Great data. Were these recorded at time of clinic visit, of test, or some other time?

Kick-R said:

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Great data. Were these recorded at time of clinic visit, of test, or some other time?

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at time of presentation. Patients were called to determine symptom length, hospitalization, etc.

That Diarrhea % is higher than I would have guessed.
Do you have any sense on what was the driving factor in these people seeking care?
The Dyspnea (shortness of breath), fever, the cough or combo?

wow 100% loss of taste/smell?

I really want to do a microbiome project related to SARS-COV-2....starting back on Monday in the lab looking at potential bacteria interactions with viral components but I really want to look at changes in microbiome composition before/after SARS-COV-2 infection.

Some indication that the microbiome can modify taste/smell

I was thinking Microbiome was GI only. Would you be looking at GI, or nasal, throat, mouth, ?

Oral + Nasal + Throat

Potential initial sites of viral replication after infection

Infection_Ag11 said:

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Ranger222 said:

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wow 100% loss of taste/smell?

I really want to do a microbiome project related to SARS-COV-2....starting back on Monday in the lab looking at potential bacteria interactions with viral components but I really want to look at changes in microbiome composition before/after SARS-COV-2 infection.

Some indication that the microbiome can modify taste/smell

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Anosmia/hyposmia/dysosmia are very common with viral upper respiratory symptoms. If you really dig into the history, essentially 100% of rhinosinusitis cases have abnormalities with olfaction.

What's a little odd about this is COVID-19 is only presenting with rhinitis or sinusitis in a very small percentage of cases, yet most have similar olfaction abnormalities. As others have said it's likely a viral neuropathy of the first cranial nerve. We also see it sometimes with HSV flares and shingles outbreaks.

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Agree. Sinusitis and normal URIs seem to cause hyposmia due to nasal airflow obstruction for the most part. If you can't get the airflow to the superior aspect of the nose, where the olfactory fibers are, you can't smell. These patients seem to be presenting quite differently in that, as you say, they have little if any normal URI/sinusitis symptoms. Almost like an olfactory neuropraxia. It will probably take a year to determine whether or not their sense of smell/taste comes back.

plain_o_llama said:

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That Diarrhea % is higher than I would have guessed.
Do you have any sense on what was the driving factor in these people seeking care?
The Dyspnea (shortness of breath), fever, the cough or combo?

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Most weren't that sick but had concerns about having COVID-19 and getting worse. The sickest patients we saw, some of who tested negative but were later hospitalized, complained mostly of dyspnea and cough together.

None that I reviewed had classic upper respiratory symptoms of congestion, sinus pressure, sore throat, etc as you would expect with disturbances of taste and smell.

Pelayo said:

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plain_o_llama said:

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That Diarrhea % is higher than I would have guessed.
Do you have any sense on what was the driving factor in these people seeking care?
The Dyspnea (shortness of breath), fever, the cough or combo?

---

Most weren't that sick but had concerns about having COVID-19 and getting worse. The sickest patients we saw, some of who tested negative but were later hospitalized, complained mostly of dyspnea and cough together.

None that I reviewed had classic upper respiratory symptoms of congestion, sinus pressure, sore throat, etc as you would expect with disturbances of taste and smell.

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The following paper from our literature confirms your findings.

Sinonasal pathophysiology of SARS-CoV-2 and COVID-19: A systematic review of the current evidence


It occurs suddenly 2 to 3 days
after the beginning of usually rather mild symptoms related to COVID
19 disease such as headaches, low-grade fever, and diarrhea. In most
cases, the signs of cold (such as cough, fever) are absent or have dis-
appeared. The sense of smell usually starts recovering after a few days
(5-10 days) and this recovery seems already complete in some patients
around day 10 to 15 but unfortunately this trouble of smell persists longer
in others." Thus, decreased sense of smell in the absence of nasal obstruc-
tion may be a highly predictive marker for COVID-19, which may be par-
ticularly helpful in identifying asymptomatic carriers or those with mild
symptoms who otherwise would not think that they have the infection.