Factors associated with anosmia and ageusia in COVID-19 patients in a Peruvian province
DOI:
https://doi.org/10.17533/udea.iatreia.152Keywords:
Ageusia , Anosmia , Coronavirus , COVID-19 , Smell , TasteAbstract
Objective: To identify the clinical presentation and factors associated with anosmia and ageusia in patients with COVID-19 in a health center in a province of Peru for the period 2020-2021.
Methods: Cross-sectional analytical study through data from the COVID-19 program of the Essalud Polyclinic in Jauja, Peru. Sociodemographic characteristics, symptoms and comorbidities of the patients were detailed. A bivariate analysis identified the factors associated with anosmia and ageusia.
Results: 356 patients were identified: 53.1 % were women, mean age was 48.7 years (±17.8) and 261 (73.3%) with mild COVID-19. Of the total, 22.2% had anosmia and 19.9% ageusia; of which the majority were under 65 and female. Associated symptoms were found in 86.1% of patients with anosmia and 83.1% with ageusia. The main factors associated with anosmia were age younger than 65 years (p=0.027), cough (p<0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and fever (p<0.001); and ageusia: age younger than 65 years (p=0.006), cough (p=0.001), headache (p<0.001), dyspnea (p<0.001), nasal congestion (p<0.001) and diarrhea (p<0.001).
Conclusion: Anosmia and ageusia are common symptoms of COVID-19. Most patients had these symptoms associated with common symptoms. Many of those who had anosmia had nasal congestion, so it is advisable to consider differentiating them when making the diagnosis.
Downloads
References
(1) Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. DOI 10.1056/NEJMoa2002032.
(2) OMS. Alocución de apertura del director general de la OMS en la rueda de prensa sobre la COVID-19 celebrada el 11 de marzo de 2020 [Internet]. Ginebra: OMS; 2020 c1998-2021 [citado 10 de mayo de 2021]. Disponible en: https://bit.ly/3qn4552
(3) WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. Ginebra: OMS; 2020 c1998-2021 [citado 29 de mayo de 2021]. Disponible en: https://covid19.who.int
(4) Perú. Ministerio Salud. Primer caso de coronavirus en Perú se dio en un joven procedente de Europa, confirma Martín Vizcarra [Internet]. Perú: Ministerio; c1998-2021 [citado 10 de mayo de 2021]. Disponible en: https://bit.ly/3wsWNhn
(5) Cáceres-Bernaola U, Becerra-Núñez C, Mendívil-Tuchía de Tai S, Ravelo-Hernández J. Primer fallecido por COVID-19 en el Perú. An Fac Med. 2020;81(2):201-4. DOI 10.15381/anales.v81i2.17858.
(6) COVID-19 Map [Internet]. Johns Hopkins Coronavirus Resource Center. EE. UU: jhu; c1996-2021 [citado 29 de mayo de 2021]. Disponible en: https://bit.ly/3mUWDvX
(7) Salleh MZ, Derrick JP, Deris ZZ. Structural Evaluation of the Spike Glycoprotein Variants on SARS-CoV-2 Transmission and Immune Evasion. Int J Mol Sci. 2021;22(14):7425. DOI 10.3390/ijms22147425.
(8) Solari Zerpa L, Huayra Niquén J, Padilla Rojas CP, Hurtado Vela CV, Mestanza Millones O, Morales Ruiz S, et al. Informe técnico: actualización de la identificación de variantes circulantes de SARS-CoV-2 en el Perú [Internet]. Instituto Nacional de Salud; 2021 [citado 26 de septiembre de 2021]. Disponible en: https://bit.ly/3ovs3ZF
(9) DE Felice F, Polimeni A. Coronavirus Disease (COVID-19): A Machine Learning Bibliometric Analysis. Vivo Athens Greece. 2020;34(3 Suppl):1613-7. DOI 10.21873/invivo.11951.
(10) Zhu J, Ji P, Pang J, Zhong Z, Li H, He C, et al. Clinical characteristics of 3062 COVID-19 patients: A meta-analysis. J Med Virol. 2020;92(10):1902-14. DOI 10.1002/jmv.25884.
(11) Zhao XY, Xu XX, Yin HS, Hu QM, Xiong T, Tang YY, et al. Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis. 2020;20(1):311. DOI 10.1186/s12879-020-05010-w.
(12) Pan L, Mu M, Yang P, Sun Y, Wang R, Yan J, et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol. 2020;115(5):766-73. DOI 10.14309/ajg.0000000000000620.
(13) Zhao Q, Fang X, Pang Z, Zhang B, Liu H, Zhang F. COVID‐19 and cutaneous manifestations: A systematic review. J Eur Acad Dermatol Venereol. 2020;34:2505-10. DOI 10.1111/jdv.16778.
(14) Estébanez A, Pérez-Santiago L, Silva E, Guillen-Climent S, García-Vázquez A, Ramón MD. Cutaneous manifestations in COVID-19: a new contribution. J Eur Acad Dermatol Venereol JEADV. 2020;34(6):e250-1. DOI 10.1111/jdv.16474.
