Emergence and Evolution of Olfactory and Gustatory Symptoms in Patients with COVID-19 in the Outpatient Setting
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ORIGINAL ARTICLE
Emergence and Evolution of Olfactory and Gustatory Symptoms in Patients with COVID-19 in the Outpatient Setting Mahboobeh Karimi-Galougahi1 • Ali Safavi Naini1 • Jahangir Ghorbani1 Nasim Raad1 • Negar Raygani1
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Received: 31 August 2020 / Accepted: 21 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract The present study aimed at evaluating the prevalence of general and sinonasal symptoms in patients with olfactory symptoms and mild coronavirus disease2019 (COVID-19) and determining the patterns in emergence and resolution of olfactory/gustatory symptoms relative to general and sinonassal symptoms. This was a prospective cross-sectional study conducted at the outpatient otorhinolaryngology clinic at a COVID-19-designated referral Hospital. We included consecutive patients with new-onset olfactory dysfunction and positive polymerase chain reaction (PCR) assay of COVID-19. We asked the patients to fill in a questionnaire about general and sinonasal symptoms in association with anosmia, hyposmia or hypogeusia, and recorded the time course of the olfactory/gustatory symptoms during 2-weeks of follow-up. 76 patients with average age of 38.5 ± 10.6 years were included. Majority of participants (94.7%) had general or sinonasal symptom. There was anosmia in 60.5% and hyposmia in 39.5%, with sudden onset of olfactory symptoms reported in 63.2% of patients. During the follow-up, 30.3% of patients completely and 44.7% partially recovered from anosmia/hyposmia. Regardless of whether the general or olfactory symptoms appeared initially, the general symptoms resolved first while a degree of olfactory dysfunction persisted during the follow-up. Our study showed that hyposmia and anosmia in mild COVID-19 are frequently associated with general and sinonasal symptoms
& Nasim Raad [email protected] 1
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Masih Daneshvari Hospital, Neyavran, Darabad, Tehran, Iran
and tend to persist longer than the general and sinonasal symptoms during the course of the disease. Keywords COVID-19 SARS-CoV-2 Anosmia Hyposmia Hypogeusia
Introduction Since January 2020 when the first cases of coronavirus disease-2019 (COVID-19) were reported from Wuhan, China [1], significant data on the pathobiology of severe acute respiratory syndrome-conoavirus-2 (SARS-CoV-2) has been accumulated at an accelerating speed in an attempt to keep pace with the nascent COVID-19 pandemic. Essential to the infectivity of the virus, the superficial spike protein of SARS-CoV-2 attaches to the angiotensin-converting enzyme 2 (ACE 2) receptor at the surface of the cells, particularly in the lungs [2], to gain access to and replicate inside the host cells. Thus, pneumonia is the dominant clinical feature of the hospitalized patients with the severe form of the disease. Clinical and imaging findings of the lower respiratory involvement including dyspnea [3], ground glass opaci
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