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Lobova OV, Avramenko IV, Shpak II. COVID-19 associated anosmia in pediatric patients: subject publications review. Wiad Lek 2024; 77:114-119. [PMID: 38431815 DOI: 10.36740/wlek202401114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment and recovery. The peculiarity of pediatric COVID-19 anosmia is due to children accounting for very low percentage of COVID-19 patients (comparing to one in adults), mostly with milder course of the disease. Awareness of anosmia and its proper diagnostics is crucial in children and adolescents, considering it can be the only manifestation in COVID-19 positive pediatric patients. PATIENTS AND METHODS Materials and Methods: In order to achieve this goal a meta-analysis of information from databases followed by statistical processing and generalisation of the obtained data was carried out. CONCLUSION Conclusions: Publications on COVID-19 anosmia in children and adolescents are less numerous than those concerning adult patients, so it is important to use every single trustworthy one. Anosmia/ageusia may be the only symptom, early identifier and the strongest predictor of COVID-19 infection in pediatric patients. Prospects for further scientific researches. Further researches regarding differential diagnostics of COVID-19 and other infections, including seasonal influenza, manifesting with both olfactory and taste dysfunction as well as anosmia diagnostics in children and adolescents with autistic spectrum and different types of mental disorders are possible.
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Affiliation(s)
| | - Iryna V Avramenko
- KYIV MEDICAL UNIVERSITY, KYIV, UKRAINE; DNIPRO STATE MEDICAL UNIVERSITY, DNIPRO, UKRAINE
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2
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Saleem MK, Lal A, Ahmed N, Abbasi MS, Vohra F, Abduljabbar T. Oral health related quality of life and the prevalence of ageusia and xerostomia in active and recovered COVID-19 Patients. PeerJ 2023; 11:e14860. [PMID: 36908817 PMCID: PMC9997189 DOI: 10.7717/peerj.14860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background Salivary disturbance is associated with patients who either have an active coronavirus disease 2019 (COVID-19) or have recovered from coronavirus infection along with loss of taste sensation. In addition, COVID-19 infection can drastically compromise quality of life of individuals. Objective This study aimed to analyze xerostomia, ageusia and the oral health impact in coronavirus disease-19 patients utilizing the Xerostomia Inventory scale-(XI) and the Oral Health Impact Profile-14. Methods In this cross-sectional survey-based study, data was collected from 301 patients who suffered and recovered from COVID-19. Using Google Forms, a questionnaire was developed and circulated amongst those who were infected and recovered from coronavirus infection. The Xerostomia Inventory (XI) and Oral Health Impact Profile-14 were used to assess the degree and quality of life. A paired T-test and Chi-square test were used to analyze the effect on xerostomia inventory scale-(XI) and OHIP-14 scale scores. A p-value of 0.05 was considered as statistically significant. Results Among 301 participants, 54.8% were females. The prevalence of xerostomia in participants with active COVID-19 disease was 39.53% and after recovery 34.88%. The total OHIP-14 scores for patients in the active phase of infection was 12.09, while 12.68 in recovered patients. A significant difference was found between the mean scores of the xerostomia inventory scale-11 and OHIP-14 in active and recovered COVID patients. Conclusion A higher prevalence of xerostomia was found in COVID-19 infected patients (39.53%) compared to recovered patients (34.88%). In addition, more than 70% reported aguesia. COVID-19 had a significantly higher compromising impact on oral function of active infected patients compared to recovered patients.
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Affiliation(s)
- Mahnoor K.M. Saleem
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Abhishek Lal
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Naseer Ahmed
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
- Prosthodontics Department, University Sains Malaysia, Kelantan, Malaysia
| | - Maria S. Abbasi
- Prosthodontics Department, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Fahim Vohra
- Prosthetic Dental Sceinces, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Prosthetic Dental Sceinces, King Saud University, Riyadh, Saudi Arabia
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3
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 DOI: 10.1093/chemse/bjad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
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 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.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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4
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Olavegogeascoechea PA, Gallardo Martinez A, Scapellato JL, Federico A. Epidemiological and clinical characteristics of survivors of SARS-COV-2 infection: A descriptive study. Medwave 2022; 22:e2581. [PMID: 36283026 DOI: 10.5867/medwave.2022.09.2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION In March 2020, the World Health Organization (WHO) declared a pandemic for coronavirus 19. Typical symptoms were fever, cough, asthenia, dyspnea, and muscle pain. Pulmonary and central nervous system compromise presented challenging characteristics for healthcare physicians. The objectives of this study were to identify epidemiological and clinical characteristics of SARS-COV-2 infection survivors in a region of Argentina and to determine differences between gender, age groups, year of infection, and evolution time since diagnosis. METHODS A descriptive and analytical cross-sectional observational study was carried out. A self-administered questionnaire was applied, which was available between August and December 2021. RESULTS Among 1868 individuals included, the mean age was 39.4 ± 13.9 years, and 72.8% were female. Arterial hypertension was the most frequent comorbidity (11.7%). The majority were outpatients (81.9%). The most frequent presentation symptoms at all ages were asthenia (83.7%), fever (54.9%), headache (60.8%), anosmia (64.8%), ageusia (53.2%), cough (54.4%) and myalgias (53.7%). For the 18 to 29 years old age group, the most prevalent presentation symptoms were: headache (69.4%), anosmia (69.1%), ageusia (60.2%), odynophagia (45%), and rhinitis/nasal congestion (46.9%). In the 30 to 64 years old age group, there was a higher prevalence of myalgias (55.8%), arthralgias (41%), and concentration/memory disorder (28.3%). Male showed higher prevalence of fever (64.9% versus 51.1%; p < 0.001) and pneumonia (23.5% versus 13.4%; p < 0.001). After 12 weeks from diagnosis, 38.1% of patients persisted with asthenia, 23.6% with anosmia/dysosmia, and 21.2% with concentration/memory disorders. CONCLUSIONS Systemic symptoms were common to all age groups with coronavirus 19 disease; however, younger, and intermediate age groups presented a higher prevalence of central nervous system symptoms such as anosmia and cognitive disorders, respectively. Symptoms beyond 12 weeks of diagnosis reached slightly more than 10% of the participants.
