Chemical Senses

BackgroundSigns of anosmia can help detect COVID-19 infection when testing for viral positivity is not available. Inexpensive mass-produced disposable olfactory sensitivity tests suitable for worldwide use might serve not only as a screening tool for potential infection but also to identify cases at elevated risk of severe disease as anosmic COVID-19 patients have a better prognosis. Methods and FindingsWe adopted paired crushable ampules with two concentrations of a standard test odorant (n-butanol) as standard of care in several clinics as community prevalence of COVID-19 infection waxed and waned. This was not a clinical trial; a chart review was undertaken to evaluate the operating characteristics and potential utility of the test device as RT-PCR testing became routine. The risk of anosmia was greater in COVID-19 patients. Olfactory sensitivity was concentration-dependent, decreased with aging, and was sex-dependent at the highest concentration. Hyposmia was detected across a wider age range than expected from the literature, and tests can be optimized to characterize different age groups. Conclusionsn-Butanol at 0.32 and 3.2% in crushable ampules can be used to characterize olfactory function quickly and inexpensively and thus has potential benefits in pandemic screening, epidemiology, and clinical decision-making.

SCENTinel - a rapid, inexpensive smell test that measures odor detection, intensity, identification, and pleasantness - was developed for population-wide screening of smell function. SCENTinel was previously found to screen for multiple types of smell disorders. However, the effect of genetic variability on SCENTinel test performance is unknown, which could affect the tests validity. This study assessed performance of SCENTinel in a large group of individuals with a normal sense of smell to determine the test-retest reliability and the heritability of SCENTinel test performance. One thousand participants (36 [IQR 26-52] years old, 72% female, 80% white) completed a SCENTinel test at the 2021 and 2022 Twins Days Festivals in Twinsburg, OH, and 118 of those completed a SCENTinel test on each of the festivals two days. Participants comprised 55% percent monozygotic twins, 13% dizygotic twins, 0.4% triplets, and 36% singletons. We found that 97% of participants passed the SCENTinel test. Test-retest reliability ranged from 0.57 to 0.71 for SCENTinel subtests. Broad-sense heritability, based on 246 monozygotic and 62 dizygotic twin dyads, was low for odor intensity (r=0.03) and moderate for odor pleasantness (r=0.4). Together, this study suggests that SCENTinel is a reliable smell test with only moderate heritability effects, which further supports its utility for population-wide screening for smell function.

BackgroundThe aims of this study are to investigate the COVID-19 status of patients with initial sudden olfactory anosmia (ISOA) using nasopharyngeal swabs for RT-PCR analysis and to explore their olfactory dysfunctions with psychophysical olfactory evaluation. MethodologyThis prospective study included 78 ISOA patients who fulfilled a patient-reported outcome questionnaire and underwent a nasopharyngeal swabs. Among these, 46 patients performed psychophysical olfactory evaluation using sniffing tests. Based on the duration of the ISOA, two groups of patients were compared: patients with anosmia duration [≤]12 days (group 1) and those with duration >12 days (group 2). ResultsAmong group 1, 42 patients (87.5%) had a positive viral load regarding RT-PCR while 6 patients (12.5%) were negative. In group 2, 7 patients (23%) had a positive viral load and 23 patients (77%) were negative. Among the 46 patients having performed a psychophysical olfactory evaluation, we observed anosmia in 52% (N=24), hyposmia in 24% (N=11) and normosmia in 24% (N=11) of patients. The viral load significantly decreased throughout the 14-days following the onset of the olfactory disorder. ConclusionsOur results support that a high proportion of ISOA patients are Covid+. Our study supports the need to add anosmia to the list of symptoms used in screening tools for possible COVID-19 infection.

Loss of smell function (Anosmia) is reported to be associated with novel coronavirus disease 2019 (COVID-19) infection. The present study was designed to evaluate the effectiveness of an indigenously developed prototype smell test to identify/diagnose asymptomatic COVID-19 positive individuals. A panel of five different odorants belonging to Indian household with unique and mutually exclusive odor were used to develop prototype kit to test the hypothesis. The developed prototype kit was tested at 2 centers (N = 49 and 34) with slight modifications. Simultaneously, the kit was also tested on 55 (N = 35 and 20) healthy controls. Our results indicate that otherwise asymptomatic COVID-19 positive individuals were having quantifiable deficit in smell sensation. Interestingly, the variable sensitivity of different odorants was observed in different patients. None of the healthy controls reported difficulty in sensing any of the odorant, whereas, some of healthy controls did misidentify the odorants. Overall, the present study provides a preliminary data that loss in smell sensation for various odorants can be exploited as a quick and affordable screening test to identify infected cases among at risk individuals.

