Dataset Information

Self-reported olfactory and gustatory dysfunction and psychophysical testing in screening for COVID-19: A systematic review and meta-analysis.

ABSTRACT:

Background

A substantial proportion of coronavirus disease-2019 (COVID-19) patients demonstrate olfactory and gustatory dysfunction (OGD). Self-reporting for OGD is widely used as a predictor of COVID-19. Although psychophysical assessment is currently under investigation in this role, the sensitivity of these screening tests for COVID-19 remains unclear. In this systematic review we assess the sensitivity of self-reporting and psychophysical tests for OGD.

Methods

A systematic search was performed on PubMed, EMBASE, and ClinicalTrials.gov from inception until February 16, 2021. Studies of suspected COVID-19 patients with reported smell or taste alterations were included. Data were pooled for meta-analysis. Sensitivity, specificity, and diagnostic odds ratio (DOR) were reported in the outcomes.

Results

In the 50 included studies (42,902 patients), self-reported olfactory dysfunction showed a sensitivity of 43.9% (95% confidence interval [CI], 37.8%-50.2%), a specificity of 91.8% (95% CI, 89.0%-93.9%), and a DOR of 8.74 (95% CI, 6.67-11.46) for predicting COVID-19 infection. Self-reported gustatory dysfunction yielded a sensitivity of 44.9% (95% CI, 36.4%-53.8%), a specificity of 91.5% (95% CI, 87.7%-94.3%), and a DOR of 8.83 (95% CI, 6.48-12.01). Olfactory psychophysical tests analysis revealed a sensitivity of 52.8% (95% CI, 25.5%-78.6%), a specificity of 88.0% (95% CI, 53.7%-97.9%), and a DOR of 8.18 (95% CI, 3.65-18.36). One study used an identification test for gustatory sensations assessment.

Conclusion

Although demonstrating high specificity and DOR values, neither self-reported OGD nor unvalidated and limited psychophysical tests were sufficiently sensitive in screening for COVID-19. They were not suitable adjuncts in ruling out the disease.

SUBMITTER: Hoang MP

PROVIDER: S-EPMC8652821 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundFrom the initial stages of the pandemic in early 2020, COVID-19-related olfactory and gustatory dysfunctions have been widely reported and are emerging as one of the most frequent long-term sequelae of SARS-CoV-2 infection. However, data regarding the long-term recovery of the sense of smell and taste are lacking. This study aimed to characterize the evolution up to one year after the diagnosis of self-reported olfactory and gustatory dysfunctions in COVID-19 cases.MethodsBased on the data of the active surveillance platform of the Apulia region, Italy, we selected the residents of Foggia district who were confirmed positive for SARS-CoV-2 from March 1st to June 16th, 2020, and home-quarantined with paucisymptomatic-to-mild clinical presentation. Self-reported olfactory and gustatory dysfunctions were recorded at baseline through a survey of dichotomous questions. The evolution of these symptoms at approximately one year was prospectively assessed via telephone by the validated sino-nasal outcome test 22 (SNOT-22, Italian version).ResultsAmong the 1,175 COVID-19 cases notified in the Foggia district during the first epidemic wave, 488 had paucisymptomatic-to-mild clinical presentation. Of these, 41.2% (n = 201, 95% confidence interval [CI] 36.8-45.7%) reported at least one sensory dysfunction. A total of 178 to 201 (88.5%) patients agreed to participate in the follow-up survey. According to the SNOT-22 results, the persistence of a sensory dysfunction was observed in the 29.8% (n = 53, 95% CI 23.2-37.1%) of them. Particularly, loss of smell persisted in 25.8% (n = 46, 95% CI 19.6-32.9%), loss of taste in 21.3% (n = 38, 95% CI 15.6-28.1%), loss of both in 17.4% (n = 31, 95% CI 12.2-23.8%) of participants in the follow-up. The rates of full recovery increased over time: from 59% at 30 days to 71.9% at 90 days for the sense of smell; from 61.3% at 30 days to 74.7% at 90 days for the sense of taste.ConclusionsThe persistence of COVID-19-related olfactory and gustatory dysfunctions up to 12 months after the disease onset in a noteworthy proportion (approximately 3 out of 10) of patients with paucisymptomatic-to-mild clinical presentation deserves further investigations due to its possible pathophysiological implications and impact on the quality of life.