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Affiliation(s)
- Pablo A Olavegogeascoechea
- Departamento de Posgrado, Facultad de Ciencias Médicas. Universidad Abierta Interamericana, Ciudad Autónoma de Buenos Aires, Argentina
| | - Andres Gallardo Martinez
- Departamento Biomédico, Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Cipolletti, Rio Negro, Argentina
| | - Jose L Scapellato
- Departamento Biomédico, Facultad de Ciencias Médicas, Universidad Nacional del Comahue, Cipolletti, Rio Negro, Argentina
| | - Andrea Federico
- Departamento de Posgrado, Facultad de Ciencias Médicas. Universidad Abierta Interamericana, Ciudad Autónoma de Buenos Aires, Argentina
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5
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Nanjo Y, Okuma T, Kuroda Y, Hayakawa E, Shibayama K, Akimoto T, Murashima R, Kanamori K, Tsutsumi T, Suzuki Y, Namba Y, Makino F, Nagashima O, Sasaki S, Takahashi K. Multiple Types of Taste Disorders among Patients with COVID-19. Intern Med 2022; 61:2127-2134. [PMID: 35527025 PMCID: PMC9381347 DOI: 10.2169/internalmedicine.9065-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective Based on the increasing incidence of smell and taste dysfunction among coronavirus disease 2019 (COVID-19) patients, such issues have been considered an early symptom of infection. However, few studies have investigated the type of taste components that are most frequently affected in COVID-19 patients. This study investigated the difference in frequencies of the types of taste component disorders among hospitalized COVID-19 patients. Methods In this retrospective, single-center, observational study, patients' background characteristics, clinical course, laboratory and radiological findings, and details on taste and/or smell disorders were collected and analyzed from medical records. Patients A total of 227 COVID-19 patients were enrolled, among whom 92 (40.5%) complained of taste disorders. Results Multiple types of taste disorders (hypogeusia/ageusia and hypersensitivity, or hypersensitivity and changing tastes) were reported in 10 patients. In particular, 23 patients reported hypersensitivity to at least 1 type of taste, and 2 patients complained of a bitter taste on consuming sweet foods. Impairment of all taste components was found in 48 patients (52.2%). The most frequent taste disorder was salty taste disorder (81 patients, 89.0%). Hypersensitivity to salty taste was most frequently observed (19 patients, 20.9%). Conclusion Patients with COVID-19 develop multiple types of taste disorders, among which salty taste disorder was the most frequent, with many patients developing hypersensitivity to salty taste. As smell and taste are subjective senses, further studies with the combined use of objective examinations will be required to confirm the findings.
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Affiliation(s)
- Yuta Nanjo
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Tomoko Okuma
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yumi Kuroda
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Eri Hayakawa
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Kohei Shibayama
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Takashi Akimoto
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Ryoko Murashima
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Koichiro Kanamori
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Takeo Tsutsumi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yohei Suzuki
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Yukiko Namba
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Fumihiko Makino
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Osamu Nagashima
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Shinichi Sasaki
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
- Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Japan
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6
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Shrestha S, Paudel A, Shrestha S, Gautam A, Bhurtel M, Adhikari P. Prevalence of Loss of Smell and Loss of Taste in COVID-19 Infected Patients. J Nepal Health Res Counc 2022; 20:84-88. [PMID: 35945858 DOI: 10.33314/jnhrc.v20i01.3852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The clinical presentations of COVID-19 have been variable, with atypical presentations being reported worldwide. Different studies have shown that olfactory and gustatory symptoms are present in confirmed COVID-19 cases, who may not have had other nasal complaints earlier. The high prevalence of these symptoms, exhibiting olfactory dysfunction before the appearance of others, is a relevant finding to aid for early detection of COVID-19. In this study, we aim to find out about the prevalence of anosmia and ageusia in COVID-19 and its correlation with age, sex, and severity of disease in the Nepalese population. METHODS Patients with laboratory-confirmed COVID-19 infection by reverse transcription-polymerase chain reaction (RT-PCR) done at Shukraraaj Tropical and Infectious Disease Hospital, Kathmandu were recruited. Questionnaires based on loss of taste and loss of smell components including age, sex, ethnicity, comorbidities were prepared, and the patients were interviewed retrospectively by phone contact. RESULTS A total of 300 patients were enrolled in our study. The mean age of the patients was 38.36±14.24 years. Prevalence of loss of smell was 54%(N=162) and loss of taste was 53% (N=159). Both of the symptoms were present in 45% of patients. The severity of the disease has a statistically significant effect on the loss of smell and taste whereas gender and smoking history has no significant difference over it. CONCLUSIONS More than half of the COVID-19 positive patients in our cohort had either loss of taste or loss of smell with the severity of disease having a significant effect on it.
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Affiliation(s)
| | | | | | - Amrit Gautam
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu
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7
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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. 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.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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8
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Sudre CH, Keshet A, Graham MS, Joshi AD, Shilo S, Rossman H, Murray B, Molteni E, Klaser K, Canas LD, Antonelli M, Nguyen LH, Drew DA, Modat M, Pujol JC, Ganesh S, Wolf J, Meir T, Chan AT, Steves CJ, Spector TD, Brownstein JS, Segal E, Ourselin S, Astley CM. Anosmia, ageusia, and other COVID-19-like symptoms in association with a positive SARS-CoV-2 test, across six national digital surveillance platforms: an observational study. Lancet Digit Health 2021; 3:e577-e586. [PMID: 34305035 PMCID: PMC8297994 DOI: 10.1016/s2589-7500(21)00115-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/05/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple voluntary surveillance platforms were developed across the world in response to the COVID-19 pandemic, providing a real-time understanding of population-based COVID-19 epidemiology. During this time, testing criteria broadened and health-care policies matured. We aimed to test whether there were consistent associations of symptoms with SARS-CoV-2 test status across three surveillance platforms in three countries (two platforms per country), during periods of testing and policy changes. METHODS For this observational study, we used data of observations from three volunteer COVID-19 digital surveillance platforms (Carnegie Mellon University and University of Maryland Facebook COVID-19 Symptom Survey, ZOE COVID Symptom Study app, and the Corona Israel study) targeting communities in three countries (Israel, the UK, and the USA; two platforms per country). The study population included adult respondents (age 18-100 years at baseline) who were not health-care workers. We did logistic regression of self-reported symptoms on self-reported SARS-CoV-2 test status (positive or negative), adjusted for age and sex, in each of the study cohorts. We compared odds ratios (ORs) across platforms and countries, and we did meta-analyses assuming a random effects model. We also evaluated testing policy changes, COVID-19 incidence, and time scales of duration of symptoms and symptom-to-test time. FINDINGS Between April 1 and July 31, 2020, 514 459 tests from over 10 million respondents were recorded in the six surveillance platform datasets. Anosmia-ageusia was the strongest, most consistent symptom associated with a positive COVID-19 test (robust aggregated rank one, meta-analysed random effects OR 16·96, 95% CI 13·13-21·92). Fever (rank two, 6·45, 4·25-9·81), shortness of breath (rank three, 4·69, 3·14-7·01), and cough (rank four, 4·29, 3·13-5·88) were also highly associated with test positivity. The association of symptoms with test status varied by duration of illness, timing of the test, and broader test criteria, as well as over time, by country, and by platform. INTERPRETATION The strong association of anosmia-ageusia with self-reported positive SARS-CoV-2 test was consistently observed, supporting its validity as a reliable COVID-19 signal, regardless of the participatory surveillance platform, country, phase of illness, or testing policy. These findings show that associations between COVID-19 symptoms and test positivity ranked similarly in a wide range of scenarios. Anosmia, fever, and respiratory symptoms consistently had the strongest effect estimates and were the most appropriate empirical signals for symptom-based public health surveillance in areas with insufficient testing or benchmarking capacity. Collaborative syndromic surveillance could enhance real-time epidemiological investigations and public health utility globally. FUNDING National Institutes of Health, National Institute for Health Research, Alzheimer's Society, Wellcome Trust, and Massachusetts Consortium on Pathogen Readiness.
