Presentation of New Onset Anosmia During the COVID-19 Pandemic (original) (raw)
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Severity of Anosmia as an Early Symptom of COVID-19 Infection May Predict Lasting Loss of Smell
Frontiers in Medicine, 2020
Introduction:To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients.Methods:Adults with confirmed COVID-19 and self-reported sudden LOS were prospectively recruited through a public call from the University of Mons (Belgium). Epidemiological and clinical data were collected using online patient-reported outcome questionnaires. Patients benefited from objective olfactory evaluation (Sniffin-Sticks-test) and were invited to attend for repeated evaluation until scores returned to normal levels.Results:From March 22 to May 22, 2020, 88 patients with sudden-onset LOS completed the evaluations. LOS developed after general symptoms in 44.6% of cases. Regarding objective evaluation, 22 patients (25.0%) recovered olfaction within 14 days following the onset of LOS. The smell function recovered between the 16th and the 70th day post-LOS in 48 patients (54.5%). At the time of final assessment at 2 months, 20.5% of patients (N= 18) had not ach...
Asian Journal of Pharmaceutical and Clinical Research, 2022
Objectives: COVID-19 outbreak is a major pandemic affecting many people worldwide, including India. The main clinical features of this disease are cough, fever, and myalgia, and in some cases, breathing difficulty. There are many non-specific symptoms also. Loss of smell (Anosmia) is one of the non-specific clinical features in many patients. The main objective of this study is to diagnose COVID-19 disease in patients presenting with loss of smell, which helps in early isolation of the patient and prevents the spread of infection to others before the diagnosis of COVID-19 is confirmed by RTPCR, which may take 2-3 days. Another objective of this study is to know the factors that influence recovery from anosmia. Methods: Data was collected from 105 patients who attended Outpatient Department/COVID Ward in GITAM Institute of Medical Sciences and Research, Rushikonda, Visakhapatnam, from April 2020 to August 2020. The follow-up study for factors influencing the recovery of anosmia was performed in 100 patients who tested positive for COVID-19 disease with loss of smell as a presenting feature. Results: Male, to female ratio of patients with upper respiratory infection and loss of smell was 64:36. Out of 105 patients, 27 were tested positive for COVID19. Thus, the prevalence of anosmia in COVID 19 patients was 28.35%. In the follow-up study, out of 100 patients, 34 patients showed complete recovery in 2 weeks, and 42 patients showed partial recovery in 2 weeks and complete recovery in 4 weeks, and 24 patients showed only partial or no recovery within 1 month from the onset of anosmia. Conclusions: The presence of anosmia can be considered as a non-specific clinical feature in COVID-19, and early identification and isolation of the patient will help in decreasing the spread of disease to other people before the COVID-19 diagnosis is confirmed. It also suggests that recovery from loss of smell is better in middle-aged and female patients. The recovery has been delayed in patients with comorbidities and older people.
Olfactory dysfunction and anosmia awareness in coronavirus disease 2019 pandemic
International Journal of Otorhinolaryngology and Head and Neck Surgery
Raise awareness of anosmia association in Coronavirus pandemic. Current finding about Coronavirus infection and its association with olfactory dysfunction and anosmia is reviewed. The exact mechanism of Coronavirus on the Olfactory system is still unresolved. The olfactory dysfunction is due to local inflammation of the nasal cavity or viral-induced olfactory nerve damage or both. Screening of all patients coming with anosmia should be done to early diagnose the disease and isolate and treat accordingly. Olfactory dysfunction is the most common clinical feature of coronavirus disease 2019 with anosmia being the most distinguished sign with patient may present with sudden onset anosmia as single clinical feature or in association with taste dysfunction and / or dry cough, sore throat, pharyngitis, fever. Clinician should be alert of anosmia and diagnose, isolate and treat patients accordingly.
