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Objective screening for olfactory and gustatory dysfunction during the COVID-19 pandemic: A prospective study in healthcare workers using self-administered testing

  • Cao, Austin C.1
  • Nimmo, Zachary M.1
  • Mirza, Natasha2
  • Cohen, Noam A.2, 3, 4
  • Brody, Robert M.2
  • Doty, Richard L.2
  • 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  • 2 Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
  • 3 Corporal Michael J. Crescenz Veterans Administration Medical Center, Philadelphia, PA, USA
  • 4 Monell Chemical Senses Center, Philadelphia, PA, USA
Published Article
World Journal of Otorhinolaryngology - Head and Neck Surgery
Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.
Publication Date
Feb 12, 2021
DOI: 10.1016/j.wjorl.2021.02.001
PMID: 33614178
PMCID: PMC7879131
PubMed Central
  • Research Paper


Background Smell and taste loss are highly prevalent symptoms in coronavirus disease 2019 (COVID-19), although few studies have employed objective measures to quantify these symptoms, especially dysgeusia. Reports of unrecognized anosmia in COVID-19 patients suggests that self-reported measures are insufficient for capturing patients with chemosensory dysfunction. Objectives The purpose of this study was to quantify the impact of recent COVID-19 infection on chemosensory function and demonstrate the use of at-home objective smell and taste testing in an at-risk population of healthcare workers. Methods Two hundred and fifty healthcare workers were screened for possible loss of smell and taste using online surveys. Self-administered smell and taste tests were mailed to respondents meeting criteria for elevated risk of infection, and one-month follow-up surveys were completed. Results Among subjects with prior SARS-CoV-2 infection, 73% reported symptoms of olfactory and/or gustatory dysfunction. Self-reported smell and taste loss were both strong predictors of COVID-19 positivity. Subjects with evidence of recent SARS-CoV-2 infection (<45 days) had significantly lower olfactory scores but equivalent gustatory scores compared to other subjects. There was a time-dependent increase in smell scores but not in taste scores among subjects with prior infection and chemosensory symptoms. The overall infection rate was 4.4%, with 2.5% reported by PCR swab. Conclusion Healthcare workers with recent SARS-CoV-2 infection had reduced olfaction and normal gustation on self-administered objective testing compared to those without infection. Rates of infection and chemosensory symptoms in our cohort of healthcare workers reflect those of the general public.

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