Dataset Information

Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis.

ABSTRACT:

Objectives

This study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease.

Methods

Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2).

Results

Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43-12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47-0.66) but moderate negative (0.78; 95% CI, 0.69-0.85] and positive (0.78; 95% CI, 0.66-0.87) predictive values and a high specificity (0.91; 95% CI, 0.83-0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms.

Conclusion

Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.

SUBMITTER: Kim DH

PROVIDER: S-EPMC8373831 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesOlfactory dysfunction is a frequent feature of COVID-19. Despite the growing evidence, current knowledge on the subject remains insufficient, so that data obtained with different tools, from multiple centers and in distinct scenarios are welcome. Yet, the predictive value of olfactory dysfunction in terms of the overall prognosis of COVID-19 is unknown. This study aims to evaluate the olfactory function of hospitalized patients with COVID-19 and the impact of the results on their clinical outcomes.MethodsPatients with severe acute respiratory distress syndrome (ARDS) admitted to a university tertiary hospital were recruited and divided into those with ARDS due to COVID-19, and those with ARDS of any other cause. Sociodemographic and clinical data were collected at baseline and the patients had their objective olfactory function evaluated by the Alcohol Sniff Test on admission and during hospital stay. The participants were then followed up until reaching an endpoint: hospital discharge, endotracheal intubation, transfer to the intensive care unit, or death. Patients with COVID-19 were also subgrouped and compared according to their olfactory thresholds and to their overall clinical outcomes. The obtained data was analyzed using R software. Level of significance was set at 0.05.ResultsEighty-two patients were included (of which 58 had COVID-19). 87.93% of the patients with COVID-19 had diminished olfactory dysfunction on admission. The mean length of hospital stay among patients with olfactory dysfunction was greater (7.84 vs 6.14 days) and nine individuals in this subgroup had poor overall outcomes. None of those with normal olfactory function developed critical COVID-19. The mean olfactory function was significantly worse among patients with COVID-19 and poor outcomes (3.97 vs 7.90 cm, P = .023).ConclusionObjective olfactory dysfunction is frequent in ARDS caused by SARS-CoV-2 infection. Patients with longitudinal poorer outcomes present worse olfactory thresholds on admission.