New onset anosmia and ageusia in adult patients diagnosed with SARS-CoV-2

Patel, A.; Charani, E.; Ariyanayagam, D.; Abdulaal, A.; Denny, S.J.; Mughal, N.; Moore, L.S.P.

OBJECTIVE: We investigated the prevalence of anosmia and ageusia in adult patients with a laboratory confirmed diagnosis of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2). METHODS: A retrospective observational analysis of patients with SARS-CoV-2 admitted to hospital or managed in the community and their household contacts across a London population during March 1 - April 1, 2020. Symptomatology and duration were extracted from routinely collected clinical data and follow-up telephone consultations. Descriptive statistics were used. RESULTS: Of 386 patients, 141 (92 community patients, 49 discharged inpatients) were included for analysis. 77/141 (55%) reported anosmia and ageusia; nine reported only ageusia and three only anosmia. The median onset of anosmia in relation to onset of SARS-CoV-2 symptoms (as defined by the Public Health England case definition) was 4 days (Interquartile range 5). Median duration of anosmia was 8 days (IQR 16). Median duration of SARS-CoV-2 symptoms in community patients was 10 days (IQR 8) versus 18 days (IQR 13.5) in admitted patients. As of April 1, 45 patients had ongoing SARS-CoV-2 symptoms and/or anosmia. 107/141 (76%) patients had household contacts. Of 185 non-tested household contacts, 79 (43%) had SARS-CoV-2 symptoms with 46/79 (58%) reporting anosmia. Six household contacts had anosmia only. CONCLUSIONS: Over half of positive patients reported anosmia and ageusia suggesting these should be added to the case definition and guide self-isolation protocols. This adaptation may be integral to case finding in the absence of population-level testing. Until we have successful population-level vaccination coverage, these steps remain critical in the current and future waves of this pandemic.