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Affiliation(s)
- Carole H Sudre
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; Medical Research Council Unit for Lifelong health and Ageing at UCL, Department of Population Science and Experimental Medicine, University College London, London, UK; Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK.
| | - Ayya Keshet
- Department of Computer Science and Applied Mathematics and Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Mark S Graham
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Amit D Joshi
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Smadar Shilo
- Department of Computer Science and Applied Mathematics and Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel; Pediatric Diabetes Unit, Ruth Rappaport Children's Hospital, Rambam Healthcare Campus, Haifa, Israel
| | - Hagai Rossman
- Department of Computer Science and Applied Mathematics and Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Benjamin Murray
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Kerstin Klaser
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Liane D Canas
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Long H Nguyen
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David A Drew
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | | | | | | | - Tomer Meir
- Department of Computer Science and Applied Mathematics and Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK; ZOE Global, London, UK
| | - John S Brownstein
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, USA
| | - Eran Segal
- Department of Computer Science and Applied Mathematics and Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; AI Institute 3IA Côte d'Azur, Université Côte d'Azur, Nice, France
| | - Christina M Astley
- Computational Epidemiology Lab, Boston Children's Hospital, Boston, MA, USA; Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA
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9
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Pagliari D, Marra A, Cosentini R. Atypical manifestations of COVID-19: to know signs and symptoms to recognize the whole disease in the Emergency Department. Intern Emerg Med 2021; 16:1407-1410. [PMID: 33389567 PMCID: PMC7778701 DOI: 10.1007/s11739-020-02574-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Danilo Pagliari
- Medical Officer of the Carabinieri Corps, Carabinieri Officers School, Rome, Italy.
- Department of Emergency Medicine, Ospedale Papa Giovanni XXIII, Piazza OMS-Organizzazione Mondiale Della Sanità, 1, 24127, Bergamo, Italy.
| | - Alessio Marra
- Department of Emergency Medicine, Ospedale Papa Giovanni XXIII, Piazza OMS-Organizzazione Mondiale Della Sanità, 1, 24127, Bergamo, Italy
| | - Roberto Cosentini
- Department of Emergency Medicine, Ospedale Papa Giovanni XXIII, Piazza OMS-Organizzazione Mondiale Della Sanità, 1, 24127, Bergamo, Italy
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10
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Moraschini V, Reis D, Sacco R, Calasans‐Maia MD. Prevalence of anosmia and ageusia symptoms among long-term effects of COVID-19. Oral Dis 2021; 28 Suppl 2:2533-2537. [PMID: 34002923 PMCID: PMC8242542 DOI: 10.1111/odi.13919] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/24/2021] [Accepted: 05/13/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Vittorio Moraschini
- Department of PeriodontologySchool of DentistryVeiga de Almeida UniversityRio de JaneiroBrazil
| | - Daiana Reis
- Department of PeriodontologySchool of DentistryVeiga de Almeida UniversityRio de JaneiroBrazil
| | - Roberto Sacco
- Division of DentistryOral Surgery DepartmentSchool of Medical SciencesUniversity of ManchesterManchesterUK
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11
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Abstract
BACKGROUND Infection due to severe acute respiratory syndrome coronavirus 2 is typically associated with a respiratory syndrome, but gastrointestinal symptoms have been described in early reports from China. However, data from European centres are scarce. OBJECTIVES We aimed to characterise the gastrointestinal manifestations of patients with coronavirus disease 2019 (COVID-19) and their disease course. METHODS Patients admitted at our centre between March and April 2020 with diagnosis of COVID-19 were included. Asymptomatic patients or those without symptom information were excluded. Clinical features, laboratory data and disease severity (mechanical ventilation, intensive care admission or death) were analysed. RESULTS Two-hundred one patients were included (median age 71 years; 56.2% male). Digestive symptoms were reported by 60 (29.9%) patients during the disease course, being part of the disease presentation in 34 (16.9%). The most frequent were diarrhoea in 36 patients (17.9%). Patients with gastrointestinal symptoms were younger (P = 0.032), had higher haemoglobin levels (P = 0.002) and lower C-reactive protein (P = 0.045) and potassium levels (P = 0.004). Patients with digestive symptoms had less severe disease (28.3 vs. 44.0%; P = 0.038). Regarding liver damage, aspartate aminotransferase (AST) was elevated in 65.2% of patients and alanine aminotransferase (ALT) in 62.7%, but these patients did not present a more severe disease (elevated AST P = 0.062; elevated ALT P = 0.276). CONCLUSION A significant portion of COVID-19 patients have digestive symptoms, mostly at presentation. This should be taken into account in order to keep a high level of suspicion to reach an early diagnosis and setup infection control measures to control the transmission rate. This subgroup of patients appears to have a less severe disease course.
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Affiliation(s)
- Tiago Leal
- Infectious Diseases Unit
- Gastroenterology Department
| | - Emanuel Costa
- Infectious Diseases Unit
- Reumathology Department, Hospital de Braga, Braga, Portugal
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12
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Petrocelli M, Cutrupi S, Salzano G, Maglitto F, Salzano FA, Lechien JR, Saussez S, Boscolo-Rizzo P, De Riu G, Vaira LA. Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study. J Laryngol Otol 2021; 135:436-441. [PMID: 33888166 PMCID: PMC8111201 DOI: 10.1017/s002221512100116x] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. METHODS Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. RESULTS A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. CONCLUSION Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance.
