Systematic Review and Meta-analysis of Smell and Taste Disorders in COVID-19

OBJECTIVE: Loss of smell and taste are considered potential discriminatory symptoms indicating triaging for coronavirus disease 2019 (COVID-19) and early case identification. However, the estimated prevalence essential to guide public health policy varies in published literature. This meta-analysis aimed to estimate prevalence of smell and taste loss among COVID-19 patients. DATA SOURCES: We conducted systematic searches of PubMed, Embase, Web of Science, and Google Scholar databases for studies published on the prevalence of smell and taste loss in COVID-19 patients. REVIEW METHODS: Two authors extracted data on study characteristics and the prevalence of smell and taste loss. Random-effects modeling was used to estimate pooled prevalence. Subgroup analysis and meta-regression were conducted to explore potential heterogeneity sources. This study used PRISMA and MOOSE guidelines. RESULTS: Twenty-seven of 32 studies reported a prevalence of loss of smell, taste, or both from a combined sample of 20,451 COVID-19 patients. The estimated global pooled prevalence of loss of smell among 19,424 COVID-19 patients from 27 studies was 48.47% (95% CI, 33.78%-63.29%). Loss of taste was reported in 20 studies and 8001 patients with an estimated pooled prevalence of 41.47% (95% CI, 3.13%-31.03%), while 13 studies that reported combined loss of smell and taste in 5977 COVID-19 patients indicated a pooled prevalence of 35.04% (95% CI, 22.03%-49.26%). CONCLUSIONS: The prevalence of smell and taste loss among COVID-19 patients was high globally, and regional differences supported the relevance of these symptoms as important markers. Health workers must consider them as suspicion indices for empirical diagnosis of severe acute respiratory syndrome coronavirus 2 infection.