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April 2021; 11 (2) Research

Hyposmia and Dysgeusia in COVID-19

Indication to Swab Test and Clue of CNS Involvement

View ORCID ProfileFrancesco Bax, Carlo Tascini, Mariarosaria Valente, Alessandro Marini, Andrea Surcinelli, Gaia Pellitteri, Chiara De Carlo, Valentina Gerussi, Gian Luigi Gigli
First published December 9, 2020, DOI: https://doi.org/10.1212/CPJ.0000000000001029
Francesco Bax
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • ORCID record for Francesco Bax
Carlo Tascini
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: c.tascini@gmail.com
Mariarosaria Valente
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: mariarosaria.valente@uniud.it
Alessandro Marini
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: alemarini00@gmail.com
Andrea Surcinelli
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: andsurcinelli@gmail.com
Gaia Pellitteri
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: pellitteri.gaia@gmail.com
Chiara De Carlo
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: chia.decarlo@gmail.com
Valentina Gerussi
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: valentina.gerussi@gmail.com
Gian Luigi Gigli
Clinical Neurology Unit (FB, MV, AM, AS, GP, GLG), and Clinical Infectious Diseases Unit (CT, CDC, VG), University of Udine, Italy.
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  • For correspondence: gigli.gl@gmail.com
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Hyposmia and Dysgeusia in COVID-19
Indication to Swab Test and Clue of CNS Involvement
Francesco Bax, Carlo Tascini, Mariarosaria Valente, Alessandro Marini, Andrea Surcinelli, Gaia Pellitteri, Chiara De Carlo, Valentina Gerussi, Gian Luigi Gigli
Neurol Clin Pract Apr 2021, 11 (2) e92-e96; DOI: 10.1212/CPJ.0000000000001029

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Abstract

Objective To evaluate the prevalence of hyposmia and dysgeusia in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their temporal relationship with the onset of other symptoms.

Methods We performed a retrospective analysis of patients admitted during the month of March 2020 to the nonintensive COVID unit of Udine University Hospital on the basis of a positive swab test and/or of clinical-radiologic signs of SARS-CoV-2 infection. Patients were interviewed with a standardized questionnaire. Clinical and laboratory data were collected. Data were analyzed with descriptive statistics, and results expressed as point estimates and 95% confidence intervals (CIs).

Results Of 141 patients admitted, 93 were interviewed. Hyposmia and dysgeusia were present in 58 cases (62.4%). In 22.4% of them, olfactory and gustatory impairment clearly preceded systemic symptoms. The presence of active smoking was very limited in both groups: 8.6% in hyposmic vs 2.9% in normosmic patients (odds ratio 3.2; 95% CI 0.3–28.6). Moreover, total leukocytes and neutrophils count were respectively 23% (effect estimate 1.23; 95% CI 1.06–1.42) and 29% (effect estimate 1.29; 95% CI 1.07–1.54) lower in the hyposmic cohort. No difference was found for other inflammatory biomarkers.

Conclusions Hyposmia and dysgeusia are common in SARS-CoV-2 infection and can precede systemic symptoms. They should be actively searched and prompt close monitoring and isolation until infection is confirmed or disproven. The lower number of total leukocytes and neutrophils in hyposmic patients might indicate an early-phase virus-induced cytopenia.

Footnotes

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • NPub.org/COVID19

  • Received April 29, 2020.
  • Accepted November 16, 2020.
  • © 2020 American Academy of Neurology
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