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Affiliation(s)
- M Petrocelli
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, Italy
| | - S Cutrupi
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Dentistry Operative Unit, Bellaria and Maggiore Hospital, AUSL of Bologna, Italy
| | - G Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F Maglitto
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F A Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitan, University of Salerno, Italy
| | - J R Lechien
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - S Saussez
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - P Boscolo-Rizzo
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - G De Riu
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Department of Medical, Surgical and Experimental Sciences, Italy
| | - L A Vaira
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Biomedical Science Department, Biomedical Science PhD School, University of Sassari, Italy
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13
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Nouchi A, Chastang J, Miyara M, Lejeune J, Soares A, Ibanez G, Saadoun D, Morélot-Panzini C, Similowski T, Amoura Z, Boddaert J, Caumes E, Bleibtreu A, Lorenzo A, Tubach F, Pourcher V. Prevalence of hyposmia and hypogeusia in 390 COVID-19 hospitalized patients and outpatients: a cross-sectional study. Eur J Clin Microbiol Infect Dis 2021; 40:691-697. [PMID: 33033955 PMCID: PMC7543958 DOI: 10.1007/s10096-020-04056-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/30/2020] [Indexed: 12/22/2022]
Abstract
Anecdotal evidence rapidly accumulated during March 2020 from sites around the world that sudden hyposmia and hypogeusia are significant symptoms associated with the SARS-CoV-2 pandemic. Our objective was to describe the prevalence of hyposmia and hypogeusia and compare it in hospitalized and non-hospitalized COVID-19 patients to evaluate an association of these symptoms with disease severity. We performed a cross-sectional survey during 5 consecutive days in March 2020, within a tertiary referral center, associated outpatient clinic, and two primary care outpatient facilities in Paris. All SARS-CoV-2-positive patients hospitalized during the study period and able to be interviewed (n = 198), hospital outpatients seen during the previous month (n = 129), and all COVID-19-highly suspect patients in two primary health centers (n = 63) were included. Hospitalized patients were significantly more often male (64 vs 40%) and older (66 vs 43 years old in median) and had significantly more comorbidities than outpatients. Hyposmia and hypogeusia were reported by 33% of patients and occurred significantly less frequently in hospitalized patients (12% and 13%, respectively) than in the health centers' outpatients (33% and 43%, respectively) and in the hospital outpatients (65% and 60%, respectively). Hyposmia and hypogeusia appeared more frequently after other COVID-19 symptoms. Patients with hyposmia and/or hypogeusia were significantly younger and had significantly less respiratory severity criteria than patients without these symptoms. Olfactory and gustatory dysfunction occurs frequently in COVID-19, especially in young, non-severe patients. These symptoms might be a useful tool for initial diagnostic work-up in patients with suspected COVID-19.
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Affiliation(s)
- Agathe Nouchi
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France.
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Julie Chastang
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Makoto Miyara
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Julie Lejeune
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - André Soares
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Gladys Ibanez
- Département de Médecine Générale, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - David Saadoun
- INSERM, UMR-S-959, Immunology-Immunopathology- Immunotherapy (I3), Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Capucine Morélot-Panzini
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Thomas Similowski
- INSERM, UMR-S-1158, Service de Pneumologie et Réanimation Médicale (Département R3S), Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Service de Médecine Interne 2, Groupe Hospitalier Universitaire APHP, Sorbonne-Université, site Pitié-Salpêtrière, Paris, France
| | - Jacques Boddaert
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- INSERM UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Service de Gériatrie, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Caumes
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Alexandre Bleibtreu
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alain Lorenzo
- Département de Médecine Générale, Sorbonne Université, Paris, France
| | - Florence Tubach
- INSERM UMR-S-1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Unité de Recherche Clinique Pitié, CIC-1422, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
| | - Valérie Pourcher
- Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
- Département des Maladies Infectieuses et Tropicales, Groupe Hospitalier Universitaire APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Groupe Hospitalier Universitaire APHP, Sorbonne Université, site Pitié-Salpêtrière, Paris, France
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14
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Dixon BE, Wools-Kaloustian KK, Fadel WF, Duszynski TJ, Yiannoutsos C, Halverson PK, Menachemi N. Symptoms and symptom clusters associated with SARS-CoV-2 infection in community-based populations: Results from a statewide epidemiological study. PLoS One 2021; 16:e0241875. [PMID: 33760821 PMCID: PMC7990210 DOI: 10.1371/journal.pone.0241875] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/26/2021] [Indexed: 01/16/2023] Open
Abstract
Background Prior studies examining symptoms of COVID-19 are primarily descriptive and measured among hospitalized individuals. Understanding symptoms of SARS-CoV-2 infection in pre-clinical, community-based populations may improve clinical screening, particularly during flu season. We sought to identify key symptoms and symptom combinations in a community-based population using robust methods. Methods We pooled community-based cohorts of individuals aged 12 and older screened for SARS-CoV-2 infection in April and June 2020 for a statewide prevalence study. Main outcome was SARS-CoV-2 positivity. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for individual symptoms as well as symptom combinations. We further employed multivariable logistic regression and exploratory factor analysis (EFA) to examine symptoms and combinations associated with SARS-CoV-2 infection. Results Among 8214 individuals screened, 368 individuals (4.5%) were RT-PCR positive for SARS-CoV-2. Although two-thirds of symptoms were highly specific (>90.0%), most symptoms individually possessed a PPV <50.0%. The individual symptoms most greatly associated with SARS-CoV-2 positivity were fever (OR = 5.34, p<0.001), anosmia (OR = 4.08, p<0.001), ageusia (OR = 2.38, p = 0.006), and cough (OR = 2.86, p<0.001). Results from EFA identified two primary symptom clusters most associated with SARS-CoV-2 infection: (1) ageusia, anosmia, and fever; and (2) shortness of breath, cough, and chest pain. Moreover, being non-white (13.6% vs. 2.3%, p<0.001), Hispanic (27.9% vs. 2.5%, p<0.001), or living in an Urban area (5.4% vs. 3.8%, p<0.001) was associated with infection. Conclusions Symptoms can help distinguish SARS-CoV-2 infection from other respiratory viruses, especially in community or urgent care settings where rapid testing may be limited. Symptoms should further be structured in clinical documentation to support identification of new cases and mitigation of disease spread by public health. These symptoms, derived from asymptomatic as well as mildly infected individuals, can also inform vaccine and therapeutic clinical trials.