(15) Pallanti S. Importance of SARs-Cov-2 anosmia: From phenomenology to neurobiology. Compr Psychiatry. 2020;100:152184. DOI 10.1016/j.comppsych.2020.152184.
(16) Rosales-Castillo A, García de los Ríos C, Mediavilla García JD. Persistent symptoms after acute COVID-19 infection: importance of follow-up. Med Clínica Engl Ed. 2021;156(1):35-6. DOI 10.1016/j.medcle.2020.08.003.
(17) Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90. DOI 10.1001/jamaneurol.2020.1127.
(18) Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Bourbao-Tournois C, Laribi S, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2021;27(2):258-63. DOI 10.1016/j.cmi.2020.09.052.
(19) Achar A, Ghosh C. COVID-19-Associated Neurological Disorders: The Potential Route of CNS Invasion and Blood-Brain Barrier Relevance. Cells. 2020;9(11):2360. DOI 10.3390/cells9112360.
(20) Aslan C, Nikfarjam S, Asadzadeh M, Jafari R. Neurological manifestations of COVID-19: with emphasis on Iranian patients. J Neurovirol. 2021;27(2):217-27. DOI 10.1007/s13365-021-00964-2.
(21) Hwang C-S. Olfactory neuropathy in severe acute respiratory syndrome: report of A case. Acta Neurol Taiwanica. 2006;15(1):26-8.
(22) Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. DOI 10.1038/s41586-020-2951-z.
(23) Korber B, Fischer WM, Gnanakaran S, Yoon H, Theiler J, Abfalterer W, et al. Tracking Changes in SARS-CoV-2 Spike: Evidence that D614G Increases Infectivity of the COVID-19 Virus. Cell. 2020;182(4):812-827.e19. DOI 10.1016/j.cell.2020.06.043.
(24) von Bartheld CS, Hagen MM, Butowt R. The D614G Virus Mutation Enhances Anosmia in COVID-19 Patients: Evidence from a Systematic Review and Meta-analysis of Studies from South Asia. ACS Chem Neurosci. 2021;12(19):3535-3549. DOI 10.1021/acschemneuro.1c00542.
(25) Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251-61. DOI 10.1007/s00405-020-05965-1.
(26) Mariños E, Espino A, Rodriguez L, Barreto E. Manifestaciones neurológicas asociadas a COVID-19 en el Hospital Edgardo Rebagliati Martins, Perú. Rev Neuropsiquiatr. 2020;83(4):243-56. DOI 10.20453/rnp.v83i4.3890.
(27) Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, et al. COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Med Infect Dis. 2021;40:101995. DOI 10.1016/j.tmaid.2021.101995.
(28) OMS. Manejo clínico de la COVID-19: orientaciones evolutivas, 25 de enero de 2021 [Internet]. Ginebra: OMS; 2020 c1998-2021 [citado 26 de septiembre de 2021]. Disponible en: https://bit.ly/3qhutNU
(29) Vaira LA, Deiana G, Fois AG, Pirina P, Madeddu G, De Vito A, et al. Objective evaluation of anosmia and ageusia in COVID-19 patients: Single-center experience on 72 cases. Head Neck. 2020;42(6):1252-8. DOI 10.1002/hed.26204.
(30) Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, et al. Self-reported Olfactory and Taste Disorders in Patients with Severe Acute Respiratory Coronavirus 2 Infection: A Cross-sectional Study. Clin Infect Dis. 2020;71(15):889-90. DOI 10.1093/cid/ciaa330.
(31) OMS. La escasez de equipos de protección personal pone en peligro al personal sanitario en todo el mundo [Internet]. Ginebra: OMS; 2020 c1998-2021 [citado 10 de mayo de 2021]. Disponible en: https://bit.ly/3wsjgLu
(32) Samaranayake LP, Fakhruddin KS, Panduwawala C. Sudden onset, acute loss of taste and smell in coronavirus disease 2019 (COVID-19): a systematic review. Acta Odontol Scand. 2020;78(6):467-73. DOI 10.1080/00016357.2020.1787505.
(33) Chen M, Shen W, Rowan NR, Kulaga H, Hillel A, Ramanathan M, et al. Elevated ACE-2 expression in the olfactory neuroepithelium: implications for anosmia and upper respiratory SARS-CoV-2 entry and replication. Eur Respir J. 2020;56(3):2001948. DOI 10.1183/13993003.01948-2020.
(34) Mascola JR, Graham BS, Fauci AS. SARS-CoV-2 Viral Variants-Tackling a Moving Target. JAMA. 6 de abril de 2021;325(13):1261-1262. DOI 10.1001/jama.2021.2088.
(35) Graham MS, Sudre CH, May A, Antonelli M, Murray B, Varsavsky T, et al. Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study. Lancet Public Health. 1 de mayo de 2021;6(5):e335-45. DOI 10.1016/S2468-2667(21)00055-4.
(36) Meunier N, Briand L, Jacquin-Piques A, Brondel L, Pénicaud L. COVID 19-Induced Smell and Taste Impairments: Putative Impact on Physiology. Front Physiol. 2021;11:625110. DOI 10.3389/fphys.2020.625110.
