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Aims: To evaluate long COVID of gustatory dysfunction and the associated risk factors regarding onset and recovery in Chinese patients. Methods: We conducted a cross‐sectional study of patients with SARS‐CoV‐2 Omicron infection at Changxing Mobile Cabin Hospital in Shanghai, China, from March to May 2022. A prospective follow‐up of patients with gustatory dysfunction was conducted at 6 months after discharge. Results: In total, 18.48% (241/1304) reported gustatory dysfunction. The 6‐month follow‐up response rate was 89.63% (216/241) and 74.02% recovered their taste sense within 1–3 weeks. A total of 20.37% of patients (44/216) presented with long COVID. Symptoms persisted for 12 patients (5.56%) after 6 months. Having multiple taste impairments (OR, 2.364; 95% CI, 1.286–4.348; p = 0.006) was associated with a higher risk of gustatory dysfunction with long COVID. Having received a COVID‐19 vaccine booster was positively associated with taste sensation recovery (HR, 1.344; 95% CI, 1.012–1.785; p = 0.041). Conclusions: About 20.37% of patients with COVID‐19 might develop long COVID of gustatory dysfunction and 5.56% with persisting changes in their sense of taste. Most patients recovered taste sensations within 1–3 weeks after COVID‐19 symptom onset and receiving a booster shot of the COVID‐19 vaccine presented a protective effect on the taste sensation recovery. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aims to examine the correlation between dopamine deficiency and olfactory dysfunction in patients with restless legs syndrome (RLS) and to juxtapose these findings with gustatory function. This comprehension of the relationship may illuminate the pathophysiology of RLS, suggesting possible therapeutic targets. Methods: We included a total of 100 male participants aged 40 and older, comprising 50 healthy volunteers and 50 patients with RLS. Participants were recruited from the Neurology Clinic at Sultan Abdulhamid Han Training and Research Hospital between September 2016 and April 2017. We objectively assessed olfactory function using the Sniffin' Sticks Test Battery, while gustatory function was evaluated using the Taste Strip test--participants identified the flavors presented to them. Results: The mean age of the RLS patient group was 52.5 years, while it was 52.7 years for the healthy group. Olfactory test scores were significantly lower in the RLS group compared to the healthy group (P<0.05). Likewise, gustatory test scores were also significantly lower in RLS patients (P=0.032). A strong positive correlation was observed between the olfactory and gustatory test results (r=+0.72), indicating a significant decline in both sensory functions in RLS patients. Conclusion: This study reveals a significant association between dopamine deficiency, olfactory dysfunction, and impaired taste perception in RLS patients. These findings suggest that RLS may involve underlying neurodegenerative processes affecting sensory perception. Further research is crucial to shed light on RLS mechanisms, which remain partially understood, and guide the development of targeted therapeutic strategies. [ABSTRACT FROM AUTHOR]

Objective To determine the incidence, symptomatic characteristics, and factors influencing morbidity and prognosis of post-infectious olfactory and gustatory dysfunction in patients infected with COVID-19 in the Tibet Autonomous Region (TAR). Methods This cross-sectional investigation involved multiple hospitals in TAR, collecting data of patients with COVID-19 through an online questionnaire from December 29, 2022 to February 2, 2023. The collected information included demographic details, previous health conditions, vaccination history, dietary predilections, nucleic acid or antigen test results, history of smoking, history of drinking, medication use after infection onset, pre- and post-infection olfactory and gustatory conditions as well as their improvement over time. The patients’ self-reported sense of smell and taste were assessed using a visual analogue scale (VAS) ranging from 0 to 10. Results A total of 523 valid questionnaires were obtained with a overall incidence rate of olfactory and gustatory dysfunction after COVID-19 infection at 55.07%, higher among females than males (χ² =13.386, P ＜ 0.01). Gender differences along with previous olfactory and gustatory dysfunction and dietary predilections were found to be correlated with the occurrence of these dysfunction following COVID-19 infection. The mean VAS scores for olfactory and gustatory decreased from pre-infection levels of 6.99/7.10 to post-infection levels of 4.28/4.73 respectively, before recovering slightly by the end of the investigation period to levels aroud 5.95/6.56. The median onset time for olfactory and gustatory disorder after COVID-19 infection was 3 days, while the median duration was 7 days for both symptoms. There were 1.6% of patients with olfactory and gustatory dysfunction lasting longer than 30 days. The overall spontaneous improvement rate of olfactory and gustatory impairment was 65.28%. The status of previous olfactory and gustatory dysfunction, negative nucleic acid or antigen test conversion, and the presence of concomitant symptoms all had significant impact on the prognosis of the disease. Conclusions The incidence of olfactory and gustatory dysfunction after COVID-19 infection in TAR was 55.07%. Female patients, prior experiences with olfactory and gustatory dysfunction within the last 3 months, and preference for spicey food were identified as risk factors. Most patients experienced some degree of spontaneous improvement, but not fully returning to original level in short term. As small number of patients continued to suffer from long-term olfactory and gustatory dysfunction, suggesting the need for active interventions. Patients who had experienced olfactory and gustatory dysfunction within the last 3 months, negative conversion of whose nucleic acid or antigen test results, and absence of concomitant symptoms were found to be more likely to recover their olfactory and gustatory function. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence, onset, associated symptoms, and clinical characteristics of COVID-19 in-patients with olfactory and gustatory dysfunction at the Philippine General Hospital from March 2021 to January 2022 and determine the number of patients with olfactory dysfunction/dysgeusia who recovered or expired. Methods: Design: Prospective Cohort Study Setting: COVID-19 Referral Hospital (Tertiary National University Hospital) Participants: COVID-19 RT-PCR positive in-patients, ages 19 and older Results: A total of 207 patients were included. Sixty-four (64) patients reported olfactory dysfunction and 79 reported dysgeusia. Olfactory and gustatory dysfunction were observed early in the course of infection, before day 6 of illness. The average length of hospital stay was 20.36 days; those with olfactory dysfunction stayed for 17.53 days, dysgeusia for 19.92 days, and 21.09 days for those who noted neither. For those subsequently intubated, 0 had olfactory dysfunction, three reported dysgeusia, three had both and six had neither. Thirteen (13) patients in the study expired. Among them, none reported olfactory dysfunction and two had dysgeusia. Conclusions: Our results corroborate existing literature that olfactory and gustatory dysfunction as key indicators of COVID-19 with 42.5% of participants reporting these symptoms early, often before day 6 of illness. Ninety-two percent (92%) of those affected recovered and had shorter hospital stays, emphasizing the importance of recognizing these dysfunctions for improved disease detection and outcomes.

Summary: Introduction: Aging is related to decrease in taste perception. As appetite is considered crucial for maintenance of proper nutritional status of older adults, its decrease during aging raises questions about its relation to gustatory functions and further prevention possibilities. Aim of the study: The aim was to assess the characteristics and eating behaviors of the patients who reported a self-perceived reduction in taste perception in the context of appetite. Material and methods: This semi-qualitative study was conducted between November 2021 and March 2022 in the Department of Internal Medicine and Geriatrics of the University Hospital in Krakow. Patients were assessed using an original appetite assessment scale, which allowed for an in-depth interview on areas related to the decline in gustatory function. Additionally, nutritional assessment was performed using Mini Nutritional Assessment and Council on Nutrition Appetite Questionnaire (CNAQ) and anthropometric measurements. Results: The most common characteristics of patients with gustatory dysfunction were early satiety, decreased appetite in the three months prior to the study and polypharmacy. A significant difference was observed in the CNAQ scores between the group of patients with and without gustatory dysfunction. Conclusion: Careful identification of patients presenting with gustatory dysfunction can provide an important cue for an individualised approach aimed at preventing malnutrition. In our work, we suggest the areas that can be addressed during a nutritional interview to enable the selection of an optimal approach.