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Affiliation(s)
- Brian E. Dixon
- Department of Epidemiology, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States of America
- * E-mail:
| | - Kara K. Wools-Kaloustian
- Department of Medicine, IU School of Medicine, Indianapolis, Indiana, United States of America
- Center for Global Health, Indiana University, Indianapolis, Indiana, United States of America
| | - William F. Fadel
- Department of Biostatistics, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
| | - Thomas J. Duszynski
- Department of Epidemiology, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
| | - Constantin Yiannoutsos
- Department of Biostatistics, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
| | - Paul K. Halverson
- Department of Health Policy and Management, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
- Department of Family Medicine, IU School of Medicine, Indianapolis, Indiana, United States of America
| | - Nir Menachemi
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, United States of America
- Department of Health Policy and Management, IU Fairbanks School of Public Health, Indianapolis, Indiana, United States of America
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15
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Eskandar EN, Altschul DJ, de la Garza Ramos R, Cezayirli P, Unda SR, Benton J, Dardick J, Toma A, Patel N, Malaviya A, Flomenbaum D, Fernandez-Torres J, Lu J, Holland R, Burchi E, Zampolin R, Hsu K, McClelland A, Burns J, Erdfarb A, Malhotra R, Gong M, Semczuk P, Gursky J, Ferastraoaru V, Rosengard J, Antoniello D, Labovitz D, Esenwa C, Milstein M, Boro A, Mehler MF. Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19. Neurology 2021; 96:e1527-e1538. [PMID: 33443111 PMCID: PMC8032378 DOI: 10.1212/wnl.0000000000011356] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/24/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is protean in its manifestations, affecting nearly every organ system. However, nervous system involvement and its effect on disease outcome are poorly characterized. The objective of this study was to determine whether neurologic syndromes are associated with increased risk of inpatient mortality. METHODS A total of 581 hospitalized patients with confirmed SARS-CoV-2 infection, neurologic involvement, and brain imaging were compared to hospitalized non-neurologic patients with coronavirus disease 2019 (COVID-19). Four patterns of neurologic manifestations were identified: acute stroke, new or recrudescent seizures, altered mentation with normal imaging, and neuro-COVID-19 complex. Factors present on admission were analyzed as potential predictors of in-hospital mortality, including sociodemographic variables, preexisting comorbidities, vital signs, laboratory values, and pattern of neurologic manifestations. Significant predictors were incorporated into a disease severity score. Patients with neurologic manifestations were matched with patients of the same age and disease severity to assess the risk of death. RESULTS A total of 4,711 patients with confirmed SARS-CoV-2 infection were admitted to one medical system in New York City during a 6-week period. Of these, 581 (12%) had neurologic issues of sufficient concern to warrant neuroimaging. These patients were compared to 1,743 non-neurologic patients with COVID-19 matched for age and disease severity admitted during the same period. Patients with altered mentation (n = 258, p = 0.04, odds ratio [OR] 1.39, confidence interval [CI] 1.04-1.86) or radiologically confirmed stroke (n = 55, p = 0.001, OR 3.1, CI 1.65-5.92) had a higher risk of mortality than age- and severity-matched controls. CONCLUSIONS The incidence of altered mentation or stroke on admission predicts a modest but significantly higher risk of in-hospital mortality independent of disease severity. While other biomarker factors also predict mortality, measures to identify and treat such patients may be important in reducing overall mortality of COVID-19.
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Affiliation(s)
- Emad Nader Eskandar
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - David J Altschul
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
| | - Rafael de la Garza Ramos
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Phillip Cezayirli
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Santiago R Unda
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Joshua Benton
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Joseph Dardick
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Aureliana Toma
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Nikunj Patel
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Avinash Malaviya
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - David Flomenbaum
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Jenelys Fernandez-Torres
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Jenny Lu
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Ryan Holland
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Elisabetta Burchi
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Richard Zampolin
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Kevin Hsu
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Andrew McClelland
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Judah Burns
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Amichai Erdfarb
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Rishi Malhotra
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Michelle Gong
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Peter Semczuk
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Jonathan Gursky
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Victor Ferastraoaru
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Jillian Rosengard
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Daniel Antoniello
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Daniel Labovitz
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Charles Esenwa
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Mark Milstein
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Alexis Boro
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
| | - Mark F Mehler
- From the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY
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Güemes A, Ray S, Aboumerhi K, Desjardins MR, Kvit A, Corrigan AE, Fries B, Shields T, Stevens RD, Curriero FC, Etienne-Cummings R. A syndromic surveillance tool to detect anomalous clusters of COVID-19 symptoms in the United States. Sci Rep 2021; 11:4660. [PMID: 33633250 DOI: 10.1101/2020.08.18.20177295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/12/2021] [Indexed: 05/25/2023] Open
Abstract
Coronavirus SARS-COV-2 infections continue to spread across the world, yet effective large-scale disease detection and prediction remain limited. COVID Control: A Johns Hopkins University Study, is a novel syndromic surveillance approach, which collects body temperature and COVID-like illness (CLI) symptoms across the US using a smartphone app and applies spatio-temporal clustering techniques and cross-correlation analysis to create maps of abnormal symptomatology incidence that are made publicly available. The results of the cross-correlation analysis identify optimal temporal lags between symptoms and a range of COVID-19 outcomes, with new taste/smell loss showing the highest correlations. We also identified temporal clusters of change in taste/smell entries and confirmed COVID-19 incidence in Baltimore City and County. Further, we utilized an extended simulated dataset to showcase our analytics in Maryland. The resulting clusters can serve as indicators of emerging COVID-19 outbreaks, and support syndromic surveillance as an early warning system for disease prevention and control.
