{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T18:20:44Z","timestamp":1773339644691,"version":"3.50.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Shaw Foundation Hong Kong"},{"name":"Michael Seak-Kan Tong"},{"name":"Richard Yu and Carol Yu"},{"name":"May Tam Mak Mei Yin"},{"name":"Jessie & George Ho Charitable Foundation"},{"name":"Perfect Shape Medical Limited"},{"name":"Respiratory Viral Research Foundation"},{"name":"Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited"},{"name":"Sanming Project of Medicine","award":["SZSM201911014"],"award-info":[{"award-number":["SZSM201911014"]}]},{"name":"High Level-Hospital Program, Health Commission of Guangdong Province, China"},{"name":"Consultancy Service for Enhancing Laboratory Surveillance of Emerging Infectious Diseases"},{"name":"Research Capability on Antimicrobial Resistance for Department of Health of the Hong Kong Special Administrative Region Governmen"},{"name":"Theme-Based Research Scheme","award":["T11\/707\/15"],"award-info":[{"award-number":["T11\/707\/15"]}]},{"name":"Research Grants Council"},{"name":"Hong Kong Special Administrative Region"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Olfactory dysfunction (OD) has been reported in coronavirus disease 2019 (COVID-19). However, there are knowledge gaps about the severity, prevalence, etiology, and duration of OD in COVID-19 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Olfactory function was assessed in all participants using questionnaires and the butanol threshold test (BTT). Patients with COVID-19 and abnormal olfaction were further evaluated using the smell identification test (SIT), sinus imaging, and nasoendoscopy. Selected patients received nasal biopsies. Systematic review was performed according to PRISMA guidelines. PubMed items from January 1, 2020 to April 23, 2020 were searched. Studies that reported clinical data on olfactory disturbances in COVID-19 patients were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 18 COVID-19 patients and 18 controls. Among COVID-19 patients, 12 of 18 (67%) reported olfactory symptoms and OD was confirmed in 6 patients by BTT and SIT. Olfactory dysfunction was the only symptom in 2 patients. Mean BTT score of patients was worse than controls (P = .004, difference in means = 1.8; 95% confidence interval, 0.6\u20132.9). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy revealed the presence of infiltrative CD68+ macrophages harboring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen in the stroma. Olfactory dysfunction persisted in 2 patients despite clinical recovery. Systematic review showed that the prevalence of olfactory disturbances in COVID-19 ranged from 5% to 98%. Most studies did not assess olfaction quantitatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Olfactory dysfunction is common in COVID-19 and may be the only symptom. Coronavirus disease 2019-related OD can be severe and prolonged. Mucosal infiltration by CD68+ macrophages expressing SARS-CoV-2 viral antigen may contribute to COVID-19-related OD.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofaa199","type":"journal-article","created":{"date-parts":[[2020,6,6]],"date-time":"2020-06-06T08:21:09Z","timestamp":1591431669000},"source":"Crossref","is-referenced-by-count":84,"title":["Olfactory Dysfunction in Coronavirus Disease 2019 Patients: Observational Cohort Study and Systematic Review"],"prefix":"10.1093","volume":"7","author":[{"given":"Tom Wai-Hin","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siddharth","family":"Sridhar","sequence":"first","affiliation":[{"name":"Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China"},{"name":"State Key Laboratory of Emerging Infectious 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