Abstract Background Olfactory and gustatory disorders are common problems encountered during the COVID-19 pandemic with a significant impact on the patient’s quality of life: The aim of this study was to assess the olfactory and gustatory functions in COVID-19 patients with correlation between them and clinical and laboratory markers. This was a cross-sectional study conducted on 63 subjects recruited from the COVID-19 clinics at Police Authority and Menoufia University hospitals. The patients were assessed using history taking, anterior rhinoscopy, endoscopic examination, computed tomography, and polymerase chain reaction (PCR) test. Olfactory functions were assessed using the alcohol threshold test. Gustatory functions were assessed using the three-drop method. The olfactory and gustatory functions were correlated with age, gender, and laboratory parameters. Also, the recovery of smell and taste disorders was correlated with our assessed laboratory markers. Results The prevalence of olfactory dysfunction among study participants was 41 patients (65%) of the participants including 12 patients (19.1%) having mild hyposmia, 10 patients (15.8%) having moderate hyposmia, 9 patients (14.3%) having severe hyposmia, and 10 patients (15.8%) having complete anosmia. The prevalence of gustatory dysfunction among study participants was 24 patients (38.1%). Age, gender, and laboratory parameters did not show any statistically significant difference between those who experienced olfactory dysfunction or gustatory dysfunction and those who did not. However, there was a significant positive correlation between the total leucocytic count, serum level of CRP, and serum level of D-dimer and the degree of olfactory dysfunction (0.049, 0.03, and 0.02, respectively). There was a nonsignificant correlation between recovery of olfactory and gustatory dysfunction and laboratory markers. Conclusion Olfactory and gustatory dysfunction are established clinical presentations among COVID-19-positive patients. The laboratory markers had no correlation with the incidence of these dysfunctions or their recovery. However, TLC, serum CRP, and serum D-dimer had a significant positive correlation with the severity of olfactory dysfunction.

Background: Olfactory and gustatory disorders are common problems encountered during the COVID-19 pandemic with a significant impact on the patient's quality of life: The aim of this study was to assess the olfactory and gustatory functions in COVID-19 patients with correlation between them and clinical and laboratory markers. This was a cross-sectional study conducted on 63 subjects recruited from the COVID-19 clinics at Police Authority and Menoufia University hospitals. The patients were assessed using history taking, anterior rhinoscopy, endoscopic examination, computed tomography, and polymerase chain reaction (PCR) test. Olfactory functions were assessed using the alcohol threshold test. Gustatory functions were assessed using the three-drop method. The olfactory and gustatory functions were correlated with age, gender, and laboratory parameters. Also, the recovery of smell and taste disorders was correlated with our assessed laboratory markers. Results: The prevalence of olfactory dysfunction among study participants was 41 patients (65%) of the participants including 12 patients (19.1%) having mild hyposmia, 10 patients (15.8%) having moderate hyposmia, 9 patients (14.3%) having severe hyposmia, and 10 patients (15.8%) having complete anosmia. The prevalence of gustatory dysfunction among study participants was 24 patients (38.1%). Age, gender, and laboratory parameters did not show any statistically significant difference between those who experienced olfactory dysfunction or gustatory dysfunction and those who did not. However, there was a significant positive correlation between the total leucocytic count, serum level of CRP, and serum level of D-dimer and the degree of olfactory dysfunction (0.049, 0.03, and 0.02, respectively). There was a nonsignificant correlation between recovery of olfactory and gustatory dysfunction and laboratory markers. Conclusion: Olfactory and gustatory dysfunction are established clinical presentations among COVID-19-positive patients. The laboratory markers had no correlation with the incidence of these dysfunctions or their recovery. However, TLC, serum CRP, and serum D-dimer had a significant positive correlation with the severity of olfactory dysfunction. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical characteristics associated with measured gustatory dysfunction in patients with chemosensory (smell and taste) discomfort. Study design: Retrospective study. Design: Hospital‐based cohort. Setting: The clinical characteristics associated with the measured diagnosis of gustatory dysfunction were statistically analysed. Participants: Patients who underwent all the psychophysical olfactory and chemical gustatory function tests (YSK olfactory function test and chemical gustometry exam) and the subjective questionnaires between October 2021 and February 2023. Main outcome measures: YSK olfactory function test and chemical gustometry results, subjective questionnaire score about chemosensory (smell and taste) functions. The Medical records of patients who visited the smell and taste centre in a tertiary. Results: A total of 219 patients were enrolled; 180 were diagnosed as having normal gustatory function, and 39 were diagnosed as having gustatory dysfunction. Subjective recognition of gustatory function was not associated with the measured gustatory function. Age, sex, measured olfactory function and the threshold and discrimination scores for the olfactory function test were significant factors in the multivariate analysis. When the patients were further divided according to age, the threshold test scores rather than other subsets in the olfactory function test were significantly associated with measured gustatory dysfunction in patients 60 and older. Conclusion: In older adult male patients with olfactory dysfunction, gustatory function should be considered regardless of subjective gustatory dysfunction. [ABSTRACT FROM AUTHOR]

Simple Summary: This study analyzed the associations of taste dysfunctions as measured by validated taste strips with demographics and co-morbidities. The study demonstrated that taste dysfunction was associated with older age, male sex, and co-morbidities such a previous major trauma, being under chemotherapy, zinc deficiency, burning mouth syndrome, and exposure to toxins. The study highlights the importance of assessment of taste disorders with a validated objective tool of taste strips and of comprehensive assessment of co-morbidities as part of the diagnostic process of patients with subjective complaints of taste disorders. This study aimed to analyze the associations of gustatory dysfunction as measured by validated taste strips with demographics and co-morbidities. This cross-sectional study retrospectively analyzed records of patients who attended the Orofacial Chemosensory Center of Hadassah Medical Center between 2017 and 2020. Taste strips were used as a validated method to determine taste dysfunction. A total of 272 subjects were included, 137 (50.4%) women and 135 (49.6%) men, with a mean age of 53.5 ± 19.3 years and age range of 18–98 years. The total taste score among the study population was 8.53 ± 4.03 (scale range 0–16). Age had a significant negative correlation with the total taste score (p = 0.001), and men exhibited worse total (p < 0.001), salty (p = 0.003), and bitter (p < 0.001) scores. Major trauma was associated with worse total (p < 0.001) and specialized taste assessments (sweet (p = 0.001), sour (p = 0.002), salty (p = 0.016), and bitter (p < 0.001)). Chemotherapy was associated with reduced total (p < 0.001), salty (p = 0.003), and bitter (p = 0.001) taste scores. Zinc deficiency exhibited worse salty (p = 0.027) and total (p = 0.038) taste scores. Patients with burning mouth syndrome (BMS) showed higher salty scores (p = 0.017). Patients who experienced exposure to toxic chemicals exhibited worse salty scores (p = 0.024). We conclude that gustatory dysfunction is associated with older age, male sex, and co-morbidities of major trauma, current chemotherapy, zinc deficiency, BMS, and exposure to toxins. The study highlights the importance of systemic evaluation and quantitive gustatory dysfunction assessment as part of the diagnostic process of patients with subjective complaints of taste disorders. [ABSTRACT FROM AUTHOR]

Background: Olfactory dysfunction has been reported to be involved in Parkinson's disease (PD) pathogenesis. However, gustatory dysfunction in PD has not been evaluated as in‐depth as olfactory dysfunction. We reviewed the previously published studies regarding gustatory function in PD patients and suggested the possibility that gustatory dysfunction may also be associated with PD. Methods: MEDLINE, Cochrane Library, Embase, and PubMed databases were searched for studies evaluating gustatory function in PD patients. We used the standardized mean difference and a 95% confidence interval (CI) as the effect analysis index regarding the taste strip test. The relative risk and 95% CI were used as the effect analysis index for the questionnaires and propylthiouracil (PTU)/phenylthiocarbamide (PTC) perception test. Statistical heterogeneity was assessed using forest plots, Cochran's Q, and the I2 statistic; heterogeneity was considered high when I2 was over 75%. Publication bias was assessed by funnel plots and the Egger bias test. Results: We identified 19 articles that reported the results of gustatory function tests in PD patients and healthy controls. Most of these studies used various gustatory tests, including taste strips, questionnaires, taste solutions, PTU/PTC perception tests, and electrogustometry, and reported significantly lower gustatory function in PD patients than in the controls. However, several articles reported contradictory results. Conclusions: Based on these studies, gustatory dysfunction is closely related to PD. However, the number of studies and enrolled subjects was small, and a unified gustatory function test was lacking. Therefore, further studies with larger populations and normalized gustatory function tests are needed. [ABSTRACT FROM AUTHOR]