(37) Barón-Sánchez J, Santiago C, Goizueta-San Martín G, Arca R, Fernández R. Afectación del sentido del olfato y el gusto en la enfermedad leve por coronavirus (COVID-19) en pacientes españoles. Neurol Barc Spain. 2020;35(9):633-8. DOI 10.1016/j.nrl.2020.07.006.
(38) Mutiawati E, Fahriani M, Mamada SS, Fajar JK, Frediansyah A, Maliga HA, et al. Anosmia and dysgeusia in SARS-CoV-2 infection: incidence and effects on COVID-19 severity and mortality, and the possible pathobiology mechanisms - a systematic review and meta-analysis. F1000Res. 2021;10:40. DOI 10.12688/f1000research.28393.1.
(39) Rearte A, María-Baldani A, Barcena P, Domínguez C, Laurora M, Pesce M, et al. Características epidemiológicas de los primeros 116 974 casos de Covid-19 en Argentina, 2020. Rev Argent Salud Publica. 2020;12(Supl):1-9.
(40) Dev N, Sankar J, Gupta N, et al. COVID-19 with and without anosmia or dysgeusia: a case-control study. J Med Virol. 2021;93(4):2499–504. DOI 10.1002/jmv.26784.
(41) Doty RL. Age-Related Deficits in Taste and Smell. Otolaryngol Clin North Am. 2018;51(4):815-25. DOI 10.1016/j.otc.2018.03.014.
(42) Sepúlveda-Loyola W, Rodríguez-Sánchez I, Pérez-Rodríguez P, Ganz F, Torralba R, Oliveira DV, et al. Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations. J Nutr Health Aging. 2020;24(9):938-47. DOI 10.1007/s12603-020-1469-2.
(43) López G, Tarazona A, Cruz-Vargas J. Distribución regional de mortalidad por Covid-19 en Perú. Rev Fac Med Hum. 2021;21(2):326-334. DOI 10.25176/rfmh.v21i2.3721.
(44) Bhopal SS, Bhopal R. Sex differential in COVID-19 mortality varies markedly by age. The Lancet. 22 de agosto de 2020;396(10250):532-3. DOI 10.1016/S0140-6736(20)31748-7.
(45) Peckham H, de Gruijter N, Raine C, Radziszewska A, Ciurtin C, Wedderburn L, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commum. 2020;11:6317. DOI 10.1038/s41467-020-19741-6.
(46) Makaronidis J, Mok J, Balogun N, Magee CG, Omar RZ, Carnemolla A, et al. Seroprevalence of SARS-CoV-2 antibodies in people with an acute loss in their sense of smell and/or taste in a community-based population in London, UK: An observational cohort study. PLoS Med. 2020;17(10):e1003358. DOI 10.1371/journal.pmed.1003358.
(47) Villalba N, Maouche Y, Alonso Ortiz MB, Cordoba Sosa Z, Chahbazian JB, Syrovatkova A, et al. Anosmia and Dysgeusia in the Absence of Other Respiratory Diseases: Should COVID-19 Infection Be Considered? Eur J Case Rep Intern Med. 2020;7(4):001641. DOI 10.12890/2020_001641.
(48) Zhang Q, Shan KS, Abdollahi S, Nace T. Anosmia and Ageusia as the Only Indicators of Coronavirus Disease 2019 (COVID-19). Cureus. 2020;12(5):e7918. DOI 10.7759/cureus.7918.
(49) Gómez-Iglesias P, Porta-Etessam J, Montalvo T, Valls-Carbó A, Gajate V, Matías-Guiu JA, et al. An Online Observational Study of Patients With Olfactory and Gustory Alterations Secondary to SARS-CoV-2 Infection. Front Public Health. 2020;8:243. DOI 10.3389/fpubh.2020.00243.
(50) Lechien JR, Cabaraux P, Chiesa-Estomba CM, Khalife M, Hans S, Calvo-Henriquez C, et al. Objective olfactory evaluation of self-reported loss of smell in a case series of 86 COVID-19 patients. Head Neck. 2020;42(7):1583-90. DOI 10.1002/hed.26279.
(51) Tanasa IA, Manciuc C, Carauleanu A, Navolan DB, Bohiltea RE, Nemescu D. Anosmia and ageusia associated with coronavirus infection (COVID-19) - what is known? Exp Ther Med. 2020;20(3):2344-7. DOI 10.3892/etm.2020.8808.
(52) Zheng J, Wong LY, Li K, Verma AK, Ortiz M, Wohlford-Lenane C, et al. COVID-19 treatments and pathogenesis including anosmia in K18-hACE2 mice. Nature. 2021;589(7843):603-7. DOI 10.1038/s41586-020-2943-z.
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Iatreia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Papers published in the journal are available for use under the Creative Commons license, specifically Attribution-NonCommercial-ShareAlike 4.0 International.
The papers must be unpublished and sent exclusively to the Journal Iatreia; the author uploading the contribution is required to submit two fully completed formats: article submission and authorship responsibility.
