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Abstract
The association of anosmia/ageusia with a positive severe respiratory syndrome coronavirus 2 (SARS-CoV-2) test is well-established, suggesting these symptoms are reliable indicators of coronavirus disease 2019 (COVID-19) infection. This study investigates the clinical characteristics and systemic inflammatory markers in hospitalized COVID-19 patients in Taiwan, focusing on those with anosmia/ageusia. We conducted a retrospective observational study on 231 hospitalized COVID-19 patients (alpha variant) from April to July 2021. Clinical symptoms, dyspnea grading, and laboratory investigations, including neutrophil-lymphocyte ratios (NLRs), platelet-lymphocyte ratios (PLRs), and ANDC scores (an early warning score), were analyzed. Cough (64.1%), fever (58.9%), and dyspnea (56.3%) were the most common symptoms, while anosmia/ageusia affected 9% of patients. Those with anosmia/ageusia were younger, had lower BMI, lower systemic inflammatory markers, and better ANDC scores than those without these symptoms. Female patients exhibited lower NLR values and ANDC scores compared to male patients (all p < 0.05). Multivariable regression analysis demonstrated significant associations between NLR and CRP and ferritin levels (all p < 0.01), and between PLR and ESR and ferritin levels (p < 0.01). Categorized ANDC scores significantly correlated with the total hospital length of stay (all p < 0.05). Despite ethnic differences in the prevalence of anosmia/ageusia, our study highlights similar clinical presentations and inflammatory profiles to those observed in Western countries. The ANDC score effectively predicted hospital stay duration. These findings suggest that anosmia/ageusia may be associated with less severe disease and a lower inflammatory response, particularly in younger and female patients. The ANDC score can serve as a valuable prognostic tool in assessing the severity and expected hospital stay of COVID-19 patients.
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1 New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation, Department of Neurology, New Taipei City, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593); Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, Department of Neurology, Taoyuan, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593); Taipei Medical University, Graduate Institute of Mind, Brain, & Consciousness, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); Shuang Ho Hospital, Brain & Consciousness Research Center, New Taipei City, Taiwan (GRID:grid.412955.e) (ISNI:0000 0004 0419 7197)
2 New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation, Department of Nursing, New Taipei City, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593)
3 New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation, Department of Neurology, New Taipei City, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593)
4 New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation, Department of Thoracic Medicine, New Taipei City, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593); New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation, Department of Respiratory Therapy, New Taipei City, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593); Chang Gung University, Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou and School of Medicine, College of Medicine, Taoyuan, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922)
5 Chang Gung University, Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou and School of Medicine, College of Medicine, Taoyuan, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922)
6 Georgia State University, School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Atlanta, USA (GRID:grid.256304.6) (ISNI:0000 0004 1936 7400)
7 Chang Gung Memorial Hospital at Linkou Medical Center and Chang Gung University College of Medicine, Department of Neurology, Taoyuan, Taiwan (GRID:grid.413801.f) (ISNI:0000 0001 0711 0593)