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[Preprint]. 2021 Oct 9:2021.10.09.21264771.
doi: 10.1101/2021.10.09.21264771.

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

Mackenzie E Hannum  1 , Riley J Koch  1 , Vicente A Ramirez  1   2 , Sarah S Marks  1 , Aurora K Toskala  1 , Riley D Herriman  1 , Cailu Lin  1 , Paule V Joseph  3   4 , Danielle R Reed  1
Affiliations

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

Mackenzie E Hannum et al. medRxiv. .

Update in

Abstract

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. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 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 in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.

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Figures

Figure 1.
Figure 1.
CONSORT flow diagram demonstrating the article selection process for this systematic review and meta-analysis.
Figure 2.
Figure 2.
Orchard plot of taste loss and COVID-19. The point estimate of the pooled prevalence (trunk) is represented by the bold turquoise or pink dot. The confidence interval of the pooled prevalence estimate (branch) is represented by the bold black line, and the prediction interval (twig) is represented by the thin black line. Individual prevalence estimates from each study are represented by the scattered colored points (slightly transparent circles). Each point is scaled by the precision of the point estimate of prevalence for each study, i.e., inverse of the standard error.
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