A Literature Systematic Review with Meta-Analysis of Symptoms Prevalence in Covid-19: the Relevance of Olfactory Symptom
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Reflections from the COVID Pandemic (A Iranzo and M Rosenfeld, Section Editor)
A Literature Systematic Review with Meta-Analysis of Symptoms Prevalence in Covid-19: the Relevance of Olfactory Symptoms in Infection Not Requiring Hospitalization A. Giorli, MD1 F. Ferretti, MD2 C. Biagini, MD1 L. Salerni, MD PhD1 I. Bindi, MD1 S. Dasgupta, MD3,4 A. Pozza, MD2 G. Gualtieri, MD2 R. Gusinu, MD2 A. Coluccia, MD2 Marco MandalA´, MD, PhD1,* Address *,1 Otolaryngology Department, Azienda Ospedaliera Universitaria Senese, Siena, Italy Email: [email protected] 2 Dipartimento Scienze Mediche Chirurgiche e Neuroscienze, Università di Siena, Siena, Italy 3 Department of Audiovestibular Medicine and Neurotology, Alder Hey Children’s Hospital NHS Trust, Liverpool, UK 4 United Kingdom and Sheffield Vertigo and Balance Centre, Sheffield, UK
Published online: 28 August 2020 * The Author(s) 2020. This article is an open access publication
This article is part of the Topical Collection on Reflections from the COVID Pandemic
36 Page 2 of 14
Curr Treat Options Neurol (2020) 22: 36
Keywords COVID-19 I Sars-CoV-2 I Olfactory disorders I Meta-analysis I Hospitalization
Abstract Purpose of review To investigate the association between the olfactory dysfunction and the more typical symptoms (fever, cough, dyspnoea) within the Sars-CoV-2 infection (COVID19) in hospitalized and non-hospitalized patients. Recent findings PubMed, Scopus and Web of Science databases were reviewed from May 5, 2020, to June 1, 2020. Inclusion criteria included English, French, German, Spanish or Italian language studies containing original data related to COVID19, anosmia, fever, cough, and dyspnoea, in both hospital and non-hospital settings. Two investigators independently reviewed all manuscripts and performed quality assessment and quantitative meta-analysis using validated tools. A third author arbitrated full-text disagreements. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 11 of 135 studies fulfilled eligibility. Anosmia was estimated less prevalent than fever and cough (respectively rate difference = − 0.316, 95% CI: − 0.574 to − 0.058, Z = − 2.404, p G 0.016, k = 11 and rate difference = − 0.249, 95% CI: − 0.402 to − 0.096, Z = − 3.185, p G 0.001, k = 11); the analysis between anosmia and dyspnoea was not significant (rate difference = − 0.008, 95% CI: − 0.166 to 0.150, Z = − 0.099, p G 0.921, k = 8). The typical symptoms were significantly more frequent than anosmia in hospitalized more critical patients than in non-hospitalized ones (respectively [Q(1) = 50.638 p G 0.000, Q(1) = 52.520 p G 0.000, Q(1) = 100.734 p G 0.000). Summary Patient with new onset olfactory dysfunction should be investigated for COVID19. Anosmia is more frequent in non-hospitalized COVID-19 patients than in hospitalized ones.
Introduction In Wuhan, China, in December 2019, a previously unidentified coronavirus emerged and spread to many other Chinese cities and then globally [1]. On March 11, 2020, the World Health Organizatio
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