Objective olfactory evaluation of self‐reported loss of smell in a case series of 86 COVID ‐19 patients

  1. Jerome R. Lechien
  2. Pierre Cabaraux
  3. Carlos M. Chiesa‐Estomba
  4. Mohamad Khalife
  5. Stéphane Hans
  6. Christian Calvo‐Henriquez
  7. Delphine Martiny
  8. Fabrice Journe
  9. Leigh Sowerby
  10. Sven Saussez

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Abstract

Objective

To investigate olfactory dysfunction (OD) in patients with mild coronavirus disease 2019 (COVID‐19) through patient‐reported outcome questionnaires and objective psychophysical testing.

Methods

COVID‐19 patients with self‐reported sudden‐onset OD were recruited. Epidemiological and clinical data were collected. Nasal complaints were evaluated with the sinonasal outcome‐22. Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey. Objective OD was evaluated using psychophysical tests.

Results

Eighty‐six patients completed the study. The most common symptoms were fatigue (72.9%), headache (60.0%), nasal obstruction (58.6%), and postnasal drip (48.6%). Total loss of smell was self‐reported by 61.4% of patients. Objective olfactory testings identified 41 anosmic (47.7%), 12 hyposmic (14.0%), and 33 normosmic (38.3%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip.

Conclusion

A significant proportion of COVID‐19 patients reporting OD do not have OD on objective testing.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.03.20088526: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study protocol was approved by the ethics committee of the Jules Bordet Institute (Central Ethics Committee, IJB-0M011-3137).
    Consent: Patients were invited to participate and informed consent was obtained once inclusion criteria were met.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Viral RNA extraction was performed by m2000 mSample Preparation SystemDNA Kit (Abbott) using 1000µl manually lysed sample (700µl sample + 800µl lysis buffer from kit) eluted in 90µl elution buffer.
    Abbott
    suggested: (Abbott, RRID:SCR_010477)
    Statistical Analyses: Statistical analyses were performed using the Statistical Package for the Social Sciences for Windows (SPSS version 22,0; IBM Corp, Armonk, NY, USA).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The main limitation of the present study is the heterogeneity between patients about the duration of the olfactory dysfunction. However, it is complicated to recruit patients at the first day of the olfactory disorder for many reasons. First, many patients have other troublesome symptoms (e.g. fatigue, myalgia, arthralgia), which may limit the realization of the tests. Second, the recruitment of patients at the first day of the olfactory dysfunction involved a continuous communication to recruit these patients. In practice, it is complicated to communicate with the general public every day for a scientific study. The lack of full objective methods to assess olfaction may be considered as another weakness. In this study, we decided to use the Identification sniffin’sticks test (16 items) for practical and ethical reasons. This test may be performed quickly, which is important to reduce the risk of potential contamination of caregivers.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1002/hed.26279
  3. Version published to 10.1101/2020.05.03.20088526v1 on medRxiv