A significant fraction of people who test positive for COVID-19 have chemosensory deficits. However, the reported prevalence of these deficits in smell and/or taste varies widely, and the reason for the differences between studies is unclear. We determined the pooled prevalence of such chemosensory deficits in a systematic review. We searched the COVID-19 portfolio of the National Institutes of Health for all studies that reported the prevalence of smell and/or taste deficits in patients diagnosed with COVID-19. Forty-two studies reporting on 23,353 patients qualified and were subjected to a systematic review and meta-analysis. Estimated random prevalence of olfactory dysfunction was 38.5%, of taste dysfunction was 30.4% and of overall chemosensory dysfunction was 50.2%. We examined the effects of age, disease severity, and ethnicity on chemosensory dysfunction. The effect of age did not reach significance, but anosmia/hypogeusia decreased with disease severity, and ethnicity was highly significant: Caucasians had a 3-6 times higher prevalence of chemosensory deficits than East Asians. The finding of ethnic differences points to genetic, ethnicity-specific differences of the virus-binding entry proteins in the olfactory epithelium and taste buds as the most likely explanation, with major implications for infectivity, diagnosis and management of the COVID-19 pandemic.

Olfactory dysfunction following viral infection is a debilitating condition. Currently, the recommended treatment for olfactory dysfunction is olfactory training, a systematic and repeated exposure to odors over a prolonged period. A new tool has been proposed for olfactory training that present odors using nasal inserts rather than hand-held devices, to increase ease of training and thereby improving compliance and adherence to the training regimen. Here, we aimed to determine how olfactory training affects subjective experience of quality of life and olfactory function and potential differences training using regular versus the nasal insert setup. Using a randomized controlled design (N = 111), we investigated the effects of an 8-week olfactory training regimen using nasal inserts compared to standard care olfactory training in individuals with post-viral functional hyposmia. Subjective measures of quality of life as well as qualitative and quantitative olfactory function were assessed before and after the training regimen, and during a 1-year follow-up. Overall, participants showed significant and sustained improvements in both subjective olfactory function and quality of life following training. Critically, the nasal insert group demonstrated greater gains in social functioning and quantitative olfactory scores shortly after training, with enhanced olfactory benefits persisting at the 1-year follow-up. The magnitude of changes in quality of life was correlated with subjective olfactory improvement overall, with a stronger association for the nasal insert group. Thus, nasal insert training appears to enhance perceived olfactory function, which coincides with improved quality of life. Findings from this trial provide insight into the benefits of olfactory training on subjective functioning and quality of life, as well as the efficacy of nasal insert training in post-viral hyposmia.

ObjectiveTo investigate olfactory dysfunction (OD) in patients with mild COVID-19 through patient-reported outcome questionnaires and objective psychophysical testing. MethodsCOVID-19 patients with self-reported sudden-onset OD were recruited. Epidemiological and clinical data were collected. Nasal complaints were evaluated with the sino-nasal outcome-22 (SNOT-22). Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey (NHNES). Objective OD was evaluated using psychophysical tests. ResultsEighty-six patients completed the study. The most common symptoms were fatigue (72.9%), headache (60.0%), nasal obstruction (58.6%) and postnasal drip (48.6%). Total loss of smell was self-reported by 61.4% of patients. Objective olfactory testings identified 41 anosmic (47.7%), 12 hyposmic (14.0%), and 33 normosmic (38.3%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip. ConclusionA significant proportion of COVID-19 patients reporting OD do not have OD on objective testing.

