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      Olfactory and gustatory function impairment in COVID‐19 patients: Italian objective multicenter‐study

      research-article
      , MD 1 , , , FRSC (ORLHNS), DM (Oxon) 2 , , MD 3 , , MD 4 , , MD 5 , , MD 6 , , MD 6 , , MD 7 , , MD 7 , , MD 8 , , MD 9 , , MD 9 , , MD 5 , , MD 10 , , MD 11 , , MD 12 , , MD 5 , , MD 9 , , MD 9 , , MD 10 , , MD 10 , , MD 13 , , MD 14 , , MD 6 , , MD, FEBOMFS 1
      Head & Neck
      John Wiley & Sons, Inc.
      ageusia, anosmia, COVID‐19, smell, taste

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          Abstract

          Background

          Objective data on chemosensitive disorders during COVID‐19 are lacking in the Literature.

          Methods

          Multicenter cohort study that involved four Italian hospitals. Three hundred and forty‐five COVID‐19 patients underwent objective chemosensitive evaluation.

          Results

          Chemosensitive disorders self‐reported by 256 patients (74.2%) but the 30.1% of the 89 patients who did not report dysfunctions proved objectively hyposmic. Twenty‐five percentage of patients were seen serious long‐lasting complaints. All asymptomatic patients had a slight lowering of the olfactory threshold. No significant correlations were found between the presence and severity of chemosensitive disorders and the severity of the clinical course. On the contrary, there is a significant correlation between the duration of the olfactory and gustatory symptoms and the development of severe COVID‐19.

          Conclusions

          Patients under‐report the frequency of chemosensitive disorders. Contrary to recent reports, such objective testing refutes the proposal that the presence of olfactory and gustatory dysfunction may predict a milder course, but instead suggests that those with more severe disease neglect such symptoms in the setting of severe respiratory disease.

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          Most cited references23

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          Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China

          The outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, is serious and has the potential to become an epidemic worldwide. Several studies have described typical clinical manifestations including fever, cough, diarrhea, and fatigue. However, to our knowledge, it has not been reported that patients with COVID-19 had any neurologic manifestations.
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            The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

            Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Person-to-person transmission of COVID-19 infection led to the isolation of patients that were subsequently administered a variety of treatments. Extensive measures to reduce person-to-person transmission of COVID-19 have been implemented to control the current outbreak. Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. In this review, we highlights the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of this fatal disease.
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              Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study

              Objective To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. Methods Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). Results A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). Conclusion Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection. Electronic supplementary material The online version of this article (10.1007/s00405-020-05965-1) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                luigi.vaira@gmail.com
                Journal
                Head Neck
                Head Neck
                10.1002/(ISSN)1097-0347
                HED
                Head & Neck
                John Wiley & Sons, Inc. (Hoboken, USA )
                1043-3074
                1097-0347
                21 May 2020
                : 10.1002/hed.26269
                Affiliations
                [ 1 ] Maxillofacial Surgery Operative Unit University Hospital of Sassari Sassari Italy
                [ 2 ] King's College London UK
                [ 3 ] Maxillofacial Surgery Unit University Hospital of Naples “Federico II” Naples Italy
                [ 4 ] Maxillofacial Surgery Operative Unit; Bellaria and Maggiore Hospital, AUSL Bologna Italy
                [ 5 ] Otolaryngology Operative Unit University Hospital of Sassari Sassari Italy
                [ 6 ] Maxillofacial Surgery Department, San Paolo Hospital, ASST Santi Paolo e Carlo University of Milan Milan Italy
                [ 7 ] Otolaryngology Operative Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences University of Milan Milan Italy
                [ 8 ] Department of Medical, Surgical and Experimental Sciences University of Sassari Sassari Italy
                [ 9 ] Infectious Diseases Operative Unit University Hospital of Sassari Sassari Italy
                [ 10 ] Respiratory Diseases Operative Unit University Hospital of Sassari Sassari Italy
                [ 11 ] Respiratory Diseases Operative Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana” University of Salerno Baronissi Salerno Italy
                [ 12 ] Surveillance and Prevention Department University Hospital of Sassari Sassari Italy
                [ 13 ] Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana” University of Salerno Baronissi Salerno Italy
                [ 14 ] University of Turin Turin Italy
                Author notes
                [*] [* ] Correspondence

                Luigi A. Vaira, Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy.

                Email: luigi.vaira@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-7789-145X
                https://orcid.org/0000-0003-1874-1686
                Article
                HED26269
                10.1002/hed.26269
                7280583
                32437022
                081990f3-4a6b-4e74-9e83-e40366c186d9
                © 2020 Wiley Periodicals, Inc.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 30 April 2020
                : 04 May 2020
                Page count
                Figures: 2, Tables: 4, Pages: 10, Words: 5229
                Categories
                Special Issue
                Special Issue
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.4 mode:remove_FC converted:09.06.2020

                Otolaryngology
                ageusia,anosmia,covid‐19,smell,taste
                Otolaryngology
                ageusia, anosmia, covid‐19, smell, taste

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