COVID-19, mainly manifested as acute respiratory distress syndrome, has afflicted millions of people worldwide since 2019. Taste dysfunction is a common early-stage symptom of COVID-19 infection that burdens patients for weeks or even permanently in some cases. Owing to its subjectivity and complexity, the mechanism of taste disorder is poorly studied. Previous studies have reported that the COVID-19 entry receptors are highly expressed in taste buds, thereby intensifying the cytocidal effect. Taste receptor cells are vulnerable to inflammation, and the COVID-19–induced cytokine storm causes secondary damage to taste function. Interferon and various proinflammatory cytokines can trigger cell apoptosis and disrupt the renewal of taste bud stem cells. This immune response can be further enhanced by the accumulation of Angiotensin II (Ang II) caused by an unbalanced local renin-angiotensin system (RAS) system. In addition, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is neurotropic and can invade the brain through the olfactory bulb, affecting the nervous system. Other factors, such as host zinc deficiency, genetic susceptibility, sialic acid, and some neurotransmitters, also contribute to the pathogenesis process. Although several medical interventions have displayed effectiveness, only a few strategies exist for the treatment of postinfectious dysgeusia. Stem cell–based taste regeneration offers promise for long-term taste disorders. Clinical studies have demonstrated that stem cells can treat long COVID-19 through immune regulation. In dysgeusia, the differentiation of taste bud stem cells can be stimulated through exogenous epithelial-derived and neural-derived factors to regenerate taste buds. Tongue organoids are also emerging as functional taste buds, offering new insights into the study of taste regeneration. This review presents the current evidence of the pathogenesis of COVID-19–related dysgeusia, summarizes currently available treatments, and suggests future directions of taste regeneration therapy. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to quantify the impact of COVID‐19 on olfactory and gustatory function in US adults. Methods: From the 2021 Adult National Health Interview Survey, demographic and survey‐specific module data concerning COVID‐19 diagnoses, testing and disease severity, and data quantifying disturbances and eventual recovery of smell and taste were extracted. Sample weights were applied to obtain nationally representative statistics. The overall rate of COVID‐19 infection was determined, and those diagnosed with COVID‐19 were analyzed with respect to disease severity, smell and taste disturbance, and respective recoveries. Results: In 2021, 35.8 million or 14% of the adult population (95% CI 13.5–14.7%; mean age, 43.9 years; 53.8% female) had been diagnosed with COVID‐19. Among those, 60.5% (58.6–62.5%) and 58.2% (56.2–60.1%) reported accompanying losses in smell or taste, respectively; there was a significant association between overall COVID‐19 symptom severity and smell (p < 0.001) and taste disturbance (p < 0.001). Following infection, 72.2% (69.9–74.3%), 24.1% (22.2–26.2%), and 3.7% (3.0–4.6%) of the patients experienced complete, partial, and no smell recovery, respectively. Recovery rates for gustatory function paralleled olfaction, with 76.8% (74.6–78.9%), 20.6% (18.7–22.7%), and 2.6 (1.9–3.4%) reporting complete, partial, and no recovery of taste, respectively. When sensory disturbance was present, severity of overall symptomatology was negatively associated with smell and taste recovery (p < 0.001 for each). Conclusion: The majority of adults infected with COVID‐19 in 2021 experienced olfactory or gustatory dysfunction with a non‐negligible population reporting incomplete or no near‐term sensory recovery. Our results are useful for providers counseling patients and suggest that interventions lessening overall COVID‐19 symptom burden may prevent prolonged sensory dysfunction. Level of Evidence: 4 Laryngoscope, 133:2357–2361, 2023 [ABSTRACT FROM AUTHOR]

Diverse manifestations have been recognized to last for a long time in patients infected with SARS-CoV-2. However, understanding of oral sequelae after recovery from COVID-19 is relatively poor compared to that of oral symptoms in the acute phase of COVID-19 and other COVID-19 sequelae. The aim of the present study was to characterize persistent gustatory and saliva secretory dysfunctions and to speculate on their pathogenic mechanisms. Articles were retrieved by searching scientific databases with a cutoff date of September 30, 2022. The literature search indicated that ageusia/dysgeusia and xerostomia/dry mouth are reported by 1–45% of COVID-19 survivors at follow-ups of 21–365 days and by 2–40% of COVID-19 survivors at follow-ups of 28–230 days, respectively. The prevalence of gustatory sequelae partly depends on difference in ethnicity, gender, age, and disease severity of subjects. Co-occurring gustatory and saliva secretory sequelae are pathogenically related to either or both of the following: expression of SARS-CoV-2 cellular entry-relevant receptors in taste buds and salivary glands, and SARS-CoV-2 infection-induced deficiency in zinc that is essential for normality of taste perception and saliva secretion. Given the long-term oral sequelae, hospital discharge is not the end of the disease; therefore, careful attention should be continuously paid to oral conditions of post-COVID-19 patients. [ABSTRACT FROM AUTHOR]

Introduction: No studies have reported data on 2-year prevalence and recovery rates of self-reported COVID-19-related quantitative and qualitative olfactory and gustatory dysfunction. The aim of the present study was to estimate the 2-year prevalence and recovery rate of self-reported COVID-19-related olfactory and gustatory dysfunction in a cohort of patients with antecedent mild-to-moderate disease. Methods: This is a prospective observational study, measuring the prevalence of altered sense of smell or taste at follow-up and their variation from baseline, on adult patients consecutively assessed at Trieste University Hospital, who tested positive for SARS-CoV-2 RNA by polymerase chain reaction during March 2020. Results: Overall, 174 (68.8%), 53 (20.9%), and 36 (14.2%) of 253 responders reported an altered sense of smell or taste (SNOT-22 >0) at baseline, 12 months, and 24 months, respectively. Among the 174 patients who have complained a COVID-19-associated olfactory or gustatory dysfunction at baseline, 138 (79.3%) reported complete resolution of smell or taste impairment with 17 subjects (9.8%) recovering after more than 1 year after the initial infection, 33 (19.0%) reported a decrease in the severity, and only 3 (1.7%) reported that the symptom was unchanged at the 24-month interview. Twenty subjects (7.9%) complained of at least one qualitative long-term symptom. Conclusion: Two years after the infection, most patients experience a favourable evolution of COVID-19-related olfactory or gustatory dysfunction. A late recovery was observed in 10% of subjects. [ABSTRACT FROM AUTHOR]

Background: Chemosensory disorders associated with COVID-19 have been widely discussed during the pandemic. We performed a meta-analysis to assess the risk factors for olfactory and gustatory dysfunction in patients with COVID-19. Methods: Three databases (PubMed, Embase, and Cochrane Library) were searched for studies published between December 1, 2019, and August 31, 2021. We selected random-effects model or fixed-effects model to pool data based on heterogeneity. The results were reported as odds ratios (ORs) or standardized mean differences (SMDs) and the corresponding 95% confidence intervals (CIs). Heterogeneity was reported as I2. Results: Twenty-six studies with a total of 13,813 patients were included. The pooled data indicated that sex (OR 1.47; 95% CI 0.93–2.31), age (SMD −5.80; 95% CI −13.35 to 1.75), smoking (OR 2.04; 95% CI 0.72–5.79), and comorbidity (OR 1.21; 95% CI 0.58–2.53) of patients with COVID-19 had no effect on gustatory dysfunction. Olfactory dysfunction was more likely to occur in older patients with COVID-19 (SMD, −5.22; 95% CI, −8.28 to −2.16). Patients with COVID-19 with nasal congestion (OR 3.41; 95% CI 2.30–5.06) and rhinorrhea (OR 2.35; 95% CI 1.60–3.45) were more prone to olfactory dysfunction. Conclusion: These findings emphasize that older patients with COVID-19 are more likely to experience olfactory dysfunction. Symptoms of nasal congestion and rhinorrhea may affect the recognition of olfactory dysfunction.