Clinical Otolaryngology, 2020
Objectives The primary aim of the study is to provide recommendations for the investigation and management of patients with new onset anosmia during the COVID-19 pandemic Design After undertaking a literature review, we used the RAND/UCLA methodology with a multi-step process to reach consensus about treatment options, onward referral imaging. Setting and participants An expert panel consistent of 15 members was assembled. A literature review was undertaken prior to the study and evidence was summarised for the panellists. Main outcome measures The panel undertook a process of ranking and classifying appropriateness of different investigations and treatment options for new onset anosmia during the COVID-19 pandemic. Using a 9-point Likert scale, panellists scored whether a treatment was: Not recommended, optional, or recommended. Consensus was achieved when more than 70% of responses fell into the category defined by the mean. Results Consensus was reached on the majority of statements after 2 rounds of ranking. Disagreement meant no recommendation was made regarding one treatment, using Vitamin A Drops. Alpha lipoic acid was not recommended, olfactory training was recommended for all patients with persistent anosmia of more than 2 weeks duration, and oral steroids, steroid rinses and omega 3 supplements may be considered on an individual basis. Recommendations have been made regarding the need for referral and investigation have been made. Conclusion This study identified the appropriateness of olfactory training, different medical treatment options,
Journal of Otolaryngology - Head & Neck Surgery
Background A rapidly evolving evidence suggests that smell and taste disturbance are common symptoms in COVID-19 infection. As yet there are no reports on duration and recovery rates. We set out to characterise patients reporting new onset smell and taste disturbance during the COVID-19 pandemic and report on early recovery rates. Methods Online Survey of patients reporting self-diagnosed new onset smell and taste disturbance during the COVID-19 pandemic, with 1 week follow-up. Results Three hundred eighty-two patents completed bot an initial and follow-up survey. 86.4% reported complete anosmia and a further 11.5% a very severe loss of smell at the time of completing the first survey. At follow-up 1 week later, there is already significant improvement in self-rating of severity of olfactory loss. 80.1% report lower severity scores at follow-up, 17.6% are unchanged and 1.9% are worse. 11.5% already report compete resolution at follow up, while 17.3% report persistent complete loss o...
Olfactory Dysfunction in COVID-19 Patients: Findings from a Tertiary Rural Centre
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Olfactory and/or taste dysfunction are potential neurological manifestations of coronavirus disease-2019 (COVID-19). The aim of the study was to document the prevalence of anosmia in COVID-19 positive patients and analyze the effect of various factors on the occurrence of these chemosensory dysfunction in the local population. Tertiary referral center. Prospective Study. 250 subjects who tested positive for SARS-CoV-2, by real-time polymerase chain reaction (RT-PCR) and admitted in Isolation ward were enrolled for the study. Data was collected from the subjects via oral questionnaire method, based on the AAO-HNS Anosmia Reporting Tool. Data was collected regarding the age, gender, olfactory or gustatory disturbances, history of recent travel or contact with a positive case, smoking, any associated symptoms, any co-morbid conditions and recovery time of sense of olfaction. Out of 250, 179 (71.6%) subjects were diagnosed with Olfactory dysfunction out of which majority were males, 105 (58.6%). Most of the patients were above 40 years of age (n = 184, 73.6%). Majority of the individuals (88 patients) had close contact with a positive case in recent past, followed by 67 patients who were health care workers, hence proving that risk of infection increases with exposure. Anosmia was present in 68.5% of all the 127 non-smokers. 66.4% had both olfactory as well as gustatory dysfunction whereas 18 patients (7.2%) were found to be totally asymptomatic. Mostly patients recovered their sense of smell within 1-2 weeks from the day of onset of anosmia. Presence of olfactory dysfunction of any degree with or without alteration in taste sensation should raise a suspicion of COVID-19 infection, especially when other classical signs are not present. In such conditions, swabs should be sent for confirmation by RT-PCR testing and till results are awaited, the individual should be shifted to quarantine facilities or advised strict self-isolation.
einstein (São Paulo), 2021
Objective: To assess the clinical and epidemiological profile of patients with olfactory dysfunction in the scenario of COVID-19 pandemic. Methods: The study selected patients with loss of smell, previously screened by telemonitoring system of the Municipal Health Department of Goiânia (GO), Brazil, who agreed to answer a questionnaire about COVID-19 symptoms and findings of exams. The interviews were conducted by six otolaryngologists, who applied the specific questionnaire, over the phone. Results: A total of 13,910 patients underwent telemonitoring, and 627 (4.51%) had olfactory loss complaints. Out of them, 330 were included in the survey. We observed a higher prevalence of altered smell in women (67%), and in patients aged under 50 years (86%). In most cases the manifestations had a sudden onset (70%), and in the first 5 days of illness (80%). The most prevalent associated symptom was a change in taste (89%), and only 2.7% of interviewed patients required hospitalization. Conclusion: Anosmia in COVID-19 is more prevalent in females and individuals aged under 50 years. It is a relevant initial symptom predictive of the disease, together with dysgeusia.
