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Association of olfactory dysfunction with hospitalization for COVID-19: a multicenter study in Kurdistan

By Hosna Zobairy, Erfan Shamsoddin, Mohammad Aziz Rasouli, Nasrollah Veisi Khodlan, Ghobad Moradi, Bushra Zareie, Sara Teymori, Jalal Asadi, Ahmad Sofi-Mahmudi, Ahmad Sedaghat

Posted 28 Jul 2020
medRxiv DOI: 10.1101/2020.07.26.20158550

Objective: To evaluate the association of olfactory dysfunction (OD) with hospitalization for COVID-19. Study Design: Multi-center cohort study. Setting: Emergency departments of thirteen COVID-19-designed hospitals in Kurdistan province, Iran. Subjects and Methods: Patients presenting with flu-like symptoms who tested positive by RT-PCR for COVID-19 between May 1st and 31st, 2020. At the time of presentation and enrollment, patients were asked about the presence of OD, fever, cough, shortness of breath, headache, rhinorrhea and sore throat. The severity of OD was assessed on an 11-point scale from 0 (none) to 10 (anosmia). Patients were either hospitalized or sent home for outpatient care based on standardized criteria. Results: Of 203 patients, who presented at a mean of 6 days into the COVID-19 disease course, 25 patients (12.3%) had new OD and 138 patients (68.0%) were admitted for their COVID-19. Patients admitted for COVID-19 had a higher prevalence of all symptoms assessed, including OD (p<0.05 in all cases), and OD identified admitted patients with 84.0% sensitivity and 34.3% specificity. On univariate logistic regression, hospitalization was associated with OD (odds ratio [OR] = 2.47, 95%CI: 1.085-6.911, p=0.049). However, hospitalization for COVID-19 was not associated with OD (OR=3.22, 95% CI: 0.57-18.31, p=0.188) after controlling for confounding demographics and comorbidities. Conclusion: OD may be associated with hospitalization for (and therefore more severe) COVID-19. However, this association between OD and COVID-19 severity is more likely driven by patient characteristics linked to OD, such as greater numbers of COVID-19 symptoms experienced or high-risk comorbidities.

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