To determine the pooled global prevalence of olfactory and gustatory dysfunction in patients with the 2019 novel coronavirus (COVID-19).
Literature searches of PubMed, Embase, and Scopus were conducted on April 19, 2020, to include articles written in English that reported the prevalence of olfactory or gustatory dysfunction in COVID-19 patients.
Search strategies developed for each database contained keywords such as anosmia, dysgeusia, and COVID-19. Resulting articles were imported into a systematic review software and underwent screening. Data from articles that met inclusion criteria were extracted and analyzed. Meta-analysis using pooled prevalence estimates in a random-effects model were calculated.
Ten studies were analyzed for olfactory dysfunction (n = 1627), demonstrating 52.73% (95% CI, 29.64%-75.23%) prevalence among patients with COVID-19. Nine studies were analyzed for gustatory dysfunction (n = 1390), demonstrating 43.93% (95% CI, 20.46%-68.95%) prevalence. Subgroup analyses were conducted for studies evaluating olfactory dysfunction using nonvalidated and validated instruments and demonstrated 36.64% (95% CI, 18.31%-57.24%) and 86.60% (95% CI, 72.95%-95.95%) prevalence, respectively.
Olfactory and gustatory dysfunction are common symptoms in patients with COVID-19 and may represent early symptoms in the clinical course of infection. Increased awareness of this fact may encourage earlier diagnosis and treatment, as well as heighten vigilance for viral transmission. To our knowledge, this is the first meta-analysis to report on the prevalence of these symptoms in COVID-19 patients.
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- 1, , , et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study [published online February 11, 2020]. Chin Med J (Engl).
- 2, . The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020; 109: 102433.
- 3 World Health Organization. Pneumonia of unknown cause—China. Accessed April 23, 2020. http://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
- 4 World Health Organization. Coronavirus. Coronavirus disease (COVID-19) outbreak situation. Published April 20, 2020. Accessed April 20, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
- 5, , , . Sinonasal pathophysiology of SARS-CoV-2 and COVID-19: a systematic review of the current evidence [published online April 10, 2020]. Laryngoscope Investig Otolaryngol.
- 6, , , et al. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak [published online March 27, 2020]. Otolaryngology.
- 7, , , et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China [published online April 10, 2020]. JAMA Neurol.
- 8, , , et al. Sudden and complete olfactory loss function as a possible symptom of COVID-19 [published online April 8, 2020]. JAMA Otolaryngol Neck Surg.
- 9, , . Isolated sudden onset anosmia in COVID-19 infection: a novel syndrome [published online April 2, 2020]? Rhinology.
- 10, , . Presentation of new onset anosmia during the COVID-19 pandemic [published online April 11, 2020]. Rhinology.
- 11, , , et al. Anosmia and dysgeusia in patients with mild SARS-CoV-2 infection. Infectious Diseases (except HIV/AIDS) [published online ahead of print April 14, 2020]. medRxiv.
- 12, , , et al. COVID-19 in a tertiary hospital from Romania: epidemiology, preparedness and clinical challenges [published online April 10, 2020]. Travel Med Infect Dis.
- 13, . A new symptom of COVID-19: loss of taste and smell [published online April 1, 2020]. Obesity.
- 14 Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19)—symptoms. Published April 17, 2020. Accessed April 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
- 15, , , , . COVID-19 Anosmia Reporting Tool: initial findings. Otolaryngol Head Neck Surg. Published April 2020. Accessed April 20, 2020. https://www.entnet.org/sites/default/files/uploads/kaye_covid-19_anosmia_reporting_tool_initial_findings.pdf
- 16 American Academy of Otolaryngology–Head and Neck Surgery. COVID-19 Anosmia Reporting Tool. Published March 25, 2020. Accessed April 22, 2020. https://www.entnet.org/content/reporting-tool-patients-anosmia-related-covid-19
- 17, . Clinical presentation of COVID-19: a systematic review focusing on upper airway symptoms [published online April 13, 2020]. Ear Nose Throat J.
- 18, , , . Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med. 2009; 6(7): e1000097.
- 19, , , , . Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Version 1.0:61. The Cochrane Collaboration, 2010.