Loss of smell in COVID-19 patients: a critical review with emphasis on the use of olfactory tests
Acta Otorhinolaryngologica Italica, 2020
Since December 2019, an outbreak of a newly isolated coronavirus (SARS-CoV-2) appeared in Wuhan, China, and then spread worldwide. Recently, it has emerged that a number of patients may present with sudden hyposmia, sometimes without other symptoms of the disease. We performed a critical review on the methods used to date to investigate the olfactory function in COVID-19 patients in order to establish which should be considered the most appropriate to use during this pandemic. Literature analysis showed that the diagnosis of hyposmia in COVID-19 patients was mainly made through subjective symptomatology collected by questionnaires and/or interview. Psychophysical tests were carried out in a few studies showing significant discrepancies between the self-reported sense of smell and test results. To date the methods used by authors to investigate smell impairment in COVID-19 patients have been very heterogeneous and predominantly based on self-reported questionnaires leading to confusing and inconclusive results. We suggest that simple validated selfadministered psychophysical olfactory tests could be a valuable instrument to investigate isolated/quarantined or hospitalised COVID-19 patients referring smell impairment in order to confirm olfactory dysfunction.
Is loss of sense of smell a diagnostic marker in COVID‐19: A systematic review and meta‐analysis
Clinical Otolaryngology, 2020
Aims 1. To systematically review the currently available evidence investigating the association between olfactory dysfunction (OD) and the novel coronavirus (COVID-19). 2. To analyse the prevalence of OD in patients who have tested positive on Polymerase Chain Reaction (PCR) for COVID-19. 2. To perform a meta-analysis of patients presenting with olfactory dysfunction, during the pandemic, and to investigate the Positive Predictive Value for a COOVID-19 positive result in this population. 3. To assess if olfactory dysfunction could be used as a diagnostic marker for COVID-19 positivity and aid public health approaches in tackling the current outbreak. Methods We systematically searched MedLine (PubMed), Embase, Health Management Information Consortium (HMIC), Medrxiv, the Cochrane Library, the Cochrane COVID-19 Study Register, NIHR Dissemination centre, Clinical Evidence, National Health Service Evidence and the National Institute of Clinical Excellence to identify the current published evidence which associates coronaviridae or similar RNA viruses with anosmia. The initial search identified 157 articles. 145 papers were excluded following application of our exclusion criteria. The 12 remaining articles, that presented evidence on the association between COVID-19 and olfactory dysfunction, were critically analysed. Results Accepted Article This article is protected by copyright. All rights reserved OD has been shown to be the strongest predictor of COVID-19 positivity when compared to other symptoms in logistic regression analysis. In patients who had tested positive for COVID-19 there was a prevalence of 62% of OD. In populations of patients who are currently reporting OD there is a positive predictive value of 61% for a positive COVID-19 result. Conclusion Our review has shown that there is already significant evidence which demonstrates an association between OD and the novel coronavirus-COVID-19. It is unclear if this finding is unique to this coronavirus as individual viral phenotypes rarely present in such concentrated large numbers. We have demonstrated that OD is comparatively more predictive for COVID-19 positivity compared to other associated symptoms. We recommend that people who develop OD during the pandemic should be selfisolate and this guidance should be adopted internationally to prevent transmission.
Six month follow-up of self-reported loss of smell during the COVID-19 pandemic
Rhinology journal, 2020
INTRODUCTION: Loss of smell and taste is now recognised as amongst the most common symptoms of COVID-19 and the best predictor of COVID-19 positivity. Long term outcomes are unknown. This study aims to investigate recovery of loss of smell and the prevalence of parosmia. METHODOLOGY: 6-month follow-up of respondents to an online surgery who self-reported loss of smell at the onset of the CO- VID-19 pandemic in the UK. Information of additional symptoms, recovery of loss of smell and the development of parosmia was collected. RESULTS: 44% of respondents reported at least one other ongoing symptom at 6 months, of which fatigue (n=106) was the most prevalent. There was a significant improvement in self-rating of severity of olfactory loss where 177 patients stated they had a normal smell of smell while 12 patients reported complete loss of smell. The prevalence of parosmia is 43.1% with median interval of 2.5 months (range 0-6) from the onset of loss of smell. CONCLUSIONS: While many p...