It has by now been widely reported that anosmia is a symptom of COVID-19—the CDC just added new loss of sense of smell to its list of known COVID-19 symptoms in its guidelines. Otolaryngology research has taken that knowledge a step further with a new study out of the University of California, San Diego Health System in La Jolla, Calif., that shows that anosmia is also a determinant of a less severe COVID-19 infection.
The study “Self-reported olfactory loss associates with outpatient clinical course in Covid-19,” by Yan CH and colleagues, was accepted for publication in International Forum of Allergy & Rhinology (doi:10.1111/alr.22592) and first published online on April 24. In the study, a retrospective analysis of self-reporting of anosmia/hyposmia and dysgeusia was performed using the medical records and self-reporting data of 128 patients who tested positive for COVID-19 between March 3 and April 8, 2020 and had olfactory and gustatory data on file.
The researchers found that patients with anosmic/hyposmic COVID-19 were five-fold more likely to be managed in the outpatient setting, and more than 10-fold less likely to be admitted to the hospital than those who retained their senses of smell and taste. In addition, patients with positive findings on chest radiograph were eight times more likely to be admitted.
Other factors associated with hospital admission included age, diabetes mellitus, dyspnea, sputum production, temperature, heart rate, respiratory rate, whether a chest radiograph was performed, and chest radiograph findings positive for infiltrates and/or pleural effusion.
According to the study authors, the findings are consistent with those of other studies evaluating both inpatient and outpatient self-reported olfactory dysfunction. They hope that anosmia assessment in COVID-19-positive individuals may help guide the post-testing triage of these patients into high- and low-risk groups for hospitalization.
“Obviously, the decision to admit a patient versus send them home is a complex decision that integrates a lot of data across both clinical and social domains, but our data highlights the significance of factoring into that equation a simple question included on the review of systems,” said senior study author Adam S. DeConde, MD. “From a clinical perspective, though, I personally think of the data in the reverse of smell loss: Remain vigilant of the normosmic COVID-19 patient.”