self reported taste and smell disorders in patients with covid 19 distinct features CORD-Papers-2021-10-25 (Version 1)

Title: Self-reported Taste and Smell Disorders in Patients with COVID-19: Distinct Features in China
Abstract: Last December 2019, a cluster of viral pneumonia cases identified as coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. We aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19. In this retrospective study, 1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (010) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. From patients (n=1172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. 20.6% COVID-19 patients had loss of taste (median score=6), while 11.4% had loss of smell (median score=5). Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum levels were positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks. In this cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is available for this article at 10.1007/s11596-021-2312-7 and is accessible for authorized users.
Published: 2/13/2021
Journal: Curr Med Sci
DOI: 10.1007/s11596-021-2312-7
DOI_URL: http://doi.org/10.1007/s11596-021-2312-7
Author Name: Song, Jia
Author link: https://covid19-data.nist.gov/pid/rest/local/author/song_jia
Author Name: Deng, Yi ke
Author link: https://covid19-data.nist.gov/pid/rest/local/author/deng_yi_ke
Author Name: Wang, Hai
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_hai
Author Name: Wang, Zhi chao
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_zhi_chao
Author Name: Liao, Bo
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liao_bo
Author Name: Ma, Jin
Author link: https://covid19-data.nist.gov/pid/rest/local/author/ma_jin
Author Name: He, Chao
Author link: https://covid19-data.nist.gov/pid/rest/local/author/he_chao
Author Name: Pan, Li
Author link: https://covid19-data.nist.gov/pid/rest/local/author/pan_li
Author Name: Liu, Yang
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_yang
Author Name: Alobid, Isam
Author link: https://covid19-data.nist.gov/pid/rest/local/author/alobid_isam
Author Name: Wang, De yun
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wang_de_yun
Author Name: Zeng, Ming
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zeng_ming
Author Name: Mullol, Joaquim
Author link: https://covid19-data.nist.gov/pid/rest/local/author/mullol_joaquim
Author Name: Liu, Zheng
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_zheng
sha: 492e08531d1985675b6c1e8106d04ea1bf0105c8
license: no-cc
license_url: [no creative commons license associated]
source_x: Medline; PMC
source_x_url: https://www.medline.com/https://www.ncbi.nlm.nih.gov/pubmed/
pubmed_id: 33582900
pubmed_id_url: https://www.ncbi.nlm.nih.gov/pubmed/33582900
pmcid: PMC7881907
pmcid_url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881907
url: https://doi.org/10.1007/s11596-021-2312-7 https://www.ncbi.nlm.nih.gov/pubmed/33582900/
has_full_text: TRUE
Keywords Extracted from Text Content: patient LDH COVID-19 [7 Wuhan edema [2] [3] [4] [5] 19] olfactory epithelium oral COVID-19 patients olfactory serum IL-6 nasal mucosa COVID-19 [13 airway P<0.01 ethnic/culture taste buds COVID-19 patients SARS-CoV-1 [20] upper respiratory rhinovirus [16] upper airway pulmonary host cells mice epithelial cells upper respiratory tract ρ=0.21 people nasal large-sample-size IL-8 interleukin-6 ρ=0.15 anorexia fig. 3 olfactory neuroepithelium eosinophils transneural corticosteroids pharyngeal swab upper respiratory tract mucosa coronavirus central nervous systems taste lactate dehydrogenase olfactory bulb COVID-19 [5] SARS-CoV-2-induced allergic P=0.99 SARS-CoV-2 eosinophilic Wuhan, AR blood [1, 6] ±2 coronaviruses LIU Zhao-qin LIAN Jian-wen RUAN Qiao XIAO Si-tao HU Jing-xian Jing-xin LIU Mengchen WANG
Extracted Text Content in Record: First 5000 Characters:serve as an early alerting symptom for COVID-19 [5] . However, an early study based on analyzing electronic medical records of 214 patients with COVID-19 in Wuhan, China reported that the proportion of patients complaining of loss of taste and loss of smell was only 5.6% and 5.1%, respectively [6] , significantly lower than that reported in Europe and USA. One potential reason for the low rates in China may be related to incomplete medical records of COVID-19 patients under actual emergency situation, which underestimated the incidences of upper airway tract manifestations. Nevertheless, it is also possible that there are different responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with distinct ethnic/culture background. Therefore, more accurate evaluation of upper airway tract manifestations in COVID-19 patients should be conducted to figure out the clinical importance of smell and taste dysfunction in the early diagnosis of COVID-19 for Chinese and to elucidate whether there are different clinical manifestations between patients with distinct ethnic/culture background. Moreover, several important questions remain to be answered. How severe are the upper airway tract symptoms in patients with COVID-19? Is there any correlation between olfactory and taste disorders and other nasal symptoms such as nasal obstruction? Will the severity of olfactory or taste disorder be associated with the severity of COVID-19? Will there be a full recovery of olfactory or taste disorder and how long it will take? In this retrospective study, we investigated the COVID-19 patients discharged from Tongji Hospital, the largest designated hospital to treat patients with COVID-19, in Wuhan. By integrating medical record analysis and reevaluation of upper airway symptoms via the telephone follow-up, we aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19. A single center, retrospective cohort study was conducted in Wuhan, China. We obtained the electronic medical records for discharged COVID-19 patients between January 27, 2020 and March 10, 2020, who were initially admitted to Tongji Hospital. The diagnosis was made on the basis of guidance for diagnosis and management of COVID-19 released by WHO [7] . A laboratory-confirmed case of COVID-19 was defined as having positive result on real-time reverse-transcriptase-polymerase-chain-reaction assay of nasal and pharyngeal swab specimens. Only laboratory-confirmed cases were included in the study. All patients were followed up by telephone on the 30th (±2) day after discharge. The study was approved by Tongji Hospital Research Ethics Committee. The degree of severity of COVID-19 was defined as severe and non-severe at the time of admission using the American Thoracic Society guidelines for community-acquired pneumonia [8] . The information of demographic characteristics, systemic major symptoms, and major commodities related to COVID-19 were extracted from electronic medical records. In addition, the results of laboratory assessments on admission were also collected from electronic medical records. All laboratory testing was performed according to the clinical care needs of the patients. Laboratory assessments consisted of a complete blood routine, blood biochemistry, coagulation function, infection biomarkers and immune function. All data were entered into a computerized database and cross-checked. The airway comorbidities and nasal symptoms, the date of symptomatic onset, and numerical rating scale scores and duration days of symptoms were obtained based on the hospital medical records and were confirmed and reevaluated by the telephone followup. The severity of upper respiratory tract symptoms was scored by patients on a numerical rating scale of 0-10, with 0 being "no complaint whatsoever" and 10 being "the worst imaginable complaint" [9, 10] . Six major symptoms of upper respiratory tract were focused on: nasal obstruction, rhinorrhea, nasal itching, sneezing, loss of smell, and loss of taste. The severity of loss of smell and loss of taste was defined as follows: mild=score 0-3; moderate=score 4-7; severe=score 8-10 [9, 10] . The difference between the symptom of loss of smell and loss of taste was explained to the patients very carefully during telephone follow-up according to previous studies [11] . The detailed questionnaire is shown in this article's Online Supplement. For continuous variables, Kruskal-Wallis H test was used to assess intergroup variability and Mann-Whitney U 2-tailed test was used for between-group comparison. Chi-square test was applied to compare the difference in proportions between groups. Spearman test was used for correlation analysis. Difference was considered to be statistically significant if a P value was less than 0.05. These stat
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