key: cord-0994625-5oen603j
authors: Lovato, Andrea; Galletti, Cosimo; Galletti, Bruno; de Filippis, Cosimo
title: Clinical characteristics associated with persistent olfactory and taste alterations in COVID-19: A preliminary report on 121 patients
date: 2020-05-26
journal: Am J Otolaryngol
DOI: 10.1016/j.amjoto.2020.102548
sha: 84298acf83885936f21f1f9c03d730426cae16e3
doc_id: 994625
cord_uid: 5oen603j

nan

J o u r n a l P r e -p r o o f

To the Editor, many patients infected by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) reported olfactory and taste dysfunction [1] [2] . Anosmia and hypogeusia were recognized as presenting clinical symptoms of Coronavirus Disease 2019 (COVID-19) 3 . Sungnak et al. 4 investigated the expression of SARS-CoV-2 entry-associated genes in multiple tissues from healthy human donors. They found that these genes were expressed in nasal epithelial cells, highlighting the cells' potential role in initial viral infection.

A multicenter European study enrolling 417 mild-to-moderate COVID-19 patients found olfactory/taste alterations in more than 80% of cases 5 . The early follow up of these patients (14 days) showed that olfactory dysfunction persisted in 56% of cases 5 . In the present investigation, our primary aim was to evaluate olfactory/taste alterations one month after COVID-19 diagnosis. The secondary aim was to search clinical characteristics associated with the persistence of sensory dysfunctions.

Three ethics committees approved the study protocol (HAP2020-011; CHUSP20032020; EpiCURA-2020-2303). Informed consent was obtained verbally during telephone interviews. Inclusion criteria were: i) > 18 years old; ii) laboratory-confirmed COVID-19 infection (reverse transcription polymerase chain reaction on nasopharyngeal swab) at least one month before inclusion; iii) olfactory and/or taste dysfunction. Exclusion criteria: i) patients with olfactory/gustatory alterations before the epidemic; ii) patients who were in the intensive-care unit at the time of the study (due to their health status). Thus, we included mild-to-moderate COVID-19 patients, defined as patients without need of intensive cares.

During the telephonic survey, we used the questionnaire proposed by the COVID-19 Task Force of YO-IFOS 5 . We classified the outcome of olfactory/taste dysfunction as persistence (1) Previous studies have already shown the ability of SARS coronavirus to cause neuronal death in mice by invading the brain via the nose close to the olfactory epithelium 1 . We could hypothesize that SARS-CoV-2 has a similar behavior, given the well-known genetic similarity with other coronaviruses 3 . In a recent clinical study, Vaira et al. 6 considering 72 COVID-19 cases, found in 34% a persistence of alterations in taste and olfaction. Also in our series of 121 COVID-19 patients olfactory and taste alterations lasted more than one month in 21.5% of cases. However, most of patients reported resolution of symptoms after a mean of 15 days, and this confirmed the data from previous survey 5 . In the present investigation, J o u r n a l P r e -p r o o f 8 

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