BackgroundSymptoms after COVID-19 infection affect the quality of life of its survivor especially to the special senses including olfactory function. It is important to prevent the disability at an earlier stage. Vaccination as key prevention has been proven to be effective in reducing symptomatic disease and severity. However, the effects of vaccination on post COVID symptoms have not been evaluated. This study aimed to evaluate the possible protection of full vaccination and the occurrence of post-COVID olfactory dysfunction, specifically anosmia and hyposmia in patients who were diagnosed with COVID19. MethodA longitudinal analysis using the retrospective cohort of the Indonesian patient-based Post-COVID survey collected from July 2021 until December 2021, involving COVID-19 Patients confirmed by RT-PCR and/or Antigen test. Variables including demography, comorbidities, health behavior, type of vaccine, symptoms, and treatment were collected through an online questionnaire based on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Participants were matched (1:1) using propensity matching score into two exposure statuses, infected 1)>14 days of full vaccination and 2)<14 days or incomplete or unvaccinated. The olfactory dysfunction was assessed two weeks and four weeks after negative conversion with PCR using a self-measured olfactory questionnaire (MOQ). The Generalized Estimating Equation (GEE) was performed to assess the effect of full vaccination on post-COVID olfactory dysfunction. The Receiver Operating Characteristic determined the sensitivity and specificity of the cutoff value of the days from fully vaccinated to diagnosis and the olfactory dysfunction. ResultsA total of 442 participants were extracted from the cohort and inoculated with the inactivated viral vaccine (99.5%). The prevalence of olfactory dysfunction in two weeks was 9.95% and 5.43% after four weeks. Adjusted by other variables, people who were infected >14 days after being fully vaccinated had a 69% (adjusted OR 0.31 95% CI 0.102-0.941) probability of developing olfactory dysfunction. Longer days of fully vaccinated to infection associated with increased risk (adjusted OR 1.012 95% CI 1.002-1.022 p-value 0.015). A cut-off of 88 days of full vaccination-to-diagnosis duration has Area Under Curve (AUC) of 0.693 (p=0.002), the sensitivity of 73.9%, and specificity of 63.3% in differentiating the olfactory dysfunction event in two weeks after COVID with a crude odds ratio of 4.852 (95% CI 1.831-12.855 p=0.001) ConclusionAfter 14 days of full vaccination, the protective effect could reduce the chance of post-COVID olfactory dysfunction although a longer full vaccination-to-diagnosis duration increases the risk. It is important to consider a booster shot starting from 89 days after the last dose in those who received the inactivated viral regimen.

Since the onset of the COVID-19 infection, many patients reported sudden loss of smell (SLS). However, due to the lack of psychophysical testings, it remains difficult to know if these patients really have hyposmia or anosmia. Our group investigated the prevalence of anosmia and hyposmia in 28 COVID-19 patients and the potential association with nasal complaints.

BackgroundSmell and taste disorders are reported very frequently and at an early stage in the evolution of the infectious disease caused by the SARS-CoV-2. These symptoms could be sensitive and specific to establish the condition of the infection, and may suggest the flow of decisions as to further therapy. We asked whether smell and taste impairment are earlier and more sensitive symptoms than the RT-PCR molecular assays for SARS-CoV-2 detection. MethodologySubjects (N=275) with a probable COVID19 diagnosis were classified as follows: Symptomatic with chemosensory dysfunction, symptomatic without chemosensory dysfunction, and asymptomatic. Subjects received a general clinical and otorhinolaryngology examination. Evaluation of the chemosensory dysfunction was performed by means of the Venezuelan Olfactory Test and taste test. Nasal swabs and blood samples were analyzed by real-time polymerase chain reaction analysis (RT-PCR) and a rapid diagnostic test to detect the SARS-CoV-2 virus and antiviral antibodies, respectively. Patients had access to molecular tests and smell and taste evaluations every 3 to 5 days until they recovered. ResultsOut of 44 patients that were positive for RT-PCR SARS-CoV-2: 45.83% had smell and taste disorders and COVID19 symptoms, 23.61% did not have smell or taste disorders, but had COVID19 symptoms, and 30.55% were asymptomatic. Mild hyposmia and hypogeusia account for the most frequent chemosensory disorders accompanying common SARS-CoV-2 symptoms. Time to recover from the chemosensory dysfunction ranges from 3 to 14 days, up to a maximum of 5 weeks, while RT-PCR becomes negative after 21 days and up to 35 days in some cases. The Venezuelan Olfactory Test and taste test has a 61.68% positive predictive value, 45.83% sensitivity, and 68.7% specificity for SARS-CoV-2 infection. ConclusionsSmell and taste disorders are frequent symptoms of SARS-CoV-2 infection, but not a significant predictor of the disease, as compared to the molecular RT-PCR test.

