Onset, duration, and persistence of taste and smell changes and other COVID-19 symptoms: longitudinal study in Israeli patients

ABSTRACT

ObjectivesThe multifaceted manifestation of COVID-19 requires longitudinal characterization of symptoms, to aid with screening and disease management. MethodsPhone interviews and follow-ups were completed with 112 mostly mild COVID-19 RT-PCR-positive adult patients, over a six-months period. ResultsMore than one symptom at disease onset was experienced by [~]70% of the patients. About 40% of the patients experienced fever, dry cough, headache, or muscle ache as the first symptom. Fatigue, if reported, usually was the first to appear. Smell and taste changes were experienced 3.9 {+/-} 5.4 and 4.6 {+/-} 5.7 days (mean {+/-} SD) after disease onset and emerged as first symptom in 15% and 18% of patients, respectively. Fever had the shortest duration (5.8 {+/-} 8.6 days), and taste and smell changes were the longest-lasting symptoms (17.2 {+/-} 17.6 and 18.9 {+/-} 19.7 days, durations censored at 60 days). Longer smell recovery correlated with smell change severity. Cough, taste change and smell change persisted after negative RT-PCR tests (in 20%, 26% and 29% of the patients in total). At six-months follow-up, 46% of the patients had at least one unresolved symptom, most commonly fatigue (21%), chemosensory changes (14%) or breath difficulty (9%). ConclusionsMore than one symptom typically occurred at disease onset. Chemosensory changes and cough persisted after negative RT-PCR in a quarter of the patients. Almost half of the patients reported at least one unresolved symptom at six-months follow up, mainly fatigue, smell changes and breath difficulty. Our findings highlight the prevalence of long-lasting effects of COVID-19.