- 20. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000; 283(15):2008.
- 21 Veritas Health Innovation. Covidence systematic review software. Accessed August 2, 2019. www.covidence.org
- 22, , , et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012; 65(9): 934–939.
- 23, , , . Anosmia and ageusia: common findings in COVID-19 patients [published online April 1, 2020]. Laryngoscope.
- 24. MedCalc statistical software. Accessed April 22, 2020. https://www.medcalc.org
- 25, . Transformations related to the angular and the square root. Ann Math Stat. 1950; 21: 607–611.
- 26, . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3): 177–188.
- 27, , , et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study [published online April 6, 2020]. Eur Arch Otorhinolaryngol.
- 28, , , et al. Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study [published online March 26, 2020]. Clin Infect Dis.
- 29, , , et al. Features of anosmia in COVID-19 [published online April 17, 2020]. Med Mal Infect.
- 30, , , et al. Utility of hyposmia and hypogeusia for the diagnosis of COVID-19 [published online April 15, 2020]. Lancet Infect Dis.
- 31, , , , . Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms [published online April 12, 2020]. Int Forum Allergy Rhinol.
- 32, , , et al. Acute-onset smell and taste disorders in the context of Covid-19: a pilot multicenter PCR-based case-control study [published online April 22, 2020]. Eur J Neurol.
- 33, , , , , . Smell dysfunction: a biomarker for COVID-19 [published online April 17, 2020]. Int Forum Allergy Rhinol.
- 34, . Contemporary assessment of the prevalence of smell and taste problems in adults: prevalence of smell and taste problems. Laryngoscope. 2015; 125(5): 1102–1106.
- 35, , , et al. Factor analysis of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2018; 8(7): 777–782.
- 36, . Epidemiological studies of smell: discussion and perspectives. Ann N Y Acad Sci. 2009; 1170: 569–573.
- 37, . The epidemiology of olfactory disorders. Curr Otorhinolaryngol Rep. 2016; 4(2): 130–141.
- 38, , . Effects of perceived and imagined odors on taste detection. Chem Senses. 2004; 29(3): 199–208.
- 39, , , . A primer on viral-associated olfactory loss in the era of COVID-19 [published online April 9, 2020]. Int Forum Allergy Rhinol.
- 40, , , et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia [published online April 9, 2020]. Neuroscience.
- 41, , , , , . Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection [published online March 12, 2020]. Front Med.
- 42, , , , Network HLB. SARS-CoV-2 entry genes are most highly expressed in nasal goblet and ciliated cells within human airways. Published March 2020. Accessed April 20, 2020. http://arxiv.org/abs/2003.06122
- 43, , , , , . Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus: a first step in understanding SARS pathogenesis. J Pathol. 2004; 203(2): 631–637.
- 44, , , , . Neuroinvasive and neurotropic human respiratory coronaviruses: potential neurovirulent agents in humans. In: R Adhikari, S Thapa, eds. Infectious Diseases and Nanomedicine I. Springer India; 2014: 75–96.
- 45, , , , . Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008; 82(15): 7264–7275.
- 46, , , et al. Nervous system involvement after infection with COVID-19 and other coronaviruses [published online March 30, 2020]. Brain Behav Immun.
- 47, , . Dysosmia and dysgeusia due to the 2019 novel coronavirus; a hypothesis that needs further investigation. Maxillofac Plast Reconstr Surg. 2020; 42(1): 9.
- 48, , , et al. Smell and taste dysfunction in patients with COVID-19 [published online April 15, 2020]. Lancet Infect Dis.
- 49, . Anosmia as a potential marker of COVID-19 infection—an update. Published April 2020. Accessed April 23, 2020. https://www.entuk.org/sites/default/files/files/ENTUK%20_%20BRS%20update%20-%20Anosmia%20as%20a%20potential%20marker%20of%20COVID-19%20infection.pdf
- 50 American Academy of Otolaryngology–Head and Neck Surgery. Coronavirus disease 2019: resources. Published March 15, 2020. Accessed April 23, 2020. https://www.entnet.org/content/coronavirus-disease-2019-resources