unibertsitate Ospitalea (ES)
- Université Libre de Bruxelles (BE)
- Epicura (BE)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Centre Hospitalier de l’Université de Montréal (CA)
- University of Campania "Luigi Vanvitelli" (IT)
- Ospedale G.B. Morgagni - L.Pierantoni (IT)
- CHU Ambroise Paré (BE)
- University Hospital of Geneva (CH)
- Inserm (FR)
- University of Padua (IT)
- Aix-Marseille Université (FR)
- Corresponding author
- Lechien, Jerome R.
- ORCID
- Venue
- European Archives of Oto-Rhino-Laryngology
- Published
- 2020-04-06
- Volume
- 277
- Issue
- 8
- Pages
- 2251-2261
- ISSN
- 0937-4477 (ISSN-L)
- 1434-4726
- PMC
- PMC7134551
- OpenAlex
- W3014922871
- Cited by
- 2,668
- References
- 29
- Citations by year
- 2026: 29 · 2025: 75 · 2024: 135 · 2023: 237 · 2022: 470 · 2021: 796 · 2020: 917 · 2019: 1 · 2018: 2 · 2014: 1
- FWCI
- 212.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Archives of Oto-Rhino-Laryngology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- ORBi UMONS (submittedVersion, other-oa)
- HAL (submittedVersion)
- Digital Access to Libraries (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Oskar-Bordeaux (Universite de Bordeaux) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- 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, olfactory dysfunction, gustatory dysfunction, anosmia, ageusia, hyposmia, olfactory recovery, sex differences, mild to moderate COVID-19, nasal obstruction
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Ageusia, Olfaction Disorders, Cough, Europe, Female, Humans, Male, Middle Aged, Nutrition Surveys, Pneumonia, Viral, Smell, Taste, Taste Disorders, Prevalence, Coronavirus, Coronavirus Infections, Pandemics, Myalgia
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