الملخص: أهداف البحث: يعد خلل الشم والذوق من الأعراض السريرية المبكرة الهامة لمرض كوفيد-19. تهدف الدراسة إلى حساب الانتشار التجميعي لهذه الأعراض؛ ثم مناقشة الآثار المحتملة على الممارسة السريرية مثل استخدامها كأدوات فحص ومؤشرات تشخيص محتملة. طرق البحث: باستخدام مجموعة من الكلمات المفتاحية ومصطلحات الميدلاين المعيارية، بحثنا عن الدراسات بالملاحظة في قواعد البيانات الخمس التالية: ''ميدلاين'' و ''سكوبس'' و''مكتبة كوكرين'' و ''شبكة العلوم'' و '' قوقل العلمي''. قام اثنان من الباحثين بفحص واختيار الدراسات، كما تم تقييم احتمالات التحيز في الدراسات المضمنة باستخدام مقياس نيوكاسل-أوتاوا. تم اتباع إرشادات ''بريزما'' لفحص المقالات النهائية وتحديدها وفقا لمعايير التضمين. كانت النتيجة المبلغ عنها للتحليل التجميعي هي معدل انتشار ضعف الشم والذوق المحسوب باستخدام نموذج التأثير العشوائي. النتائج: تم تضمين 17 دراسة مع حجم عينة إجمالي 4149 في هذا التحليل التلوي. من بين هؤلاء، أبلغ 2106 و 2676 مريضا عن درجة من الخلل الوظيفي الشمي و/أو الذوقي مع كوفيد-19؛ على التوالي. كانت النتائج المبلغ عنها من حيث الانتشار التجميعي، مع ضعف الذوق 57.33٪ والخلل الشمي 59.69٪، والذي يعتبر انتشارا كبيرا. الاستنتاجات: هناك معدل مرتفع لحدوث ضعف في حاسة الشم والذوق في مرض كوفيد-19. نظرًا لعدم وجود اختبار موضوعي للكشف عن ضعف الشم والذوق في معظم الدراسات، فمن المرجح أن يكون معدل الانتشار المرتفع الذي اكتشفناه أقل من الانتشار الحقيقي. هذا يعني أنه يجب على الأطباء استخدامها كمؤشرات مبكرة موثوقة لمرض كوفيد-19 وتوظيفها قبل فحص المرضى باختبارات باهظة الثمن. Abstract: Objective: Olfactory and gustatory dysfunction (OGD) are important early clinical symptoms of COVID-19. We aim to calculate the pooled prevalence of these symptoms and discuss the likely implications on clinical practice such as their use as screening tools and potential prognosis indicators. Methods: Using a combination of keywords and medical subject headings, we searched for observational studies in the following five databases: Medline/PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar. Two authors independently screened and selected the final articles according to the inclusion criteria. Two investigators independently assessed the risk of bias in individual studies using the Newcastle–Ottawa Scale. Heterogeneity and publication bias were also assessed. The reported outcome of the pooled analysis was the prevalence of OGD calculated using a random-effect model. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to report results. Results: Seventeen studies with a total sample size of 4149 were included in this meta-analysis. Out of these, 2106 and 2676 patients reported some degree of olfactory and/or gustatory dysfunction with COVID-19, respectively. The reported outcomes were in terms of pooled prevalence, with gustatory dysfunction being 57.33% and olfactory dysfunction being 59.69%, a significantly high occurrence. Conclusion: There is a high occurrence of smell and taste impairment in COVID-19. Given the lack of objective testing for detecting OGD in most studies, the high prevalence found is likely to be an underestimation of the true prevalence. This implies that physicians must use them as reliable early indicators of COVID-19 and employ them before using expensive tests.

Purpose of Review: A number of sequelae after acute coronavirus disease 2019 (COVID-19) significantly affect the quality of life of patients. The chemosensory disorders including olfactory dysfunction (OD) and gustatory dysfunction (GD) are two of the commonest symptoms complained by patients with COVID-19. Although chemosensory function has been reported improved in over 60% of COVID-19 patients in a short time after acute infection, it may last as a major symptom for patients with long COVID-19. This narrative review discussed current literatures on OD and GD in long COVID-19 including the prevalence, risk factors, possible mechanisms, and potential therapies. Recent Findings: Although the prevalence of OD and GD has declined continuously after acute COVID-19, a considerable number of patients had persistent chemosensory disorders 3 months to 2 years after symptom onset. Female gender, initial severity of dysfunction, nasal congestion, emotional distress and depression, and SARS-CoV-2 variants have been identified as risk factors for persistent OD and GD in long COVID-19. The pathogenesis of OD and GD in long COVID-19 remains unknown, but may be analogous to the persistent OD and GD post common respiratory viral infection. Corticosteroids and olfactory training might be a potential choice regarding the treatment of lasting OD and GD after SARS-CoV-2 infection; however, more studies are needed to prove it. Summary: OD and GD are common long-term consequences of COVID-19 and influenced by gender, initial severity of dysfunction, emotional distress and depression, and SARS-CoV-2 variants. More studies are needed to illustrate their pathogenesis and to establish therapeutic strategies. [ABSTRACT FROM AUTHOR]

Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020–2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%–40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: It is reported that coronavirus disease (Covid-19) can affect the sense of smell and taste of infected people. It is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions in patients with comorbidities in Northwestern Greece. Material and Methods: We used a questionnaire to collect information about patients' demographics, medical history and symptoms during infection. The total sample consists of three hundred patients. 150 of them recovered at home while the other half were hospitalized. A subgroup of 53 patients with comorbidities, such as hypertension, diabetes mellitus (type I & II) and cardiovascular diseases (CVD) were examined separately. Results: Analysis of reported symptoms showed that 57% of patients appeared loss of smell during infection, in the total sample. In the subgroup of hospitalized patients this rate was 46,67%, while in self-quarantined patients this rate was 67,33%. A statistically significant difference (p=0.000) was found regarding the loss of smell in home-quarantine patients compared to those who were hospitalized. Moreover, a statistically significant difference (p=0,008) was shown between the subgroup of patients with comorbidities and without olfactory loss. Conclusion: Our data, confirm the commonality of chemosensory dysfunction in Covid-19 infection and the significantly less pronounced combined symptoms of anosmia and dysgeusia in patients with co-morbidities. Although there are insufficient data on the clinical course of covid-19 disease, our study shows that olfactory dysfunction in patients with covid-19 is statistically significantly related to the patient's recovery at home, in Epirus, Greece. [ABSTRACT FROM AUTHOR]

