Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study

J Investig Allergol Clin Immunol. 2020;30(5):346-357. doi: 10.18176/jiaci.0595. Epub 2020 Jun 17.


Background and objective: Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers.

Methods: We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms.

Results: STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection.

Conclusion: STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.

Keywords: COVID-19; Hospital admission; Loss of smell; Loss of taste; SARS-CoV-2.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Betacoronavirus* / genetics
  • Betacoronavirus* / immunology
  • COVID-19
  • Case-Control Studies
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / virology
  • Cross-Sectional Studies
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / diagnosis
  • Olfaction Disorders / epidemiology*
  • Olfaction Disorders / etiology*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / virology
  • Polymerase Chain Reaction
  • Public Health Surveillance
  • SARS-CoV-2
  • Severity of Illness Index
  • Spain / epidemiology
  • Symptom Assessment
  • Taste Disorders / diagnosis
  • Taste Disorders / epidemiology*
  • Taste Disorders / etiology*
  • Young Adult