key: cord-0860615-8ccftiwe
authors: Hornuss, Daniel; Lange, Berit; Schröter, Nils; Rieg, Siegbert; Kern, Winfried V.; Wagner, Dirk
title: Anosmia in COVID-19 patients
date: 2020-05-22
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.05.017
sha: 5e6f954d3cee79693ffefc03fda3691bf779c58d
doc_id: 860615
cord_uid: 8ccftiwe

nan

Coronaviruses (CoVs) including SARS-CoV-2, the cause of the current pandemic of coronavirus 28 disease 2019 (COVID-19), have a neuroinvasive propensity [1, 2] , with olfactorial neurons being 29 currently discussed as portal of entry for neuroinvasion and a spread of CoVs after infection of 30 neural cells from CNS to the periphery via a transneural route [1] . A quarter of admitted COVID-31 19 patients report a smelling disturbance [3], which may be related to this capability. We hypoth-32 esized that loss of smell is often not noted subjectively and that the proportion of affected pa-33 tients is higher. Burghart-Sniffin'-Sticks ® , a widely used screening test for smelling disorders, 34 was used in a prospective cross-sectional study to objectified the magnitude of the smelling dis- 

Neurologic Alterations Due to Respiratory

Report of impaired smelling (n, %, 95CI) ¶ yes 22 (49%) 10 (45%, 24-68%) 10 (45%, 24-68%) 2 (10%, 1-29%) no 23 (51%) 8 (34%, 16-57%) 10 (43%, 23-65%) 5 (21%, 7-43%) Time course (days; median ± STD) first symptom to first positive PCR result 2 ± 4.2 2 ± 4.1 1.5 ± 3.7 2 ± 4 first symptom to reported impaired smelling 5 ± 3.04 6.5 ± 3 2.5 ± 2.7 5.5 ± 2.5 first symptoms to Sniffin test 10 ± 5.1 11 ± 4 8.5 ± 4.5 12 ± 7.5 first positive PCR result to Sniffin test 4 ± 4.6 3.5 ± 3.9 4 ± 4.4 5 ± 6.3 COVID-19 patients diagnosed with Sniffin' sticks as normosmic, hyposmic or anosmic (e.g. correctly identifying 11-12, 7-10, and 0-6 odors of Sniffin' sticks, respectively) are shown. n, number; %, percentage; STD, standard deviation; 95%CI, 95% confidence interval; PCR, polymerase chain reaction; NIV = noninvasive ventilation; IMV, invasive mechanical ventilation; ECMO, extracorporal membrane oxygenation. § ± 2 days from the day of testing, n=33-41. # Linear regression analysis adjusted for age and sex show that COVID-19 patients on average smell 4 sticks less than uninfected controls. ¶ at the day of testing.*p< 0,001, chi square test with null hypothesis that anosmia in COVID-19 is the same as in controls.