Objective olfactory evaluation of self-reported loss of smell in a case series of 86 COVID-19 patients

Head Neck. 2020 Jul;42(7):1583-1590. doi: 10.1002/hed.26279. Epub 2020 May 21.

Abstract

Objective: To investigate olfactory dysfunction (OD) in patients with mild coronavirus disease 2019 (COVID-19) through patient-reported outcome questionnaires and objective psychophysical testing.

Methods: COVID-19 patients with self-reported sudden-onset OD were recruited. Epidemiological and clinical data were collected. Nasal complaints were evaluated with the sinonasal outcome-22. Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey. Objective OD was evaluated using psychophysical tests.

Results: Eighty-six patients completed the study. The most common symptoms were fatigue (72.9%), headache (60.0%), nasal obstruction (58.6%), and postnasal drip (48.6%). Total loss of smell was self-reported by 61.4% of patients. Objective olfactory testings identified 41 anosmic (47.7%), 12 hyposmic (14.0%), and 33 normosmic (38.3%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip.

Conclusion: A significant proportion of COVID-19 patients reporting OD do not have OD on objective testing.

Keywords: COVID-19; anosmia; coronavirus; evaluation; olfaction; olfactory; smell; taste.

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / diagnosis*
  • Olfaction Disorders / virology
  • Pandemics
  • Patient Reported Outcome Measures
  • Pneumonia, Viral / complications*
  • SARS-CoV-2
  • Self Report*
  • Surveys and Questionnaires