The clinical course and diagnostic relevance of olfactory loss in a SARS-CoV-2 infection

Abstract

Background: The acute onset of olfactory and/or gustatory dysfunction is a frequent complaint during the COVID-19 pandemic. It is predominantly reported by subjects with asymptomatic to mild disease severity during the early stage of the infection. The high prevalence of anosmia/dysosmia and/or ageusia/dysgeusia in this current era implements a strong correlation with a SARSCoV-2 infection and these symptoms could therefore be seen as important prodromes. The purpose of this study was to outline the occurrence, epidemiology and clinical course of olfactory and/or gustatory disorders in (suspected) COVID-19 cases and to analyse the diagnostic significance of these neurosensory dysfunctions. Methods: An online questionnaire was carried out which addressed 500 participants with new onset olfactory and/or gustatory impairment during the COVID-19 pandemic. Results: Acute olfactory and gustatory loss was reported by 487 (97.4%) and 464 (92.8%), respectively. A significant higher prevalence of neurosensory complaints was reported by women and people of younger age. The most prevalent concurrent symptoms were fatigue, headaches, nasal congestion, dry cough, rhinorrhoea and sneezing. The recovery rate after 8 weeks was 41.9% for olfactory impairment and 53.7% for gustatory impairment. Among the 93 subjects tested, 82 (88.2%) tested positive for SARSCoV-2. Conclusion: Olfactory and/or gustatory disorders are prevalent clinical findings during the COVID-19 pandemic. Neurosensory impairments, isolated or in association with other mild complaints, need to be addressed as potential symptoms of a SARS-CoV-2 infection and should be implemented as clinical markers.