Olfactory and Oral Manifestations of COVID-19: Sex-Related Symptoms—A Potential Pathway to Early Diagnosis

Ameen Biadsee*, Ameer Biadsee, Firas Kassem, Or Dagan, Shchada Masarwa, Zeev Ormianer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: The coronavirus disease 2019 (COVID-19) pandemic poses a threat to global health. Early diagnosis is an essential key to limit the outbreak of the virus. Study Design: Case series, study conducted between March 25, 2020, and April 15, 2020. Setting: Ambulatory, nonhospitalized patients who were quarantined in a designated hotel for COVID-19 patients and were recruited by an advertisement at the hotel. Subjects and Methods: In total, 140 patients participated in a web-based questionnaire assessing initial symptoms of common viral diseases, olfactory and taste functions, xerostomia, and orofacial pain. Results: A total of 58 men and 70 women participated. Initial symptoms were cough (59.4%), weakness (47.7%), myalgia (46.9%), fever (42.2%), headache (40.6%), impaired sense of smell (38.3%), impaired sense of taste (32.8%), sore throat (26.6%), runny nose (26.6%), and nasal congestion (22.7%). All symptoms were more frequent among women; however, only runny nose was statistically significant (P =.018). The most common combination of symptoms was cough and weakness (37.5%). A total of 25.8% reported olfactory and taste dysfunctions in the absence of other symptoms. In a comparison between the sexes, cough and runny nose were the most common combination in women (P =.018). A total of 38.3% of patients reported olfactory dysfunction as an initial symptom. Anosmia and facial pain were more common among women (P '.001 and P =.01, respectively), and 56% of patients reported xerostomia. Conclusion: A considerable number of patients presented with olfactory and oral disorders. Interestingly, women presented with a different cluster of symptoms than men, which may suggest a new clinical approach to diagnosing COVID-19 disease.

Original languageEnglish
Pages (from-to)722-728
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Issue number4
StatePublished - 1 Oct 2020


  • COVID-19
  • anosmia
  • coronavirus
  • dysgeusia
  • xerostomia


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