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Smell and Taste Dysfunction in COVID-19 Is 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, Spain
2Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain
3Department of Allergy, Clínica Diagonal, Barcelona, Spain
4Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
5Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
6CIBER of Respiratory Diseases (CIBERES), Spain
7Department of Otorhinolaryngology, Donostia University Hospital, San Sebastian, Spain
8Department of Otorhinolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
9Rhinology Section, Department of Otorhinolaryngology, Hospital General Universitario Gregorio Marañón and Hospital La Milagrosa, Spain
10Department of Otorhinolaryngology, Hospital Universitario de Fuenlabrada and Hospital La Milagrosa, Spain
11Rhinology and Skull Base Unit, Department of Otorhinolaryngology, University Hospital Virgen de la Macarena, Seville, Spain
12Department of Otorhinolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain
13Department of Otolaryngology, Hospital Universitario La Paz, Spain
14Department of Otorhinolaryngology, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain
15Rhinology Section, Department of Otorhinolaryngology, Hospital Universitario de Cruces, Bilbao, Spain
16Rhinology and asthma Unit, UGC ORL Hospital de Jerez, Servicio Andaluz de Salud, Cadiz, Spain
17Department of Otorhinolaryngology, Hospital Ramón y Cajal, Madrid, Spain,
18Department of Otorhinolaryngology, Hospital Reina Sofía de Córdoba, Córdoba, Spain
19Department of Otorhinolaryngology, Hospital Vall d'Hebron, Barcelona, Spain
20Department of Infectious Diseases, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, 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) : 346-357
doi: 10.18176/jiaci.0595

Background: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD).
Objective: The aim of our study 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: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms.
Results: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection.
Conclusion: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.

Key words: Loss of smell, Loss of taste, SARS-CoV-2, COVID-19, Hospital admission

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