Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

doi:10.1007/s00405-020-06548-w

. 2021 Aug;278(8):2851-2859.

doi: 10.1007/s00405-020-06548-w. Epub 2021 Jan 16.

Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

Jerome R Lechien^#^{1

2

3

4}, Carlos M Chiesa-Estomba^#^{5

6}, Luigi A Vaira⁷, Giacomo De Riu⁷, Giovanni Cammaroto^{5

8}, Younes Chekkoury-Idrissi⁹, Marta Circiu⁹, Lea Distinguin⁹, Fabrice Journe¹⁰, Christophe de Terwangne¹¹, Shahram Machayekhi¹¹, Maria R Barillari^{5

12}, Christian Calvo-Henriquez¹³, Stéphane Hans^#⁹, Sven Saussez^#^{5

10

14}

Affiliations

¹ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Jerome.Lechien@umons.ac.be.
² Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. Jerome.Lechien@umons.ac.be.
³ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France. Jerome.Lechien@umons.ac.be.
⁴ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. Jerome.Lechien@umons.ac.be.
⁵ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia/ Biodonostia Research Institute, San Sebastian, Spain.
⁷ Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy.
⁸ Department of Otolaryngology-Head and Neck Surgery, Morgagni Pierantoni Hospital, Forli, Italy.
⁹ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
¹⁰ Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
¹¹ Intensive Care Unit, EpiCURA Hospital, Hornu, Belgium.
¹² Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy.
¹³ Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
¹⁴ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.

^# Contributed equally.

PMID: 33452919
PMCID: PMC7811338
DOI: 10.1007/s00405-020-06548-w

Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

Jerome R Lechien et al. Eur Arch Otorhinolaryngol. 2021 Aug.

. 2021 Aug;278(8):2851-2859.

doi: 10.1007/s00405-020-06548-w. Epub 2021 Jan 16.

Authors

Affiliations

¹ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. Jerome.Lechien@umons.ac.be.
² Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. Jerome.Lechien@umons.ac.be.
³ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France. Jerome.Lechien@umons.ac.be.
⁴ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. Jerome.Lechien@umons.ac.be.
⁵ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia/ Biodonostia Research Institute, San Sebastian, Spain.
⁷ Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy.
⁸ Department of Otolaryngology-Head and Neck Surgery, Morgagni Pierantoni Hospital, Forli, Italy.
⁹ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
¹⁰ Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
¹¹ Intensive Care Unit, EpiCURA Hospital, Hornu, Belgium.
¹² Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy.
¹³ Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
¹⁴ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.

^# Contributed equally.

PMID: 33452919
PMCID: PMC7811338
DOI: 10.1007/s00405-020-06548-w

Erratum in

Correction to: Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients.
Lechien JR, Chiesa-Estomba CM, Vaira LA, De Riu G, Cammaroto G, Chekkoury-Idrissi Y, Circiu M, Distinguin L, Journe F, de Terwangne C, Machayekhi S, Barillari MR, Calvo-Henriquez C, Hans S, Saussez S. Lechien JR, et al. Eur Arch Otorhinolaryngol. 2021 Aug;278(8):2861. doi: 10.1007/s00405-021-06656-1. Eur Arch Otorhinolaryngol. 2021. PMID: 33564911 Free PMC article. No abstract available.

Abstract

Objective: To investigate prevalence and epidemiological and clinical factors associated with olfactory dysfunction (OD) and gustatory dysfunction (GD) in COVID-19 patients according to the disease severity.

Study design: Cross-sectional study.

Methods: A total of 2579 patients with a positive diagnosis of COVID-19 were identified between March 22 and June 3, 2020 from 18 European hospitals. Epidemiological and clinical data were extracted. Otolaryngological symptoms, including OD and GD, were collected through patient-reported outcome questionnaire and Sniffin'Sticks tests were carried out in a subset of patients.

Results: A total of 2579 patients were included, including 2166 mild (84.0%), 144 moderate (5.6%) and 269 severe-to-critical (10.4%) patients. Mild patients presented an otolaryngological picture of the disease with OD, GD, nasal obstruction, rhinorrhea and sore throat as the most prevalent symptoms. The prevalence of subjective OD and GD was 73.7 and 46.8%, and decreases with the severity of the disease. Females had higher prevalence of subjective OD and GD compared with males. Diabetes was associated with a higher risk to develop GD. Among the subset of patients who benefited from psychophysical olfactory evaluations, there were 75 anosmic, 43 hyposmic and 113 normosmic patients. The prevalence of anosmia significantly decreased with the severity of the disease. Anosmia or hyposmia were not associated with any nasal disorder, according to SNOT-22.

Conclusion: OD and GD are more prevalent in patients with mild COVID-19 compared with individuals with moderate, severe or critical diseases. Females might have a higher risk of developing OD and GD compared with males.

Keywords: Anosmia; COVID-19; Clinical; Coronavirus; Epidemiological; Hyposmia; Olfactory; Outcome; SARS-CoV-2; Smell.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

**Fig. 1**
Flow chart. *COVID-19* coronavirus disease 2019; *RT-PCR* reverse transcriptase polymerase chain reaction

**Fig. 2**
Distribution of the most prevalent general and otolaryngological symptoms according to the severity

**Fig. 3**
Mean and standard deviation of Sniffin’Stick test values according to the severity group

See this image and copyright information in PMC

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References

1. WHO website. www.who.int/docs Consulted July 24, 2020.
1. Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020 doi: 10.1007/s00405-020-05965-1. - DOI - PMC - PubMed
1. Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of smell and taste in 2013 European mild-to-moderation COVID-19 patients. Ann Int Med. 2020;173(8):672–675. doi: 10.7326/M20-2428. - DOI - PMC - PubMed
1. Vaira LA, Hopkins C, Salzano G, et al. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study. Head Neck. 2020 doi: 10.1002/hed.26269. - DOI - PMC - PubMed
1. Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020;58(3):295–298. doi: 10.4193/Rhin20.116. - DOI - PubMed

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[1] WHO website. www.who.int/docs Consulted July 24, 2020.

[2] WHO website. www.who.int/docs Consulted July 24, 2020.

[3] Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020 doi: 10.1007/s00405-020-05965-1. - DOI - PMC - PubMed

[4] Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020 doi: 10.1007/s00405-020-05965-1. - DOI - PMC - PubMed

[5] Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of smell and taste in 2013 European mild-to-moderation COVID-19 patients. Ann Int Med. 2020;173(8):672–675. doi: 10.7326/M20-2428. - DOI - PMC - PubMed

[6] Lechien JR, Chiesa-Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of smell and taste in 2013 European mild-to-moderation COVID-19 patients. Ann Int Med. 2020;173(8):672–675. doi: 10.7326/M20-2428. - DOI - PMC - PubMed

[7] Vaira LA, Hopkins C, Salzano G, et al. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study. Head Neck. 2020 doi: 10.1002/hed.26269. - DOI - PMC - PubMed

[8] Vaira LA, Hopkins C, Salzano G, et al. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study. Head Neck. 2020 doi: 10.1002/hed.26269. - DOI - PMC - PubMed

[9] Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020;58(3):295–298. doi: 10.4193/Rhin20.116. - DOI - PubMed

[10] Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020;58(3):295–298. doi: 10.4193/Rhin20.116. - DOI - PubMed

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Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

Affiliations

Epidemiological, otolaryngological, olfactory and gustatory outcomes according to the severity of COVID-19: a study of 2579 patients

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Conflict of interest statement

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