Gustatory dysfunction is an often overlooked symptom in people with multiple sclerosis (PwMS), potentially leading to poor appetite, malnutrition, weight loss, and decreased quality of life. This systematic review and meta-analysis aimed to assess the pooled prevalence of gustatory dysfunction in PwMS and compare their gustatory test scores with healthy controls. An online database search of PubMed, Embase, Scopus, and Web of Science was conducted on 2024 June 29. Observational studies reporting gustatory dysfunction or gustatory test scores in PwMS were included. Pooled prevalence rates were calculated using a random-effects model, with subgroup analyses based on the type of gustatory test used. Standardized mean differences (SMD) were calculated for comparisons between PwMS and healthy controls. A total of 9 studies encompassing 1385 PwMS were included. The pooled prevalence of gustatory dysfunction among PwMS was 16.4% (95% confidence intervals [95% CI]: 8.7% to 24.1%, I² = 90%, P < 0.01). Subgroup analysis showed a prevalence of 18.8% (95% CI: 10.5% to 27.2%, I² = 0%) in 4 studies using the Taste Strip Test (TST), while 3 non-TST studies using liquid tastants or self-reports reported a prevalence of 20.2% (95% CI: 7.2% to 33.3%, I² = 86%). PwMS had significantly lower gustatory test scores compared to healthy controls (SMD: -0.93, 95% CI: -1.20 to -0.65, I² = 0%, P = 0.48). Gustatory dysfunction affects a notable proportion of PwMS, with prevalence rates varying by assessment method. Future studies should assess the possible causes of gustatory dysfunction in PwMS using validated gustatory assessment scales., (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Olfactory and/or taste dysfunction are potential neurological manifestations of coronavirus disease -2019 (COVID-19). The aim of the study was to document the prevalence of anosmia in COVID-19 positive patients and analyze the effect of various factors on the occurrence of these chemosensory dysfunction in the local population. Tertiary referral center. Prospective Study. 250 subjects who tested positive for SARS-CoV-2, by real-time polymerase chain reaction (RT-PCR) and admitted in Isolation ward were enrolled for the study. Data was collected from the subjects via oral questionnaire method, based on the AAO-HNS Anosmia Reporting Tool. Data was collected regarding the age, gender, olfactory or gustatory disturbances, history of recent travel or contact with a positive case, smoking, any associated symptoms, any co-morbid conditions and recovery time of sense of olfaction. Out of 250, 179 (71.6%) subjects were diagnosed with Olfactory dysfunction out of which majority were males, 105 (58.6%). Most of the patients were above 40 years of age (n = 184, 73.6%). Majority of the individuals (88 patients) had close contact with a positive case in recent past, followed by 67 patients who were health care workers, hence proving that risk of infection increases with exposure. Anosmia was present in 68.5% of all the 127 non-smokers. 66.4% had both olfactory as well as gustatory dysfunction whereas 18 patients (7.2%) were found to be totally asymptomatic. Mostly patients recovered their sense of smell within 1–2 weeks from the day of onset of anosmia. Presence of olfactory dysfunction of any degree with or without alteration in taste sensation should raise a suspicion of COVID-19 infection, especially when other classical signs are not present. In such conditions, swabs should be sent for confirmation by RT-PCR testing and till results are awaited, the individual should be shifted to quarantine facilities or advised strict self-isolation. [ABSTRACT FROM AUTHOR]

Abstract Background It could be of great benefit to determine smell and taste dysfunction in COVID-19 patients and to investigate the relationship between these symptoms and clinical characteristics as the determination of points requiring attention during the clinical course of the disease. Method Evaluations of patients diagnosed with COVID-19 were made using a questionnaire method. Those with smell and taste dysfunction completed a visual analog scale (VAS) to determine severity. The patients were evaluated at the end of 1 and 2 months. Results Evaluation was made of a total of 105 patients with a mean age of 55.9±17.6 years. Smell and taste dysfunction was present in 56 (53.3%) patients with a mean age of 48.7±17.6 years and the 49 (46.7%) patients with no smell and taste dysfunction had a mean age of 64±13.6 years. It was determined that as age increased, the complaints of smell and taste dysfunction decreased. Full recovery was determined in 31 (55%) patients after 1 month, and in 16 (28%) patients, smell and taste dysfunction continued at the end of the second month. The symptoms of smell and taste dysfunction were determined to last longer in patients with no comorbidities, no symptoms of fever or shortness of breath, and those treated as outpatients (p=0.043, p=0.031, p=0.034, p=0.028, respectively). In the older age patient group, the VAS scores were observed to be higher and the time to recovery was shorter (p=0.007, p=0.018, respectively). Conclusion Smell and taste dysfunction in COVID-19 patients is seen more as age decreases and recovery takes longer. Smell and taste dysfunction is seen more in patients with symptoms of cough, nasal obstruction, and headache and lasts longer in patients without symptoms of fever and shortness of breath, with no comorbidities and in those treated as outpatients.

Background: Establishing a relationship between COVID-19 severity and olfactory dysfunction may be beneficial in patient follow-up. Thus, in this study, we aimed to evaluate the association between self-reported olfactory dysfunction and the clinical stages of COVID-19. Methods: The patients included in this study were divided into three groups according to the severity of the novel coronavirus disease as mild, severe, and critical (life-threatening) patients. Patients were then contacted by phone and asked questions with the help of structured questionnaires that evaluated their general status, sense of smell, taste and compared the data within the three groups. Results: Among the 144 subjects evaluated in the present study (mild, n = 60; moderate, n = 61, severe, n = 23), 70 of the participants were males, and 74 were females. The findings showed that olfactory loss was the most prominent feature of the COVID-19's mild clinical course and the majority of the patients with loss of smell were female and young patients. Conclusion: The findings obtained from clinically mild cases suggest that more olfactory dysfunction, indicating that the effects of viral load alone, is not decisive for olfactory dysfunction.

Background/Purpose: To investigate the characteristics of dysosmia and dysgeusia among patients diagnosed with coronavirus disease 2019 (COVID-19) in Taiwan. Methods: Prospective data collection between January 22, 2020 to May 7, 2020 of nucleic acid confirmed COVID-19 hospitalized patients in northern Taiwan by the Taiwan Centers for Disease Control were analyzed. Results: Of 217 patients enrolled, 78 (35.9%) reported dysosmia (n = 73, 33.6%) and/or dysgeusia (n = 62, 28.6%). The median duration of COVID-19 associated symptom-onset to development of dysosmia and/or dysgeusia was

Coronavirus disease-19 (COVID-19) is a new pandemic caused by severe acute respiratory syndrome coronavirus 2. The prevalent symptoms in COVID-19 include fever, cough, sore throat, rhinorrhea, myalgia, headache, dyspnea, and diarrhea. At the initial period of the COVID-19 pandemic, the clinical presentations such as olfactory and gustatory dysfunctions were considered as atypical. At present, olfactory and gustatory dysfunctions are not uncommon symptoms among COVID-19 infections in the COVID-19 pandemic. Initially, these two symptoms were underestimated and not recognized among scientific community. At present, many otolaryngologists over the world documented that COVID-19 patients presented with olfactory and gustatory dysfunctions even without the presence of nasal obstruction or rhinorrhea. The exact etiopathology for olfactory and gustatory dysfunctions is still not known. Future clinical and basic science studies may help to understand the mechanism for olfactory and gustatory dysfunctions in this pandemic. The objective of this review article is to discuss details of the olfactory and gustatory dysfunctions in COVID-19 patients. This article will surely increase awareness among the clinicians and people who are dealing with COVID-19 patients and their early diagnosis.

