ACS Chem Neurosci. 2020 Sep 1. doi: 10.1021/acschemneuro.0c00460. Online ahead of print.
A significant proportion of people who test positive for COVID-19 have chemosensory deficits. However, the reported prevalence of these deficits in smell and taste varies widely, and the reason for the differences between studies is unclear. We determined the pooled prevalence of such chemosensory deficits in a systematic review and meta-analysis. We searched the COVID-19 portfolio of the National Institutes of Health for studies that reported the prevalence of smell and/or taste deficits in patients diagnosed with COVID-19. One-hundred-four studies reporting on 38,198 patients qualified and were subjected to a systematic review and meta-analysis. Estimated random prevalence of olfactory dysfunction was 43.0%, of taste dysfunction was 44.6%, and of overall chemosensory dysfunction was 47.4%. We examined the effects of age, gender, disease severity, and ethnicity on chemosensory dysfunction. Prevalence of smell and/or taste dysfunction decreased with older age, male gender, and with disease severity. Ethnicity was highly significant: Caucasians had a three times higher prevalence of chemosensory dysfunctions (54.8%) than Asians (17.7%). The finding of geographic differences points to two, not mutually exclusive causes. A virus mutation (D614G) may cause differing infectivity, while, at the host level, genetic, ethnicity-specific variants of the virus-binding entry proteins may facilitate virus entry in the olfactory epithelium and taste buds. Both explanations have major implications for infectivity, diagnosis and management of the COVID-19 pandemic.