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Original Investigation
July 2, 2020

Evolution of Altered Sense of Smell or Taste in Patients With Mildly Symptomatic COVID-19

Author Affiliations
  • 1Section of Otorhinolaryngology, University of Padova, Treviso, Italy
  • 2Guy’s and St Thomas’ Hospitals, London, United Kingdom
  • 3Section of Otorhinolaryngology, University of Padova, Padova, Italy
  • 4Head and Neck Department, Cattinara Hospital, University of Trieste, Trieste, Italy
  • 5Department of Clinical Pathology, AULSS 2 - Marca Trevigiana, Treviso, Italy
  • 6Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
  • 7King’s College, London, United Kingdom
JAMA Otolaryngol Head Neck Surg. Published online July 2, 2020. doi:10.1001/jamaoto.2020.1379
Key Points

Question  What is the evolution of sudden-onset altered sense of smell or taste in patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection?

Findings  In this prospective survey-based study of 202 patients, at 4 weeks from the onset 55 patients (48.7%) reported complete resolution of smell or taste impairment, 46 (40.7%) reported an improvement in the severity, and only 12 (10.6%) reported the symptom was unchanged or worse. Persistent loss of smell or taste was not associated with persistent SARS-CoV-2 infection.

Meaning  The loss of smell or taste is among the most common and persistent symptoms of mildly symptomatic patients with coronavirus disease 2019; however, most patients reported a complete resolution or improvement of these symptoms.

Abstract

Importance  An altered sense of smell and taste has been reported to be associated with coronavirus disease 2019 (COVID-19). To understand the evolution of these symptoms during the course of the disease is important to identify patients with persistent loss of smell or taste and estimate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the burden of olfactory and gustative dysfunctions.

Objective  To evaluate the evolution of the loss of sense of smell and taste in a case series of mildly symptomatic patients with SARS-CoV-2 infection.

Design, Setting, and Participants  This cross-sectional survey-based study included 202 mildly symptomatic adults (≥18 years) consecutively assessed at Treviso Regional Hospital, Italy, between March 19 and March 22, 2020, who tested positive for SARS-CoV-2 RNA by polymerase chain reaction on nasopharyngeal and throat swabs.

Main Outcomes and Measures  Prevalence of altered sense of smell and taste at follow-up and their variation from baseline.

Results  Of 202 patients completing the survey at baseline, 187 (92.6%) also completed the follow-up survey (103 [55.1%] women; median age, 56 years). The evaluation of the evolution of altered sense of smell or taste in the 113 patients reporting sudden onset of these symptoms at baseline showed that 55 patients (48.7%; 95% CI, 39.2-58.3) reported complete resolution of smell or taste impairment, 46 (40.7%; 95% CI, 31.6-50.4) reported an improvement in the severity, and only 12 (10.6%; 95% CI, 5.6-17.8) reported the symptom was unchanged or worse. Persistent loss of smell or taste was not associated with persistent SARS-CoV-2 infection.

Conclusions and Relevance  At 4 weeks from the onset, 89% of the SARS-CoV-2–positive mildly symptomatic patients who had had a sudden onset of altered sense of smell or taste experienced a complete resolution or improvement of these symptoms. Persistent loss of smell or taste was not associated with persistent SARS-CoV-2 infection.

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