Gustatory Dysfunction: A Highly Specific and Smell-Independent Symptom of COVID-19
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Gustatory Dysfunction: A Highly Specific and Smell-Independent Symptom of COVID-19 Luigi Angelo Vaira1 • Jerome R. Lechien2,3 • Giovanni Salzano4 • Francesco Antonio Salzano5 • Fabio Maglitto4 • Sven Saussez2,3 • Giacomo De Riu1
Received: 30 August 2020 / Accepted: 23 September 2020 Association of Otolaryngologists of India 2020
Abstract Chemosensitive dysfunctions are now considered as frequent and early symptoms of coronavirus disease 2019 (COVID-19). In the last few weeks, researchers’ greatest efforts have been focusing mainly on the analysis of olfactory disorders, neglecting taste dysfunctions. According to our psychophysical evaluations, it can be inferred that the pathogenesis of taste disorders in COVID19 patients is largely smell-independent. Moreover, isolated gustatory disorders are highly specific of SARS-CoV2 infection. For these reasons, it is essential that gustatory dysfunctions, like olfactory disorders, are included in the COVID-19 guidelines. Keywords COVID-19 SARS-CoV-2 Coronavirus Chemosensitive dysfunction Olfactory dysfunction Ageusia Taste Gustatory dysfunction Anosmia
& Luigi Angelo Vaira [email protected] 1
Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy
2
COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Mons, Belgium
3
Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
4
Maxillofacial Surgery Unit, University Hospital of Naples ‘‘Federico II’’, Via Pansini 5, 80131 Naples, Italy
5
Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, ‘‘Scuola Medica Salernitana’’, University of Salerno, 84081 Baronissi, Salerno, Italy
Introduction Chemosensitive dysfunctions are now considered as frequent and early symptoms of coronavirus disease 2019 (COVID-19) in Europe and America, affecting 60–80% of patients [1–4]. In the last few weeks, researchers’ greatest efforts have been focusing mainly on the analysis of olfactory disorders, neglecting taste dysfunctions, for two main reasons. According to a first hypothesis, the olfactory pathway could represent a way of access to the central nervous system for the coronavirus [5]. Therefore, olfactory dysfunctions could represent a sign of neuroinvasion, while ageusia and hypogeusia would not have any possible interesting pathogenetic implication. Secondly, the gustatory disturbances have generally been classified as a consequence of the retronasal olfactory loss and for this reason they have been often overlooked [6]. After the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Italy, we immediately began evaluating patients with psychophysical tests [7–10]. In this way, we were able to obtain a large amount of objective data that allowed us to evaluate the relationships betwe
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