Olfactory and Oral Manifestations of COVID-19: Sex-Related Symptoms—A Potential Pathway to Early Diagnosis

• Published in: Otolaryngology-head and neck surgery Vol. 163; no. 4; pp. 722 - 728
• Main Authors: Biadsee, Ameen, Biadsee, Ameer, Kassem, Firas, Dagan, Or, Masarwa, Shchada, Ormianer, Zeev
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2020
• Subjects: Adolescent; Adult; Aged; anosmia; Betacoronavirus; coronavirus; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; COVID-19; dysgeusia; Early Diagnosis; Female; Humans; Male; Middle Aged; Nasal Obstruction - diagnosis; Nasal Obstruction - etiology; Olfaction Disorders - diagnosis; Olfaction Disorders - etiology; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Retrospective Studies; SARS-CoV-2; Smell - physiology; xerostomia; Young Adult; COVID-19; coronavirus; xerostomia; dysgeusia; anosmia
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599820934380

Objective The coronavirus disease 2019 (COVID-19) pandemic poses a threat to global health. Early diagnosis is an essential key to limit the outbreak of the virus. Study Design Case series, study conducted between March 25, 2020, and April 15, 2020. Setting Ambulatory, nonhospitalized patients who were quarantined in a designated hotel for COVID-19 patients and were recruited by an advertisement at the hotel. Subjects and Methods In total, 140 patients participated in a web-based questionnaire assessing initial symptoms of common viral diseases, olfactory and taste functions, xerostomia, and orofacial pain. Results A total of 58 men and 70 women participated. Initial symptoms were cough (59.4%), weakness (47.7%), myalgia (46.9%), fever (42.2%), headache (40.6%), impaired sense of smell (38.3%), impaired sense of taste (32.8%), sore throat (26.6%), runny nose (26.6%), and nasal congestion (22.7%). All symptoms were more frequent among women; however, only runny nose was statistically significant (P = .018). The most common combination of symptoms was cough and weakness (37.5%). A total of 25.8% reported olfactory and taste dysfunctions in the absence of other symptoms. In a comparison between the sexes, cough and runny nose were the most common combination in women (P = .018). A total of 38.3% of patients reported olfactory dysfunction as an initial symptom. Anosmia and facial pain were more common among women (P < .001 and P = .01, respectively), and 56% of patients reported xerostomia. Conclusion A considerable number of patients presented with olfactory and oral disorders. Interestingly, women presented with a different cluster of symptoms than men, which may suggest a new clinical approach to diagnosing COVID-19 disease.