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Affiliation(s)
- Amparo Güemes
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA.
| | - Soumyajit Ray
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
| | - Khaled Aboumerhi
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
| | - Michael R Desjardins
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Anton Kvit
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Anne E Corrigan
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Brendan Fries
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Timothy Shields
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Robert D Stevens
- Department of Anesthesiology and Critical Care Medicine, Neurology, Neurosurgery and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Frank C Curriero
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ralph Etienne-Cummings
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
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Güemes A, Ray S, Aboumerhi K, Desjardins MR, Kvit A, Corrigan AE, Fries B, Shields T, Stevens RD, Curriero FC, Etienne-Cummings R. A syndromic surveillance tool to detect anomalous clusters of COVID-19 symptoms in the United States. Sci Rep 2021; 11:4660. [PMID: 33633250 PMCID: PMC7907397 DOI: 10.1038/s41598-021-84145-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Coronavirus SARS-COV-2 infections continue to spread across the world, yet effective large-scale disease detection and prediction remain limited. COVID Control: A Johns Hopkins University Study, is a novel syndromic surveillance approach, which collects body temperature and COVID-like illness (CLI) symptoms across the US using a smartphone app and applies spatio-temporal clustering techniques and cross-correlation analysis to create maps of abnormal symptomatology incidence that are made publicly available. The results of the cross-correlation analysis identify optimal temporal lags between symptoms and a range of COVID-19 outcomes, with new taste/smell loss showing the highest correlations. We also identified temporal clusters of change in taste/smell entries and confirmed COVID-19 incidence in Baltimore City and County. Further, we utilized an extended simulated dataset to showcase our analytics in Maryland. The resulting clusters can serve as indicators of emerging COVID-19 outbreaks, and support syndromic surveillance as an early warning system for disease prevention and control.
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Affiliation(s)
- Amparo Güemes
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA.
| | - Soumyajit Ray
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
| | - Khaled Aboumerhi
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
| | - Michael R Desjardins
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Anton Kvit
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Anne E Corrigan
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Brendan Fries
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Timothy Shields
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Robert D Stevens
- Department of Anesthesiology and Critical Care Medicine, Neurology, Neurosurgery and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Frank C Curriero
- Department of Epidemiology, Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ralph Etienne-Cummings
- Department of Electrical and Computer Engineering, Johns Hopkins Whiting School of Engineering, The Johns Hopkins University, 3400 N. Charles Street, 105 Barton Hall, Baltimore, MD, 21218, USA
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Ray PS. Anosmia, Ageusia and COVID-19. J Assoc Physicians India 2020; 68:66-69. [PMID: 33247646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
COVID-19 is certainly the greatest global health problem now and for the foreseeable future. Clinicians and scientists from all over the world have been producing evidence to understand the epidemiology, clinical profile and prognostic factors of COVID-19. In the last six months a large list of COVID-19 symptoms including loss of taste and smell have emerged which can be used for screening and risk stratification. Robust workup of this evidence will help to reach strong conclusions to advance clinical medicine, epidemiology, public health, immunology and evidence-based treatment options in the spectrum of disease that we now know as COVID-19.
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Affiliation(s)
- Partha S Ray
- Consultant Neurologist and Neurophysiologist, NHS England and Clinical Lecturer Liverpool University and Post Graduate Medical School Liverpool
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Asseo K, Fierro F, Slavutsky Y, Frasnelli J, Niv MY. Tracking COVID-19 using taste and smell loss Google searches is not a reliable strategy. Sci Rep 2020; 10:20527. [PMID: 33239650 PMCID: PMC7689487 DOI: 10.1038/s41598-020-77316-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023] Open
Abstract
Web search tools are widely used by the general public to obtain health-related information, and analysis of search data is often suggested for public health monitoring. We analyzed popularity of searches related to smell loss and taste loss, recently listed as symptoms of COVID-19. Searches on sight loss and hearing loss, which are not considered as COVID-19 symptoms, were used as control. Google Trends results per region in Italy or state in the US were compared to COVID-19 incidence in the corresponding geographical areas. The COVID-19 incidence did not correlate with searches for non-symptoms, but in some weeks had high correlation with taste and smell loss searches, which also correlated with each other. Correlation of the sensory symptoms with new COVID-19 cases for each country as a whole was high at some time points, but decreased (Italy) or dramatically fluctuated over time (US). Smell loss searches correlated with the incidence of media reports in the US. Our results show that popularity of symptom searches is not reliable for pandemic monitoring. Awareness of this limitation is important during the COVID-19 pandemic, which continues to spread and to exhibit new clinical manifestations, and for potential future health threats.
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Affiliation(s)
- Kim Asseo
- The Institute of Biochemistry, Food Science and Nutrition, The Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Fabrizio Fierro
- The Institute of Biochemistry, Food Science and Nutrition, The Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yuli Slavutsky
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Johannes Frasnelli
- Department of Anatomy, University of Québec in Trois-Rivières, Trois-Rivières, QC, Canada
| | - Masha Y Niv
- The Institute of Biochemistry, Food Science and Nutrition, The Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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Rocha-Filho PAS, Magalhães JE. Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia. Cephalalgia 2020; 40:1443-1451. [PMID: 33146035 PMCID: PMC7645592 DOI: 10.1177/0333102420966770] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/05/2020] [Accepted: 09/27/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia. METHODS This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists. RESULTS Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47-66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66-17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test; p < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine (p < 0.05). CONCLUSION Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.
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Affiliation(s)
- Pedro Augusto Sampaio Rocha-Filho
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Division of Neuropsychiatry, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - João Eudes Magalhães
- Hospital Universitario Oswaldo Cruz, Universidade de Pernambuco (UPE), Recife, Brazil; Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, Brazil
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Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S. 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; 277:2251-2261. [PMID: 32253535 PMCID: PMC7134551 DOI: 10.1007/s00405-020-05965-1] [Citation(s) in RCA: 1648] [Impact Index Per Article: 412.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/02/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. METHODS Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). RESULTS A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). CONCLUSION Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.
