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Loss of Smell and Taste in 2013 European Patients With Mild to Moderate COVID-19

2020; American College of Physicians; Volume: 173; Issue: 8 Linguagem: Inglês

10.7326/m20-2428

1539-3704

Jérôme R. Lechien, Carlos M. Chiesa‐Estomba, Stéphane Hans, Maria Rosaria Barillari, Lionel Jouffe, Sven Saussez,

Respiratory and Cough-Related Research

Letters26 May 2020Loss of Smell and Taste in 2013 European Patients With Mild to Moderate COVID-19FREEJerome R. Lechien, MD, PhD, MS, Carlos M. Chiesa-Estomba, MD, MS, Stephane Hans, MD, PhD, MS, Maria Rosaria Barillari, MD, PhD, MS, Lionel Jouffe, PhD, and Sven Saussez, MD, PhDJerome R. Lechien, MD, PhD, MSCentre Hospitalier Universitaire Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium (J.R.L.)Search for more papers by this author, Carlos M. Chiesa-Estomba, MD, MSHospital Universitario Donostia, San Sebastian, Spain (C.M.C.)Search for more papers by this author, Stephane Hans, MD, PhD, MSFoch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France (S.H.)Search for more papers by this author, Maria Rosaria Barillari, MD, PhD, MSUniversity of Campania Luigi Vanvitelli, Naples, Italy (M.R.B.)Search for more papers by this author, Lionel Jouffe, PhDBayesia, Changé, France (L.J.)Search for more papers by this author, and Sven Saussez, MD, PhDUniversity of Mons, Mons, Belgium (S.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-2428 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The coronavirus disease 2019 (COVID-19) pandemic has spread worldwide rapidly. Commonly reported symptoms, such as fever, cough, dyspnea, fatigue, and myalgia, are nonspecific, and the lack of testing in some European countries may make the diagnosis of COVID-19 challenging. However, 2 distinctive symptoms were identified recently: loss of smell and loss of taste (1). These symptoms were not reported extensively in initial studies (2) and might help in the clinical diagnosis of COVID-19.Objective: To evaluate the prevalence and features of, as well as recovery from, smell dysfunction in European patients with mild to moderate COVID-19.Methods: From 22 March to 23 April 2020, we identified 2153 consecutive ambulatory and hospitalized patients with positive results on reverse transcriptase polymerase chain reaction (RT-PCR) testing at 18 European hospitals. Patients had mild to moderate COVID-19, defined as an infection not requiring intensive care, and those who were hospitalized were discharged during the study period. Of the 2153 patients, 2013 (93.5%) provided informed consent and participated in the study (Figure), which was approved by the ethics committee at each institution.Figure. Flow chart of the study.COVID-19 = coronavirus disease 2019; ICU = intensive care unit; RT-PCR = reverse transcriptase polymerase chain reaction.* The diagnostic tests of ambulatory and hospitalized patients were centralized in hospital laboratories, allowing identification of patients with positive results.† For hospitalized patients, physicians entered information directly on an online questionnaire; home-managed (quarantined) patients completed the questionnaire at home.‡ Among the patients with total loss of smell, those who came from Hainaut, Belgium, were contacted to be included in a second study to objectively assess the olfactory disorder. The following exclusion criteria were considered: history of nasal surgery, history of head or neck trauma, history of chronic rhinosinusitis or polyposis, degenerative neurologic disease, and history of chronic loss of smell before the epidemic. Patients who did not respond to the questionnaire were excluded (n = 7). Download figure Download PowerPoint Using a standardized online questionnaire, we collected clinical and epidemiologic data from hospitalized patients on discharge day and from ambulatory patients after the resolution of key symptoms (such as cough, fever, dyspnea, headache, myalgia, and arthralgia) (Figure). We assessed general and otolaryngologic symptoms believed to be associated with COVID-19 (by using a 4-point scale, from 0 for no symptoms to 4 for severe symptoms). The olfactory and gustatory assessment was based on 8 questions on the smell and taste component of the National Health and Nutrition Examination Survey (3).Objective evaluations for olfactory dysfunction were performed in a subset of patients who reported total loss of smell at 1 of the study sites (EpiCURA Hospital, Hainaut, Belgium) at the time of the questionnaire. We used a standard olfactory identification test (Sniffin' Sticks [MediSense]) (4), in which we presented 16 scented pens to each patient to smell every 30 seconds. Patients were asked to choose the best term among 4 options to describe the aroma. The test was scored on the basis of a 16-point total. 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Trial): Protocol for a Prospective Case-Control Study 20 October 2020Volume 173, Issue 8 Page: 672-675 ePublished: 26 May 2020 Issue Published: 20 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. 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