Since the worldwide spread of SARS-CoV-2 infection, the management of COVID-19 has been a challenge for healthcare professionals. Although the respiratory system has primarily been affected with symptoms ranging from mild pneumonia to acute respiratory distress syndrome, other organs or systems have also been targets of the virus. The mouth represents an important route of entry for SARS-CoV-2. Cells in the oral epithelium, taste buds, and minor and major salivary glands express cellular entry factors for the virus, such as ACE2, TMPRSS2 and Furin. This leads to symptoms such as deterioration of taste, salivary dysfunction, mucosal ulcers, before systemic manifestation of the disease. In this review we report and discuss the prevalence and socio-demographics of taste disturbances in COVID-19 patients, analysing the current international data. Importantly, we also take stock of the various hypothesized pathogenetic mechanisms and their impact on the reported symptoms. The literature indicated that COVID-19 patients frequently present with gustatory dysfunction, whose prevalence varies by country, age and sex. Furthermore, this dysfunction also has a variable duration in relation to the severity of the disease. The pathogenetic action is intricately linked to viral action which can be expressed in several ways. However, in many cases these are only hypotheses that need further confirmation. [ABSTRACT FROM AUTHOR]

Backround: We aimed to assess the relation of chemosensory dysfunction with the reported symptoms in two subgroups of patients in Northwestern Greece: the first one included patients with moderate to severe symptomatology who needed hospitalization and the second one, patients with mild symptoms who recovered at home. Methods: We used a questionnaire to select information about patient demographics, medical history and reported symptoms during infection. Three hundred COVID-19 positive patients who were identified via RT-PCR test in the University Hospital of Ioannina, Greece, were included in the present study, of which 150 recovered at home and the remaining 150 needed hospitalization. Statistical analysis was based on IBM-SPSS Statistics 26.0. Results: The majority of patients had fever during infection, while o minor percentage of those who needed hospitalization (12.67%) suffered from sore throat. There was a statistically significant difference between the loss of smell and clinical symptoms including fatigue, nose congestion, body aches and headache, and loss of taste and reported symptoms including fatigue, body aches, runny nose, headache and sore throat. Conclusion: Fever was the symptom with the highest percentage rate, while sore throat was the symptom with the lowest percentage rate. There are reported clinical symptoms related with olfactory and gustatory dysfunction during COVID-19 infection. [ABSTRACT FROM AUTHOR]

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Abstract Although most COVID‐19 patients feel their olfactory function returns to normal, the smell test demonstrates that a mild impairment of the olfactory function may have remained. Therefore, their olfactory function should be evaluated by a smell test.

Objective: We studied the prognosis of olfactory and gustatory dysfunctions in patients with long COVID (Coronavirus Disease 2019) after treatment with oral zinc and steroids., Methods: We measured olfactory and gustatory functions of long COVID patients at their first visits, and after 2-4 months of treatment with oral zinc and steroids using the traditional Chinese version of the University of Pennsylvania Smell Identification Test and the Waterless Empirical Taste Test. We also assessed by phone the recovery of olfactory and gustatory functions at a mean of about 10 months of follow-up., Results: Among our 71 long COVID patients, 34 complained of loss of smell and taste. Their objective test results showed 88.2% hyposmic, 23.5% hypogeusic at the first visit. After treatment, 77.8% of the patients were hyposmic, and 16.7% were hypogeusic. After a mean follow-up of 10.35 months, 91.2% of the patients reported improvement in their olfactory function. Among the 36 patients who had complained only of smell loss, the objective test results showed 75% hyposmic at their first visit. After treatment, 71.4% of the patients were hyposmic. After a mean of 10.42 months of follow-up, 77.8% of the patients reported improvement in their olfactory function. Only one patient complained of taste loss., Conclusions: We found that olfactory dysfunction in most long COVID patients persisted for more than 10 months., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Given the ever-progressing studies on coronavirus disease 2019 (COVID-19), it is critical to update our knowledge about COVID-19 symptomatology and pathophysiology. In the present narrative review, oral symptoms were overviewed using the latest data and their pathogenesis was hypothetically speculated. PubMed, LitCovid, ProQuest, and Google Scholar were searched for relevant studies from 1 April 2021 with a cutoff date of 31 January 2022. The literature search indicated that gustatory dysfunction and saliva secretory dysfunction are prevalent in COVID-19 patients and both dysfunctions persist after recovery from the disease, suggesting the pathogenic mechanism common to these cooccurring symptoms. COVID-19 patients are characterized by hypozincemia, in which zinc is possibly redistributed from blood to the liver at the expense of zinc in other tissues. If COVID-19 induces intracellular zinc deficiency, the activity of zinc-metalloenzyme carbonic anhydrase localized in taste buds and salivary glands may be influenced to adversely affect gustatory and saliva secretory functions. Zinc-binding metallothioneins and zinc transporters, which cooperatively control cellular zinc homeostasis, are expressed in oral tissues participating in taste and saliva secretion. Their expression dysregulation associated with COVID-19-induced zinc deficiency may have some effect on oral functions. Zinc supplementation is expected to improve oral symptoms in COVID-19 patients. [ABSTRACT FROM AUTHOR]

The optimal indication for the nucleic acid amplification test (NAAT) in areas with low endemicity for coronavirus disease 2019 (COVID-19) is unclear. This study aimed to identify patients who should undergo the NAAT for COVID-19 diagnosis. We retrospectively analyzed the clinical data of patients with suspected COVID-19 who underwent NAAT between October 5, 2020, and May 31, 2021 in our institution. A total of 1238 patients were enrolled and NAAT positive results were observed in 40 patients (3.2%). The NAAT positivity rate was 34.3% (23/67) in patients with a history of close contact and 1.5% (17/1171) in patients without a history of close contact. Olfactory/gustatory dysfunction and a history of stay in other prefectures were independent risk factors of COVID-19 in patients without a history of close contact. On the other hand, the NAAT positivity rate was only 0.7% (8/1073) in patients without olfactory/gustatory dysfunction and a history of stay in other prefectures. Among them, the group without respiratory symptoms/sign had only one NAAT-positive case (0.1%: 1/1073). This study revealed that a history of close contact, olfactory/gustatory dysfunction, and a history of stay in other prefectures are key eligibility criteria for NAAT in areas with relatively few patients with COVID-19. On the other hand, NAAT may not be necessary in cases without all of these factors and respiratory symptoms/sign. [ABSTRACT FROM AUTHOR]

Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020–2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%–43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms. [ABSTRACT FROM AUTHOR]

This is the first update of the previously published living systematic review that summarized evidence on the prevalence of oral signs and symptoms in patients with COVID-19. Hitherto, 183 studies were included, reporting data from 64,876 patients with COVID-19 worldwide. The overall prevalence of taste disorders was 38% (95% CI = 22% to 56%, I2 = 98%). Hypogeusia, dysgeusia, and ageusia were also evaluated by a meta-analysis, and the pooled prevalence was 34% for hypogeusia, 33% for dysgeusia, and 26% for ageusia. Taste disorders were associated with a positive COVID-19 test (odds ratio [OR] = 7.54, 95% CI = 5.24 to 10.86, I2 = 93%, P < 0.00001), showing high certainty of evidence. However, the association between taste disorders and mild/moderate severity of COVID-19 (OR = 1.63, 95% CI = 1.33 to 1.99, I2 = 69%, P < 0.0001) and female patients with COVID-19 (OR = 1.77, 95% CI = 1.26 to 2.48, I2 = 79%, P = 0.001) presented low certainty of evidence. Xerostomia was a new feature of this update, and the pooled data demonstrated a prevalence of 43% (95% CI = 36% to 50%, I2 = 71%) in patients with COVID-19. Regarding oral mucosal lesions, the most common clinical pattern was aphthous like, followed by herpes-like lesions, candidiasis, glossitis/depapillation/geographic tongue, parotitis, and angular cheilitis. Oral lesions were more frequent in the tongue, lips, and palate, presenting miscellaneous clinical aspects that are more likely to represent coinfections. Therefore, the reanalysis of current evidence suggests the triad xerostomia, taste dysfunction, and oral mucosal lesions as common manifestations in patients with COVID-19. However, these outcomes are under discussion, and more studies will be necessary to confirm their association with direct SARS-CoV-2 infection in the oral cavity. [ABSTRACT FROM AUTHOR]

