Frequency and outcome of olfactory impairment and sinonasal involvement in hospitalized patients with COVID-19

Neurol Sci. 2020 Sep;41(9):2331-2338. doi: 10.1007/s10072-020-04590-4. Epub 2020 Jul 12.


Background: Olfactory dysfunction has shown to accompany COVID-19. There are varying data regarding the exact frequency in the various study population. The outcome of the olfactory impairment is also not clearly defined.

Objective: To find the frequency of olfactory impairment and its outcome in hospitalized patients with positive swab test for COVID-19.

Methods: This is a prospective descriptive study of 100 hospitalized COVID-19 patients, randomly sampled, from February to March 2020. Demographics, comorbidities, and laboratory findings were analyzed according to the olfactory loss or sinonasal symptoms. The olfactory impairment and sinonasal symptoms were evaluated by 9 Likert scale questions asked from the patients.

Results: Ninety-two patients completed the follow-up (means 20.1 (± 7.42) days). Twenty-two (23.91%) patients complained of olfactory loss and in 6 (6.52%) patients olfactory loss was the first symptom of the disease. The olfactory loss was reported to be completely resolved in all but one patient. Thirty-nine (42.39%) patients had notable sinonasal symptoms while rhinorrhea was the first symptom in 3 (3.26%). Fifteen patients (16.3%) had a taste impairment. Patients with sinonasal symptoms had a lower age (p = 0.01). There was no significant relation between olfactory loss and sinonasal symptoms (p = 0.07).

Conclusions: Sudden olfactory dysfunction and sinonasal symptoms have a considerable prevalence in patients with COVID-19. No significant association was noted between the sinonasal symptoms and the olfactory loss, which may suggest that other mechanisms beyond upper respiratory tract involvement are responsible for the olfactory loss.

Keywords: Olfaction disorders; Pandemics; Smell; Taste.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / epidemiology
  • Female
  • Follow-Up Studies
  • Hospitalization / trends*
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders / diagnostic imaging*
  • Olfaction Disorders / epidemiology
  • Pandemics
  • Paranasal Sinuses / diagnostic imaging*
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / epidemiology
  • Prospective Studies
  • SARS-CoV-2
  • Treatment Outcome