BackgroundOlfactory impairment is a major sequela of SARS-CoV-2 infection and has a negative impact on daily life quality. Olfactory loss can be assessed in many ways but seems to be little realized in a daily clinical practice. The sniffin Sticks test - 12 items (SST-12) can be used in quick olfactory disorders screening. Its use in a post-covid19 situation was the main objective of this work. MethodologyConsecutive patients consulting to the ENT department with post-Covid-19 olfactory loss were included. The clinical examination included an analog scale for the self-assessment of olfactory recovery (VAS), self-reported salt and sugar intake, a nasofibroscopy, the complete Sniffin Stick Test (SST) and the SST-12. ResultsAmong the 54 patients included, based on the SST-12, 14,8% (n=8) of the patients could be classified as normosmic (SST-12[&ge;]11), 48,1% (n=26) as hyposmic (6< SST-12<10) and 37% (n=20) as functional anosmic (SST-12[&le;]6). We report excellent and significant correlations between SST-12 and SST or VAS assessments. Salt and Sugar increased intake seems significantly related to SST-12 results. ConclusionsSST-12 is a reliable way to screen post-COVID-19 olfactory disorders could be used in a daily clinical practice and might be used to prevent bad diet habits and so cardiovascular risk.

ObjectiveTo determine the prevalence of olfactory dysfunctions, mainly, anosmia and to identify its associated factors in patients with COVID-19 infection. Study designA hospital-based prospective observational cohort study SettingA COVID dedicated hospital, Square Hospitals Ltd., Dhaka, Bangladesh. MethodsWe collected patients information including laboratory-confirmed COVID-19 test results. We used Pearson Chi-square test and logistic regression model to assess the associations between demographic and clinical characteristics and olfactory outcomes. ResultsOut of 600 COVID-19 positive patients, 38.7% were diagnosed with olfactory dysfunction. Our analyses showed that patients age, smoking status, cough, dyspnea, sore throat, asthenia, and nausea or vomiting were significantly associated with the anosmia. We observed the risk of developing anosmia was greater in younger patients than in older patients, and this risk decreased as age increased [odds ratio (OR) range for different age groups: 1.26 to 1.08]. Smoking patients were 1.73 times more likely to experience anosmia than non-smoking patients [OR=1.73, 95% confidence interval (CI) = 1.01-2.98]. In addition, patients complained asthenia had a significantly double risk of developing the anosmia [OR = 1.96, CI = 1.23-3.06]. ConclusionsOur study shows that about 39% of patients diagnosed with olfactory dysfunction. Patients age, smoking status, and asthenia are significantly positively associated with the anosmia. Since anosmia can be a significant marker for the diagnosis of COVID-19, we suggest regular screening of olfactory dysfunction in patients with early symptoms of COVID-19, particularly younger patients, smoker, and complained asthenia.

OBJECTIVESDiagnosis of smell/taste dysfunction is necessary for appropriate medical care. This study examines factors affecting testing and diagnosis of smell/taste disorders. METHODSThe online USA Smell and Taste Patient Survey was made available to US patients with smell/taste disorders between April 6-20, 2022. 4,728 respondents were included. RESULTS1,791 (38%) patients reported a documented diagnosis. Patients most often saw family practitioners (34%), otolaryngologists (20%), and Taste/Smell clinics (6%) for smell/taste dysfunction. 64% of patients who went to Taste/Smell clinics received smell testing, followed by 39% of patients who saw otolaryngologists, and 31% of patients who saw family practitioners. Factors associated with increased odds of diagnosis included age (25-39 years (OR 2.97, 95% CI [2.25, 3.95]), 40-60 (OR 3.3, 95% CI [2.56, 4.52]), and >60 (OR 4.25, 95% CI [3.21, 5.67]) vs. 18-24 years), male gender (OR 1.26, 95% CI [1.07, 1.48]), insurance status (private (OR 1.61, 95% CI [1.15, 2.30]) or public (OR 2.03, 95% CI [1.42, 2.95]) vs. uninsured), perception of their family practitioner to be knowledgeable (OR 2.12, 95% CI [1.16, 3.90]), otolaryngologic evaluation (OR 6.17, 95% CI [5.16, 7.38]), and psychophysical smell testing (OR 1.77, 95% CI [1.42, 2.22]). CONCLUSIONPsychophysical testing, otolaryngologic evaluation, patient assessment of family practitioner knowledge level, insurance, age, and gender are significant factors in obtaining smell/taste dysfunction diagnosis. This study identifies barriers to diagnosis including lack of insurance or access to specialist evaluation and highlights the importance of educating family practitioners in diagnosis and management of patients with smell/taste disorders.