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Affiliation(s)
- Jerome R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
| | - Carlos M Chiesa-Estomba
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Daniele R De Siati
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Mihaela Horoi
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge D Le Bon
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandra Rodriguez
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Didier Dequanter
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge Blecic
- Department of Neurology, EpiCURA Hospital, Ath, Belgium
| | - Fahd El Afia
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Lea Distinguin
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Younes Chekkoury-Idrissi
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Irene Lopez Delgado
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Quironsalud Valencia, Valencia, Spain
| | - Christian Calvo-Henriquez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Philippe Lavigne
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Chiara Falanga
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, Naples, Italy
| | - Maria Rosaria Barillari
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, Naples, Italy
| | - Giovanni Cammaroto
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Head and Neck Surgery, Morgagni Pierantoni Hospital, Forli, Italy
| | - Mohamad Khalife
- Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Pierre Leich
- Department of Otolaryngology-Head and Neck Surgery, CHU Ambroise Paré, Mons, Belgium
| | - Christel Souchay
- Department of Otolaryngology-Head and Neck Surgery, CHU Ambroise Paré, Mons, Belgium
| | - Camelia Rossi
- Division of Infectious Disease, CHU Ambroise-Paré, Mons, Belgium
| | - Fabrice Journe
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Julien Hsieh
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Myriam Edjlali
- Department of Neuroradiology, Université Paris-Descartes-Sorbonne-Paris-Cité, IMABRAIN-INSERM-UMR1266, DHU-Neurovasc, Centre Hospitalier Sainte-Anne, Paris, France
- Department of Radiology, APHP, Hôpitaux R. Poincaré-Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France
| | - Robert Carlier
- Department of Radiology, APHP, Hôpitaux R. Poincaré-Ambroise Paré, DMU Smart Imaging, GH Université Paris-Saclay, U 1179 UVSQ/Paris-Saclay, Paris, France
| | - Laurence Ris
- Department of Neurosciences, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Andrea Lovato
- Department of Neuroscience, Audiology Unit, Padova University, Treviso, Italy
| | - Cosimo De Filippis
- Department of Neuroscience, Audiology Unit, Padova University, Treviso, Italy
| | - Frederique Coppee
- Department of Metabolic and Molecular Biochemistry, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Nicolas Fakhry
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Otorhinolaryngology-Head and Neck Surgery, APHM, Aix Marseille University, La Conception University Hospital, Marseille, France
| | - Tareck Ayad
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sven Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Otolaryngology-Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
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Abstract
Purpose At the time of writing, there is a pandemic affecting virtually every country on Earth. There is considerable discussion amongst clinicians as well as lay people about anosmia and ageusia in COVID-19 sufferers. We aimed to report the results from comprehensive olfactory and gustatory testing in a series of hospital in-patients. Methods The prospective study evaluated 81 individuals with a COVID-19 infection, as confirmed by 2019 n-cov Real-Time PCR laboratory testing. The control group consisted of forty individuals with COVID-19 negative. Olfactory and gustatory testings were carried out by an examiner utilizing stringent safety standards and wearing full personal protective equipment. The results obtained in the case group were then compared with those obtained for the controls. Results In the case group, 41(50.6%) of patients were male and 40 (49.4%) were female, mean age of 54.16 ± 16.98 years (18–95). In the control group, 21 (52.5%) of subjects were male and 19 (47.5%) were female, and mean age was 55 ± 15.39 years (18–90). Fifty (61.7%) COVID-19-positive patients had complaints related to olfaction. The distribution of olfactory symptoms in the case group differed at the level of statistical significance from the control group (p < 0.001). Turning to gustatory abnormalities, within the case group, 22 individuals (27.2%) had taste malfunction. A statistically significant difference was found in the distribution of gustatory abnormalities between cases and controls (p < 0.001). Conclusions Olfactory and gustatory dysfunctions are strongly associated with SARS-CoV-2 infection. Hyposmia with or without hypogeusia is potentially a reliable indicator of latent COVID-19.
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Affiliation(s)
- Fazilet Altin
- Department of Otorhinolaryngology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Cemal Cingi
- Medical Faculty, ENT Department, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Tankut Uzun
- Medical Faculty, ENT Department, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Cengiz Bal
- Medical Faculty, Biostatistics Department, Eskişehir Osmangazi University, Eskişehir, Turkey
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Abstract
Initially, acute loss of smell (anosmia) and taste (ageusia) was not considered important symptoms for coronavirus disease 2019 (COVID-19). To determine the prevalence of these symptoms and to evaluate their diagnostic significance, we (approximately 150 physicians of the Daegu Medical Association) prospectively collected data of cases of anosmia and ageusia from March 8, 2020, via telephone interview among 3,191 patients in Daegu, Korea. Acute anosmia or ageusia was observed in 15.3% (488/3,191) patients in the early stage of COVID-19 and in 15.7% (367/2,342) patients with asymptomatic-to-mild disease severity. Their prevalence was significantly more common among females and younger individuals (P = 0.01 and P < 0.001, respectively). Most patients with anosmia or ageusia recovered within 3 weeks. The median time to recovery was 7 days for both symptoms. Anosmia and ageusia seem to be part of important symptoms and clues for the diagnosis of COVID-19, particularly in the early stage of the disease.
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Affiliation(s)
| | | | | | - Shin Woo Kim
- Daegu Medical Association, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
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24
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Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A, Babudieri S, Petrocelli M, Serra A, Bussu F, Ligas E, Salzano G, De Riu G. Objective evaluation of anosmia and ageusia in COVID-19 patients: Single-center experience on 72 cases. Head Neck 2020; 42:1252-1258. [PMID: 32342566 PMCID: PMC7267244 DOI: 10.1002/hed.26204] [Citation(s) in RCA: 383] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 01/05/2023] Open
Abstract
Background The first European case series are detecting a very high frequency of chemosensitive disorders in COVID‐19 patients, ranging between 19.4% and 88%. Methods Olfactory and gustatory function was objectively tested in 72 COVID‐19 patients treated at University Hospital of Sassari. Results Overall, 73.6% of the patients reported having or having had chemosensitive disorders. Olfactory assessment showed variable degree hyposmia in 60 cases and anosmia in two patients. Gustatory assessment revealed hypogeusia in 33 cases and complete ageusia in one patient. Statistically significant differences in chemosensitive recovery were detected based on age and distance from the onset of clinical manifestations. Conclusion Olfactory and gustatory dysfunctions represent common clinical findings in COVID‐19 patients. Otolaryngologists and head‐neck surgeons must by now keep this diagnostic option in mind when evaluating cases of ageusia and nonspecific anosmia that arose suddenly and are not associated with rhinitis symptoms.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative UnitUniversity Hospital of SassariSassariItaly
| | - Giovanna Deiana
- Department of Medical, Surgical and Experimental SciencesUniversity of SassariSassariItaly
| | | | - Pietro Pirina
- Respiratory Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Giordano Madeddu
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Andrea De Vito
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Sergio Babudieri
