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Smell and taste dysfunctions in COVID-19 are associated with younger age in ambulatory settings - a multicenter cross-sectional study

Izquierdo-Domínguez A1,2,3,¶, Rojas-Lechuga MJ4,5,6,¶, Chiesa-Estomba C7, Calvo-Henríquez C8, Ninchritz-Becerra E7, Soriano-Reixach M7, Poletti-Serafini D9, Villarreal IM10, Maza-Solano JM11, Moreno-Luna R11, Villarroel PP12, Mateos-Serrano B13, Agudelo D14, Valcarcel F15, del Cuvillo A16, Santamaría A17, Mariño-Sánchez F5,6,17, Aguilar J18, Vergés P19, Inciarte A20, Soriano A20, Mullol J4,5,6,*, Alobid I2,4,5,6,*

1Department of Allergy, Consorci Sanitari de Terrassa. Barcelona, Catalonia, Spain
2Unidad Alergo Rino, Centro Médico Teknon. Barcelona, Catalonia, Spain
3Department of Allergy, Clínica Diagonal. Barcelona, Catalonia, Spain
4Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona. Barcelona, Catalonia, Spain
5Clinical and Experimental Respiratory Immunoallergy, IDIBAPS. Barcelona, Catalonia, Spain
6CIBER of Respiratory Diseases (CIBERES), Spain
7Department of Otorhinolaryngology, Donostia University Hospital. San Sebastian, Basque Country, Spain
8Department of Otorhinolaryngology. Hospital Complex of Santiago de Compostela. Santiago de Compostela, Galicia, Spain
9Rhinology Section, Department of Otorhinolaryngology. Hospital General Universitario Gregorio Marañón and Hospital La Milagrosa. Madrid, Spain
10Department of Otorhinolaryngology. Hospital Universitario de Fuenlabrada and Hospital La Milagrosa. Madrid, Spain
11Rhinology and Skull Base Unit, Department of Otorhinolaryngology, University Hospital Virgen de la Macarena. Seville, Andalusia, Spain
12Department of Otorhinolaryngology. Hospital Universitario Virgen de las Nieves. Granada, Andalusia, Spain
13Department of Otolaryngology, Hospital Universitario La Paz, Madrid, Spain
14Department of Otorhinolaryngology. Hospital de Sant Joan Despí Moisès Broggi. Barcelona, Catalonia, Spain
15Rhinology Section, Department of Otorhinolaryngology. Hospital Universitario de Cruces. Bilbao, Basque Country, Spain
16Rhinology and asthma Unit, UGC ORL Hospital de Jerez, Servicio Andaluz de Salud. Cadiz, Andalusia, Spain
17Department of Otorhinolaryngology. Hospital Ramón y Cajal. Madrid, Spain
18Department of Otorhinolaryngology. Hospital Reina Sofía de Córdoba. Córdoba, Andalusia, Spain
19Department of Otorhinolaryngology. Hospital Vall d'Hebron. Barcelona, Catalonia, Spain
20Department of Infectious Diseases, Hospital Clínic Barcelona, Universitat de Barcelona. Barcelona, Catalonia, Spain
These authors share first author responsibilities
*These authors equally contribute as senior and corresponding authors

J Investig Allergol Clin Immunol 2020; Vol. 30(5)
doi: 10.18176/jiaci.0595

Background: Since China’s initial anecdotal reports of coronavirus disease 2019 (COVID-19), there have been a growing number of studies describing smell and/or taste dysfunction (STD).
Objective: The aim was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers.
Methods: A multicenter cross-sectional study on SARS-CoV-2 positive patients (n=846) and controls (n=143) from 15 Spanish Hospitals. Data of STD with an in-person survey was collected prospectively. STD severity was categorized by visual analogue scale. STD onset time, recovery rate, time to recovery, hospital admission, pneumonia diagnosis, comorbidities, smoking and symptoms were analyzed.
Results: STD were at least 2-fold more common in COVID-19-positive compared to controls. In COVID-19-positive, hospitalized patients were older, with lower frequency of STD and recovered earlier than out-patients. Stratified analysis by severity of STD showed that more than a half of COVID-19 subjects presented severe loss of smell (53.7%) or taste (52.2%), in >90% this impairment was of both senses. In the multivariate analysis, an older age (>60yo), being hospitalized and an increased level of C-reactive protein were factors associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement of smell (45.6%) and taste (46.1%) at the time of the survey, 90.6% in less than two weeks’ post-infection.
Conclusion: STD is a common symptom in COVID-19, and mainly present in young and non-hospitalized patients. More studies are needed to evaluate the follow-up of the chemosensory impairment.

Key words: Smell loss, Taste loss, SARS-CoV-2, COVID-19, Hospital admission

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