Chemosensitive dysfunctions are now considered as frequent and early symptoms of coronavirus disease 2019 (COVID-19). In the last few weeks, researchers' greatest efforts have been focusing mainly on the analysis of olfactory disorders, neglecting taste dysfunctions. According to our psychophysical evaluations, it can be inferred that the pathogenesis of taste disorders in COVID-19 patients is largely smell-independent. Moreover, isolated gustatory disorders are highly specific of SARS-CoV-2 infection. For these reasons, it is essential that gustatory dysfunctions, like olfactory disorders, are included in the COVID-19 guidelines. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of objective gustatory (GD) and olfactory (OD) dysfunction in COVID-19 patients. Methods: This is a prospective, cross-sectional study of 51 COVID-19 positive patients diagnosed using RT-PCR-based testing. Of these study participants, 41 reported having present GD and OD at the time of enrollment and ten patients were without symptomatic OD and GD. All participants were objectively tested for OD by Brief Smell Identification Test (BSIT) and for GD by Burghart taste strip test, which were mailed to the participants. The subjective presence and severity of COVID-19 symptoms of smell loss, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough and shortness of breath were also assessed. Results: Of the 41 patients with GD and OD, only 25.6% (10/39; p ≤ 0.0001) objectively presented GD and 39.1% (16/41; p ≤ 0.0001) OD at the time of their subjective dysfunction. Regarding GD, 23.1% (9/39) suffered from total hypogeusia, 2.6% (1/39) from ageusia. A significant loss of sour (33.3% (13/39)) and salty taste (17.9% (7/39)) could be recognized. Only 10.3% (4/39) showed a reduction in sweet and bitter taste. Concerning OD, 9.8% (4/41) showed a deficit relative to younger age in the BSIT and 29.3% (12/41) results abnormal relative to age. Conclusion: Subjective and objective findings in GD and OD differ significantly. Most patients suffering from objective dysgeusia present a deficit in sour and salty taste. Trial registration number: DRKS00021516; 22/04/2020. [ABSTRACT FROM AUTHOR]

Background: Recently, it has been shown that coronavirus disease 2019 (COVID-19), which has caused a pandemic since December 2019, can be accompanied by some neurological disorders. This study aimed to assess the prevalence of the most common neurological symptoms and comorbidities and systematically review the literature regarding the most prevalent neurological complications of COVID-19 infection. Methods: All relevant studies had been collected from PubMed, Scopus, Embase, and Web of Science databases. All extracted data were analyzed using Stata version 11.2. The I2 index was applied, and a random-effects model or a fixed-effects model was used for pooled estimation to assess the heterogeneity of studies. Furthermore, Egger and Beeg's tests were used to evaluate the publication bias. Results: Fifty-seven studies (26 observational and 31 case reports) were included (including 6,597 COVID-19 patients). The most prevalent general symptoms were fever, cough, and dyspnea with 84.6% (95% CI: 75.3–92.1; I2 = 98.7%), 61.3% (95% CI: 55.3–67.0; I2 = 94.6%), and 34.2% (95% CI: 25.6–43.4; I2 = 97.7%), respectively. Neurological symptoms observed among COVID-19 patients were fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness, and nausea with 42.9% (95% CI: 36.7–49.3; I2 = 92.8%), 35.4% (95% CI: 11.2–64.4; I2 = 99.2%), 28.9% (95% CI: 19.9–38.8; I2 = 96.3%), 25.3% (95% CI: 1.6–63.4; I2 = 99.6%), 10.1% (95% CI: 2.7–21.0; I2 = 99.1%), 6.7% (95% CI: 3.7–10.5; I2 = 87.5%), and 5.9% (95% CI: 3.1–9.5; I2 = 94.5%). The most prevalent neurological comorbidity in COVID-19 was cerebrovascular disease with 4.3% (95% CI: 2.7–6.3; I2 = 78.7%). Conclusion: The most prevalent neurological manifestations of COVID-19 include fatigue, gustatory dysfunction, anorexia, olfactory dysfunction, headache, dizziness, and nausea. Cerebrovascular disorders can either act as a risk factor for poorer prognosis in COVID-19 patients or occur as a critical complication in these patients. Guillain-Barre syndrome, encephalitis, and meningitis have also been reported as complications of COVID-19. [ABSTRACT FROM AUTHOR]

Olfactory dysfunction (OD) and gustatory dysfunction (GD) has been reported as one of the presenting symptoms amongst COVID-19 patients. However the literature available is disjunct on this aspect. This study is conducted to identify the prevalence of olfactory and/or gustatory dysfunction in patients with coronavirus disease in Northern part of India. It's a cross-sectional observation study, conducted over 387 COVID-19 positive patients, at ENT dept of tertiary care hospital. A retrospective survey was conducted using a pre designed questionnaire and details of Olfactory and Gustatory dysfunction was collected. The patient's demographic details, disease course and recovery time for olfactory (OD) and/or gustatory dysfunctions (GD) were collected. A total of 387 patients with COVID-19 completed the study. 228 (58.9%) patients suffered from influenza like illness (ILI) (fever, sore throat, dry cough, malaise, and myalgia). There was significant positive association seen between with ILI and OD and / or GD. 167/387 (43.15%) patients reported OD, and 153/387 (39.53%) reported GD. 43.71% and 50.3% patients had mild OD & GD respectively. Recovery rates for both OD and GD are high and almost similar, with 161 (96.4%) and 148 (96.73%) patients had complete recovery of smell and taste. Maximum recovery was noticed between 4 and 6 weeks. COVID-19 patients with habits have significantly high probability of developing OD &/or GD. There is a significant correlation between OD and GD and there is high probability that patients who reported to have OD will also have GD or vice versa. Prevalence of OD and GD in Indian population may not be as high as mentioned in western literature, however, both are frequent and early symptoms of COVID-19. Recent onset of these should be considered as red flag symptoms for COVID-19. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of olfactory and gustatory dysfunction among patients with COVID-19 infection and the recovery rate. Methods: Adult patients (≥18 years) tested positive for COVID-19 via reverse transcription-polymerase chain reaction (RT-PCR) and admitted in Hospital Tuanku Ja'afar Seremban, Malaysia, were recruited in this study. Patients completed a questionnaire via telephone interview comprising the following details: age, sex, ethnicity, comorbidities, general and otorhinolaryngological symptoms, onset and duration of olfactory and gustatory dysfunction. Patients with persistent olfactory and gustatory dysfunction at the time of the initial interview were followed-up every 3 to 5 days till resolution. Results: A total of 145 patients were included in our study. The mean age of patients was 43.0 ± 17.7 (range: 18-86). Fever (44.1%) and cough (39.3%) were the most prevalent general symptoms. Thirty-one patients (21.4%) reported olfactory dysfunction and 34 (23.4%) reported dysgeusia. There was a significant association between both olfactory and gustatory dysfunction (P <.001). Altered sense of smell or taste occurred before other symptoms in 7 (15.9%); concomitant in 16 (36.4%) and after in 15 (34.1%). Six patients (13.6%) reported isolated sudden-onset anosmia. The median duration of olfactory and gustatory dysfunctions was 7 days. Complete recovery was achieved for 70.5% of the patients within 7 days of symptom onset. Only 6 (19.4%) of the 31 patients with olfactory dysfunction experienced nasal obstruction or rhinorrhea. Olfactory dysfunction was not significantly associated with nasal obstruction or rhinorrhea. Olfactory dysfunction was significantly associated with younger age (P =.002), female (P =.011), and hyperlipidemia (P =.012). Gustatory dysfunction was significantly associated with fever (P =.019) and cough (P =.039). Conclusion: Olfactory and gustatory dysfunction is a pertinent manifestation of COVID-19. Most of the affected patients achieve rapid and complete recovery. Sudden onset of olfactory and gustatory dysfunction should be recognized as a major symptom of COVID-19 as we implore to contain this pandemic. [ABSTRACT FROM AUTHOR]

Coronavirus disease-19 (COVID-19) is a new pandemic caused by severe acute respiratory syndrome coronavirus 2. The prevalent symptoms in COVID-19 include fever, cough, sore throat, rhinorrhea, myalgia, headache, dyspnea, and diarrhea. At the initial period of the COVID-19 pandemic, the clinical presentations such as olfactory and gustatory dysfunctions were considered as atypical. At present, olfactory and gustatory dysfunctions are not uncommon symptoms among COVID-19 infections in the COVID-19 pandemic. Initially, these two symptoms were underestimated and not recognized among scientific community. At present, many otolaryngologists over the world documented that COVID-19 patients presented with olfactory and gustatory dysfunctions even without the presence of nasal obstruction or rhinorrhea. The exact etiopathology for olfactory and gustatory dysfunctions is still not known. Future clinical and basic science studies may help to understand the mechanism for olfactory and gustatory dysfunctions in this pandemic. The objective of this review article is to discuss details of the olfactory and gustatory dysfunctions in COVID-19 patients. This article will surely increase awareness among the clinicians and people who are dealing with COVID-19 patients and their early diagnosis. [ABSTRACT FROM AUTHOR]

