Prospective Study in 355 Patients With Suspected COVID‐19 Infection: Value of Cough, Subjective Hyposmia, and Hypogeusia

• Published in: The Laryngoscope Vol. 130; no. 11; pp. 2674 - 2679
• Main Authors: Martin‐Sanz, Eduardo, Riestra, Juan, Yebra, Laura, Larran, Alba, Mancino, Fiorella, Yanes‐Diaz, Joaquin, Garrote, Maria, Colmenero, Marta, Montiel, Esther, Molina, Cristina, Moreno, Daniel, Rodriguez, Antonio, Monedero, Gerardo, Sanz‐Fernández, Ricardo, Gonzalez, Rocio, Esteban‐Sanchez, Jonathan
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-11-2020; Wiley Subscription Services, Inc
• Subjects: Adult; Ageusia - epidemiology; Ageusia - virology; Anosmia - epidemiology; Anosmia - virology; Case-Control Studies; Coronaviruses; Cough - epidemiology; Cough - virology; COVID-19; COVID-19 - complications; Female; Health Personnel - statistics & numerical data; Humans; Hyposmia, hypogeusia, COVID‐19, odds ratio, incidence, ROC; Incidence; Infections; Male; Middle Aged; Olfaction disorders; Olfaction‐Chemosensation; Prospective Studies; Real-Time Polymerase Chain Reaction; ROC Curve; SARS-CoV-2; Sensitivity and Specificity; Taste disorders; Hyposmia, hypogeusia, COVID-19, odds ratio, incidence, ROC
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.28999

Objective
To evaluate the incidence of certain symptoms in a population of health workers exposed to coronavirus disease 2019 patients.
Study Design
Case‐control study.
Methods
The study was conducted at a tertiary care hospital from March 1 to April 7, 2020. Health workers with suspected coronavirus disease 2019 (COVID‐19) infection were included. The presence of COVID‐19 was detected by using real‐time polymerase chain reaction (RT‐PCR) methods. Positive and negative RT‐PCR patients were used as case and control groups, respectively.
This study analyzed the incidence of COVID‐19 symptoms in both patient groups. Visual analog scales were used for self‐assessment of smell and taste disorders, ranging from 0 (no perception) to 10 (excellent perception).
Results
There were 215 (60.6%) patients with positive RT‐PCR and 140 (39.4%) patients with negative RT‐PCR. The presence of symptoms such as hyposmia hypogeusia, dysthermia, and cough were strongly associated with a positive RT‐PCR. The association of cough and subjective hyposmia had 5.46 times higher odds of having a positive test. The receiver operating characteristic (ROC) analysis showed that a fever higher than 37.45°C resulted in sensitivity and specificity of 0.65 and 0.61, respectively. A total of 138 cases (64.1%) and 114 cases (53%) had subjective hyposmia and hypogeusia, respectively. The 85.4% of these patients recovered olfactory function within the first 14 days of the onset of the symptoms.
Conclusion
There is a significant association between positive RT‐PCR and subjective hyposmia. The association of subjective hyposmia and cough increase significantly the odds of having a positive RT‐PCR. The measurement of fever as the only method for screening of COVID‐19 infection resulted in a poor association.
Level of Evidence
3 Laryngoscope, 130:2674–2679, 2020