- Infectious Diseases Operative UnitUniversity Hospital of SassariSassariItaly
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative UnitBellaria and Maggiore HospitalBolognaItaly
| | - Antonello Serra
- Department of Surveillance and PreventionUniversity Hospital of SassariSassariItaly
| | - Francesco Bussu
- Otolaryngology Operative UnitUniversity Hospital of SassariSassariItaly
| | - Enrica Ligas
- Maxillofacial Surgery Operative UnitUniversity Hospital of SassariSassariItaly
| | - Giovanni Salzano
- Maxillofacial Surgery UnitUniversity Hospital of Naples “Federico II”NaplesItaly
| | - Giacomo De Riu
- Maxillofacial Surgery Operative UnitUniversity Hospital of SassariSassariItaly
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25
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De Carli L, Gambino R, Lubrano C, Rosato R, Bongiovanni D, Lanfranco F, Broglio F, Ghigo E, Bo S. Impaired taste sensation in type 2 diabetic patients without chronic complications: a case-control study. J Endocrinol Invest 2018; 41:765-772. [PMID: 29185232 DOI: 10.1007/s40618-017-0798-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/17/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE Few and contradictory data suggest changes in taste perception in type 2 diabetes (T2DM), potentially altering food choices. We, therefore, analyzed taste recognition thresholds in T2DM patients with good metabolic control and free of conditions potentially impacting on taste, compared with age-, body mass index-, and sex-matched normoglycemic controls. METHODS An ascending-concentration method was used, employing sucrose (sweet), sodium chloride (salty), citric acid (sour), and quinine hydrochloride (bitter), diluted in increasing concentration solutions. The recognition threshold was the lowest concentration of correct taste identification. RESULTS The recognition thresholds for the four tastes were higher in T2DM patients. In a multiple regression model, T2DM [β = 0.95; 95% CI 0.32-1.58; p = 0.004 (salty); β = 0.61; 0.19-1.03; p = 0.006 (sweet); β = 0.78; 0.15-1.40; p = 0.016 (sour); β = 0.74; 0.22-1.25; p = 0.006 (bitter)] and waist circumference [β = 0.05; 0.01-0.08; p = 0.012 (salty); β = 0.03; 0.01-0.05; p = 0.020 (sweet); β = 0.04; 0.01-0.08; p = 0.020 (sour); β = 0.04; 0.01-0.07; p = 0.007 (bitter)] were associated with the recognition thresholds. Age was associated with salty (β = 0.06; 0.01-0.12; p = 0.027) and BMI with sweet thresholds (β = 0.06; 0.01-0.11; p = 0.019). CONCLUSIONS Taste recognition thresholds were higher in uncomplicated T2DM, and central obesity was significantly associated with this impairment. Hypogeusia may be an early sign of diabetic neuropathy and be implicated in the poor compliance of these patients to dietary recommendations.
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Affiliation(s)
- L De Carli
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - R Gambino
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - C Lubrano
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - R Rosato
- Department of Psychology, University of Turin, Turin, Italy
| | - D Bongiovanni
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - F Lanfranco
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - F Broglio
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - E Ghigo
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy
| | - S Bo
- Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
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26
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Abstract
Given that gustatory and olfactory impairments occur with Human Immunodeficiency Virus (HIV) and the normal aging process, people aging with HIV may experience considerable chemosensory losses. Declines may place such adults at risk for eating contaminated foods, malnutrition, cognitive complaints, and reduced quality of life. Implications for study and treatment are considered.
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27
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Nagai A, Kubota M, Katayama Y, Kojima C. Evaluation of taste acuity by the filter-paper disc in Japanese young women: the relationship with micronutrients status. Asia Pac J Clin Nutr 2012; 21:406-410. [PMID: 22705431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of the present study is to investigate the taste acuity in Japanese young women in relation to their micronutrient status. Thirty-eight healthy young women (mean age; 21.3, range; 19-27 years) were enrolled. Gustatory thresholds were estimated for four basic tastes: sweet (sucrose), salty (sodium chloride), sour (tartaric acid), and bitter (quinine hydrochloride) by a filter-paper disk method. Various concentrations at each taste were serially scored from disc number 1 (lowest) to number 5 (highest). The lowest concentration at which the quality of the taste was correctly identified was defined as the recognition threshold. The mean of three measurements for each test on three different days was calculated. We divided our participants into normal taste and hypogeusia groups based on the mean threshold disc numbers, <=3.5 and >3.5, respectively, according to previous literature using the same method. We also measured serum concentrations and dietary intakes of micronutrients including zinc, iron, copper, and selenium. The numbers of participants belonging to the hypogeusia group were 24 (63.2%) for sweet, 19 (50.0%) for sour, 17 (44.7%) for bitter, and 16 (42.1%) for salty taste. Although the hypogeusia group exhibited significantly lower serum iron concentrations, except for the salty taste, the other three micronutrients concentrations did not show any association with the four taste acuities. Dietary micronutrient intake did not show any association with the four taste acuities. This study indicates that in addition to zinc status, iron status should be considered in the study of taste acuity.
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Affiliation(s)
- Ayako Nagai
- Department of Human Life and Environment, Nara Women's University, Nara, Japan
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28
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Abstract
Although complete or near-complete olfactory loss has been extensively documented and described, few published reports have documented severe generalized gustatory loss (across qualities and neural fields) with rigorous psychophysical testing, and none have explored the prevalence or causes of such losses in a large clinical population. This study retrospectively reviews our chemosensory clinic's experience of 1,176 patients evaluated for complaints of chemosensory dysfunction in order to address these issues. Our series confirms that despite the complex, bilateral innervation and regenerative capacity of the gustatory system, severe generalized taste loss does occur as a clinical entity, albeit rarely: only 0.85% (n = 10) of our patients evidenced such a deficit, as compared to 32% (n = 371) who were found to have a profound olfactory deficit. Combinations of systemic and/or acute events may underlie many cases of severe taste loss, and in half of our cases, these patients evidenced moderate to complete smell loss as well.
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Affiliation(s)
- Edmund Pribitkin
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, and the Monell Chemical Senses Center, Monell-Jefferson Taste and Smell Clinic, Philadelphia, Pennsylvania 19104, USA
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29
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Etta KM, Watson RS. Taste sensitivity to phenylthiocarbamide in non-goitrous and goitrous Nigerians. Niger Med J 1976; 6:160-2. [PMID: 16296132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Taste sensitivity to phenylthiocarbamide is thought to reflect a genotype homozygous for a single recessive gene. European and North American populations show a mean non-taster frequency of about 30% whereas Mongoloid populations show a much lower frequency of non-tasters. In the present study of Nigerians, there were mean non-taster frequencies of 1.9-2.9% among healthy subjects and not a significantly different level, 3.5%, among goitrous ones. Among subjects with nodular goiter, however, the non-taster frequency was 18.7%, significantly higher. The results suggest that there is a rarity of non-tasters among Nigerians and that non-tasters are more susceptible to the development of nodular goiter than are tasters.
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Affiliation(s)
- K M Etta
- Department of Human Physiology, Faculty of Medicine, A.B.U., Zaria
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