BackgroundRecent surge of olfactory dysfunction in patients who were referred to ENT clinics and concurrent COVID-19epidemic in Iran motivated us to evaluate anosmic/hyposmic patients to find any relation between these two events. MethodsThis is a cross-sectional study with an online checklist on voluntary cases in all provinces of Iran between the 12th and 17th March, 2020. Cases was defined as self-reported anosmia/hyposmia in responders fewer than 4 weeks later (from start the of COVID-19 epidemic in Iran). Variables consist of clinical presentations, related past medical history, family history of recent respiratory tract infection and hospitalization. ResultsIn this study 10069 participants aged 32.5{+/-}8.6 (7-78) years, 71.13% female and 81.68% non-smoker completed online checklist. They reported 10.55% a history of a trip out of home town and 1.1% hospitalization due to respiratory problems recently. From family members 12.17% had a history of severe respiratory disease in recent days and 48.23% had anosmia/hyposmia. Correlation between the number of olfactory disorder and reported COVID-19 patients in all 31 provinces till 16th March 2020 was highly significant (Spearman correlation coefficient=0.87, p-Value<0.001). The onset of anosmia was sudden in 76.24% and till the time of filling the questionnaire in 60.90% of patients decreased sense of smell was constant. Also 83.38 of this patients had decreased taste sensation in association with anosmia. ConclusionsIt seems that we have a surge in outbreak of olfactory dysfunction happened in Iran during the COVID-19 epidemic. The exact mechanism of anosmia/hyposmia in COVID-19 patients needs further investigations.

The objective of this study was to design a short smell test adapted to the Venezuelan population using the UPSIT test as a reference.Methodology: Preliminary surveys were carried out in 2 groups of patients (1010 patients for each group) until obtaining the most frequently recognized odors and preferred values of that population. Normosmia, hyposmia and anosmia were normalized. The results of the new Venezuelan test were compared with the UPSIT test in 169 patients. Results: Sensitivity 73%, Specificity 100% and Positive predictive value of 100 with a diagnostic accuracy of 85,21%. Conclusions: short venezuelan smell test is safe and with reliable results in the diagnosis of olfactory alterations.

BackgroundPost-COVID-19 olfactory dysfunction (PCOD) is a common sequela of SARS-CoV-2 infection, with some cases persisting beyond the acute phase. While prolonged PCOD has been considered primarily sensorineural, recent studies suggest that olfactory cleft (OC) obstruction may contribute to olfactory dysfunction (OD). This study aimed to investigate OC obstruction in prolonged PCOD compared to post-infectious olfactory dysfunction (PIOD) and assess its impact on olfactory function. Methodology/PrincipalWe retrospectively analysed sinus computed tomography scans of patients with prolonged PCOD and PIOD. OC obstruction was classified into absent (0%), mild (1-90%), and severe (>90%) types. The severity of OC obstruction was compared between PCOD and PIOD cases, and olfactory test results were analysed according to OC obstruction severity. ResultsA total of 87 PCOD patients and 67 PIOD patients were included. Mild and severe OC obstruction was more prevalent and severe in prolonged PCOD (mild: 35.6%, severe: 18.4%) than PIOD (mild: 13.4%, severe: 3%). Moreover, worsened olfactory function was found in PCOD patients with severe OC obstruction. In contrast, OC obstruction showed little association with olfactory function in PIOD patients. ConclusionsMild and Severe OC obstruction appear to be more common in prolonged PCOD. Moreover, severe OC obstruction may further impair olfactory function in PCOD patients. Conversely, severe OD in PIOD patients occurred independently of OC obstruction.

