Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis

Chem Senses. 2023 Jan 1:48:bjad043. doi: 10.1093/chemse/bjad043.

Abstract

Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.

Keywords: COVID-19; ageusia; coronavirus; gustatory dysfunction; taste loss.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Ageusia* / epidemiology
  • Ageusia* / etiology
  • COVID-19* / complications
  • Female
  • Humans
  • Male
  • Middle Aged
  • Olfaction Disorders*
  • SARS-CoV-2
  • Smell
  • Taste
  • Taste Disorders / diagnosis
  • Taste Disorders / epidemiology
  • Taste Disorders / etiology