Background: Olfactory and gustatory dysfunctions can be considered as important symptoms to screen for the mild cases of the COVID-19 disease. However, there are limited studies on the specificity of olfactory and gustatory changes in patients with COVID-19, and it is unclear to what extent the changes may be unique to the disease. This study aimed to evaluate the duration and outcome of olfactory and gustatory disorders in patients with COVID-19. Methods: The study population was patients with COVID-19 at Afzalipour Hospital whose disease was confirmed by nasopharyngeal polymerase chain reaction (PCR) test. 20 patients with olfactory and gustatory dysfunctions were studied. Data were collected using two forms, which were completed at the time of diagnosis and two weeks after the onset of the disease. Results: In 20% of the patients, olfactory and gustatory dysfunctions were among the early symptoms. In 85% of the cases, these dysfunctions were permanent during the disease. 30% of the cases had a chronic underlying disease such as sinusitis, nasal polyps, and allergy. In follow-up, 13 patients (60%) reported that their olfactory dysfunctions had completely improved. Conclusion: The patients whose only symptom is the sudden olfactory or gustatory dysfunction or the dysfunctions are among their early symptoms, should be screened for COVID-19. Most of the patients will recover over the time. [ABSTRACT FROM AUTHOR]

Introduction: Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. Methods: We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. Results: The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16–36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05–3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02–5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19–0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06–0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03–4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06–0.76). Conclusion: Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

This living systematic review aims to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. The review was reported per the PRISMA checklist, and the literature search was conducted in 6 databases and in gray literature. Studies published in any language mentioning oral symptoms and signs in patients with COVID-19 were included. The risk of bias was assessed by the Joanna Briggs Institute appraisal tools. The certainty of evidence was evaluated through GRADE assessment. After a 2-step selection, 40 studies were included: 33 cross-sectional and 7 case reports. Overall, 10,228 patients (4,288 males, 5,770 females, and 170 unknown) from 19 countries were assessed. Gustatory impairment was the most common oral manifestation, with a prevalence of 45% (95% CI, 34% to 55%; I 2 = 99%). The pooled eligible data for different taste disorders were 38% for dysgeusia and 35% for hypogeusia, while ageusia had a prevalence of 24%. Taste disorders were associated with COVID-19 (odds ratio [OR], 12.68; 95% CI, 6.41 to 25.10; I 2 = 63%; P < 0.00001), mild/moderate severity (OR, 2.09; 95% CI, 1.25 to 3.49; I 2 = 66%; P = 0.005), and female patients (OR, 1.64; 95% CI, 1.23 to 2.17; I 2 = 70%; P = 0.0007). Oral mucosal lesions presented multiple clinical aspects, including white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitis. Tongue, palate, lips, gingiva, and buccal mucosa were affected. In mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however, in those who required medication and hospitalization, the lesions developed approximately 7 to 24 d after onset symptoms. Therefore, taste disorders may be common symptoms in patients with COVID-19 and should be considered in the scope of the disease's onset and progression. Oral mucosal lesions are more likely to present as coinfections and secondary manifestations with multiple clinical aspects (PROSPERO CRD42020184468). [ABSTRACT FROM AUTHOR]

Background/purpose: To investigate the characteristics of dysosmia and dysgeusia among patients diagnosed with coronavirus disease 2019 (COVID-19) in Taiwan.Methods: Prospective data collection between January 22, 2020 to May 7, 2020 of nucleic acid confirmed COVID-19 hospitalized patients in northern Taiwan by the Taiwan Centers for Disease Control were analyzed.Results: Of 217 patients enrolled, 78 (35.9%) reported dysosmia (n = 73, 33.6%) and/or dysgeusia (n = 62, 28.6%). The median duration of COVID-19 associated symptom-onset to development of dysosmia and/or dysgeusia was <1 days (interquartile range [IQR], <1-6 days) and 53 of 78 (67.9%) patients developed dysosmia and/or dysgeusia as one of the initial symptoms of COVID-19. Of 59 closely monitored patients, 41 (69.5%) patients recovered within 3 weeks after symptoms onset and the median time to recovery was 12 days (IQR, 7-20 days). Only 6 of the 59 (10.2%) patients reported persistent dysosmia and/or dysgeusia before discharge from hospitals. Multivariate analysis showed that younger individuals (adjusted hazard ratio [AHR], 0.93 per one-year increase; 95% confidence interval [95% CI], 0.89-0.97; P = 0.001), women (AHR, 2.76; 95% CI, 1.05-7.25; P = 0.04) and travel to North America (AHR, 2.35; 95% CI, 1.05-5.26; P = 0.04) were the significant factors associated with dysosmia and/or dysgeusia.Conclusion: Dysosmia and/or dysgeusia are common symptoms and clues for the diagnosis of COVID-19, particularly in the early stage of the disease. Physicians should be alerted to these symptoms to make timely diagnosis and management for COVID-19 to limit spread. [ABSTRACT FROM AUTHOR]

Objective: To prospectively assess the rate and timing of recovery of olfactory (OD) and gustatory (GD) dysfunction in patients affected by COVID-19. Study Design: Cohort study. Setting: Population-based evaluation in a COVID-19 high-prevalence region. Subjects and Methods: We analyzed the clinical course of OD and GD in a cohort of home-quarantined SARS-CoV-2–positive patients from Northern Italy. Physicians administered a survey-based questionnaire at recruitment (T0). During follow-up, patients responded to online dedicated surveys modulated according to symptoms at T0. Results: A total of 151 patients completed the follow-up survey. OD and/or GD were observed in 83% and 89% of subjects, respectively. Resolution rates of OD and GD at 30 days from onset were 87% and 82%, respectively. Risk factors for late resolution were grade of dysfunction at onset (total vs partial), gender, and presence of nasal congestion. Three (2%) patients previously reporting complete resolution of symptoms complained of subsequent recurrence of OD and/or GD after a mean of 19 days from resolution of the previous episode. Conclusion: COVID-19–related OD and GD had high rate of resolution in the first month from onset of symptoms. However, in 10% to 15% of patients, these symptoms showed only partial improvement after this period. [ABSTRACT FROM AUTHOR]

Objective/hypothesis: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on the olfactory and gustatory functions, and the potential mechanisms affecting olfactory and gustatory functions. Materials and methods: A total of 120 men between the ages of 41 and 70 (mean age (SD) = 56 ± 7.5) were divided into three groups according to polysomnography results: snoring group, mild to moderate OSAS group, and severe OSAS group. Olfactory and gustatory functions were evaluated by the Sniffin' Sticks test and the triple-drop method, respectively. Otorhinolaryngologic examination, as well as sleep and quality of life questionnaires, were completed by all subjects one day before or after polysomnography. Results: There was a significant difference in odor thresholds (THR), odor discrimination (OD), odor identification (OI), thresholds-discrimination-identification (TDI) (p < 0.001, p < 0.001, p = 0.003, p < 0.001), and total taste score (p = 0.004, p = 0.021, p = 0.006) in all three groups. Of the subjects in the OSAS group, 43 (54%) exhibited olfactory dysfunction, including 18 subjects (45%) in the mild to moderate group and 25 subjects (63%) in the severe group. Significant negative correlations were found between all olfactory parameters and polysomnography parameters. Furthermore, a negative correlation was present between the total taste scores and the apnea-hypopnea index (AHI). Conclusion: Men with OSAS exhibited impairment in olfactory and gustatory functions. Significant correlations were found between AHI and olfactory parameters, as well as between AHI and total taste scores. [ABSTRACT FROM AUTHOR]