BackgroundChemosensory disorders (including smell, taste and chemesthesis) are among the established symptoms of COVID-19 infection; however, new data indicate that the changes in chemosensory sensation caused by COVID-19 may differ among populations and COVID-19 variants. To date, few studies have focused on the influence of the SARS-CoV-2 Omicron variant on qualitative changes and quantitative reductions in chemosensory function in China. MethodologyWe conducted a cross sectional study of patients with COVID-19 caused by the Omicron variant, to investigate the prevalence of chemosensory disorders and chemosensory function before and during infection, using an online questionnaire. ResultsA total of 1245 patients with COVID-19 completed the survey. The prevalence rates of smell, taste, and chemesthesis disorders were 69.2%, 67.7%, and 31.4%, respectively. Our data indicate that sex, age, smoking, and COVID-19-related symptoms, such as lack of appetite, dyspnea, and fatigue, may be associated with chemosensory disorders during COVID-19. ConclusionsSelf-rating of chemosensory function revealed that patients experienced a general decline in smell, taste, and chemesthesis function. Further longitudinal research studies are needed to generate additional data based on objective assessment and investigate the factors influencing chemosensory function in COVID-19.

There is a relationship between smell and taste disturbances and coronavirus infection. These symptoms have been considered the best predictor of coronavirus infection, for this reason, it was decided to evaluate the predictive value of the smell and taste test and its association with the results of SARS-CoV-2 PCR-RT and rapid diagnostic tests. in the diagnosis of pathology. Methodology: 248 patients divided into 3 groups: asymptomatic, symptomatic without chemosensory disorders, and chemosensory disorders alone. All of them underwent SARS-CoV-2 PCR-RT, a rapid diagnostic test and a test of Venezuelan smell and basic taste at the beginning. Weekly follow-up with smell and taste test and SARS-CoV-2 PCR-RT until recovery. Results: 20.56% of patients had smell and taste disorders to a variable degree and were positive by SARS-CoV-PCR-RT. 2.15.3% of patients with chemosensory disorders were negative for COVID-19. The positive predictive value of the smell and taste test was 57.3; Sensitivity 41.13% and specificity 69.35%. There were no statistically significant differences by age, sex and chemosensory disorders. The predominant chemosensory disorder was the combination of mild hyposmia and hypogeusia and appeared in the company of other symptoms. Recovery occurred in an average of 8.5 days, asynchronously with the SARS-CoV-2 RT-PCR negativization, which occurred up to more than 15 days after the senses recovered. Maximum time of negativization of the RT-PCR of 34 days. Conclusion: chemosensory disorders are a symptom and / or sign of coronavirus disease but cannot be considered as predictors of said disease in this population studied. The gold standard remains the SARS-CoV-2 PCR-RT test. Rapid diagnostic tests should be used for follow-up. Recommendations: it is necessary to expand the sample, include routine psychophysical smell and taste tests to screen cases and take race and virus mutations into consideration to explain behavior in certain populations.

ObjectiveTo investigate clinical and radiological features of olfactory clefts of patients with mild coronavirus disease 2019 (COVID-19). MethodsSixteen COVID-19 patients were recruited. The epidemiological and clinical data were extracted. Nasal complaints were assessed through the sino-nasal outcome test 22 (SNOT-22). Patients underwent psychophysical olfactory testing, olfactory cleft examination and CT-scan. ResultsSixteen anosmic patients were included. The mean SniffinSticks score was 4.6{+/-}1.7. The majority of patients had no endoscopical abnormality, with a mean olfactory cleft endoscopy score of 0.6{+/-}0.9. The olfactory clefts were opacified in 3 patients on the CT-scan. The mean radiological olfactory cleft score was 0.7{+/-}0.8. There were no significant correlations between clinical, radiological and psychophysical olfactory testing. ConclusionThe olfactory cleft of anosmic COVID-19 patients is free regarding endoscopic examination and imaging. The anosmia etiology would be not related to edema of the olfactory cleft. Level of Evidence4

ObjectiveTo evaluate the association of olfactory dysfunction (OD) with hospitalization for COVID-19. Study DesignMulti-center cohort study. SettingEmergency departments of thirteen COVID-19-designed hospitals in Kurdistan province, Iran. Subjects and MethodsPatients 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. ResultsOf 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. ConclusionOD 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.