3 These chemosensory impairments are often the sole warning symptoms and the strongest predictors of SARS-CoV-2 infection. Women were less likely to recover their sense of smell (odds ratio 0.52, 95% confidence interval 0.37 to 0.72, seven studies, I 2=20%, τ 2=0.0224) and taste (0.31, 0.13 to 0.72, seven studies, I 2=78%, τ 2=0.5121) than men, and patients with greater initial severity of dysfunction (0.48, 0.31 to 0.73, five studies, I 2=10%, τ 2<0.001) or nasal congestion (0.42, 0.18 to 0.97, three studies, I 2=0%, τ 2<0.001) were less likely to recover their sense of smell.Ĭhange in the sense of smell and taste is highly prevalent in patients with covid-19, with 40-50% of people on average reporting these symptoms globally, 1 2 and up to 98% showing olfactory dysfunction when tested objectively. Sensitivity analyses suggest these could be underestimates. Based on parametric cure modelling, persistent self-reported smell and taste dysfunction could develop in an estimated 5.6% (95% confidence interval 2.7% to 11.0%, I 2=70%, τ 2=0.756, 95% prediction interval 0.7% to 33.5%) and 4.4% (1.2% to 14.6%, I 2=67%, τ 2=0.684, 95% prediction interval 0.0% to 49.0%) of patients, respectively. Risk of bias was low to moderate conclusions remained unaltered after exclusion of four high risk studies. Results 18 studies (3699 patients) from 4180 records were included in reconstructed IPD meta-analyses. 11Department of Otorhinolaryngology-Head and Neck Surgery, Guy’s and St Thomas’ Hospitals, London, UK.10Edge Hill University Medical School, Orsmkirk, UK.9Wigan and Leigh Teaching NHS Foundation Trust, Wrightington, UK.8Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, USA.7Department of Molecular Cell Genetics, L Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.6Department of Otorhinolaryngology-Head and Neck Surgery, Vanderbilt University Medical Centre, Nashville, TN, USA.5Department of Otorhinolaryngology-Head and Neck Surgery, Sengkang General Hospital, Singapore.4Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore.3Surgery Academic Clinical Program, SingHealth, Singapore.2Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Song Tar Toh, associate professor of otolaryngology 3 4.Claire Hopkins, professor of rhinology 11 12,.B Nirmal Kumar, professor of otolaryngology 9 10,.Christopher S von Bartheld, professor of physiology and cell biology 8,.Rafal Butowt, assistant professor of physiology and cell biology 7,.Naweed Chowdhury, assistant professor of otolaryngology 6,.Rakesh K Chandra, professor of otolaryngology 6,.Nikita Chapurin, chief resident of otolaryngology 6,.Shuhui Xu, consultant otolaryngologist 3 4,.Anna See, assistant professor of otolaryngology 3 4 5,.Tze Choong Charn, assistant professor of otolaryngology 3 4 5,.Neville Wei Yang Teo, assistant professor of otolaryngology 3 4,.Yiong Huak Chan, founding mentor of Biostatistics Unit 2,.Claire Jing-Wen Tan, medical student 1,.Nicole Kye Wen Tan, medical student 1,.Benjamin Kye Jyn Tan, house officer 1,.
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